SCHIP Fact Check
posted by Frank Pasquale
As the children’s health insurance bill heads toward a veto from the President, it’s important to discuss exactly why he thinks it so important to keep insurance out of reach of so many kids. After all, about 11% of all children are uninsured. A fact check from the Center on Budget and Policy Priorities helps clarify matters and is heavily quoted below.
On Sept. 20, the President asserted that there was a tension between insuring “poor” children, and expanding the program to those coming from middle class families. I’m a bit skeptical–as employer-based health insurance becomes harder to find, more of the middle class is starting to face the same difficult individual insurance market as the poor. Moreover, consider this analysis from the CBO:
A Congressional Budget Office analysis of the SCHIP bill passed by the Senate last month — which the emerging agreement will closely resemble — found that at least 85 percent of the otherwise-uninsured children who would gain coverage under the bill have incomes below states’ current SCHIP eligibility limits.
Here’s a bit more commentary on the President’s position:
The President’s statement that Congress should “focus on making sure poor children get the health insurance they were promised” is particularly ironic given that on August 31, the Administration announced that it would completely eliminate federal Medicaid matching funds for Medicaid outreach and enrollment activities undertaken by school personnel, even though this is widely recognized as one of the best ways to reach poor children who are eligible for publicly funded coverage but are unenrolled and uninsured.
The administration has also argued that “tax breaks” should be the preferred resolution of the crisis of the uninsured, but “less than one-quarter of the benefits of those tax breaks would go to people who would otherwise be uninsured, according to an analysis by MIT economist Jonathan Gruber.” Gruber is no reflexive liberal–he’s on the conservative wing of Massachusetts’ Connector Clearinghouse for health insurance plans. But people across the ideological spectrum can recognize that a “world in which the sick and dying get to deduct some of the cost of health insurance that they don’t have — and can’t get — on their taxes” isn’t much of a policy accomplishment.
One last point from CBPP after the break:
The President also claimed today that the emerging congressional SCHIP agreement is “an incremental step toward the goal of government-run health care for every American.” This, too, is incorrect. Most SCHIP beneficiaries receive coverage through private managed care plans that contract with their state, not through government doctors. The American Medical Association and the trade associations for the private insurance companies and the drug companies — hardly supporters of “government-run” health care — support expanding SCHIP to cover more uninsured low-income children.
So why is the media still covering the story via its normal “horse-race” narrative–as though somewhere between the two sides an “objective” balance could be found? Jonathan Chait’s The Big Con suggests one reason, as this NYT review relates: “the press, wary of seeming partisan, simply reported the claims on each side rather than analyzing them.”
I have a sense that the press, if it were up to the task, would put one simple question to the Administration: If a government program like the VA could provide good medical care at a cost lower than private plans, would they oppose it simply because it is “government run”? If that is indeed the case, rational argument about health care reform may become impossible.
Hat Tip: TPM.
September 23, 2007 at 8:47 am
Posted in: Health Law
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Responses (4)
Dudley - September 26, 2007 at 10:35 am
The Mainstream Media have been terrible on this story. The Republicans have figured out that media outlets such as AP and NYT are so terrified of appearing subject to the mythical “liberal media bias” that they refuse to do anything other than “he said, she said” type stories.
The Repubicans take advantage of this tendency by just repeading distortions, red herrings, and outright lies, and watch them reported on as if they were true. But sometimes there are not two sides to a story. There was no “other side” to Abu Gharib, there was “other side” to the torture memos, and there is no “other side” to SCHIP. Either you want fewer children to die of preventable causes or you don’t. It’s that simple.
A quick read over the Guardian or the BBC will show you how far ahead the Brits are when it comes to decent journalism and analysis.
AYY - September 26, 2007 at 9:52 pm
Frank, just because it’s not being covered by the NYT doesn’t mean it isn’t being covered by the media. The National Review and Rush have been all over it. See Grace Marie Turner’s Sept 18th NRO article. She says:
“But congressional lawmakers will actually be harming needy children if they move to expand the State Children’s Health Insurance Program (SCHIP) to cover kids in higher-income families, as both houses have voted to do.
Congress has until September 30 to reauthorize the ten-year-old SCHIP. But rather than merely reauthorizing the program, Congress aims to expand SCHIP, allowing states to cover not simply children of low income households, but almost all children.
Expanding SCHIP in such a way, however, would mean shifting focus and resources away from the children who most need help. Moreover, it would grow the program into a massive entitlement that goes far beyond its current mission of helping near-poor children.
. . .
If Congress were truly concerned about covering low-income children, then it would acknowledge that two-thirds of America’s uninsured kids are already are eligible for either Medicaid or SCHIP, but aren’t enrolled. Instead of giving states more money to put higher-income children on SCHIP, Congress should encourage states to enroll children who already are eligible.
Further, access to SCHIP should be restricted to those at or below 200-percent of the federal poverty line — to families earning about $40,000 a year — and not be extended to families at 400-percent of poverty — $83,000 a year or more — as the House wants to do.
The Congressional Budget Office (CBO) found that 89-percent of children in families with incomes between 300- and 400-percent of the poverty line, and 77-percent of children in families within 200- and 300-percent, already have private health care coverage.”
So much for the comment about there being no other side to the SCHIP.
Then you say:
“If a government program like the VA could provide good medical care at a cost lower than private plans”
The Boston Globe (7/18/07) said the folowing about the resignation of former VA secretary:
“It also ends a beleaguered two-year tenure in which Nicholson repeatedly fought off calls for his resignation over the VA’s unexpected $1.3 billion shortfall in 2005 that put healthcare at risk; last summer’s theft of 26.5 million veterans’ personal data in what was the government’s largest security breach; and, more recently, the award of $3.8 million in bonuses to senior officials who were responsible for the agency’s budget problems”
This is what we might have to look forward to.
Frank - September 26, 2007 at 9:59 pm
AYY:
As for “losing focus” on the very poor by helping middle class uninsured: is that really the tradeoff? Or is the cost of SCHIP trivial compared to the following:
http://lawprofessors.typepad.com/healthlawprof_blog/2007/09/schip-in-graphi.html
As for the VA: The article in Washington Monthly provides a number of reasons for thinking the program overall is meeting crucial benchmarks better than others.
And frankly, if there’s some graft at the top as the cost of saving thousands of people from dying painful deaths from lack of insurance, that’s a price I’m willing to pay. You hold government to a much higher standard than the private sector–compare, for example, the backdated options of the United Health CEO, which gained him about a billion dollars of revenue. That’s about 250 times the bonus figures you object to at the VA…for a single CEO at a single insurer.
AYY - September 27, 2007 at 2:26 am
Frank, I’m glad you brought up the points you did.
“Thousands of people dying painful deaths from lack of insurance?” Well, the Republicans are against that too. But that’s not what the issue is. It’s about putting people into a government program when those people have enough money to pay for their own health insurance. So yes, tax incentives would help them.
And yes, a health care CEO shouldn’t be making a billion dollars on backdated options. I’m with you on that too. But aren’t there laws against backdating options. My point was directed more to the 1.3 billion shortfall that risked health care.
So no I’m not holding government to a higher standard than the private sector. And even if I were, isn’t that the reason the left claims that government should be involved in health care– that it will be held to a higher standard?
There’s a program already in place. The Republicans want to increase funding by about 5 billion, and keep private insurance in place The Dems want to increase funding by 35 billion which will get rid of private insurance and will leave the taxpayers to pay for insurance for people who can afford health insurance.
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