 I'm Doug Hock, I'm the Chief Operating Officer of Children's Hospital of Philadelphia. We are here today for two reasons. First to celebrate the passage and today's signing of the reauthorization of Pennsylvania's Children's Insurance Program, but also to demand that Congress follow suit and reauthorize the federal portion of the CHIP program immediately. At this moment, approximately 9 million children nationally and 176,000 children in Pennsylvania are in jeopardy of losing their health care due to inaction at the congressional level. Other states around the country are preparing to send letters to CHIP recipients that their health care coverage may lapse. Many states will have to choose between cutting children from the program altogether or limiting the services it provides. That's something Pennsylvania will have to consider in the very near future if Congress doesn't follow Pennsylvania's lead and reauthorize this program. The accomplishments and history of CHIP are well known to many in this crowd. In fact, we have been hosting a number of events calling for Congress to act and have asked our employees, friends and families to become advocates for this program. We at CHOP know how important this program along with Medicaid can be. Last fiscal year, we saw over 6,000 CHIP patients and upwards of 45 percent of our patients are on some kind of public insurance program. We are honored to host Governor Tom Wolf, Theresa Miller, Secretary of Department of Human Services, and Senator Vincent Hughes. The Governor, Secretary and Senator have been great partners in all our efforts and are committed to seeing CHIP continued. I want to thank them for their support and leadership. CHIP started here in Pennsylvania and went on to become a lauded bipartisan federal state partnership that together with Medicaid has led to the lowest levels of uninsured rates in our nation's history. That is something we all can support. Now I'd like to introduce Secretary Theresa Miller. Thank you, Doug. And thank you all so much for joining us today as we on the one hand celebrate the 25th anniversary of CHIP and on the other hand do something really important and that is push for reauthorization needed at the federal level so that we can continue the really amazing work of this program. It really is an honor to be here with all of you. I want to thank the Children's Hospital for hosting us today and I want to thank Policy Lab for all the work that they do and most importantly I want to thank the CHIP families and children that are here today to tell their stories. With this being the 25th anniversary of CHIP we had hoped that this would be a celebratory time for the program but unfortunately we still have much work to be done. According to law in 1992 by Pennsylvania Governor Bob Casey our CHIP program was the first in the nation of its kind and 10 years ago Governor Randell expanded CHIP to offer coverage to all children. Depending on the family income children are eligible for free coverage or coverage based on a sliding scale. This program works. It's credited with helping to cut the uninsured rate for kids in half while also reducing hospitalization rates, improving kids' educational outcomes, and bolstering their family's economic well-being. It's also a safety net rarity in today's polarized Washington with strong bipartisan support. Since 2009 more than 850,000 kids have enrolled in CHIP commonwealth wide. Despite all the families touched by CHIP and the access to high quality healthcare coverage that it provides, this program will no longer exist unless congress acts. Nationally this affects 9 million kids and in Pennsylvania today we have more than 180,000 kids covered. Its authorization expired at the end of September and at least five and maybe as many as ten states will exhaust their leftover funds by the end of this year. That number goes up to 32 by the end of March. Community is exploring all contingency options to extend the funding period and adjust the notification timeline to families. But as of now we're able to fund CHIP and the commonwealth through some time in the first quarter of next year. Contingency planning means figuring out how much money we have now and how long we can continue to provide this program. It's not just trying to pinpoint the exact date that we're going to run out of money but it's also executing the statutorily required process to shut down the program. It means determining the best way to notify CHIP families of what's going on. Just last week the department sent out a letter to the CHIP insurance companies in the commonwealth asking them to share some information with their participants on what will happen if congress doesn't renew federal funding. As of now nothing is changing. CHIP kids can continue to go to the doctor and dentist and use their insurance. For those children in low cost or at cost CHIP continue to pay those premiums. If you get a renewal notice fill it out and send it back. If the CHIP program continues you need to complete the renewal to keep your child enrolled. Right now unfortunately there is a draft of a letter on my desk informing thousands of Pennsylvania parents that their kids may lose their health coverage after the holidays. This letter could cause panic to CHIP families who will be left wondering if they're going to lose their doctor and how they might get coverage for their kids. As we work through the contingency planning we appreciate your continued advocacy to keep the pressure on congress to reauthorize CHIP as soon as possible because I'm hopeful that I never have to send that letter. But we also don't want to surprise parents and we need to give them time to try to find other coverage should our CHIP program end. There's a lot of talk today about bipartisanship and CHIP is the poster child for bipartisanship. One of the few programs that I think we can still say that about today. Everyone insists that CHIP's reauthorization will happen within the next few weeks but we've been hearing that now for months. With every day that goes by our concern increases. We need congress to act quickly so kids and their families are no longer left wondering whether they're going to have coverage at the end of February or the end of March. Please visit