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The Texas Blue
Advancing Progressive Ideas

On SCHIP, Children Have the Most to Lose

Perhaps the most bitter and significant fight in Congress this year has to do with the State Children’s Health Insurance Program (SCHIP). SCHIP is designed to provide health insurance to children whose parents make “too much money” to qualify for Medicaid and who have no other health insurance options. In Texas, thousands of children of the working poor qualify for SCHIP but remain without any kind of health insurance.

Right now, Democrats, Republicans and the President can not agree on how much money to spend, how to fund the program, and on how to restrict states so that they insure children, rather than adults, as some states have chosen to do.

On October 2, Congress voted for the first time on SCHIP; the bill, H.R. 976, passed in the House by a vote of 265 to 159. It was designed to provide 10 million American children with health care and would have ensured that:

  1. the focus would be enrolling low-income children in SCHIP first;
  2. SCHIP would not cover illegal immigrants;
  3. SCHIP coverage of adults would be phased out; and
  4. children leaving private insurance for SCHIP should be minimized.

Republicans and Democrats alike supported it. Sadly, on October 3, the President vetoed the bill.

The House and Senate went back to the drawing board and worked out a compromise that they felt might be able to win the votes of two-thirds of the House and Senate and thus override the President’s veto. The revised SCHIP bill again would provide 10 million American children with health care, and it also addresses specific concerns that had prevented some lawmakers from supporting the original version:

First of all, the revised bill further clarifies low-income children should be enrolled in SCHIP first:

  • Any family making more than 300 percent of poverty level will not be able to enroll children in SCHIP; the program is for low-income children only.

Second, the revised bill ensures that illegal immigrants will not be able to enroll in SCHIP:

  • If the Social Security Administration cannot confirm an applicant’s citizenship, the applicant will be required to provide the state with additional documentation to confirm eligibility.

Third, the revised bill will allow only for children’s health insurance coverage; no funds may be spent on adults (except pregnant women):

  • Under the original bill, childless adults are phased out over two years; under the revised bill, they are phased out within one year.

Fourth, the revised bill contains language to minimize children being kicked out of private insurance into SCHIP (called “crowd-out”):

  • All states will be required to develop plans to minimize “crowd-out.”
  • Premium assistance programs (using SCHIP funds to help subsidize employer-sponsored health coverage for a child) will be added to the list of things a state can do to get bonus payments.

The bill ensures that the 6.6 million children who currently participate in SCHIP will continue to receive health care coverage. It also extends coverage to 3.8 million children who are currently uninsured. The President believes that an investment of $35 billion in new funding over five years for SCHIP is too expensive. However, the revenue will be provided by raising the tobacco tax by 61 cents a pack. Also: the higher the cost of cigarettes, the less likely kids will begin smoking. According to the Campaign for Tobacco-Free Kids, a 61-cent increase in the tobacco tax means that 1,873,000 fewer children will take up smoking.

Despite claims by President Bush, this bill does nothing to “expand” the SCHIP program; it maintains current eligibility levels for SCHIP. Only two-thirds of uninsured children currently eligible for SCHIP or Medicaid coverage are enrolled in the programs. This bill gives states the resources necessary to reach millions of uninsured children and enroll them into the program. An additional benefit of the revised SCHIP bill is that it includes dental and mental health benefits.

In summary, the SCHIP bill is thoughtful health care policy that has taken concerns of Democrats and Republicans alike. It does great things to extend health insurance to the children of the working poor, who would otherwise have limited options. It pays for itself via a tobacco tax and, in my view, is responsible and compassionate toward our nation’s most vulnerable citizens: our children.

As a nurse, I am committed to fighting for the good health of Texas children, and I will work to get this bill passed. Health is a precious commodity, and our kids are worth the battle.

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