From the category archives:

Children's Health Insurance Program

Jerid posted on this over at BSB last night (after I had gone to bed, actually). I specifically wanted to comment on Kucinich’s comments about his no vote.

“I cannot support legislation which extends health coverage to some children while openly denying it to other children,” Kucinich said. “This legislation is woefully inadequate: and I will not support it.

“Legal immigrant children deserve the same quality health care as other children receive. It is Congress’ responsibility to address the main difficulties that prevent legal immigrant children from gaining access to health care. Today, we did exactly the opposite.

“HR 676 guarantees full health care coverage for all children. When considering a universal health care proposal, HR 676, the Medicare for All bill, is the only health care plan that addresses three important issues: quality, accessibility, and cost. HR 676 stands alone in an increasingly crowded field of efforts to provide health care coverage to all,” Kucinich said.

Sigh.

Look, Dennis. I appreciate your dedication towards getting coverage for all. I really do. H.R. 676 appears to have reasonably solid support (83 cosponsors), but it will be undoubtedly more difficult to pass, especially with a President who will undoubtedly veto anything that, you know, helps people.

You should have supported this bill, and modified H.R. 676 to make obsolete the parts of this bill in conflict. We should be trying to do the most good for the most people, with the goal of providing perfect coverage for all people. Just because you can’t provide for all doesn’t mean you shouldn’t do what you can for those you can help.

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That’s right, President Bush has set new policies that would actually prevent individual states from expanding the Children’s Health Insurance Program.

The Bush administration, continuing its fight to stop states from expanding the popular Children’s Health Insurance Program, has adopted new standards that would make it much more difficult for New York, California and others to extend coverage to children in middle-income families.

The Children’s Health Insurance Program has strong support from governors of both parties, including Republicans like Arnold Schwarzenegger of California, Tim Pawlenty of Minnesota and Sonny Perdue of Georgia. When the Senate passed a bill to expand the program this month, 18 Republican senators voted for it, in defiance of a veto threat from Mr. Bush.

What are the limitations Bush is imposing?

In the letter sent to state health officials about 7:30 p.m. on Friday, Dennis G. Smith, the director of the federal Center for Medicaid and State Operations, set a high standard for states that want to raise eligibility for the child health program above 250 percent of the poverty level.

Before making such a change, Mr. Smith said, states must demonstrate that they have “enrolled at least 95 percent of children in the state below 200 percent of the federal poverty level” who are eligible for either Medicaid or the child health program.

Deborah S. Bachrach, a deputy commissioner in the New York State Health Department, said, “No state in the nation has a participation rate of 95 percent.”

If a state wants to set its income limit above 250 percent of the poverty level ($51,625 for a family of four), Mr. Smith said, “the state must establish a minimum of a one-year period of uninsurance for individuals” before they can receive public coverage.

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Jonathan over at MYDD.com has a good post up today discussing the fight in congress over expansion of the Children’s Health Insurance Program.

House Republican leader, Representative John A. Boehner of Ohio has threatened that “Republicans will fight these proposals”.

And the Democrats have accused Boehner and the Republicans of trying to deny the Democrats a political victory through their “diligence to the cause of obstructionism”.

Which does seems reasonable.

But Jonathan takes it step further, suggesting that some of these Republican lawmakers are actually ideologically opposed to giving kids healthcare.

Given that “Americans support the idea of expanding SCHIP to cover all children by a remarkable 84 percent to 11 percent margin”- lets hope Jonathan is right and the Republicans stick to their guns on this issue.

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I have to be honest, I had tempered my expectations going in… and Strickland blew me out of the water. Belt-tightening in excess of Blackwell’s ridiculous spending cap nonsense, a freeze on college tuition, and a real focus on improving the lot of Ohioans living in the bottom half. In addition to killing the voucher program, he’s increasing the state’s funding of schools while cutting property taxes, targeting increases to troubled districts, and dramatically increasing accountability. Lots of excellent stuff about education.

Then there is health care. I wish I took notes, or fisked the speech live, but bottom line – Strickland will make health care dramatically more available to all low-income Ohioans, and guarantee it for children. In addition, he’s finding innovative ways to use federal dollars to help seniors and those at risk of losing health coverage maintain proper care.

What’s likely to be overlooked amongst the health care and education issues was one of the very first things Strickland talked about: advanced energy research and implementation. This is really an emerging market, and if we get a jump on it, Ohio could be well poised to land a significant chunk of the alternative energy industry. Really, this goes hand-in-hand with the health and education issues – ensuring Ohioans are healthy and educated makes them more likely to want to live here, and make them a more employable workforce. The alternative energy market provides cutting-edge jobs for these employees to fill.

Fabulous SotS address, IMO. I don’t think I could have dreamed of something better.

UPDATE: Full text of the speech

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Governor Ted Strickland was in Washington yesterday for the winter meeting of the National Governors Association- where he helped push the Bush administration to provide more cash to fund the Children’s Health Insurance Program.

George, of course, just wanted to talk about the war.

When asked about the cut in funding proposed by his recent budget- and how it would mean that some kids wouldn’t be covered- Bush told the Governors that it was a “management problem” i.e. “You guys figure it out- I need the money for my war”.

