Tin ear for politics
I'll sometimes wonder whether Bush can make the SCHIP issue so uncomfortable for congressional Republicans that they'll ultimately defect in large enough numbers to override a veto. Pretty soon there after, though, I come crashing back to planet earth. But still!
The Bush administration, continuing its fight to stop states from expanding the popular Children’s Health Insurance Program, has adopted new standards that would make it much more difficult for New York, California and others to extend coverage to children in middle-income families.Administration officials outlined the new standards in a letter sent to state health officials on Friday evening, in the middle of a monthlong Congressional recess. In interviews, they said the changes were intended to return the Children’s Health Insurance Program to its original focus on low-income children and to make sure the program did not become a substitute for private health coverage.
After learning of the new policy, some state officials said yesterday that it could cripple their efforts to cover more children and would impose standards that could not be met.
Anybody interested in running as a Republican in '08? Anybody? Bueller?
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Here's the link to the NYT article Brian quotes above.
Bush protects the private insurance companies from evil state governments. Yes, that's right. Federalism, Bush style.
The Next Hurrah: The beef with SCHIP that Bush has? It interferes with private insurance. Forget about the fact that there are millions children currently uninsured, and millions more that are underinsured. Nothing could be clearer in terms of the priorities of this Administration.
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.
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. [emphasis added]
The NYT: The poverty level for a family of four is set by the federal government at $20,650 in annual income. Many states have received federal permission to cover children with family incomes exceeding twice the poverty level — $41,300 for a family of four. In New York, which covers children up to 250 percent of the poverty level, the Legislature has passed a bill that would raise the limit to 400 percent— $82,600 for a family of four — but the change is subject to federal approval.
California wants to increase its income limit to 300 percent of the poverty level, from 250 percent. Pennsylvania recently raised its limit to 300 percent, from 200 percent. New Jersey has had a limit of 350 percent for more than five years.
Firedoglake makes some good points:
Under the new rules, states would have to:
- Prove that 95 percent of those eligible at the 200 percent of the poverty level are covered before allowing kids in families at 250 percent of the poverty level to be covered. State officials all agree this standard cannot be met, which means the state would not only be prohibited from expanding eligibility to more children in the future but also have to scale back current expanded eligibility rules. In other words, children above the poverty line and currently covered by SCHIP could be removed from the program because the state can’t meet the condition for covering them. [emphasis added]
- Demonstrate that raising the eligibility standard would not result in a reduction in private insurance. In other words, states can’t expand public coverage except by protecting the private insurance market share.
- Require that children who receive care under SCHIP pay deductibles set high enough to make the private insurance coverage “competitive.” Translation: arbitrarily impose additional costs on families using the public system so that the private system looks more attractive in comparison, even though the aggregate effect is to raise total costs for covering the same number of children, with no guarantee that those facing higher SCHIP deductibles would actually seek private insurance instead of just foregoing health care they can no longer afford. [emphasis added]
...
Nor is there even a “conservative” policy justification for subsidizing a private insurance scheme merely for the purpose of making it appear “competitive,” when in fact it is more costly (as well as less effective in providing actual care). That’s phony competition, subsidized by tax payers, and even Republicans should oppose that.
This is a simple case of insurance company greed and influence coupled with the Bush Administration’s complete distortion of ideological preference for markets. This isn’t genuine competition. Instead, here we see the hand of government using subsidies or penalties to tip the scales to favor private schemes that are more costly and less desireable, with two inevitable effects: (1) fewer children will receive health care and (2) it will cost more for those who do. So much for “compassionate conservatism.”
The new rules are bad public policy no matter how you look at them; it’s bad market economics, bad fiscal policy, bad health care policy, bad conservative principles and most of all, it’s bad for kids. It’s just plain bad for America.
Bad for America, Good for Insurance Companies. The GOP way!
Brian: could you make clear the rules that govern when a comment is held for review at the new site. I posted a reply with three links and substantial quotation from the links, and my comment was 'held'. Is the hold a result of the links, the length of the comment, or what?
Huh. Yeah, I'll look into it today, Jim. Sorry about that!
Allowing children upto the age of 25, and incomes up to 82K clearly means that this is not about providing insurance coverage for needy children, but is a not quite hidden continuation towards the goal of "universal coverage" aka "socialized medecine". If states are all fired up about providing such coverage, let them enact it and pay for it instead of sticking the federal government (and other taxpayers) with the bill. And while they are at it, perhaps they can provide cars, cellphones, TVs, food, clothes, and whatever else is deemed a necessity for needy children, the poor dears.
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