President and Congress Battle over Child Health Plan
In the ongoing battle between Congress, the Senate and the White House, the Bush administration has announced new policies that will make it harder for states to insure all but the lowest-income children.
The new administrative policies, 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. According to Democrats and children's advocates these policies will jeopardize coverage for children whose parents work at jobs that do not provide employer-paid insurance.
Under the new proposed 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.
These and other steps must be implemented within a year, Dennis G. Smith, director of the federal Center for Medicaid and State Operations, advised state health officials in a letter on Friday.
"We would not expect any effect on current enrollees from this review strategy," Smith wrote. He added that this focus on "the core uninsured targeted low-income population" will strengthen the program, known as SCHIP.
States had already been taking steps, such as imposing waiting periods, to keep parents from switching from private to government-subsidized insurance. But children's advocates called the new measures overly restrictive.
In a statement by Cindy Mann, executive director of the Center for Children and Families at Georgetown University, these steps "would effectively foreclose the opportunity for states to cover children in families with incomes of about $40,000 to $50,000 a year, depending on the size of family."
The administrative move, announced while lawmakers are out of town during the August recess, comes after the White House has battled with Congress for months over the future of the $5 billion-a-year program.
The Senate and the House have passed legislation that would significantly increase funding and make it possible to sign up millions of new children for coverage. President Bush, however, wants to keep the program largely unchanged and has promised to veto either bill, saying they would inappropriately increase the federal role in health care.
Published on August 21, 2007
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