Next time, I’d like to see the governors tell Mr. Bush that his war is a fucking management problem- and the states need their national guard troops for homeland security.

Anyway- here’s the story in the NYT…

Child Health Care Splits White House and States
By ROBERT PEAR

WASHINGTON, Feb. 26 — Governors clashed with the White House on Monday over the future of the popular Children’s Health Insurance Program, an issue that some members of both parties said was as important as money for the Iraq war.

In the session at the White House, when President Bush reported on progress of the war, governors pressed him to provide more money so they could guarantee health insurance for children. In response, administration officials said states should make better use of the money they already had.

Gov. Sonny Perdue of Georgia, a Republican, said afterward, “Health care for children ought to be a priority, irrespective of anyone’s views on the war.”

Georgia will exhaust its allotment of federal money for the Children’s Health Insurance Program within three months, Mr. Perdue said. Thirteen other states expect to run out by September, according to data released here at the winter meeting of the National Governors Association.

Governors said the Clinton and Bush administrations had encouraged them to expand children’s coverage and had granted waivers allowing them to cover parents and even some childless adults.

Having successfully expanded the health insurance programs in their states, some governors now suggest that the Bush administration is pulling the safety net out from under many children.

In his budget this month, Mr. Bush said he wanted to return the program to its “original objective” of covering children with family incomes less than twice the poverty level. Budget documents note that 16 states cover children above that level and that “one state, New Jersey, covers children up to 350 percent of the federal poverty level.”

A family of four is classified poor if its annual income is less than $20,650.

An influential member of Congress said Monday that he would not be taking up White House proposals to restrict eligibility and financing for the child health program.

“I have absolutely no intention of moving the president’s proposals through our subcommittee,” said the lawmaker, Representative Frank Pallone Jr., Democrat of New Jersey.

Mr. Pallone is chairman of the Health Subcommittee of the Energy and Commerce Committee, which has authority over the children’s program.

Speaker Nancy Pelosi said Monday that “Democrats in Congress understand the urgency” of the problem and would provide money to the 14 states that did not have enough to cover their current enrollment. Although Mr. Bush would reduce federal payments for adults and for children with family incomes above 200 percent of the poverty level, Mr. Pallone said states should have discretion to cover children above 200 percent of the poverty level and adults in some circumstances, too.

“In New Jersey, we made a decision to go up to 350 percent of the poverty level, because we have the highest cost of living in the country,” Mr. Pallone said.

Likewise, he said, New Jersey found that covering adults increased the likelihood that their children would stay on the rolls.

“The hallmark of all this is flexibility,” Mr. Pallone said. “A robust Children’s Health Insurance Program is an important part of any effort to try to achieve universal coverage.”

The federal government spends $5 billion a year on the program. Mr. Bush wants to continue that level, and he is seeking an ”additional allotment” of $4.8 billion over the next five years.

States would need substantially more to continue their programs with current eligibility rules and benefits. New estimates from the Congressional Budget Office show that the states face shortfalls of $700 million this year and a total shortage of $13.4 billion from 2008 to 2012.

Gov. Jim Douglas of Vermont, a Republican, said the Bush proposals would jeopardize his state’s phenomenal success in covering children. In Vermont, he said, fewer than 4 percent of the children are uninsured, and “we don’t want to lose ground.”

Bush administration officials emphasized that states received a fixed amount of federal money each year, and they said individual children did not have a legal entitlement to benefits. Michael O. Leavitt, secretary of health and human services, said he would work with Congress to find “a short-term solution” for states exhausting their allotments this year. He said states could avoid shortfalls by managing their programs better.

In his experience as governor of Utah, Mr. Leavitt said, “when we were out of an allotment, we just discontinued enrolling people until we had room.” Likewise, he said, states could cover more people if they provided less comprehensive benefits.

Gov. Ted Strickland of Ohio, a Democrat, said: “If we don’t get the money we need, children will go without coverage.”

“In the meeting with the president and Secretary Leavitt,” Mr. Strickland said, “when questions were raised about children maybe having to be removed from the program or eligible children not being able to participate, we were told that that was basically a management problem.”

Gov. Jon Corzine of New Jersey, a Democrat, said that under the president’s proposals “we will end up having fewer children covered.” That prospect “was chilling to some of us,” Mr. Corzine said, adding that states wanted to avoid “rationing health care to our most vulnerable and our most needy.”

Gov. Edward G. Rendell of Pennsylvania, a Democrat, said Mr. Bush’s budget request was “clearly insufficient” to continue coverage for the six million children enrolled in the program.

Many governors want to expand the program, which they see as a foundation for their efforts to expand coverage generally.

Mr. Rendell framed the issue as a choice, asking: “Should we be giving tax cuts to billionaires and millionaires or should we be giving health care to children? Should we make health care for children, at the very least, an entitlement?”

Domestic policy is in a straitjacket because of the cost of the war, the cost of tax cuts and the president’s plan to balance the budget within five years, Mr. Rendell said.

Gov. Arnold Schwarzenegger of California, a Republican, said federal aid was essential to his $12 billion plan for universal health coverage. Mr. Schwarzenegger said that in a private meeting he told the president, “We need the federal government’s help.” He did not say whether he got a commitment.

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