On a nondescript Wednesday morning in July, Bruce Lesley, president of the children’s welfare group First Focus, took to the podium at the National Press Club in Washington and delivered a stark message.
Even as more children are falling into poverty, Lesley warned, less of the nation’s budget is going toward kids’ programs — and Congress is doing almost nothing to correct the imbalance.
{mosads}While children’s spending accounted for about 8 percent of the budget in 2006, Lesley noted, that figure fell to 7.6 percent two years later — representing a 5 percent drop in overall spending.
Over the past 50 years, the portion of the budget devoted to children’s programs has sunk by roughly a quarter, Lesley said, while entitlement spending on adult programs has more than doubled. And while last year’s stimulus bill reversed the downward trend in 2009 and 2010, that funding is soon to expire, with prospects for future spending uncertain amid the charged partisan atmosphere of Congress.
“Gridlock,” Lesley said, “is one of our biggest enemies.”
For most of the past two decades, Lesley has been a recurring presence in healthcare debates on Capitol Hill. He has worked for a diverse roster of lawmakers, including former Sen. John Breaux (D), a conservative-leaning Louisianan, and Rep. Diana DeGette (D), a Colorado liberal.
He said the relative powerlessness of kids to influence federal policy nudged him toward focusing full-time on children’s-welfare issues.
“Kids don’t vote,” he said, “and parents don’t necessarily vote with their kids in mind.”
It was, he decided, “a constituency that really needed a voice.”
Raised in Texas, Lesley traces his interest in children’s issues to his parents, who were both teachers, and a job he held decades ago at a public hospital in El Paso, where almost 40 percent of kids lack health insurance.
“Just going up to the pediatric ward and seeing those kids — there was just something about that,” Lesley said. “It really resonated with me.”
At First Focus, he’s had his work cut out for him. In 2007 and 2008, children’s-welfare advocates could only watch as President George W. Bush twice vetoed a Democratic bill to reauthorize the Children’s Health Insurance Program (CHIP), a popular 13-year-old initiative that covers kids from families who don’t qualify for Medicaid but can’t afford their own insurance.
The bill was among the first to be signed by President Obama when he assumed the White House in early 2009 — “a huge deal,” Lesley said, for the roughly 9 million kids covered under the program.
As part of the reauthorization signed by Obama, Congress expanded CHIP to include dental care and to cover legal immigrant children — changes for which Lesley and other child advocates had lobbied heavily.
More recently, Lesley led the charge against a provision of the Democrats’ health reform bill that would have scrapped CHIP in 2014 and shifted the children covered under it to either Medicaid or private plans on the exchange. The Congressional Budget Office said the change would have shifted additional costs onto CHIP families, causing a number of those kids to lose coverage altogether.
The pushback caused Democratic leaders to abandon the plan, instead funding CHIP through 2015.
Sen. Jeff Bingaman (D-N.M.), for whom Lesley worked prior to joining First Focus in late 2006, said Lesley’s success as an advocate stems largely from his ability to cross the aisle to build support.
“Bruce knows how to build coalitions … and he has a tremendous track record,” Bingaman, a member of both the Senate Finance and Health committees, said Monday in an e-mail. “He is an extremely dedicated and effective advocate for America’s children — a constituency that lacks its own well-funded lobby effort.”
DeGette echoed those sentiments, saying Lesley’s “passion and conviction” for the well-being of kids “drive all of us to do better.”
“In a town where cynicism often colors the perception of advocacy organizations, Bruce is the real deal – a tireless, and well-respected, advocate for those who can’t fight for themselves,” she said in an e-mail.
Sen. Chuck Grassley (Iowa), the senior Republican on the Finance Committee, agreed.
“[Lesley] recognizes that children’s issues should not be partisan, and working on a bipartisan basis is the best way to get things done in this area,” Grassley wrote in an e-mail.
The fruits of Lesley’s efforts have been tangible. When the U.S. Census Bureau last month released its latest tally of the nation’s uninsured, for instance, the news was dismal for adults — but not for kids.
While the number of Americans without insurance jumped from 46.3 million (15.4 percent) in 2008 to 50.7 million (16.7 percent) in 2009, the rate for children remained a steady 10 percent — even despite a rise in the number of kids living in poverty.
Family health advocates say the reason is no mystery: CHIP and Medicaid were able to absorb kids during the recession even as their parents were losing coverage.
“Working together, these public programs successfully maintained a lifeline to children during the economic downturn,” Joan Alker, co-director of Georgetown University’s Center for Children and Families, said last month.
Not every fight, of course, has resulted in victory. A $4.5 billion Senate proposal to expand child nutrition programs, for instance, passed the upper chamber recently but was never considered in the House.
The DREAM Act, which would offer citizenship to accomplished students who arrived in the country illegally, is another unfinished priority of the kids’-welfare community.
Lesley said he’s hopeful Congress will have enough life left after the tough elections to consider those proposals during the lame-duck.
Looking into next year, Lesley plans to fight for legislation requiring Congress to keep a separate budget tally of all spending on children’s programs. The proposal — sponsored by Rep. Danny Davis (D-Ill.) and Sen. Robert Menendez (D-N.J.) — would offer a comprehensive look at how kids are faring under any given budget — not just how they’re doing based on a vote or two.
Ensuring that kids are taken care of, he said, “really requires an accounting and a look at the whole child.”
Part of his success will surely hinge on whether the parties in 2011 are as divided as they were this year — the most partisan Congress he said he’s ever seen.
“Our hope,” he said, “is that that will end.”