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Paul Ronningen , Published June 12 2010

Does ND value its children?

Children can become productive citizens, leaders and role models only if they are healthy.

Unfortunately, 13,000 children in North Dakota are living without health care coverage.

Increasing the number of children covered by health insurance in North Dakota will reap long-term benefits both to these children and our state’s budding work force. Research shows that children enrolled in the Children’s Health Insurance Program are more likely to have fewer hospital stays, miss less school and have improved quality of health in adulthood.

What does it cost to raise a child in North Dakota? North Dakota State University calculated how much an employed mother would need to earn to support two children without government assistance. She would need to work full time at an hourly wage of $25.75 or $43,596 per year.

I have yet to read any data that would suggest that low-income working families can afford health care coverage for their children. Based on North Dakota wages and the costs of supporting a family, many of our neighbors are caught in a riptide between public assistance and financial sustainability.

In 40 years of professional work on these issues, I have yet to find any research that counters these findings.

Low-income working families are doing what we value in North Dakota: working hard, paying taxes, paying their bills and supporting their families. Unfortunately, even though they are following the rules, they are not earning enough to cover the cost of health insurance for their children.

It seems a contradiction that children are an oft-touted political priority; yet, as a state, we remain unwilling to follow through in providing the support and assistance for these families and their children whose health and safety we purport to protect.

I understand and appreciate fiscal constraint. However, in July the North Dakota Office of Management and Budget will be recalculating the growth in the general fund. This figure is anticipated to be at or over a billion dollars.

This reserve, coupled with the fact that North Dakota taxpayers have already paid for 75 percent of the Children’s Health Insurance Program through taxes to the federal government, should pose no dilemma to policymakers concerned with efficient use of tax dollars.

North Dakota could and should recapture those tax dollars that we sent to D.C. For every dollar the state puts into the Children’s Health Insurance Program, three federal tax dollars are returned to the state in the form of federal matching money.

We talk about “family values;” if ever there was a family values issue, this is it.

It confounds me that the majority party in the Legislature has chosen not to put those tax dollars to work for North Dakotans. By electing not to use these resources, North Dakota has locked up the status of “dead last in the nation” for providing health care coverage to children from low-income working families. In fact, North Dakota provides Children’s Health Insurance Program coverage up to 160 percent of the Federal Poverty level while New York is at 400 percent FPL. Eleven states are at 300 percent FPL or higher.

Thus, my boss, Marian Wright Edelman, noted in a recent national speech that “North Dakota (160 percent FPL) and Mississippi (200 percent FPL) children deserve the same level of health care coverage as the children in New York (400 percent FPL) and Massachusetts (300 percent).”

I am really trying to understand “what the politics are behind this issue” since it seems straightforward to me on a fiscal and a moral basis. What am I missing?


Ronningen is state coordinator, Children’s Defense Fund – North Dakota.