Unrelenting. It's just one of the words that can be used to describe pediatricians’ advocacy over the past two years. From the front lines of the pandemic, AAP members have been steadfast in speaking up for children, be it within their clinic walls, at socially distanced town halls in their communities or in front of a computer screen talking with congressional staff.
“While our members faced unprecedented challenges of their own, both professional and personal, they continued showing up and finding new ways to make a difference for their patients,” said AAP President Moira A. Szilagyi, M.D., Ph.D., FAAP. “In the face of the ongoing pandemic, the Academy was able to make tangible progress for child health that cannot be overlooked. Our work is far from over, but it’s important to recognize these wins along the way, no matter how big or small.”
As we reflect on the two-year anniversary of the pandemic, here is a look at several COVID-19 advocacy victories and what they mean for children, families and pediatricians.
Financial support for pediatricians
Since the pandemic's start, the AAP has been advocating to ensure its members receive federal financial support so they can keep their doors open and continue to care for their patients.
Initially, this meant advocating to ensure that Medicaid and Children's Health Insurance Program (CHIP) providers were included in the government provider relief funding, which originally was distributed only to Medicare providers. The AAP also urged the federal government to streamline the application process.
As a result, the Department of Health and Human Services refocused their relief funds to better target small practices and those who care for a higher number of patients enrolled in Medicaid and CHIP. Pediatricians have received more than $700 million in relief funds, representing a major advocacy victory for the Academy.
Sweeping federal legislation
When Congress negotiated several pieces of sweeping pandemic relief legislation, the Academy worked to ensure its priorities were included.
For instance, the American Rescue Plan, which was signed into law around the pandemic's one-year anniversary, included funding for vaccinations and youth mental health, K-12 education to help schools reopen safely, nutrition programs to address food insecurity and home visiting programs to assist families virtually. It also provided funding to prevent and respond to child abuse and neglect, which was especially critical during a time of heightened family stress and challenges.
Notably, the law gave states flexibility to quickly extend Medicaid coverage until 12 months after the end of pregnancy — an important step toward ending preventable maternal deaths and reducing inequities.
Progress on vaccinations
Access to a safe and effective COVID-19 vaccine for children has been a constant driver of the Academy's advocacy. Pediatricians have played an integral role in vaccinating children who are eligible, and this work continues across the country.
Last December, the Biden administration announced it would require payment for vaccine counseling in Medicaid. This longstanding AAP advocacy priority will help ensure families can get their questions about vaccination answered, and pediatricians can be paid adequately for this time.
Additionally, the American Rescue Plan provided funding to implement the AAP-championed VACCINES Act, which helps strengthen vaccine confidence and address vaccine hesitancy.
Throughout the pandemic, the Academy has pushed government leaders to keep children at the forefront of the vaccine development and rollout process. The AAP advocated for inclusion of children in clinical trials, immediate changes in vaccine distribution to reach patients and prioritization of pediatricians’ role in the vaccine rollout for children.
Youth mental health
The AAP has been a leading voice in calling for urgent action to address the youth mental health crisis, which has been exacerbated by the pandemic. Government leaders are listening, and the topic is gaining traction on Capitol Hill.
Last year, the Academy released principles with nearly 30 health groups, outlining ways to improve and enhance mental health services. Later, alongside child and adolescent psychiatrists and children's hospitals, the AAP declared a national state of emergency in youth mental health, which received widespread media coverage and captured the attention of federal leaders. On the heels of the declaration, the U.S. surgeon general issued an advisory highlighting the need for immediate action.
Also as a result of AAP advocacy, the American Rescue Plan included funding for the Pediatric Mental Health Care Access Program, which increases access to mental health services for children and adolescents. This funding helped to expand the program from 21 to 45 jurisdictions, and the AAP will be working on the program's reauthorization in the coming months.
Throughout the pandemic, many issues that played out on the national stage were amplified at the state level and in communities. AAP chapters are undertaking advocacy efforts at all levels of government and have seen their share of critical child health victories.
One ongoing aspect of this work includes litigation efforts of the Academy and several chapters to support universal masking in schools to stem the spread of the virus. At press time, the AAP and its chapters have submitted 25 briefs in 14 states on the topic. In several states, these efforts have helped reinstate school mask requirements or block harmful orders.
Around the world
The AAP's COVID-19 advocacy has extended beyond the country's borders.
Of note, the White House hosted the first Global COVID-19 Summit last September, which the AAP advocated for along with the global health community. The summit brought together leaders from around the world to increase access to COVID-19 vaccines globally. The United States has pledged to donate 1.1 billion doses of COVID-19 vaccines for global use before 2023, more than any other country.
Through innovative partnerships, ongoing collaborations across federal agencies and coalitions within the medical community, the AAP continues to transform its child health expertise into opportunities for advocacy progress. The Academy and its members will pursue new ways to elevate the child health perspective at the national, state and community levels.
While pandemic's path remains unpredictable, the AAP's place at the table with leaders at all levels of government to forge a way forward is unquestionable. The months ahead will bring no shortage of opportunities to urge policymakers to put children first.