Losing Touch with Reality

Losing Touch with Reality

- in Weekly Briefing

Will the Far Right Come to Its Senses on Children’s Health Care?

By Rob Schofield

Quick Take:

  • With a deadline looming, Congressional leaders have reached a bipartisan agreement to extend and expand the popular and successful Children’s Health Insurance Program.
  • Unfortunately, President Bush is threatening to veto the proposal. He argues for an alternative that would result in cuts to current service levels.
  • The events of the coming week seem likely to resolve the issue. Positive action from either of North Carolina’s U.S. senators could make an enormous difference. 

Last Friday, leading members from both parties in the U.S. Senate reached an agreement on a renewal and expansion of the highly successful State Children’s Health Insurance Program (a.k.a., “”SCHIP” or “CHIP”, or here in North Carolina, “Health Choice”).  The program, which underwrites most of the cost of providing health insurance to millions of poor children throughout the nation, is scheduled to expire this coming Sunday.  

Here’s what a leading Republican negotiator told the Washington Post after the agreement was reached:

"This legislation will get the Children’s Health Insurance Program back on track and reclaim precious resources for low-income kids," said Sen. Charles E. Grassley (R-Iowa), one of the lead negotiators. "It breaks the legislative impasse and should have strong support from both Democrats and Republicans."

Unfortunately, this is apparently not the view of some intransigent market fundamentalists – including George W. Bush. According to his most recent statements on the matter and the comments of aides after the agreement was announced, the President plans to veto the package because it attempts to expand coverage to children other than just the poorest of the uninsured.

Despite the bipartisan nature of the SCHIP agreement, the president views the deal as “an incremental step toward the goal of government-run health care for every American.” His Secretary of Health and Human Services made the following rather remarkable statement in this regard:

"We desire to see SCHIP continue to cover those children who are under 200 percent of the poverty line. We believe that the $5 billion is adequate to do that. If it isn’t, then we’re prepared to talk about what the number should be. But it’s the policy, the ideologic (sic) question that we want to focus on.”

In other words, the most important thing to the Bush administration and its few remaining allies on the far right when it comes to one the central challenges facing our nation (how to provide healthcare for our children) is this: “ideologic” purity. Somehow, according to this strange and twisted view of reality, when children whose parents make 200% of the federal poverty guideline (FPG) receive assistance it’s okay, but when such assistance is provided to children whose parents earn 225% of FPG, it’s a step toward “socialized medicine.”      

What’s At-Stake?

SCHIP is one of the most successful government human services programs in recent American history. Since it was initiated in 1997, the number of uninsured poor children has actually declined by a third, even as the number of uninsured American children overall has risen. More than six million kids now enjoy health insurance coverage as the result of SCHIP. In North Carolina, 130,000 children are now covered by Health Choice.

The benefits of expanded healthcare coverage for poor children are significant and unsurprising. According to the national nonprofit, Families USA,

“CHIP is vital to improving children’s health care. Children enrolled in CHIP or Medicaid are three times more likely to have a usual source of care than are uninsured children. And CHIP reduces the percentage of children with an unmet health care need. Children enrolled in CHIP or Medicaid are one-and-a-half times more likely than uninsured children to receive well-child care, see a doctor during the year, and get dental care. Clearly, CHIP and Medicaid are critical programs that allow otherwise uninsured children to get the health services they need.”

In recent years, the remarkable success of SCHIP has motivated state political leaders throughout the country to move to expand the program. Several states, including North Carolina, have liberalized the eligibility criteria in order to allow large numbers of near poor and lower-middle class children to be enrolled.    

This year, when it came time to reauthorize the program, Congress followed the lead of the several states and moved to expand the program’s coverage. Right now, it is estimated that there are around nine million uninsured children in the country and approximately 270,000 in North Carolina. According to the best estimates, the new reauthorization language agreed to last week could cut those numbers in half at a cost of around $35 billion in new spending over five years (or about three to four months’ expenditures on the Iraq war at current spending rates) .  

In contrast, the President’s proposal of $5 billion in new money over five years would, according to the Congressional Budget Office, actually result in cuts to current coverage rates. His solution: Make private insurance more affordable. How and when this might be accomplished in the real world, however, he really doesn’t say. Given that private insurance costs remain formidable (often prohibitive) for even middle and upper middle class families at present, the notion that any kind of quick, “private” solution might be found on the time frame of an SCHIP expansion seems to be a fantasy.

Where are Dole and Burr?

As with so many issues in recent years (see last week’s Weekly Briefing), North Carolina’s most visible national politicians have been missing in action on SCHIP. Both Senators Dole and Burr voted against the bi-partisan Senate bill that is at the heart of the new compromise. Both have remained loyal to the President’s hard line position in favor of cutting children off the program and have not, as of today, sent any public signals that they intend to rethink their approach.

Indeed, a search of the two senators’ respective websites produced only one reference in the last three months to the topic of health care – a July press release regarding a widely panned proposal to promote more private health insurance company coverage. Neither has apparently seen fit to say much of anything – much less stake out a leadership position – on the most important and visible domestic policy debate confronting the country at the present moment.

The lack of action from Dole and Burr is disappointing. Both were elected to their current seats on promises to be moderate problem solvers – senators who put getting things done ahead of “ideologic” purity. If either acted upon these promises now, the logjam in Washington could be easily broken. Unfortunately, at this point, it appears that both of North Carolina’s senators are placing loyalty to their market fundamentalist president over the immediate well-being of millions of innocent kids. Let’s hope they have a change of heart.    

About the author

Rob Schofield, Director of NC Policy Watch, has three decades of experience as a lawyer, lobbyist, writer and commentator. At Policy Watch, Rob writes and edits daily online commentaries and handles numerous public speaking and electronic media appearances. He also delivers a radio commentary that’s broadcast weekdays on WRAL-FM and WCHL and hosts News and Views, a weekly radio news magazine that airs on multiple stations across North Carolina.