Conviction and Compassion Creates the Federal Children's Health Insurance Program.

INTRODUCTION: For a quarter century, the Children's Health Insurance Program (CHIP) has provided essential health care coverage for children and pregnant women in working families. Established as part of the Balanced Budget Act of 1997, CHIP provides critical coverage for children living in families with incomes falling between eligibility for Medicaid and employment-based coverage. Since its enactment, CHIP has markedly reduced the number of children who were uninsured in 2020 to approximately 3.7 million children (5.0%), an extraordinary 67% reduction. This article traces the history of the federal CHIP legislation based in large part upon the success of Pennsylvania's innovative efforts. METHODS: Review of the literature. Personal Communications. RESULTS: Since its enactment, CHIP has markedly reduced the number of children who were uninsured in 2020 to approximately 3.7 million children (5.0%), an extraordinary 67% reduction. DISCUSSION: This article traces the history of the federal CHIP legislation based in large part upon the success of Pennsylvania's innovative efforts. The authors certify that the material presented in this article was prepared in accord with prevailing ethical principles.

While CHIP has been heralded for greatly improving access to health coverage, little is known about its origins, especially the contribution of the Pennsylvania CHIP, and the history of prior efforts. This article reviews the history of providing insurance coverage for children and recounts the personal involvement of the authors for CHIP's enactment.

Patient-Centered Therapy Development for Myotonic Dystrophy: Report of the Myotonic Dystrophy Foundation-Sponsored Workshop.

Myotonic dystrophy (DM) is an autosomal dominant, repeat expansion, progressive disorder with no drug therapies. Consequently, to better define a regulatory pathway in anticipation of new treatment strategies under investigation, the Myotonic Dystrophy Foundation convened a workshop entitled "Patient-Centered Therapy Development for Myotonic Dystrophy" in September 2015. Participants included representatives from academia, industry, the patient community, the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). Presenters described the symptom burden of the disease, and existing data on DM biomarkers, endpoints, natural history, and benefit-risk considerations. FDA participants helped clarify the regulatory requirements for new drug treatment approvals and DM-specific issues such as variability, slow progression, and low prevalence. Workshop attendees gained a better understanding of DM and the current status of existing data and tools to support therapeutic drug research and development.

The National Children's Study of environmental effects on child health and development.

Increasing recognition that children may be more susceptible than adults to environmental exposures and that they experience potentially life-long consequences of such exposures has led to widespread support for a large new cohort study in the United States. In this article, we propose a framework for a new cohort study of children, with follow-up beginning before birth and continuing to age 21 years. We also describe the administrative structure that has been built to develop the proposal further. The structure includes a partnership between federal and nonfederal scientists and relies on a collaborative, interdisciplinary research effort of unprecedented scale in medical research. We discuss briefly how the proposed cohort could be used to examine, among many other things, the effect of chemical contaminants in breast milk on children's health and development.