And to be brutally honest about it, the worry about crowd-out is overblown in any case. Why? Because if current trends continue (And there is no reason to suppose they won’t.) the people at this level of income are going to be losing their employer provided health care in the not too distant future in any case. I work for a small business and at the rate insurance costs are being jacked up who knows how much longer they’ll be able to afford it? I have yet to see any proposal that includes leaving the existing insurance companies in place as they currently practice business that will do anything to improve the situation.

So what?

Grow up.

Did her income suddenly increase when the child was born, making her and her child ineligible? I don’t think so.

She gets on S-CHIP (doesn’t have to be on Medicaid already), then her child gets on the program as well. The program grows. This is probably the intent of the authors of the bill; the same is likely for the incursion into employer-based insurance. (There is no doubt the new state options would be exercised; the state governments love the federal matching-rate funds.)

So what? Try some logical thinking. A pregnant woman applies for aid. She fills out the paperwork and is found to qualify. Why should another batch of paperwork be generated when the child is born? Did her income suddenly increase when the child was born, making her and her child ineligible? I don’t think so. Whatever objection your 6:58 post was trying to make doesn’t make much sense.

pre-natal care

This would be the predictable argument for adding pregnant women. (Ironically, often it’s by many who are zealots about abortion and government-financed abortion services.)

The result of women receiving assistance is

(e) Automatic Enrollment for Children Born to Women Receiving Pregnancy-Related Assistance- If a child is born to a targeted low-income pregnant woman who was receiving pregnancy-related assistance under this section on the date of the child’s birth, the child shall be deemed to have applied for child health assistance under the State child health plan and to have been found eligible for such assistance under such plan or to have applied for medical assistance under title XIX and to have been found eligible for such assistance under such title, as appropriate, on the date of such birth and to remain eligible for such assistance until the child attains 1 year of age. During the period in which a child is deemed under the preceding sentence to be eligible for child health or medical assistance, the child health or medical assistance eligibility identification number of the mother shall also serve as the identification number of the child, and all claims shall be submitted and paid under such number (unless the State issues a separate identification number for the child before such period expires).

which probably was not merely coincidental when the bill was written.

crowd-out really isn’t being reduced, just studied

In case you didn’t notice, the bill claims to address crowd-out by studying the matter — while extending the subsidy for child insurance to people with insurance through their employer.

We know what results are desired by proponents.

I didn’t mean that you were a right-wing ally- I know you don’t like a lot of the things the Bush administration has done. What I meant was that the talking points fit your ideology and you believe them. Sorry for the confusion.

1. Thank you.

2. The thing to do here probably is just to look at the bill itself. It does continue to cover some adults; in fact it adds new adults to the system (probably because pregnancy is associated with children); it’s basically adding pregnant women (and their children, later), freezing and trying to phase out parents (though with a separate grant nobody is, or should be, fooled), and cutting off childless adults. (I speculate that this was the result of some of the bargaining among the Democrats and Republicans.) The raising of the poverty level that defines low-income qualifications from 250 per cent in the Bush rules to 300 per cent in this bill is a direct challenge to Bush, as is the adding of pregnant women. More remarkable, though subtle, in that it’s not even been discussed widely, is the new subsidy for existing employer insurance (section 301). It really is an incrementalist encroachment into the private sector. Here are key details:

A State may elect to offer a premium assistance subsidy (as defined in subparagraph (C)) for qualified employer-sponsored coverage (as defined in subparagraph (B)) to all targeted low-income children who are eligible for child health assistance under the plan and have access to such coverage in accordance with the requirements of this paragraph. …

a group health plan or health insurance coverage offered through an employer–

`(I) that qualifies as creditable coverage as a group health plan under section 2701(c)(1) of the Public Health Service Act;

`(II) for which the employer contribution toward any premium for such coverage is at least 40 percent; and

`(III) that is offered to all individuals in a manner that would be considered a nondiscriminatory eligibility classification for purposes of paragraph (3)(A)(ii) of section 105(h) of the Internal Revenue Code of 1986 (but determined without regard to clause (i) of subparagraph (B) of such paragraph).

`(ii) EXCEPTION- Such term does not include coverage consisting of–

`(I) benefits provided under a health flexible spending arrangement (as defined in section 106(c)(2) of the Internal Revenue Code of 1986); or

`(II) a high deductible health plan (as defined in section 223(c)(2) of such Code), without regard to whether the plan is purchased in conjunction with a health savings account (as defined under section 223(d) of such Code).

That’s not providing subsidized insurance to people who don’t have it, and are typically assumed to not be able to get it or afford it. That is providing subsidies to people who currently have traditional insurance through their employer.