CHIPcoversPAkids.com to get a letter to send to your representative. Let them know that we need to get CHIP done because our children depend on it. Thank you so much. Thank you Secretary Miller. I would now like to introduce Dr. David Rubin, a CHOP pediatrician and co-director of the Policy Lab at CHOP. Dr. Rubin. Good morning. You know I'd like to start by just I want to thank our governor and I actually want to thank our legislature for showing the example of what bipartisanship looks like here in the state that created the CHIP program in its 25th anniversary. I didn't plan on saying this but I also want to send out a special note to you Teresa because I've thought a lot in the last few months as we've been watching a lot of language coming out of DC telling us how they're going to reauthorize this program. What it would be like to be in your shoes holding that letter you just talked about at the holidays. So I thank you for your public service and I think people need to recognize the sort of weighty decisions that our public servants every day have to make on behalf of taking care of families here in the Commonwealth. Now I'm going to talk to you as a pediatrician, a researcher and as a parent here in Pennsylvania. You know I think first and foremost I'm a pediatrician here at the Children's Hospital of Philadelphia and people who know me in my practice know that I kind of spent a lot of time getting down and dirty to know what's going on out there over the years and you know the Medicaid and CHIP programs historically have really been responsible to creating nearly universal coverage, health insurance coverage for children in this country including in the Commonwealth of Pennsylvania. Which means we don't have a lot of folks who remember what it's like when kids were coming into our emergency departments without insurance. Children with dental abscesses that could have been cared for by a dentist. We are asthma exacerbations nearly on death's door. Psychiatric emergencies, suicide attempts. It's not that we've solved all these issues today but it starts with having health insurance coverage and no one should leave here today without understanding the importance of that first gate which is the importance of affordable coverage that provides comprehensive benefits to children. Now I'm going to pivot to my role as the director of policy lab here at the Children's Hospital, Philadelphia because people know that our work at policy lab begins with asking families what's happening out there. It's our care for children here at CHOP that informs the types of research we care about and in that context over the last few years I've been asking families, how's it been going out there? Because families are having a hard time in terms of balancing the monthly budget out there and I wanted to know what was going on with regards to health insurance. And what I started to see was that there were more and more families whose parents I knew were both employed and yet they were needing coverage from the children's health insurance program here in the Commonwealth. When CHIP was formed back in 1997 it was to address this group of families, often small business owners or folks who were in hourly wage jobs, they were just above the level of poverty and they couldn't get coverage. Well most folks and when I talk about this they're surprised to hear that nowadays CHIP is more important than ever because you've got folks in large companies whose companies are no longer providing any coverage for their dependents or when they do so they're asking you to pay a $10,000 deductible before your insurance kicks in. It's basically an insurance card without access or affordability. For those families particularly low and moderate income households, CHIP has become the backstop to providing health insurance coverage for their children. I will add that as folks are making decisions down in Washington they sort of see this population of nine million children and they think it's just nine million children. But how many children are going to need the CHIP program in two years? If we took away the CHIP program are those insurance plans going to get more affordable for people at work? I don't think so. That should create a level of urgency here about why this CHIP reauthorization is so important in Washington so I'm going to conclude a little bit with my thoughts as a parent. What I think is so beautiful about the CHIP program is that the states were given flexibility and Pennsylvania led the nation in showing if you brought a bunch of people together at the state level and asked what are the types of services that all children need regardless of payer, regardless of whether you were poor or whether you had really good jobs. They sat around in a room and they created a plan that said these kids need vision services, they need dental care, they need physical health services, they need behavioral health care and they sort of created the package that every child should have in this country. That's what's in danger today and if I could have the option, I will tell you today if I had the option to buy into the CHIP program for my children, wink wink, I would do it. I think many parents once they read about the CHIP program in Pennsylvania would do the same. Pennsylvania has led here today as the governor gets ready to sign this bill showed that this is not a partisan issue. This is a no-brainer and you can feel a sense of urgency for me because it's outrageous that this has not been done as this program that's been around since 1997 has not been reauthorized at the federal level. We need to stop playing using children as a political football here in this country. I call on our United States Congress to follow the lead for what bipartisan CHIP looks like here in Pennsylvania, the first CHIP program in the country and get it done because there's a sense of irony, I'll close with this comment, states are running out of money in the next month or two to reauthorize this program. That letter is sitting on Teresa's desk and yet we have a sense of urgency this week around a tax bill regardless of how you feel about that tax bill for what I'm going to do when I pay my taxes in April of 2019 while states are running out of money for children's health