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Bush Backpedals to Block Children's Health Bill

August 21, 2007 - by Donny Shaw

With Congress looking likely to beat the administration in a fight over expanding a health care program for children when they come back in September, Bush jumped in and changed a couple key rules of the game.

The State Children’s Health Insurance Plan (SCHIP) is popular. It helps out families who can’t afford private insurance for their children, but aren’t poor enough to receive Medicaid. States love the program because it gives them the flexibility to create their own ways of spending SCHIP money to match the needs of their residents. Governors across the country, both Democrat and Republican, support increasing funding for the program.

It’s up for renewal this year — the first time since its initial authorization in 1997 — and Congress is hoping to increase its funding by $35 billion, enough to give insurance to 4.1 million children by 2012 who would otherwise go uninsured. Most of these children (3.5 million of them) would already be eligible for SCHIP; about half-a-million would be covered by changes in the the income levels that states provide for. This relatively small group of children has prompted the Administration to backpedal on the growth of SCHIP that they have been authorizing for the past six years, a change which will actually take health care away from low-income children who currently have it.

From the Washington Post:

>New administrative hurdles, which state health officials were told about late last week, are aimed at preventing parents with private insurance for their children from availing of the government-subsidized State Children’s Health Insurance Program. But Democrats and children’s advocates said that the announcement will jeopardize coverage for children whose parents work at jobs that do not provide employer-paid insurance.
>
>Under the new policy, a state seeking to enroll a child whose family earns more than 250 percent of the poverty level — or $51,625 for a family of four — must first ensure that the child is uninsured for at least one year. The state must also demonstrate that at least 95 percent of children from families making less than 200 percent of the poverty level have been enrolled in the children’s health insurance program or Medicaid — a sign-up rate that no state has yet managed.

And from the New York Times:

>In his letter, Mr. Smith [the director of the federal Center for Medicaid and State Operations] said the new standards would apply to states that previously received federal approval to cover children with family incomes exceeding 250 percent of the poverty level. Such states should amend their state plans to meet federal expectations within 12 months, or the Bush administration “may pursue corrective action,” Mr. Smith said.

So if the states don’t take away childrens’ health care right away, the federal government will come in and do it for them.

As Matt Lewis of OMBWatch points out,"the White House has a pattern of pursuing policy goals that Congress has rejected with regulatory and management tools. Lewis reminds us that “the IRS offered early retirement to nearly ”http://www.ombwatch.org/article/articleview/3565/1/87?TopicID=1">half of all estate tax auditors just after the Senate rejected both a repeal and a roll back of the estate tax."

When Congress returns in September, the House and Senate-passed SCHIP reauthorization bills will go to a conference committee to have their differences ironed out and then back to the separate chambers for final votes. The Senate passed their version with a veto-proof majority and if the conference committee decides on a final bill similar to the original senate one, the House may be able to override a veto as well.

UPDATE: A new study, hot on the heels of the administration’s announcement of their new SCHIP policy, shows how far off the states are from being able to enroll 95 percent of eligible children who are currently eligible.

>Despite a decade of marketing efforts by governments and private foundations, nearly 30 percent of children who are eligible for the health insurance program and are not covered by private plans have yet to enroll, according to a new government study.

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