Bush Makes It Harder For Middle Income Children To Get State Health Insurance

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Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pediatrics / Children's Health
Article Date: 21 Aug 2007 - 7:00 PST

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The New York Times reported on Monday that the White House is making it harder for states to bring children from middle income families into the State Children's Health Insurance Program (SCHIP). Instead, the Bush administration, which is currently battling with US Congress over expansion of SCHIP, wants states to focus on making sure the program covers the poorest children first.

Director of the federal Center for Medicaid and State Operations, Dennis G. Smith, wrote to state health departments last week.

In his letter Smith outlined new SCHIP standards whereby states wanting to include children from families whose income is more than two and a half times the federal poverty level (this would be an income of 51,625 dollars for a family of four) can only do so if they can prove they have already covered at least 95 per cent of children in families whose income is less than twice the poverty level and who are eligible for Medicaid or SCHIP.

Federal officials told the New York Times the intention was to get states to focus on children from poorer backgrounds and not allow SCHIP to become a replacement for private insurance.

When they read the letter, some state officials told the newspaper that the new standards could not be met and in effect the move "could cripple their efforts to cover more children".

Deputy commissioner of human services in New Jersey, Ann Clemency Kohler said in an interview that she and her colleagues were "horrified" at the news and that the new federal policy will "cause havoc" to their program and "could jeopardize coverage for thousands of children".

According to the New York Times, several states are either preparing to raise the SCHIP income ceiling from two or two and a half times the federal poverty level or have already done so. Pennsylvania raised the ceiling to 3 times the federal poverty level, California is preparing to raise it to that as well, and in New York state a bill was passed raising the ceiling to 4 times the federal poverty line.

Smith has given state health officials a year to implement the new standards. According to the Washington Post earlier today, Smith wrote there should be no "effect on current enrollees from this review strategy".

Children's welfare groups and members of the Democrat party said the new measures will hurt many children, particularly those whose parents can't get employer sponsored medical insurance.

Executive director of the Center for Children and Families at Georgetown University, Cindy Mann, told the Washington Post that the new standards:

"Would effectively foreclose the opportunity for states to cover children in families with incomes of about 40,000 to 50,000 dollars a year, depending on the size of family."

Both the House and the Senate have passed bills to increase the federal spending on SCHIP so that millions more children can be brought under its wing.

However, President Bush has said a number of times that he will veto both pieces of legislation and that increasing funding for SCHIP beyond that needed to keep it within its current coverage is too much state intervention in the health care system. His administration supports a policy of tax breaks to encourage families to buy private insurance.

Click here to read the full article in the New York Times.

Written by: Catharine Paddock
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