SCHIP’S REALITY

Instead of chiding Congress for “wasting time” by passing a pared down version of a children’s health care bill, President Bush should consult with members of his own party to understand why this measure is needed.

After the House passed an amended version of a bill to fund the State Children’s Health Insurance Program, known as SCHIP, the president criticized Democratic leaders for spending time on the legislation. He vetoed a different version of the SCHIP funding bill earlier this month and has threatened to veto this one, which passed the House by seven votes less than the two-thirds needed to override a veto.

SCHIP provides federal subsidies, matched with state dollars, to offer health care coverage to children whose parents earn too much to qualify for Medicaid. The program covers about 4 million children a month. The question in Congress is to what extent SCHIP should be expanded and how it should be funded.

The compromise answer from negotiators ended up close to the version produced by the Senate: an additional $35 billion, paid for with a tax increase on tobacco sales. The new version passed by the House would target funds for the lowest income children, would tighten citizenship requirements and speed the elimination of adults from the program.

According to the Congressional Budget Office, the new bill would cover more children who are currently uninsured than the version the president vetoed earlier. One reason the president has said he vetoed the SCHIP legislation was because it removed children from private insurance plans and put them into a government program. SCHIP uses government funds to provide private insurance, often with co-pay and premiums. Further, the CBO estimates that the bill passed by the House would cover nearly 4 million children who would otherwise be uninsured. About a third of the children in the program could be eligible for some type of private insurance, but this does not mean they have that insurance now or that the coverage would be comprehensive. A primary reason for children losing insurance is when their parents lose their jobs.

The president’s arguments against SCHIP have put him in a corner. He opposes the program, he says, because he doesn’t want the government making decisions for doctors and customers. Patients don’t have their medical decisions made by government under SCHIP; they use private insurers and private doctors, who presumably make their decisions based on their medical expertise. He has also painted the program as a Democratic scheme.

To get out of that corner, he should consult with “Democrats” like Sens. Olympia Snowe, Susan Collins, Orrin Hatch and Chuck Grassley to understand why they are such strong supporters of the program.

Maybe if they explain the program allows “customers” – children, in this case – who now have no relationship with a doctor because they have no insurance, to start one, he’ll better understand and support the program.