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Pediatric Academic Societies Annual Meeting

Washington, DC
May 6, 2013

Good morning.  And thank you, Dr. Ingram, for that introduction.  It’s a pleasure to be here with so many people who work so hard every day to care for America’s children.

As the President has said, caring for our children is our first job.  It’s our highest obligation.  It’s how we as a society will be judged.  So I want to start by saying thank you for everything that you do to help us meet that obligation: for the direct care you provide, for the research that ushers in new treatments and cures, for all the ways that you contribute to the wellbeing of the next generation.

Like all parents, I have a special place in my heart for pediatricians.  You’re the first number on our speed dials.  You’re with us at some of our scariest and proudest moments.  We learn from you and rely on you. 

But America’s pediatricians have always understood that the health of our children is affected not just by the care they receive from you, but by policies that are shaped at the national level.  And you have consistently given a voice to our nation’s children by advancing policies that have the greatest potential to improve their health.

When I issued a challenge four years ago to help enroll more of our most vulnerable children in Medicaid and CHIP, America’s pediatricians were among the first to sign on.  And today, the percentage of uninsured children in America has dropped to a record low.

When the First Lady launched a campaign to tackle the epidemic of childhood obesity, America’s pediatricians took a leadership role.  And today, thanks in part to these efforts, we’re seeing childhood obesity rates drop in several major cities across the country.

When it came time to speak frankly about the devastating toll that gun violence takes on children in our society, America’s pediatricians took a stand. 

And I want to be clear that we will move forward with our efforts to curb gun violence.  When first-graders are wearing bulletproof backpacks to school, inaction is not an option.  When firearms are responsible for twice as many deaths among American children as cancer, we have a responsibility to do what we can to save these children’s lives. 

The Administration is already moving forward with some parts of the agenda outlined by the President after the Newtown tragedy.  We’ve made it clear that there are no rules restricting doctors from talking to their patients and families about gun safety.  And we’ve made it clear that research on gun violence—the third leading cause of death for our children—is not prohibited by Congress.  And last week, the IOM met to begin mapping a proposed research strategy for the CDC on preventing gun violence.

Obviously, other parts of the agenda put forward by the President require Congress to act.  That’s something they’ve refused to do so far.  But as the President said last month, members of Congress work for the American people who overwhelmingly support common sense steps to keep guns out of the wrong hands.  And eventually, Congress will have to listen.

So I want to thank you for all the work you’ve done to raise awareness about gun violence as a health issue.  And I hope you will continue to speak on behalf of our children in this debate.

Over the last four years, you also helped pass one of the most important children’s health care laws in our history: the Affordable Care Act.

The law is already making a huge difference for America’s children.  Insurers can no longer deny coverage to children because of a pre-existing condition.  Lifetime limits on the amount of care insurance companies will pay for are gone for good.  More than three million young people under the age of 26 have gained coverage under their parents’ plans.  And many children have gained access to services recommended by the Bright Futures guidelines, which provide for well-child exams, preventive screenings, and immunizations at no additional cost to parents.  We’re proud to partner with the APA and the AAP to promote research for preventive health through the Bright Futures initiative.

And these benefits are just the start.  In the coming months, we’re going to dramatically expand health coverage in two ways.

First, new Health Insurance Marketplaces are being set up in every state. When they open for enrollment on October 1st, these Marketplaces will give families a whole new way to find coverage that fits their budget.  Discrimination against pre-existing conditions will be outlawed.  Financial help will be available to help them cover the cost of insurance.  And in-person help will be available to help them fill out the application.

At the same time, many states are choosing to expand their Medicaid programs to cover a family of four earning up to about $31,000 a year, and individuals earning up to about $15,000.

This means millions of families that had been priced or locked out of the insurance market are finally going to have access to health insurance.  But we can’t make the possibilities of this law a reality without your help.

So today, I want to ask for your help in three ways.

First, we need you to educate yourselves, your colleagues, your patients, and your communities about the health care law.  There are a lot of benefits that people simply don’t know about.  There are parents putting off check-ups and vaccinations because they’re worried about a co-pay that no longer exists.  There are families who are afraid to call up their insurance company because they don’t know their child who was born with a heart defect can no longer be turned away.

You have colleagues who don’t know that Medicaid will pay them a higher rate starting next year.  They don’t know that their patient who’s graduating from high school can still keep coverage through her parent’s plan.

We need you to be educators about this law so that patients and doctors take full advantage of its benefits. 

We also need you to help make it clear what’s at stake when it comes to expanding Medicaid.  The law offers states an incredible deal.  For the first three years, the federal government will cover 100% of the costs, and it will cover at least 90% of the costs after that. 

In return for that small investment, states can improve health, protect families from financial ruin, ensure that doctors and hospitals get paid for the care they deliver, and boost local economies.

And they can also provide more security for their state’s children.  You know that adults with health insurance are more likely to get their kids covered too.  Adults who get preventive care are more likely to make sure their kids get preventive care too.  And adults who aren’t going bankrupt from medical bills are more likely to have the resources they need to invest in better nutrition, safer living spaces, and everything else that we know contributes to their children's health.

Expanding Medicaid is good for the health of America’s children, and we need your help to make sure that people understand this. 

And we also need your help to make sure people actually sign up for coverage.  We’ve learned from our efforts to get children enrolled in CHIP and Medicaid that simply making coverage available is not enough.  Some people aren’t paying attention, or may not realize that they qualify.  Others are dealing with a language barrier.   Some simply assume that affordable health coverage will never be within reach. 

Our ability to get more people covered and create healthier families is going to be determined by our ability to educate people and sign them up.  And we’re going to need your help.

Right now, you can go to and sign up for e-mails and text messages that will help prepare them for enrollment this fall.  You can encourage your patients to sign up too. 

And as we approach October 1st when those new Marketplaces are going to open for enrollment in every state, we’re going to need all hands on deck.  Make sure parents know about the new options.  Make sure your older patients know they can stay on their parents’ plan after they graduate high school.  And if that’s not an option, let them know that affordable coverage will be available in the new Marketplace.

This is going to be an historic undertaking, and we cannot do it without you.  One of the best ways we can get more kids covered is by getting more families covered.  And no one is in a better position to help us do that than you.

Thanks in large part to your efforts, children’s health has been one of the great under-the-radar success stories of the last few years.  We’ve made strides when it comes to covering more kids, reversing the obesity epidemic, and opening the door to affordable coverage for millions of children.  And we’ve done it all in a challenging economic climate.

While we can be proud of that work, we also recognize that there is so much more to do.  Now is our chance to put affordable health insurance within reach of every family in America.  It’s a once in a lifetime opportunity.  And we need your help to make the most of it.

So thank you for everything you do on behalf of your patients and on behalf of all America’s children.  And I look forward to working with you in the months to come to improve the health of children and families across our country.

Thank you.