Monday, September 03, 2007

Fraud and deception about SCHIP

The battle should be over by now, but it’s not. Congress has still not passed the bill that revises and reconstitutes the State Children’s Health Insurance Program (SCHIP), since it recessed for summer vacation – umm, excuse us, constituent services travel – before reconciling the House and Senate versions of the legislation. However, as a final step in at least attempting to insulate this impending legislation from simply becoming another clandestine step to nationalized health insurance, the Bush administration has added what Reuters called “new standards” to limit the applicability of that healthcare subsidy to truly low-income recipients.

If a state wants to offer subsidies to families with incomes above 250 percent of the poverty-level, they must first prove that they have already extended the offer to at least 95 percent of those families earning below the 200 percent amount, providing for those children through either Medicare or the child health program. (There are other conditions, but this is the one raising the most unwarranted controversy.) Since none of the 50 states have thus far come anywhere near that level of coverage for the truly indigent, the expectation is that efforts to raise the bar will now be considered to be in violation of both spirit and letter of the SCHIP authorization.

Why this is exactly wrong somehow … well, that remains to be seen. If the intended beneficiaries of a “hand-up” program (aiding the children of poor families) are not being served adequately, it’s hard to argue that funds aimed at that target population should somehow be diverted to helping those who are somewhat less hamstrung by their economic status. The charge that advocates of such a “middle-class handout” are merely using the SCHIP reauthorization to promote their intended socialization of healthcare seems pretty valid. But immediately following the news of the Bush regime’s rule-change, the barrage began.

A Boston Globe account, entitled “Children may lose out on insurance,” starts right in with its lead paragraph, declaring that, “Thousands of Massachusetts children from low-income families could be denied health insurance under new rules imposed by the Bush administration late last week. The rules could cut federal matching funds for a state-run program that is a key component of the state’s health insurance initiative.”

Let’s examine those phrases: Apparently there are “thousands of children” in the Bay State alone, who come from “low-income families” (defined how? They make more than twice the poverty-level, but less than 2-1/2 times it) and would be denied “health insurance” (it says nothing about access to healthcare, only “insurance”) because the Bush program would “cut federal matching funds” that supplement an existing state program.

Translation: Families with children exist in Massachusetts (and by implication in many other states) who cannot provide healthcare for their children on their own, and do not qualify for public assistance from the state … because they make too much money! And the reason the state can’t assist them anyway is because it will be denied “federal matching funds” to pay for such subsidies – unless it can show it has ALREADY taken care of all the even POORER families in the state, the ones who REALLY need the help! Forgive us for looking askance, but this is just socialist claptrap, disguising a not-so-covert attempt to expand the scope of public healthcare subsidization!

And as the article continues, the state’s senior Senator, Edward M. Kennedy, who has never seen a federal subsidy program he couldn’t wish were more widespread, is leading the fight to challenge the new restrictions, described as “the latest volley in the national battle over the future of … SCHIP.” The piece notes that the program already insures “some 6.6 million children nationally and 90,500 in Massachusetts” among low-income families. During its recent (Mitt) Romneyfication, the state had raised that 200 percent ceiling, to families at 300 percent of the poverty-level income ($61,950 for a family of four). This added “about 14,000” children to the coverage

Excuse us for wondering, but is there really a need to pay for the healthcare of families making that kind of money? And even if we grant that there is, is there really a burden being placed, merely by requiring that BEFORE those (rather affluent, by most standards) folks are serviced, you make sure you are caring for and covering all the folks down at the $40K family income and lower ranges?

The outrage seems entirely misdirected. Instead of railing against restrictions of federal subsidy of yet another government program, these voices should be raised in favor of efforts to promote lower access costs to healthcare, for EVERY family, regardless of income. Such measures as tax credits for individuals, rather than corporations, for providing for their own wellness … now there’s a step in the right direction.

The Globe article (still posing as “news” mind you) goes on to state that “In Massachusetts, the program is the main means of insuring children in families above the poverty level who do not qualify for Medicaid and who frequently cannot afford private insurance.” It adds, somewhat indignantly, that “The state’s health insurance initiative did not include any other effort to cover children,” while stating that the new guidelines “could block enrollment of more children above 250 percent of the poverty level and could make it tougher for the state to continue covering about 4,500 already enrolled.” Meanwhile, it concedes, “State officials said they do not yet have a count of the number who are eligible but not enrolled.”

Massachusetts is not the only place where this tightening will affect “the children”: citing the lobbying group Families USA, the story notes that “at least 17 other states” have already expanded their coverage up the income ladder, and five more have been considering raising the ceilings. The overall effect was to strike fear in the Bush administration, which (understandably?) viewed this as a stealth campaign to create a de facto universal healthcare program.

Dennis Smith, director of the federal Centers for Medicare & Medicaid Services, who sent out the policy letter, is quoted as saying that, “SCHIP was created for children in low-income families, We want to make sure those kids are covered before we go to the higher-income kids.” This is hardly a radical statement by any standards. His intention in sending the letter, he says, was to enforce rules “designed to ensure that the program is not substituting for private insurance.”

As if this were not enough evidence, the so-called “progressive” ranks have also weighed in with outrage at Smith’s proclamation. One notable example comes from Harold Meyerson posting at The American Prospect site, with “A Dickens of a President []. Meyerson cleverly compares the actions of the Bushites, and Smith in particular, to the fictional antics of the orphanage overseers in “Oliver Twist,” quoting rather extensively from the Charles Dickens classic, and comparing the Bushies to the likes of “Limbkins, Bumble and kindred Dickensian grotesques …”

Regardless of the literary eloquence (as was noted in the editor’s note to this blurb a few days ago), this whole argument is a crock. The claims that these restrictions would harm the truly poor are nonsense; what would hurt them far more (granting for the sake of argument the validity and effectiveness of the existing program, which is the one thing both sides of the aisle, both houses of Congress and the President seem to concur on) is the death of the program as it now stands, simply because of the self-serving agendas of both sides.

Meanwhile, in both of those houses, efforts to raise the limits continue, with Bush still threatening to veto the program’s extension if these additional measures are not stricken from the bill placed on his desk for signature. To these eyes, it would appear that the new rules, if they were to stick, might actually make such a veto academic, while allowing the program for the truly indigent to proceed. That would hardly seem to be a bad thing, for those who really care about helping poor kids.


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