RE: Bush Administration wants to limit health care coverage for children

[Loathe]

Why should middle income kids get government medical care?

> -----Original Message-----
> From: Larry Lyons [mailto:[EMAIL PROTECTED]
> Sent: Tuesday, August 21, 2007 10:53 AM
> To: CF-Community
> Subject: Bush Administration wants to limit health care coverage for
> children
> 
> Hey can't let those pesky poor kids get healthy you know, they may grow
> up to vote for the Democrats.
> 
> 
> http://www.nytimes.com/2007/08/21/washington/21health.html?ex=134534880
> 0&en=f98ec523f6e60c2c&ei=5090&partner=rssuserland&emc=rss
> 
> August 21, 2007
> Rules May Limit Health Program Aiding Children
> By ROBERT PEAR
> 
> 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.
> 
> “We are horrified at the new federal policy,” said Ann Clemency
> Kohler, deputy commissioner of human services in New Jersey. “It will
> cause havoc with our program and could jeopardize coverage for
> thousands of children.”
> 
> Stan Rosenstein, the Medicaid director in California, said the new
> policy was “highly restrictive, much more restrictive than what we
> want to do.”
> 
> 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.
> 
> As with issues like immigration, the White House is taking action on
> its own to advance policies that have not been embraced by Congress.
> 
> In his budget in February, President Bush proposed strict limits on
> family income for the child health program. Both houses of Congress
> voted this month to renew the program for five years, but neither
> chamber accepted that proposal. Legal authority for the program expires
> on Sept. 30.
> 
> The administration’s new policy is explained in a letter that was
> sent about 7:30 p.m. on Friday to state health officials from Dennis G.
> Smith, the director of the federal Center for Medicaid and State
> Operations. The policy would continue indefinitely, though Democrats in
> Congress could try to override it.
> 
> The Children’s Health Insurance Program has strong support from
> governors of both parties, including Republicans like Arnold
> Schwarzenegger of California, Tim Pawlenty of Minnesota and Sonny
> Perdue of Georgia. When the Senate passed a bill to expand the program
> this month, 18 Republican senators voted for it, in defiance of a veto
> threat from Mr. Bush. The House passed a more expansive bill and will
> try to work out differences with the Senate when Congress reconvenes
> next month.
> 
> In his letter, Mr. Smith set a high standard for states that want to
> raise eligibility for the child health program above 250 percent of the
> poverty level.
> 
> Before making such a change, Mr. Smith wrote, states must demonstrate
> that they have “enrolled at least 95 percent of children in the state
> below 200 percent of the federal poverty level” who are eligible for
> either Medicaid or the child health program.
> 
> Deborah S. Bachrach, a deputy commissioner in the New York State Health
> Department, said, “No state in the nation has a participation rate of
> 95 percent.”
> 
> And 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.”
> 
> The Congressional Budget Office has said that the president’s budget,
> which seeks $30 billion for the program from 2008 to 2012, is not
> enough to pay for current levels of enrollment, much less to cover
> children who are eligible but not enrolled.
> 
> When Congress created the Children’s Health Insurance Program in
> 1997, it said the purpose was to cover “uninsured low-income
> children.” Under the law, states are supposed to make sure public
> coverage “does not substitute for coverage under group health
> plans.”
> 
> In an interview yesterday, Mr. Smith said, “The program was always
> meant for children in lower-income families.” As a state increases
> its income limits, he said, “it’s more likely to substitute for
> private coverage.”
> 
> 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 middle-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.
> 
> That is considerably stricter than past requirements. In February, for
> example, the Bush administration allowed Pennsylvania to increase its
> income limit to 300 percent of the poverty level after the state agreed
> to a six-month waiting period for children who were 2 and older with
> family incomes exceeding 200 percent of the poverty level.
> 
> As another precaution, Mr. Smith said, states that want to cover
> children above 250 percent of the poverty level must show that “the
> number of children in the target population insured through private
> employers has not decreased by more than two percentage points over the
> prior five-year period.”
> 
> 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.”
> 
> In the Senate debate this month, several Republicans offered a proposal
> similar to the new Bush administration policy. They wanted to require
> states to cover 95 percent of low-income children before allowing
> states to expand eligibility.
> 
> Senator Max Baucus, the Montana Democrat who is chairman of the Finance
> Committee, argued against the proposal, saying: “No state can meet 95
> percent. No state currently meets 95 percent.”
> 
> In his letter, Mr. Smith said the new standards would apply to states
> that previously received federal approval to cover children with family
> incomes over 250 percent of the poverty level. Such states should amend
> their state plans to meet federal expectations within 12 months, or the
> Bush administration “may pursue corrective action,” Mr. Smith 
> said.
> 
> Two Republican senators, Charles E. Grassley of Iowa and Pat Roberts of
> Kansas, urged the Bush administration last week to deny New York’s
> request to cover children with family incomes up to four times the
> poverty level. The proposal, they said, violates the original intent of
> Congress.
> 
> But Gov. Eliot Spitzer of New York said that, “contrary to the
> senators’ objections,” federal law allows states to set higher
> income limits. “Granting this expansion,” Mr. Spitzer said, 
> “is
> essential to the health and well-being of New York’s children.”
> 
> Copyright 2007 The New York Times Company
> 
> 
> 

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