It just seems like every issue gets clouded over by misinformation campaigns that support the Bush position.

Or that oppose it.

Well, we do know the President is clarity- and diction-”challenged” and that doesn’t help. Why didn’t he just explain things plainly, as dumb DLS has done? Pregnant women are being added, the additional-block-grant game is just that, a game, when it comes to parents, crowd-out really isn’t being reduced, just studied, the tobacco tax is regressive and counter-productive (outrageous in the case of cigars, like the 10,000% tax on ammunition sought by anti-gun members of Congress in the past), and the subsidy is being aimed at existing employer insurance, which really is a stealthy (it’s not discussed or admitted by the bill’s proponents) encroachment into the private sector. And this is a program that provides federal money to “match” state expenditures, and federal, not state law — this really is incremental federalization of health care. Many will say “Yes!” to the question, “Is that what we want?” but we should be honest first about what is wanted and what is sought. And openly defying Bush’s new rules and obvious objectives for the program of course is risking and even earning a veto. Bush is very weak and while many of you may think he simply was stupid, he probably was counseled that given the details of the bill, he can veto it. (Not that such a big spender can object to it on cost grounds alone.)

Now let’s see if Congress will override the veto, will try to pass the same legislation multiple times (very childish as well as counter-productive), or will modify the bill and make it cleaner and less expansive and ambitious, and dare Bush to veto it, too. (Lower the poverty-level threshold to 250 per cent from 300, for example; strike the new features like pregnant women and employer insurance subsidies; make it funded out of general revenue, something of a cop-out but no longer regressive; they can override those rules they most object to if they conform to others that the public more easily grasps and if they drop what is truly seen as expansion in the scope of the program — make it primarily or even only about poor children next time)

if you scroll on down past the section that DLS quoted you’ll find the whole text of the bill. … it is understandable if you can work your way through it

Obviously. I provided the section numbers as a convenience. Just search the text for the desired section number to jump to it quickly. The bill itself was shown in case you were ready to claim the speaker as well as I was lying. I wasn’t, of course.

Interestingly, what is proposed to combat crowd-out begins with…not action, like the Bush administration’s new rules, but studies:

a) Findings-

(1) Congress agrees with the President that low-income children should be the first priority of all States in providing child health assistance under CHIP.

(2) Congress agrees with the President and the Congressional Budget Office that the substitution of CHIP coverage for private coverage occurs more frequently for children in families at higher income levels.

(3) Congress agrees with the President that it is appropriate that States that expand CHIP eligibility to children at higher income levels should have achieved a high level of health benefits coverage for low-income children and should implement strategies to address such substitution.

(4) Congress concludes that the policies specified in this section (and the amendments made by this section) are the appropriate policies to address these issues.

(b) Analyses of Best Practices and Methodology in Addressing Crowd-Out-

(1) GAO REPORT- Not later than 18 months after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Finance of the Senate and the Committee on Energy and Commerce of the House of Representatives and the Secretary a report describing the best practices by States in addressing the issue of CHIP crowd-out. Such report shall include analyses of–

(A) the impact of different geographic areas, including urban and rural areas, on CHIP crowd-out;

(B) the impact of different State labor markets on CHIP crowd-out;

(C) the impact of different strategies for addressing CHIP crowd-out;

(D) the incidence of crowd-out for children with different levels of family income; and

(E) the relationship (if any) between changes in the availability and affordability of dependent coverage under employer-sponsored health insurance and CHIP crowd-out.

(2) IOM REPORT ON METHODOLOGY- The Secretary shall enter into an arrangement with the Institute of Medicine under which the Institute submits to the Committee on Finance of the Senate and the Committee on Energy and Commerce of the House of Representatives and the Secretary, not later than 18 months after the date of the enactment of this Act, a report on–

(A) the most accurate, reliable, and timely way to measure–

(i) on a State-by-State basis, the rate of public and private health benefits coverage among low-income children with family income that does not exceed 200 percent of the poverty line; and

(ii) CHIP crowd-out, including in the case of children with family income that exceeds 200 percent of the poverty line [but the laws they change use 300 per cent as the threshold]; and

(B) the least burdensome way to gather the necessary data to conduct the measurements described in subparagraph (A).

Out of any money in the Treasury not otherwise appropriated, there are hereby appropriated $2,000,000 to carry out this paragraph for the period ending September 30, 2009.

permitting a delay well past the 2008 elections until anything real is actually considered and done. And yes, the low-income definition limit is raised from 250 to 300 per cent of the federal poverty level or “line” as is the word used in the text. And I haven’t yet mentioned the additional employer-insurance subsidy in section 301. But it’s there if you care to look.) Adults are covered by this program and in fact are added to the program (pregnant women may be added).

