SCHIP: A Repository of Conflicting FactsOctober 5, 2007 - by Donny Shaw
Confused by all the conflicting accounts of the State Children’s Health Insurance Program bill that President Bush vetoed this week? Don’t worry, you’re not alone.
Because this bill has become prime political battleground, pitting Republicans against Democrats in a virtualization of the healthcare debate that is shaping up to take center stage in the 2008 elections, its particular facts — what it actually proposes and what its actual effects would be — have been sacrificed.
Rather than being another voice trying to shout “the facts” about this bill above all the rest, I have decided to provide a rundown of the competing analyses that are being cited in the sound bites and talking points. Here are links to some of the most important reports on Congress’s SCHIP bill along with excerpts that, I think, sum up their key findings. For reports that were released before the final bill was negotiated, I chose to excerpt parts that discuss the Senate’s bill, as the version negotiators agreed upon closely mirrors it. Click on the links to learn more:
>Bush is simply wrong to say that the legislation “would” result in families making $83,000 a year to be eligible. It might happen in a future administration, but that would be possible without the new legislation.
>The Census Bureau estimates there were about 9 million children who sometime during 2006 did not have health insurance. The Congressional Budget Office estimates that about 3.8 million of those uninsured children would get government coverage under the bill. It also estimates that about 2 million children now covered by private insurance would switch to SCHIP.
>Under the Senate’s SCHIP expansion, an estimated 1 million to 1.2 million children would gain SCHIP coverage, but between 467,000 and 611,000 children would lose private coverage. Due to poor targeting and the relative cost of crowd out, the annual cost to taxpayers of covering an uninsured child under the Senate’s expansion plan would increase from $1,418 to between $2,508 and $2,859.
>In July 2007, bills to reauthorize the State Children’s Health Insurance Program were passed in both the House and the Senate. One question that has been raised is how well the bills target low-income children. In this brief, Genevieve Kenney and colleagues estimate that the proportion of children below 200 percent of the Federal Poverty Level (FPL) covered by the bills is 70% or higher. The share of uninsured children below 200 percent of the FPL who would gain coverage is estimated to be even higher (78 to 85 percent).
>The Senate bill grandfathers in New York at a higher SCHIP match rate than the rest of the country – allowing SCHIP to cover children in some households with incomes of up to $83,000 per year.
>In economic terms, then, Senator Smith is suggesting that the federal government more than double its most “regressive” tax—that is, the tax that hits the poor hardest. Perhaps to mitigate this hit on the poor, he suggests that the government spend the funds on one of its most “progressive” programs, that is, a program originally designed to funnel money to low-income households with children. However, because states make their own SCHIP policies, the poor in some states will face the higher cigarette tax but receive little in extra SCHIP spending.
>The CBO estimates show that 2.5 million of these children are uninsured children who already would be eligible for SCHIP or Medicaid under the current eligibility rules that states have set for these programs. Another 700,000 are SCHIP children who otherwise would lose their coverage in coming years and end up uninsured, because states would (under the “budget baseline” that CBO uses) receive insufficient federal SCHIP funding to sustain their existing programs.
Congress will attempt to override Bush’s veto on October 17th. Here’s Matt Lewis of OMBWatch’s thorough explanation of how many votes are needed for the override to be successful.
Undoubtedly, there are other important analyses of Congress’s SCHIP bill. If you know of any that I have missed, let me know in the comments and I will put up a link.