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Posted by on Jul 19, 2009 in Economy, Health, Politics, Society | 29 comments

“Universal” Health Care Is Debatable, Children’s Health Care Is Not

childrens-health-insurance

Although it is very difficult to remain unemotional when the health and welfare of our most precious individuals—children—are involved, I’ll give it a try.

The New York Times has a heart-rending article this morning.

It’s about how some states have been reluctant to repair the safety net, improve health insurance, for their most vulnerable ones, and how other states, 13 of them, “despite budgets ravaged by the recession… have invested millions of dollars this year to cover 250,000 more children with subsidized government health insurance.”

First, some background.

The Children’s Health Insurance Program (CHIP) is a program enacted in 1997, administered by the U.S. government, that provides matching funds to states for health insurance to families with children with incomes that are low, but too high to qualify for Medicaid.

States have flexibility in how they design and implement their S(tate)CHIP; they set their own eligibility levels and some have received waivers to also cover some parents of SCHIP eligible children.

When Congress attempted to reauthorize and expand funding for CHIP, towards the end of the Bush administration, Bush fought such tooth and nail, including vetoing the legislation twice. Congressional Democrats kept the program alive through temporary extensions.

In February 2009, President Barack Obama signed the Children’s Health Insurance Reauthorization Act of 2009 that extends the program through 2013, provides $32.8 billion in new financing over that period, and thereby expands the program to cover an additional 4 million children and pregnant women.

Five months after President Obama signed the legislation and encouraged states to increase enrollment in the program, at least 13 states have done exactly that, “despite budgets ravaged by the recession.”

The states that have expanded health coverage for children are, according to the New York Times:

Alabama, where “Democratic legislators overrode the veto of Gov. Bob Riley, a Republican, to extend coverage to 14,000 children at an additional cost to the state of $8 million.” Democratic State Senator Roger H. Bedford said, “Our economy is tough here, but our decision was to fund the health care needs of our children because a healthy child learns better and they don’t show up at the emergency room needing acute care.”

Kansas, where, “in one of her final acts as governor of Kansas in April, Ms. Sebelius, a Democrat, signed a two-year expansion worth $4.4 million that had been approved by her overwhelmingly Republican Legislature.”

Colorado, where Democratic Governor Bill Ritter Jr. said, “In a downturn, the number of people who need the safety net increases”

Washington, where the broadening of eligibility has now made 8-year-old Sarah, “who endured lung surgery at 3 and heart surgery at 6 and now has asthma,” and who had been uninsured for a year, eligible for the program. According to the Times, Sarah’s mother, Ms. McIntyre, 41, who works part time in a store to supplement her husband’s income as a welder, said: “We were into credit card debt and payday loans…Her medicine at one point was $880 a month, and we had to pay cash, so we were struggling. It is such a relief now that I can just take her to the doctor if I need to and get her medicine.”

The other states expanding eligibility are Arkansas, Indiana, Iowa, Montana, Nebraska, North Dakota, Oklahoma, Oregon, and West Virginia. Ohio’s expanded eligibility has been approved by the Legislature, but its implementation depends on the results of a pending court case.

According to the Times:

The states’ willingness to spend, even under excruciating budget pressures, is a measure of the support for expanding health care coverage to the uninsured as Congress and the administration intensify their negotiations over a new federal health care bill.

And, while 48 states faced budget shortfalls this year, “in those that have managed to expand eligibility, governors and legislators said they viewed CHIP as a cost-effective investment.”

Several states have either decided not to enact previously authorized expansions or failed to pass legislation to expand eligibility or lower premiums.

Among these:

Sarah Palin’s Alaska

Bobby Jindal’s Louisiana.

Rick Perry’s Texas. (We remember well how Gov. Rick Perry rejected $555 million in federal stimulus money to help deal with Texas’ rising unemployment because the stimulus money had “strings attached.” Now, the great state of Texas is asking the federal government for a $170 million loan so that the state can continue paying unemployment benefits.)

Other states are : Jack Markell’s (D) Delaware; Sonny Perdue’s (R) Georgia; Jay Nixon’s (D) Missouri, Beverly Perdue’s (D) North Carolina; and Donald Carcieri’s (R) Rhode island.

And, according to the Times, “in California, the Legislature beat back Mr. Schwarzenegger’s proposal to eliminate CHIP altogether but seems to have accepted the enrollment freeze.”

Finally, the Times:

CHIP, which served about 7.4 million people in 2008, is credited with helping reduce the number of uninsured children by 2.5 million over its first decade. The Congressional Budget Office estimated that the revitalized program would eventually reduce the number of uninsured youths by an additional 4.1 million.

I hope that I have not gotten emotional about this issue, but in my honest opinion, blocking viable, affordable health insurance for America’s adults is one thing. In America, failing to provide vital health care for our children, is another thing—a shameful thing.

Image: Courtesy www.aafp.org

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