Congress Accepts Paternity Results

Three cheers for congress. Hip-Hip Hooray! Hip-Hip Hooray! Hip-Hip Hooray! Finally, we have a Congress by the people for the people, or at least… for the little people. The Democratic Party in all its glory and might was able to pass health care aid to millions of uninsured children. Now Congress like Sexual Chocolate in “Coming to America” can sing about how children are the future.

Congress, not only following Sexual Chocolate’s mandate but the majority of the American public took a step towards fixing the gaping hole that is healthcare. A majority of Americans say the federal government should guarantee health insurance to every American, especially children, and are willing to pay higher taxes to do it, according to the latest New York Times/CBS News poll.

The Senate passed CHIP reauthorization by a veto-proof 68-31 vote, and the House passed an even better bill by 225-204.

Ponder this, when it comes to health insurance, what happens to a family that makes too much money to qualify for Medical Assistance, but doesn’t make enough to afford health insurance? Step in State Children's Health Insurance Program or SCHIP.

The State Children's Health Insurance Program (SCHIP), created by the Balanced Budget Act of 1997, enacted Title XXI of the Social Security Act and allocated about $20 billion over five years to help states insure more children. SCHIP continues to receive considerable attention as states implement or continue to expand and refine their initial SCHIP plans. SCHIP plans have been approved in all 50 states, the District of Columbia and 5 territories.

How Does SCHIP Work?

The program covers kids in families with incomes too high for Medicaid but too low to afford private or employer-sponsored insurance. With funding both from the federal government and from their own treasuries, states can decide whether to create a separate SCHIP program, expand Medicaid, or both. States have the flexibility to set income eligibility limits, and most states cover children in families with incomes of up to 200 percent of the federal poverty level. Any money that states don’t use can be redistributed to other states that face shortfalls.

How Is SCHIP Helping Children?

A look at the numbers shows just how successful SCHIP has been in the past 10 years...

• 6 million children enrolled over the course of a year.

• 4.1 million children enrolled in June 2007.

...but also how far we still must go to achieve affordable coverage for all:

• 9 million children are still uninsured.

• The White House estimates that 1.1 million currently uninsured children are eligible for SCHIP or Medicaid

• ...But the Congressional Budget Office estimates that 5 million to 6 million currently uninsured children are eligible for SCHIP or Medicaid.

Well the House bill which is more generous would set aside nearly $11 billion for incentive payments to states that do a good job boosting these enrollments; it focuses on getting states to sign up the poorest, Medicaid-eligible kids. The Congressional Budget Office estimates that, under the House bill, in 2012, about 5 million children who would not otherwise have insurance would be covered; of those, 3 million would be on Medicaid. This would represent an impressive reduction in the more than 4 million children currently eligible for Medicaid but not enrolled.

The House health-care bill unveiled this month has two noteworthy innovations. It would focus additional federal health-care spending on ensuring that poor children eligible for coverage actually receive it. And it would end expensive and unnecessary subsidies for managed-care programs for seniors while making new efforts to help the poorest seniors -- an approach that will be the subject of a separate editorial. The measure faces a daunting political path, both because of its high price tag and because of the financing mechanism, a combination of higher tobacco taxes and lower payments to managed-care plans. But the priorities it reflects are those that lawmakers -- and the Bush administration -- should keep in mind as the debate progresses.

What’s the Big Deal?

The controversy over renewing SCHIP has largely centered on authorizing or expanding coverage for children higher up the income scale, above 200 percent of the poverty level. The administration argues that providing coverage above this level -- $34,340 for a family of three -- would simply shift children from private coverage onto the government dole. Certainly, this is a risk, but so is the threat of children without insurance because of rising premiums and dropped coverage. The poverty level is set nationwide, so that a family at 200 percent of poverty in a high-cost state could easily be unable to afford insurance.

The launching point for the House effort is the need to reauthorize the State Children's Health Insurance Program (SCHIP), a joint federal-state program that provides coverage to children in low-income families that earn too much to qualify for Medicaid. The 10-year-old program expires in September. The House would spend an additional $50 billion over five years, while a bipartisan Senate measure mandates $35 billion. President Bush has threatened to veto even the smaller Senate measure. Instead, he has proposed just $4.8 billion in extra spending above the $25 billion that straight reauthorization would cost -- an amount that would fail even to retain the number of children already covered.

What Do We Think?

Chris Satullo a columnist for the Philadelphia Inquirer writes, "Health care is a classic public good that should be supported by a social compact: The healthy should pay into the system to underwrite care for those who need it now, both as a matter of civic morality and self-interest."

It is the opinion of this blog that good healthcare during childhood is extremely important. If a child is healthy he (or she) is much more likely to be healthy, happy, and productive throughout his (or her) life. So CHIP is an investment in today’s children that will pay dividends over the long term in the form of more productive citizens and lower health costs.