Nexus: Take this child and SCHIPP it

Recent debate over whether to expand the State Children’s Health Insurance Program shows the dysfunction of our Congress. The debate isn’t over the merits of the program, but rather over how much to expand the program. With the number of uninsured in this country rising to 47 million, SCHIP expansion would seem to be something that Congress could reach a compromise on, and at least make some incremental progress, but partisan politics stands in the way.

The Bush administration has argued that SCHIP is a good program that should be modestly expanded so that more families under 200% of poverty could be covered. They have also claimed that Democratic bills would raise the limit to 400% of poverty. In fact, the 400% figure was proposed by New York’s SCHIP program, but was rejected. The Democrats would like to see the cap increased but have indicated that they would accept a 300% of poverty level cap.

The poverty level for a family of 4 is $20,650. At 300% of poverty level a family of four earning less than $62,000 would qualify for assistance. An uninsured family with a $62,000 income would have a difficult time affording the health care needs of a very ill child and would not qualify for any other medical assistance. It does not seem unreasonable to provide healthcare coverage for the children of such a family.

The administration has also claimed that expansion of SCHIP is a step on the road to socialized medicine. SCHIP is funded by both state and federal funds, and is administered by the states under broad federal guidelines in partnership with private insurance companies and health care providers. Public/private partnerships are not socialism—at least not when it pertains to privatization of Department of Defense or State Department activities—only health care.

Many bloggers have made the claim that the expansion taxes the poor to benefit the rich. They cite figures showing that the lower one’s income the more likely one is to smoke. Therefore any increase in the income cap for SCHIP funded by a tobacco tax hurts the poor and benefits the wealthy. They fail to mention that 60% of smokers exceed 200% of poverty, and that second hand smoke is a significant contributing factor to children’s health problems. Higher tobacco costs can also be a deterrent to smoking.

Hard-line Republican arguments against SCHIP do not hold much credibility, but they appeal to an angry conservative base that feels the administration and Congress have not held to fiscally conservative values.

On the other hand there are moderate Republicans who would vote for SCHIP expansion given a few compromises. Republicans are looking for provisions that would eliminate incentives to drop existing private insurance plans, deny the SCHIP to illegal immigrants and hold down the income cap. Health and Human Services Secretary Mike Leavitt has indicated that 300% is not out of the question.

So why are Democrats so unwilling to work out a compromise? The issues raised by the Republicans with exception of the illegal immigrant issue are not so tough that a reasonable compromise can’t be achieved. But hard-line Democrats would rather hang on to what they see as a political advantage than expand SCHIP. With election season around the corner,

Democrats would like nothing more than to point to “the stingy Republicans” who wouldn’t even fund health care for poor children than settle for incremental expansion of a proven program that benefits millions of children. For them SCHIP can wait.

Of course we have differences in Congress, but when we have a program that both parties agree works, and when we have more and more uninsured children, we need the political gamesmanship to end, and the art of effective policy making to begin.

To contact Michael directly at mmelon15@hotmail.com. Previous Nexus articles can be read at www.fargonexus.blogspot.com.