insurance this month. So I urge everyone to call their congressman, to call their senators and to ensure that we get this CHIP package done and now I'm going to turn it over to my favorite guest of the morning, right, Kamal Shabazz and his mom, Jenny Sheeks. She's coming over here, they're coming over here to tell you about their personal experience with the CHIP program. Thank you. Hi everybody, thank you all for being here and for all your hard work. Like Dr. Rubin said, we are a family, my husband and I both work full time for non-profit organizations and we've really relied on CHIP when we haven't been able to afford other health insurance and it's been a worry and a stressor and such a relief when we have been able to access CHIP and have an affordable option and it's been most important for my youngest son and he actually talks about it all the time and why it's important and that's why we've asked him to come here today and share his own story. So can you tell everybody your name? Kamal. And how old are you? Eight years old. You can leave it up. And what grade are you in? Third grade. Third grade. And why did you want to come here today? So I could talk about CHIP and how we should keep CHIP going. And have you always had health insurance? No. What was it like when you didn't have health insurance? I was worried that I could get sick or hit and then not be able to go to the doctors. And do you remember how you were always harassing me to fill out the paperwork and get everything in so we could get CHIP? Yeah. And do you remember what you said as soon as your health insurance card came in the mail? To go to the doctors. Yeah, you wanted to go. Why did you want to go to the doctor? No kid wants to go to the doctor. You wanted to go to the doctor. How come? So I could see if I was sick or not and... Mm-hmm. Cool. So Kama really was worried. We were all worried if he would get a head cold or be playing rough with his siblings in the yard. Was he going to get hurt when we didn't have coverage? And it was a stressor. And it's been such a relief not to have that worry. But I'm a little worried now because if we were to lose our CHIP, if we were to get that letter in the mail, I don't know how we would afford health insurance. It would really be coming out of the grocery budget to be honest, which is a really terrifying thought. So I thank you for all of your work that you're doing and Kama, did you want to add anything else? Yeah, I just want to thank everybody that's involved at CHIP, especially Governor Wolf. Mm-hmm. Can I please introduce Governor Wolf to the stage? All right. Good job. Shake the governor's hand. I don't want to assume here, but I'm really happy that Kamal is too young to run for governor. That's all I have to say. Thank you, Kamal. Thank you very much. And Dr. Rubin, I want to add what you said about Theresa. She's doing a phenomenal job, and I wouldn't want to have her job if this is not reauthorized at the federal level. She's doing a tremendous work for all the families of Pennsylvania. But we need help. We need the help from the folks in Washington. But I'm proud to be here to do what apparently they haven't been able to do in Washington. And that is sign the reauthorization for the CHIP bill. And I stand ready to help anybody in Washington who wants to understand how we can get some bipartisan work to refund this really important piece of legislation. And I think, Dr. Rubin, you pointed out something that's really important. At a time when they seem to be racing toward a trillions of dollars of expense to give tax breaks to people throughout the country, seems to me that their first priority ought to be to reauthorize this piece of legislation, the Children's Health Insurance Program. It involves so much less in the way of resources and money. But it is so much more important than anything that that tax reform, and I know I'm biased here, but more important than anything that's in that tax reform, we really need to do this. And as you pointed out, 90% of the cost of the Children's Health Insurance Program that means insurance for 170, I think 8,000, almost 180,000 children in Pennsylvania, that is really an important issue. And multiply that, how many millions of children across the country. This is where we ought to be spending our time, devoting our effort. That ought to be our priority. The other thing is practically, if we don't do it here, they are going to go back to the expensive route of poor health coming to our emergency rooms, doing things that we just can't afford to have happen. And it's not going to be good for any of us. Not just for Kamal, not just for children throughout Pennsylvania, the United States, but for any of us. So I want us to be able to be partners with the federal government. I want them to reauthorize the chip bill, do what we've done here in Harrisburg in a bipartisan way, reach across the aisle, get it done so that we don't have to, so that Teresa doesn't have to send those letters out to families over the holiday season. This should not be a partisan issue. There are 180,000 almost children right here in Pennsylvania waiting for Congress to do the right thing. We've been waiting for months. It's time, long past due, time for them to act on this. Let's get this done. And I want to also give a shout out to Senator Bob Casey, who's doing, I think, Yeoman's work in Washington to try to get him to do what we've done here in Pennsylvania. He's trying his best and I think has worked very hard to try to get his colleagues to see how this is a really important thing. So I want this for Pennsylvania. I want this for this country. We need to have this chip bill reauthorized at the federal level. As I say, I think all of us, Senator Hughes, all of us here in Pennsylvania stand ready to give any advice that we can give to show the folks in Washington how bipartisanship can actually work to make the lives of children and families better right here in Pennsylvania. So having said that, I would like to now sign the chip reauthorization bill for Pennsylvania and I'm going to stand back and because I have a bad back. I'm not going to move this podium and I'd like to have Secretary Miller come up here and sit with me and I'll sign this and I'll give you a pen.