President George Bush has said that he’ll veto any increase in funding for the vital State Children’s Health Insurance Program (SCHIP). By itself the threatened and expected veto by the US president speaks volumes about a man and Administration whose prolific tax cuts for the wealthy and super rich are now the things that will define his legacy in much as the Iraq quagmire will. The specter of a president quibbling over a measly $2 billion increase that will help enroll up to 10 million low-income, uninsured children is mind-boggling in its scope even as he gets from Congress $150 billion to fight losing wars in Iraq and Afghanistan.
SCHIP covers low-income children who are not low income enough to qualify for Medicaid and proponents of the increase say that it would help insure millions of children living without health insurance in the richest country in the world. The new increases would make an additional 4 million children get the much-needed health insurance. Ironically, Mr. Bush proposed the $5 billion increase five years ago but now says that the present proposal goes way too far allowing states to cover kids at up to 400% of the poverty level.
The SCHIP bill passed both the Senate and the House last week extending the program for another five years and would increase spending from the $5 billion level to $7 billion a year. The increase will be paid for by a 61% tax on cigarettes. Projections are that this increase would greatly expand the program and realistically enroll up to 10 million children although that seems unlikely based on the way that states handle the enrollment process, public education and advertising of the program
And the vote numbers in both the House and Senate also is an object lesson on the way that Washington works. In the Senate the bill passed by a 67-29 majority while in the House it passed by a 265 -159 margin with eight Democrats joining 151 Republicans. While the Senate has enough votes to override a presidential veto, in the House of Representatives at least 25 congress members would have to come on board with the legislation to beat the Bush veto.
To justify his opposition to the bill President Bush and the White House singled out a provision in the bill that would allow a family of four in New York state making up to $82,600 to qualify for state-paid health insurance, as though that was an outrageous extravagance. Congressional Republicans denounced this as “middle-class welfare,” although given the high cost of living in the state, and particularly in New York City, $82,600 a year for a family of four is little more than a subsistence living.
New York State is a very bad but cunningly calculated choice by President Bush and his Republican cronies. He chose a state where inflation, rents and the cost of living indices are very high when compared to other states in the nation. New York State is the tale of two states – one rich and privileged; the other poor and poorer.
Further, New York is the only state that has proposed to provide health insurance through SCHIP to families with incomes up to 400 percent of the official poverty line. New Jersey has sought to provide SCHIP for families up to 350 percent of the poverty line, and all other states have set the upper limit at 200 to 300 percent (the federal level is 200 percent).
The result is that nearly all children covered by SCHIP live in families with incomes below $63,150 a year (the 300 percent level) and the vast majority live in families with incomes below $41,000 (the 200 percent level). The bill passed by Congress would actually make the New York and New Jersey plans isolated exceptions, by sharply cutting back the federal subsidy when states choose to extend insurance beyond 300 percent of the poverty level.
THE REAL DEAL
President Bush’s stance and that of some of his Republicans in the US Congress are at odds with large sections and groups of business clusters who want the program reformed for their own special reasons. Spurred on by the supine almost timid behavior of the Democrats in the Congress who bowed to Republican pressures to drape part of the SCHIP legislation with immigration clothes Democrats cowardly dropped language in the bill that would have guaranteed the children of legal immigrants to coverage.
And the main insurance lobby – also out of step with the Republican Administration on this one – supported the bill because it understood that Democratic healthcare reform would create a large and lucrative market for their products and services since state governments do no directly run health insurance programs but subsidize purchase of private insurance by families eligible for SCHIP.
PROGRAM BACKGROUND
SCHIP came into being after the Democratic-Republican healthcare war of 1997 when the then Republican-controlled Congress defeated Democratic President Bill Clinton’s comprehensive health insurance program. SCHIP targeted lower-income working families as opposed to the indigent and unemployed who are covered under the federal Medicaid program.
But things have change drastically since President Clinton left office. Today, under President George Bush, there are approximately 48 million people uninsured in America and as states battle to deliver healthcare to growing populations they have taken advantage of federal subsides under SCHIP to extend insurance coverage to as many children as possible.
The program was set to expire on September 30, 2007 since it was enacted for a 10-year period but legislation was passed in Congress to extend the program. Initially, the Bush Administration supported the expansion and the funding for the program including new areas of dental and mental health services. But this August as the 2008 presidential campaign got underway Republicans pressured the White House to demonstrate “fiscal responsibility” by opposing any significant increase in the program calling it “a government-run socialized wolf masquerading in the sheep skin of children’s health.”
And right-wing Republicans in the Congress did not stop there. Using the bill as a tool to attack undocumented immigrants House Republicans also sought to disguise their opposition to health insurance for children by waving the anti-immigration banner. The bill contains reactionary provisions banning the use of federal money to provide health benefits for “illegal” immigrants. House Republicans also demanded more stringent enforcement procedures, including requiring documents like birth certificates or passports from patients seeking medical care, even for the care of newborn babies who, by virtue of being born in the United States, are automatically American citizens.
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