HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Monday, July 9, 2007

Child Health Insurance Battle Looms

It is amazing to me how every suggestion of an expansion of health care insurance becomes political .  The New York Times reports today on the impasse over the State Children's Health Insurance Program.    It reports,

The seemingly uncontroversial goal of insuring more children has become the focus of an ideological battle between the White House and Congress. The fight epitomizes fundamental disagreements over the future of the nation’s health care system and the role of government.

Democrats have proposed a major expansion of the program, the State Children’s Health Insurance Program, to cover more youngsters with a substantial increase in federal spending.

Administration officials have denounced the Democratic proposal as a step toward government-run health care for all. They said it would speed the erosion of private insurance coverage. And they oppose two of the main ideas contemplated by Democrats to finance expanded coverage for children: an increase in the federal tobacco tax and cuts in Medicare payments to private insurance companies caring for the elderly.

White House objections to the Democratic plan are “philosophical and ideological,” said Allan B. Hubbard, assistant to the president for economic policy. In an interview, he said the Democrats’ proposal would move the nation toward “a single-payer health care system with rationing and price controls.”

Democrats said the insurance program, created 10 years ago with bipartisan support, had improved access to care for millions of children and sharply reduced the number who were uninsured. Democratic leaders in both houses of Congress — with support from doctors, consumer groups and many state officials — want to increase enrollment in the program, which served 7.4 million people at some time in the last year. . . . .

To return the children’s insurance program to what he calls “its original intent,” Mr. Bush has asked Congress to reduce federal payments to the states for coverage of children in families with incomes of more than twice the poverty level. (A family of four is considered poor if its annual income is less than $20,650.) At least 18 states cover children with family incomes more than twice the poverty level. . . .

Mr. Bush and some Republicans in Congress worry that as public coverage becomes available to families with higher incomes, it tends to replace private coverage.

In a recent report, the Congressional Budget Office said that for every 100 children who get public coverage as a result of the children’s insurance program, “there is a corresponding reduction in private coverage of between 25 and 50 children.”

That increases the cost of efforts to expand coverage, according to the budget office, because the government inevitably picks up some people who recently had private insurance when it tries to sign up the uninsured. Thus, the budget office said, to reduce the number of uninsured children by three million, states may need to add four million to six million children to the rolls.

Peter R. Orszag, director of the budget office, said that other efforts to expand coverage — for example, by offering tax breaks for buying private insurance — faced a similar challenge: some benefits would go to people who already had coverage.

How horrible - the government might actually provide help to people who don't immediately need it -- I don't recall this concern when the Bush tax cuts were enacted.

Update:  Dean Baker has some additional thoughts on the manner in which health care reform and health care proposals are being debated this year.

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