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Children’s Health Act Signed into Law
Six Key Provisions Support March of Dimes Mission
The March of Dimes achieved a tremendous victory for the health of mothers, infants and children with President Clinton’s signing of the "Children’s Health Act of 2000" on Oct. 17 (P.L. 106-310).
"Support provided by volunteers and staff through their visits to Capitol Hill, letters and telephone calls were key to building momentum for broad-based bipartisan approval and I want to thank each and every one of you for your contribution to this important legislative victory," said Dr. Jennifer L. Howse, president of the March of Dimes.
While the act includes a lengthy list of provisions to improve the health of America’s children, the following six provisions are especially important to the advancement of the March of Dimes mission.
(1) National Center on Birth Defects and Developmental Disabilities
The Act creates a 7th Center at the Centers for Disease Control and Prevention (CDC) that will elevate the stature and effectiveness of birth defects and developmental disabilities policy development within the Executive branch. The Center will collect, analyze and distribute data on birth defects and developmental disabilities including information on causes, incidence and prevalence. The Center will conduct applied epidemiological research on the prevention of such defects and disabilities and provide information to the public on proven prevention activities.
(2) Newborn Screening Initiative
The Act authorizes grants to states to improve and expand newborn screening programs. It also creates an advisory committee to provide guidance and recommendations to the Secretary of the U.S. Department of Health and Human Services (HHS) for the development of grant administration policies and to enhance the ability of the Secretary to reduce mortality or morbidity from heritable disorders.
(3) Folic Acid Awareness Campaign
The Act expands CDC’s folic acid education and public awareness campaign. It authorizes the conduct of research to identify effective strategies for increasing folic acid consumption by women of reproductive age and calls for the evaluation of the effectiveness of these strategies. Finally, it enables CDC to conduct research to increase the understanding of the effects of folic acid in preventing birth defects.
(4) Autism Research and Surveillance
The Act authorizes the expansion, intensification and coordination of the National Institutes of Health’s (NIH) research on autism. It also establishes three CDC regional centers of excellence in autism and pervasive developmental disabilities, whose purpose will be to collect and analyze information on the number, incidence and causes of autism and related developmental disabilities. Additionally, it calls for establishing a program to provide information on autism to health professionals and the general public, and establishes a committee to coordinate all autism related activities within HHS.
(5) Pediatric Research at the National Institutes of Health
The Act authorizes a "Pediatric Research Initiative" at NIH to enhance collaborative efforts among NIH institutes, provide increased support for pediatric biomedical research, and ensure that expanding opportunities for advancement in scientific investigations and care for children are realized.
(6) Safe Motherhood Monitoring and Infant Health Promotion
The Act authorizes the development of a national surveillance program designed to improve the understanding of the burden of maternal complications and mortality, and to develop strategies to decrease the disparities among populations at risk of death and complications from pregnancy. It also authorizes expansion of research concerning risk factors, prevention strategies, and authorizes public education campaigns to promote healthy pregnancies. Finally, it authorizes funding for research initiatives and programs to prevent drug, alcohol and tobacco use among pregnant women.
"We want children to be healthy, and we want pregnant women to be healthy. Passage today of the Children’s Health Act promises to bring us closer to this simple but critically important goal," said Senator Christopher "Kit" Bond (R-MO).
For the full text of the Act go to http://thomas.loc.gov/ and search "By Bill Number" for H.R. 4365.
New U.S. Census Bureau Data Shows Millions of Women and Children Remain Uninsured
New U.S. Census Bureau data commissioned by the March of Dimes reinforces the need to increase health insurance coverage for women of childbearing age and children.
Almost one in five women of childbearing age – nearly 12 million – were uninsured in 1999, according to this new data. The rate of uninsured women ages 15 to 44, 19.2 percent, is only a slight improvement over the 1998 figure of 19.8 percent. Although, women are more likely to have health insurance when they are pregnant, a separate March of Dimes study shows that nearly 14 percent of pregnant women were uninsured in 1997.
While the percentage of uninsured children under age 19 dropped from 15.6 in 1998 to 14.1 in 1999, some 10.8 million children remained uninsured. The Census Bureau reports that the State Children's Health Insurance Program (S-CHIP) likely contributed to the increase in coverage of children.
The proportion of uninsured vary by state. For example, the percent of women age 15 to 44 who lack insurance ranges from 30 percent in New Mexico to less than 10 percent in Minnesota. The Census Bureau reports state data as a 3-year average, for 1997-1999, because small sample sizes make single year state data less reliable.
The pattern of racial and ethnic differences in insurance status is similar for women and children. Hispanics and Native Americans are about twice as likely as whites to lack insurance. African Americans and Asians are also more likely than whites to be uninsured.
Overall, the 1999 Census data shows that the proportion of the U.S. population without health insurance declined for the first time since 1987. Despite that improvement, however, approximately 43 million Americans –15.5 percent – lacked coverage (in 1998, 16.3 percent of the population was uninsured).
"Even under existing programs, the March of Dimes believes that more can be done to provide health insurance coverage for children," said March of Dimes president Dr. Jennifer L. Howse. "Education and outreach efforts to inform parents and ease the enrollment process are key to improving participation rates." Indeed, 62 percent of uninsured children live in families with incomes below 200 percent of poverty -- levels at which children are likely to be eligible for coverage under S-CHIP or Medicaid.
