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Hey Pennsylvania: How dare you try to give poor-but-not-the-very-poorest kids doctors!
Submitted by jennifer on Mon, 08/20/2007 - 8:20pm.
When your head hurts from wishing everything you read in the New York Times was an Onion article:
The White House just adopted restrictive standards for CHIP, the program that insures poor children across the United States. They tried to block expanded funding for the program, because--god forbid--this would mean taxing the tobacco industry. Cigarettes versus children's health? Easy choice for this president.
Congress passed the funding anyway, and now the White House has promulgated strict federal standards that keep states including Pennsylvania from providing free children's health insurance to anyone but the very poorest people. The idea is that if a state wants to raise the eligibility bar to insure more children, they must first prove that they have enrolled 95% of the children in the state at below 200% of the line, practically speaking, a very difficult task. Don't take my word for it:
Cindy Mann, a research professor at the Health Policy Institute of Georgetown University, said, “No state would ever achieve that level of participation under the president’s budget proposals.”
If unchallenged, this would mean that many children who are currently eligible for CHIP in Pennsylvania, which says that anyone at 300% of the poverty line is eligible, could be knocked off the books and back to being uninsured. Well, the president says that they'd be encouraged to re-enter the private market. But that takes money, and even 300% of our ridiculously low official poverty rate ($20,650 for a family of four!) doesn't give you all that much. Not to mention that the president's chosen bugbear, the threat to private insurance, is not supported by evidence:
In New Jersey, which has a three-month waiting period, Ms. Kohler said, “we have no evidence of a decline in employer-sponsored coverage resulting from the Children’s Health Insurance Program.”
From the states:
After learning of the new policy, some state officials said today that it could cripple their efforts to cover more children by imposing standards that could not be met.
Ann Clemency Kohler, deputy commissioner of human services in New Jersey, said: “We are horrified at the new federal policy. It will cause havoc with our program and could jeopardize coverage for thousands of children.”
Stan Rosenstein, the Medicaid director in California, said the federal policy was “highly restrictive, much more restrictive than what we want to do.”
Currently Pennsylvania covers those at 300% of the poverty line, recently raised from 200. California is at 250 and wants to go to 300. New York is at 250 and has legislation introduced to raise it to 400. New Jersey's been at 350.
For administration conservatives to make this move to cut off state-approved expansion of CHIP is shameful. Aside from tossing federalism out the window whenever convenient (medical marijuana, children's health coverage), no one wants this. No one except politicians bound to serve the interests of the insurance and tobacco lobbies before that of among the most vulnerable citizens.
This kind of thing makes real bad headlines. It's somewhat amazing that fact isn't enough to stop such a callous move, even if basic human emotions like shame do not seem to kick in.
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PS
From the article: "If a state wants to set its income limit above 250 percent of the poverty level ($51,625 for a family of four), Mr. Smith said, “the state must establish a minimum of a one-year period of uninsurance for individuals” before they can receive public coverage."
Uninsurance!
It's unbelievable how believable this stuff is
Thanks for drawing our attention to this, Jennifer.
You know, I'm tempted to write a screed here again about the dangers of ideology here, but you know what: ideology isn't really the issue. Free Market Ideology is just a smokescreen for stuff like this. The Bush Administration and its allies are bought and paid for. That's the real explanation.
---
BradyDale OnLine
The R.I.I.C. Blog
The Philadelphia Unemployment Project
Political Strategy re Health Care
The conventional wisdom about health policy is that we have to whittle away at the problem, expanding programs to provide health insurance little by little preferably by using rather than directly attacking the private health insurance market. This is the rationale for backing Governor Rendell's health proposals, which I fully support.
But while that stategy makes sense at the state level, I wonder whether at the federal level it is simply time to go straight to single payer national health insurance. For so long as there is a large private health insurance market, there will be enormous political pressure to stop the expansion of government provided health insurance and limit government regulation of the private market. In addition, so long as we have allow employer based health insurance to continue, we won't have the political support of large corporations who have a real interest in replacing their health insurance plans with government provided insurance.
Think, for example, of the student loan programs. For the last thirty years we have gone back and forth, limiting private lenders and reducing costs for students when Ds were in poer and expanding their role and increasing costs for studetns when Rs are in power. Do we want that to happen with health insurance?
It is hard to generate the political will and create the coalition for health insurance. And it is harder to sustain it over time as the health insurance industry launches a counter-attack over many years. We may have to drive a stake through the heart of the industry to attain the goal we really want, health insurance for everyone.
I'm just thinking alound here and am not sure of any of us.
It's not a free market at all
It's not a free market at all. The new federal guidelines dictate the terms of competition between the gov't provided health care and what's currently available from private insurers. And those guidelines basically say, the gov't-provided health care isn't allowed to compete. It's a fixed market. In a free market, CHIP wins.
