The Children’s Defense Fund’s top policy goal in 2007 has been comprehensive health coverage for all 9 million uninsured children and pregnant women in America. It will remain our top priority until we succeed. Meanwhile, pending congressional legislation gives new hope to three to four million children across the country. The House of Representatives and the Senate passed bills to reauthorize the State Children’s Health Insurance Program (SCHIP) for another five years, with new funding and some policy improvements that will extend health coverage to millions of currently uninsured children.
Enacting legislation to strengthen and improve SCHIP is a vital national priority. Simply put, this legislation will save children’s lives and improve health for generations to come. However, passing the House and Senate bills is only the first step on the road to final passage. A Senate-House conference committee will soon begin working out the differences between these measures to forge a compromise bill, which must be approved by both houses of Congress before it reaches President Bush, who is threatening to veto it. Time is of the essence because SCHIP, which presently provides health coverage for more than 6 million children, expires on September 30.
Both bills give states the option to provide health coverage to children and pregnant women in low-income working families who earn too much to be eligible for Medicaid but can’t afford private health insurance. The House bill would add more than $47 billion for children’s health coverage over the next five years, reducing the 9 million currently uninsured children by 4.2 million. The bipartisan Senate bill would only add $35 billion for children’s health coverage over five years and with fewer policy improvements, allowing states to cover 3.2 million additional uninsured children.
What is required now is statesmanship and political will. In part, this means that members of Congress must brush aside pressures from powerful tobacco and insurance industry lobbies, which are fighting these bills.
Both bills would pay for the expansion of SCHIP by increasing the federal tax on tobacco, the House bill by 45 cents for a pack of cigarettes and the Senate bill by 61 cents. The House bill also would redirect funds from overpayments to insurance companies in the Medicare Advantage program, a scheme that costs the Medicare program an additional $1,000 for each senior enrolled in the program. Together, these two approaches would generate more than enough revenue to strengthen and improve SCHIP.
These funding methods are also good policy.
Tobacco is a dangerous, addictive drug. According to the American Lung Association, cigarette smoking causes about 438,000 deaths each year and hundreds of thousands of cases of heart, lung and respiratory diseases. The resulting costs to society—in shortened life spans, lost productivity, and increased health care expenditures—are astronomical. Raising taxes on tobacco will not only provide desperately needed funds, but help deter children and teenagers from smoking in the first place.
Reducing government overpayments to insurance companies through Medicare Advantage programs is completely justified. Insurance companies have profiteered from the overpayments to this program, which was originally intended to save money and provide better health care for seniors. Rather than benefiting seniors, a large portion of these expensive overpayments has gone toward insurance company profits, marketing expenses, and administrative costs. The overpayments are a drain on taxpayers and have also resulted in higher premiums for all seniors participating in traditional Medicare. Eliminating these overpayments would not throw seniors off the Medicare program, as has been charged, but would actually strengthen the program.
In the richest country in the world, children, who are the least expensive and most cost-effective group to insure, shouldn’t have to wait until they are 65 to be covered by a national health safety net. And the Children’s Defense Fund is disappointed that Congress is leaving the fate of some children to the lottery of geography where the quality of care varies from state to state.
Virtually all industrialized democracies provide health care to all their children. The American people overwhelmingly support providing coverage for all our children. While the SCHIP legislation moving through Congress right now does not cover all uninsured children, it takes an important step in the right direction. In 2008, we need to finish the job of extending coverage to the millions of children left behind by our political leaders.
For now, I hope the congressional conferees adopt the House-passed SCHIP funding and improvements, and I urge President Bush to sign the SCHIP bill when it reaches his desk instead of vetoing it as he has threatened to do. The time to act is now.