"SCHIP, Symbol Of Democrat Clout Or Legitimate Health Care Need?"

Wed Jan 14, 3:51 PM ETHouse Speaker Nancy Pelosi of Calif., right, and House Majority Leader Steny Hoyer of Md., attend a news conference on Capitol Hill in Washington, Wednesday, Jan. 14, 2009, to discuss the House passage of the State Children's Health Insurance Program (SCHIP) legislation. (AP Photo/Haraz N. Ghanbari

Making a down payment on President-elect Barack Obama's promise of universal health coverage, the House voted overwhelmingly Wednesday to expand government-sponsored insurance to 4 million more children in working families with income too high to qualify for Medicaid.

Between 300,000 and 600,000 of the new enrollees could be non-citizen children of legal immigrants who have been in the country less than five years, a sticking point for some Senate Republicans who also will consider a similar bill.

Obama said he hoped the Senate acts with the "same sense of urgency so that it can be one of the first measures I sign into law when I am president."

"In this moment of crisis, ensuring that every child in America has access to affordable health care is not just good economic policy, but a moral obligation we hold as parents and citizens," he said.

Forty Republicans joined Democrats in passing the bill 289-139. Congress passed similar legislation in 2007 but it was vetoed both times by departing President George W. Bush.

The bill would raise the federal excise tax on cigarettes by 61 cents to $1 a pack to pay for the $32.3 billion cost of expanding the State Children's Health Insurance Program for the next 4 1/2 years. Other tobacco products would experience a comparable tax increase.

About 7 million children now get government-sponsored health care through SCHIP.

The Senate Finance Committee is scheduled to begin writing a similar bill Thursday. Democrats would like to send a House-Senate compromise to Obama for his signature in coming weeks as an early victory signifying the party's control of both the White and Congress for the first time since 1994.

"This is only the beginning of the change we will achieve with our new president," said House Speaker Nancy Pelosi, D-Calif., who got a congratulatory call from Obama after the vote.

The Congressional Budget Office projected that nearly 83 percent of the 4.1 million uninsured children who would gain coverage are in families with incomes below current eligibility limits. About 700,000 children would gain coverage because their states broadened eligibility.

Most of the children who gain coverage live in families with incomes of less than twice the federal poverty level — $42,400 for a family of four, analysts said. However, some states have expanded their programs to cover families with more moderate incomes, as much as three times the federal poverty level — or $63,600 for a family of four.

Republicans pointed to budget office estimates that the bill would shift 2.4 million children currently with private coverage to government-provided care.

"The priority of SCHIP should always be to serve those children most in need of assistance, not subsidize those who already have access to private insurance," said Rep. Darrell Issa, R-Calif.

They also objected to the additional spending.

"The kids will have to pay through the nose for the things we are doing today," said Rep. Dan Burton, R-Ind. "We don't have the money to do all these things."

Democrats dismissed both arguments

"Forty days in Iraq equals over 10 million children in America insured for one year," Pelosi said. "We certainly can afford to do that."

Opponents also said the tobacco tax increase would not be enough to keep pace with the growing costs of health care. As a result, lawmakers down the road will have to cut children from the program or increase taxes. They said the latter option is more likely.

"The Democrats are blowing a giant cloud of smoke into the face of the American taxpayers, and I believe the impending tax increases that must come to cover this program will have us all in a severe coughing fit," said Rep. Dave Camp, R-Mich.

The State Children’s Health Insurance Program (SCHIP) is a United States federal government program that gives funds to states in order to provide health insurance to families with children. The program was designed to cover uninsured children in families with incomes that are modest but too high to qualify for Medicaid.

At its creation in 1997, SCHIP was the largest expansion of taxpayer funded health insurance coverage for children in the U.S. since Medicaid began in the 1960s. The statutory authority for SCHIP is under title XXI of the Social Security Act. It was sponsored by Senator Ted Kennedy in a partnership with Senator Orrin Hatch with support coming from First Lady Hillary Rodham Clinton during the Clinton administration.

States are given flexibility in designing their SCHIP eligibility requirements and policies within broad federal guidelines. Some states have received authority through waivers of statutory provisions to use SCHIP funds to cover the parents of children receiving benefits from both SCHIP and Medicaid, pregnant women, and other adults. SCHIP covered 6.6 million children and 670,000 adults at some point during Federal fiscal year 2006, and every state has an approved plan. However, the program is already facing funding shortfalls in several states. Attempts to expand funding for the program have met with political controversy amidst studies that debate the program's fiscal impacts. Two proposals passed by the Congress in 2007 to reauthorize and expand SCHIP from an average of $5 billion yearly to approximately $12 billion yearly over the next five years were vetoed by President George W. Bush. At the end of 2007, President Bush signed an extension of the program to cover current enrollment levels through March 2009 so that problematic issues could be fixed in the program prior to further extension.

Despite SCHIP, the number of uninsured children continues to rise, particularly among families that cannot qualify for SCHIP. An October 2007 study by the Vimo Research Group found that 68.7 percent of newly uninsured children were in families whose incomes were 200 percent of the federal poverty level or higher.

    Many working class American families know what it is like to make too much money for Medicaid but not enough money to  afford private or employer based health insurance. The State Children’s Health Insurance Program (SCHIP) was designed to provide health insurance for children in families in this financial situation. Unfortunately, like many government subsidized or "welfare programs" there is fraud and families taking advantage of SCHIP that really don't need it. As  see it, there are a lot of bugs in the SCHIP program that need to be ironed out before a blanket expansion of the program. In my opinion, SCHIP is more a symbol of newly won political clout, with a Democrat president and a Democrat controlled Congress now able to pass any legislation they desire. President Elect Obama has promised to "line item veto" legislation that is unwise and unnecessary. America can't afford to waste money on symbols right now. Congress should carefully craft a SCHIP extension and expansion that will cover only legitimate health care needs, as I see it.

tags: schip  congress  barack obama  politics  takebackamerica  health insurance  free market  business  capitalism  welfare  medicaid  

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