As a pediatrician with 40 years of experience seeing children in central Maine, I believe that access to high-quality care for kids is essential for Maine’s future. Fortunately, MaineCare has covered health costs for an increasing percentage of my patients over the decades, especially since the late 1990s when the CHIP program increased the income cutoffs for eligibility.

There is a persistent issue that reduces Maine kids’ stable access to care, but a bill under consideration by the Legislature — LD 896 — would eliminate this hurdle. The official term for this issue is “churning” — the tendency for families to move in and out of eligibility.

Currently each child needs to be renewed yearly to make sure that the family situation meets financial limits. However, families often move and aren’t informed, or struggle to navigate the renewal process. In addition, family incomes jump around due to job changes, family illnesses, etc. The result? The child’s coverage can be interrupted and services are cut off.

Though a large proportion of the kids who lose MaineCare end up being re-enrolled, periods of lapsed coverage end up being quite common. The average duration of continuous enrollment is only one year. LD 896 would modify the rules to allow children who qualify to remain on MaineCare consistently through age 5. Similar systems are already in place in Pennsylvania, North Carolina and Ohio and are working well, eliminating much of the administrative red tape faced by families.

Providing MaineCare to kids is inexpensive — the annual per-person cost for a child 0-5  is less than half the cost for an  adult — in spite of the fact that children are seen frequently in the early years to allow for early identification of problems. MaineCare, unlike most private insurers, also covers the therapies needed by kids who are identified with special needs. Loss of access to these services reduces the child’s chances of being ready for school.

In addition, temporary gaps in coverage can be financially devastating for families given the steep costs for medications needed to manage chronic diseases like asthma. The cost of one basic asthma rescue inhaler is $60, and the inhalers commonly used for preventing attacks cost more than $200. Families with no coverage will defer the latter, perhaps use only the rescue meds, and the child may end up in the ER or be admitted if they have an acute attack.

The outcome results from the first five years of life are the most important predictors of eventual adult success. Timely identification of developmental problems is only made possible by avoiding the gaps in care that delay diagnosis and interventions. Stable MaineCare coverage is essential to both facilitate the periodic screenings done in offices as well as fund the corrective therapies. The desired outcome is improved school readiness, which in turn facilitates long-term academic and adult success.

This is a tough year to propose any legislation that may increase costs to state government. However, improving the health and well-being of children is an investment with large eventual returns. Early intervention to correct health and developmental issues saves money in the long run. The Maine Medical Association, Maine Osteopathic Association and Maine Chapter of the American Academy of Pediatrics all support LD 896. Children are our future and deserve continuous coverage in these early years. Tell your state representative and senator you support it also.