“As in the past, I was wrong again, DLS. I’m sorry.”

Prioritizing children’s coverage. The agreement makes several modifications as it relates to populations eligible for CHIP.

Pregnant Women: The agreement provides coverage to pregnant women as a new state option as well as preserving the options to cover them through a state waiver or through regulation.

Parents: The agreement prohibits any new waivers to cover parents in the CHIP program. States that have received waivers to cover low-income parents under CHIP will be allowed to transition parents into a separate block grant. The federal match for services to parents covered through CHIP will be reduced.

Childless Adults: The agreement retains the current law prohibition of waivers to allow coverage of childless adults. Currently covered childless adults will transition off CHIP. For states that have received CHIP waivers to cover childless adults, the agreement terminates those waivers after a one-year period, provides temporary Medicaid funding for already-enrolled adults, and allows states to apply for a Medicaid waiver for coverage.

Wow. So they tried to not hose people who are already being helped because of waivers their state applied for too much. How evil of them.

Because of tireless efforts to undermine a much needed measure, I would support this bill now even if I knew it was the worst bill in the history of mankind.. Anything to oppose that kind of near-sighted, thinking.

It never ceases to amaze me, how successful the administration and its right-wing allies are at disseminating false information when it supports their position.

First of all, you’re rushing to an invalid conclusion (maybe because you’re upset). I am not a “right-wing ally of the Bush administration” merely because I supported the veto decision.

Second, “adults” includes not only childless adults (the most notorious group of beneficiaries), but parents as well as pregnant women, who are being added to, not removed from, S-CHIP. This bill does not promptly remove all adult beneficiaries from S-CHIP:

Pregnant Women: The agreement provides coverage to pregnant women as a new state option as well as preserving the options to cover them through a state waiver or through regulation.

Parents: The agreement prohibits any new waivers to cover parents in the CHIP program. States that have received waivers to cover low-income parents under CHIP will be allowed to transition parents into a separate block grant. The federal match for services to parents covered through CHIP will be reduced.

Childless Adults: The agreement retains the current law prohibition of waivers to allow coverage of childless adults. Currently covered childless adults will transition off CHIP. For states that have received CHIP waivers to cover childless adults, the agreement terminates those waivers after a one-year period, provides temporary Medicaid funding for already-enrolled adults, and allows states to apply for a Medicaid waiver for coverage.

In addition, the bill does something else, besides implementing taxes on tobacco, that would naturally be asking for a veto. It overrules the rules issued by the Bush administration on S-CHIP that had addressed the income-level crowd-out problems (requirements that would effectively prohibit extension of coverage above 250 per cent of the poverty level; a one-year waiting period to discourage replacing private insurance with S-CHIP subsidized insurance). These are the rules a few states are suing to have overturned, rules that this bill would override:

Agreement Replaces CMS August 17th Letter to States. The Congress agrees with the President on the importance of covering low-income children have health coverage while taking steps to address crowd-out and prioritize coverage of lower income children. The agreement replaces the flawed CMS August 17th letter to states with a more thoughtful and appropriate approach. In place of the CMS letter, the agreement gives states time and assistance in developing and implementing best practices to address crowd out. The agreement also puts the lowest income children first in line by phasing in a new requirement for coverage of low-income children as a condition of receiving CHIP funding for coverage of children above 300 percent of the poverty level.

Naturally Bush would be motivated to veto an override of rules his administration issued to constrain the scope of the program and reduce crowd-out (and raises the low-income limit from 250 to 300 per cent).

It helps to know what the current program is and what is in the bill. Do you know?

This “false” falsehood is getting annoying, not merely tiresome.

Pregnant women are not children. Parents (typically) are not children.

Sec. 111. State option to cover low-income pregnant women under CHIP through a State plan amendment.

Sec. 112. Phase-Out of coverage for nonpregnant childless adults under CHIP; conditions for coverage of parents.

Sec. 113. Elimination of counting Medicaid child presumptive eligibility costs against Title XXI allotment.

Sec. 114. Limitation on matching rate for States that propose to cover children with effective family income that exceeds 300 percent of the poverty line.

Sec. 115. State authority under Medicaid.

Sec. 116. Preventing substitution of CHIP coverage for private coverage.

DLS is typical of so many conservatives who are presenting their talking points- points that aren’t contained in the actual legislation, but that might sway public opinion in their direction.

Do you know the history of this program?