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President Puts Band-Aid on Children's Health Program

Posted by Jane Akre
Wednesday, January 02, 2008 1:21 AM EST
Category: Major Medical, Protecting Your Family
Tags: Major Medical

The SCHIP program has been extended to 2009 with little fanfare and no new funding for the children's health program.


President Bush has put a band-aid on the controversial national child health insurance program, extending the present program until March 2009.

As Congress wrapped-up before the holidays, the House voted Wednesday 411-3 to approve legislation to extend the State Children’s Health Insurance Program (SCHIP) as well as approving a massive $555 billion spending bill including $70 billion for the continued conflict in Iraq and Afghanistan.

The president quietly signed the SCHIP legislation without adding extra funding sought by Democrats and some Republicans that would have expanded the popular program to cover as many as 10 million children.  

Senator Orrin Hatch, a Republican of Utah, said supporting the bill is “the morally right thing to do.”

The plan technically expired September 30, 2007.

The president had previously vetoed any expansion of SCHIP.  Democrats and some Republican supporters had wanted to add $35 billion in funding to cover four million additional uninsured children.  The money would have come from an increased tobacco tax, something lawmakers from tobacco growing states had opposed. 

An editorial in the New York Times says the Bush administration has overblown fears about many dropping their private insurance to sign up with the plan. The New York Times finds in New York State, about 3 percent of children were shifted into SCHIP insurance from private  insurance. 

The president’s signature essentially diffuses the charged issue from the 2008 elections and defers it to the next administration.

SCHIP covers families who make too much to qualify for Medicaid and too little to afford private insurance.  Increasingly the cost of premiums, which have grown by over 100 percent since 1996, the rising cost of health care and the cost of living in some cities, means that more middle-income families and children are going uninsured- currently estimated at 9.4 million children under the age of 19. 

Last August, the president began putting the breaks on an SCHIP expansion. Under the Centers for Medicare and Medicaid Services (CMS), SCHIP was limited to families below 250 percent of the federal poverty level (FPL).  14 states had plans to cover children above the 250 percent FPL.  In 2007 that equaled $42,925 for a family of three.

Here is how it works.  Under SCHIP, the government pays from 65 to 85 percent of the share of coverage costs.  But under the new directive, the feds stopped paying the state its share of costs for children in families above 250 percent of the FPL. The August directive is unclear on how to calculate a family income. Left undetermined was how expenses, such as child care costs, affect a family's income or how child support payments should be applied to the 250 percent of the FPL formula.  

In the first comprehensive review since the policy, Georgetown University calls the directive “Moving Backward” because it has made it more difficult for states to enroll uninsured children. It concludes that a one-size-fits-all approach ignores the huge variation in what it costs to live in various states.

In San Francisco, for example, it takes at least $60,000 to cover basic living costs compared to less than half of that for those living in Houston.

The December 18th report concludes that at a time of growing ranks of uninsured children, thousands have “already lost the opportunity to gain coverage and tens of thousands more will be affected over time.”


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