Dr. Howse also indicated that many uninsured women of childbearing age could be covered if S-CHIP was expanded to provide coverage to pregnant women and parents as well as children. For this reason, she continued, the March of Dimes is making improved access to coverage for women, infants and children a priority, by working to assist enrollment of all children under 19 currently eligible for S-CHIP or Medicaid, advocating federal expansion of S-CHIP to cover pregnant women over age 18 and parents as well as children, and supporting state efforts to expand Medicaid coverage to include more women of childbearing age.
Uninsured Women Ages 15-44 and Children Under Age 19, by State (1997-1999 Average)
| |
Women Ages 15-44
|
Children Under Age 19 |
| STATE |
NUMBER
(in thousands) |
PERCENT |
NUMBER
(in thousands) |
PERCENT |
| Alabama |
216 |
22.1 |
166 |
14.8 |
| Alaska |
27 |
18.2 |
33 |
15.2 |
| Arizona |
300 |
28.0 |
367 |
25.3 |
| Arkansas |
120 |
22.4 |
150 |
20.2 |
| California |
2,007 |
26.1 |
1,909 |
19.4 |
| Colorado |
177 |
19.0 |
161 |
14.4 |
| Connecticut |
111 |
16.0 |
95 |
10.5 |
| Delaware |
27 |
16.6 |
29 |
13.3 |
District of
Columbia |
20 |
16.9 |
19 |
16.5 |
| Florida |
702 |
23.0 |
657 |
18.8 |
| Georgia |
368 |
20.1 |
361 |
16.3 |
| Hawaii |
27 |
10.2 |
29 |
8.9 |
| Idaho |
62 |
22.7 |
76 |
19.1 |
| Illinois |
455 |
16.2 |
464 |
12.7 |
| Indiana |
209 |
16.1 |
201 |
12.3 |
| Iowa |
70 |
11.5 |
69 |
8.8 |
| Kansas |
81 |
14.0 |
77 |
10.3 |
| Kentucky |
158 |
18.2 |
140 |
13.8 |
| Louisiana |
242 |
24.1 |
261 |
21.9 |
| Maine |
46 |
17.1 |
34 |
10.6 |
| Maryland |
183 |
16.4 |
166 |
13.0 |
| Massachusetts |
184 |
13.2 |
135 |
8.7 |
| Michigan |
355 |
16.0 |
291 |
9.8 |
| Minnesota |
104 |
9.7 |
122 |
8.3 |
| Mississippi |
156 |
23.6 |
148 |
18.2 |
| Missouri |
142 |
11.7 |
137 |
9.3 |
| Montana |
46 |
22.9 |
51 |
19.3 |
| Nebraska |
43 |
11.6 |
40 |
8.0 |
| Nevada |
89 |
22.9 |
123 |
22.1 |
| New Hampshire |
33 |
12.3 |
31 |
8.5 |
| New Jersey |
349 |
18.9 |
282 |
13.3 |
| New Mexico |
111 |
30.0 |
129 |
21.8 |
| New York |
868 |
21.1 |
707 |
14.0 |
| North Carolina |
305 |
18.6 |
287 |
14.8 |
| North Dakota |
22 |
15.8 |
27 |
15.0 |
| Ohio |
331 |
13.1 |
305 |
9.6 |
| Oklahoma |
157 |
22.7 |
171 |
19.1 |
| Oregon |
117 |
16.6 |
112 |
12.4 |
| Pennsylvania |
317 |
12.4 |
258 |
8.4 |
| Rhode Island |
21 |
10.3 |
18 |
7.5 |
| South Carolina |
193 |
22.3 |
187 |
17.9 |
| South Dakota |
25 |
15.9 |
23 |
11.5 |
| Tennessee |
199 |
16.0 |
160 |
10.5 |
| Texas |
1,269 |
27.7 |
1,522 |
25.2 |
| Utah |
81 |
16.0 |
87 |
11.9 |
| Vermont |
15 |
11.1 |
12 |
7.2 |
| Virginia |
245 |
16.5 |
228 |
12.8 |
| Washington |
225 |
16.9 |
161 |
10.2 |
| West Virginia |
91 |
24.2 |
46 |
12.2 |
| Wisconsin |
142 |
12.6 |
128 |
8.8 |
| Wyoming |
22 |
21.0 |
22 |
15.3 |
| U.S. (3-yr. average) |
11,865 |
19.5 |
11,416 |
15.0 |
Source: Data prepared for the March of Dimes by the Bureau of the Census using Current Population Surveys from March 1998- March 2000. State data are compiled using three-year averages because small sample sizes make single-year state data less reliable.
Legislation Protects Nonprofit Mailers
On Oct. 27, President Clinton signed S. 2686 into law, a bill designed to preserve nonprofit preferred postal rates. The Act permanently links nonprofit postal rates to commercial postal rates to moderate future increases.
"The March of Dimes relies heavily on mail to distribute educational materials and to raise funds in support of our mission, mailing more than 100 million appeals annually," said March of Dimes president Dr. Jennifer L. Howse in an Aug. 29 letter to the Senate Governmental Affairs Committee Chair Fred Thompson (R-TN). "If this legislation does not become law, the cost to the Foundation in 2001 alone will exceed $750,000, necessitating a diversion of funds from mission priorities that include biomedical research and community services."
The Alliance of Nonprofit Mailers estimates that the measure will save the nonprofit community $1.035 billion annually by securing the preferred postal rate currently enjoyed by nonprofit organizations.
Appropriations Update
As we go to press, Congress and the President are still negotiating several issues within the Labor, Health and Human Services, and Education Appropriations bill. This bill contains funding for most health agencies, including the Centers for Disease Control and Prevention and the National Institutes of Health.
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