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October 2007 A controversial proposal to expand the State Children’s Health Insurance Program was expected to be vetoed by President Bush at press time because the plan would have increased funding for the program by $35 billion over a five-year period, as opposed to his proposal of $5 billion. “The most important piece of this legislation in respect to uninsured children is that it creates financial incentives for states to do a better job at enrolling children who are currently eligible for either the State Children’s Health Insurance Program (SCHIP) or Medicaid, but are not currently enrolled,” Peters Willson, vice-president for public policy of the National Association of Children’s Hospitals, told Infectious Diseases in Children. “For example the program would allow states to use SCHIP funds for premium assistance, so instead of enrolling the child in a SCHIP program the state can provide SCHIP funds to allow the parents to keep a child in their private insurance coverage program,” he said. Bush said he opposed the proposal because it would shift the focus of health care from private care to “government-run.” He also said it will unfairly burden some people, referring to a proposed tax on a pack of cigarettes that would help fund the legislation. Despite the promised veto from Bush, the legislation does enjoy bipartisan backing, and passed by bipartisan majorities in the House and Senate, even if the majorities are not big enough to override a veto. The new legislation would allocate funding to develop, test and validate quality measures for children’s health care. “This represents a substantial commitment to further reducing the number of uninsured children in this country. Beyond that, it builds on what has been successful for the last ten years. During this time, the number of uninsured Americans continued to rise but the number of uninsured children decreased due to both Medicaid and SCHIP, which both picked up the children who were losing private coverage. This legislation seeks to build on this success,” Willson said. On Aug. 17, 2007, an official with the Centers for Medicaid and Medicare Services sent a letter to state SCHIP directors, telling them as early as August 2008, the federal government would cease making SCHIP payments to states that cover children above the 250% poverty level. The letter proposed that this action would be put into effect unless the state covers 95% of all eligible children below the 200% poverty level. The letter also stated that children must be uninsured for more than a year before receiving SCHIP coverage if their family incomes were above 250%. According to Willson, this would result in children losing coverage, since no state that currently covers children above 250% of poverty has reached 95% enrollment. “Increasingly, we are in a health care marketplace in which consumers look for measures of the quality of care being purchased ... This legislation would make a substantial investment to develop new measures of quality for children’s health care,” he said. |
