Insuring kids, federally

Lawmakers are debating whether to increase the tax on cigarettes and use the money to fund children’s health care. Sound familiar? It is, except the debate is not taking place in the Maine State House but in Congress, where a promising proposal in the Senate has gained bipartisan and executive branch support.

The Senate last month supported a $24 billion plan over five years to raise cigarette taxes by 20 cents per pack and use the money to provide basic health insurance, including vision and hearing services, for children. The president has expressed interest in such a plan, but a stumbling block could be the House, which passed a much weaker health care package. The House-Senate conference committee is meeting this week to work out differences. The nation’s children will be better off if the conference favors the Senate’s version.

The children in need of health coverage come from working poor families. Medicaid pays for health care of the unemployed and impoverished; better off families either have insurance in part through their employment or pay for it themselves outright. But from 1989 to 1995, according to the General Accounting Office, the percentage of children with insurance fell from 73 percent to 66 percent. The reason for this can be seen here in Maine.

Broad changes in the economy have replaced long-term manufacturing jobs with service industry jobs that often do not include health insurance. The continued rise in the cost of insurance has made it harder for employers to offer the benefit while employees struggle to pay their increasing portion of the insurance. The result is that many children go without relatively inexpensive preventive care and instead are treated when their conditions require emergency-room attention — an inhumane and expensive system that benefits no one. The Maine Legislature and Gov. Angus King had the opportunity to help reduce this problem that affects approximately 36,000 children in this state, but the best they could agree on was to study the situation further.

The Senate’s health care bill partially addresses this by offering funds sufficient to insure an additional 6 million children. It would guarantee a minimum of benefits, providing that states pay for 10 percent to 20 percent of the health care. Maine, because of its size and relative lack of wealth, is likely to need to provide only a 10 percent match to qualify for the funding. The House version, on the other hand, comes in the form of a block grant, worth a total of $16 billion, with no strict requirements that states use the money for its intended purpose. This flexibility leaves the program ripe for abuse.

The current system of ignoring uninsured childrens’ illnesses until a crisis is reached is unacceptable. Useful, low-cost preventive care for these kids should be a priority of government. While Maine studies the problem, action on the federal level could eliminate much of the debate locally. The Senate bill deserves strong support.