It's an especially sore issue for me. My wife and I are expecting a son in September, who we're enrolling (or are planning to enroll) in SCHIP, since it provides better coverage at a (much) better price than either of our employers. And we're just about at 250% of the poverty line. It's as though the federal government reached out, plucked us out of thin air and said, "screw you."
--Tim
Ah! Congratulations!
that is so exciting. and so soon!
Also is one of those two employers Penn? Sad.
We are very excited.
We are very excited.
Penn is not great for dependent care for its graduate students. Actually, very few schools are. The situation is much better for bona fide employees.
But for grads, no health care subsidy, no child care assistance. You can request an unpaid leave of up to one year if you deliver a child (the policy specifically states "student mothers"), but otherwise, bupkus. It puts students who don't have independent means in a very difficult position, since regardless of advances in family planning, your reproduction is never something of which you're in total control.
To some extent, academia has never fully caught up -- the ideal still seems to be the Oxford dons, all-male celibate knights for knowledge.
"To minimize the risk of
"To minimize the risk of such substitution, Mr. Smith said in his letter, states should charge co-payments or premiums that approximate the cost of private coverage and should impose “waiting periods,” to make sure higher-income children do not go directly from a private health plan to a public program."
Basically he's arguing that the public system should be intentionally crippled to even the playing field with the current private HMO system, to keep people from trying to switch to the public system.
I really wish this hypocracy were bigger news than they will be. HMOs can't even "compete" with the poorly-funded public healthcare programs that we do have in the US. The same applies to Medicare, where the government pays the private plans more money for the same procedures than it pays public Medicare.
SCHIP and Medicare are more cost-effective than private insurance alternatives, despite the way the system is set up against them. It flies in the face of the right's free market ideology.
SCHIP cuts hurt voters
I organized a press conference in Harrisburg earlier this summer with Governor Rendell and both U.S. Senators in attendance, supporting full funding for SCHIP. One of the people who spoke at that press conference was a single mom with two teenaged daughters, who was unable to pay for family coverage (her employer only covered her) until the SCHIP program in PA expanded its income limits.
She was a school nurse, and she made decent money--but the cost of providing housing and healthcare was more than her salary could bear.
We also had, at that press conference, a nurse from a pediatric cancer ward in a hospital, who talked about the difference between treating a kid who had early-stage cancer (caught by a pediatrician at a check-up), versus caring for a kid with late stage cancer, who had, because of a lack of insurance, been diagnosed much later.
I think the Administration has seriously miscalculated the popularity--and necessity--of this program for many eligible voters in the states affected by their policy change.
Finally--a bit of organizational self-promotion--SEIU, in conjunction with other allies who are interested in children's healthcare, has been working to ensure full-funding of SCHIP in this year's reauthorization. There's a petiton online here.
You can also download petitions to circulate at the SEIU Healthcare website. We'll be having a press event to present one million of these signatures in DC in mid-September.
The self (and it's not even really that) -promotion is great
I'm glad someone showed up with concrete steps for voters to take.
argh
sorry, my link didn't work. here is the url: http://seiuaction.org/campaign/careforkids_fundschip
Good article by Howard Meyerson in today's (8/22) WP
Meyerson points out how it appears that Bush's health care policies appear to be based on the classics; in this case, on Charles Dickens' _Oliver Twist._ I've linked it below.
http://www.washingtonpost.com/wp-dyn/content/article/2007/08/21/AR200708...
-Z
A-mazing
"How else to explain what's historically distinctive about George W. Bush and his administration save to note that this is the only American presidency that takes its moral guidance from Limbkins, Bumble and kindred Dickensian grotesques?"
As a friend of mine said elsewhere on the internet, in explaining how they had faced an imposed waiting period after losing private market insurance:
"We were facing this stipulation when our family coverage premium doubled last year and my employer could no longer cover the difference. Our only option was to go without insurance on our then 5-month old before he would be eligible for CHIP. Hell, why not just leave him in the woods to fend for himself for a year. I mean seriously what is this, the middle ages?"
It's worse
The US, under the reign of king shrub- the only person to ever attain the office through right of fillial succession- the US is eerily close to becoming a massively-armed third world country. Think about it: what do we actually make anymore, other than weapons and the soldiers to use them? Precious little.
And, like any decent third world country, we have a tiny but increasingly-rich upper class which controls a growing percentage of the nation's wealth, + a much larger group of poor which has less and less.
We are, in other words, going out of our way to make Marx's prediction of a revolution of the proletariat correct. This a mere ~ 20 years after the greatest middle class in the world had seemingly proved Marx wrong. Clearly, we didn't count on the orthodox Marxist theoreticians of the Republican Party. They knew precisely how to set things up for the revolution which they, clearly, desire so desperately.
Viva la revolution! And off with their heads, while we're at it.
'A Modest Proposal,' if you would,
-Z