Local Commentary

Jim Moran

When Congress returns from the July 4th recess next week, we will begin action on one of the most important domestic initiatives of the 110th Congress: the reauthorization of the State Children’s Health Insurance Program (SCHIP).

Established in 1997, SCHIP’s goal is to provide health care coverage to low-income children who fall outside Medicaid’s income requirements. The program is funded through federal-state matching grants, and each state is allowed substantial leeway to develop their own individualized programs. While some states have simply covered these children through Medicaid, others, including Virginia, have implemented stand-alone programs that offer access to a range of insurance options.

Since its inception, the number of uninsured children has declined by one-third. In 2006, there were 6.7 million children who receive health insurance through SCHIP, almost all of which came from families with yearly incomes less than $33,200 for a family of three, or 200% of the federal poverty line. According to an overwhelming majority of health provider organizations, state health administrators, and child advocacy groups, SCHIP has succeeded in making health insurance accessible and affordable.

As a result of SCHIP coverage, children have greater access to preventative care, such as immunizations and health checkups, and have fewer unmet health needs. They are also more likely to have regular visits with a doctor and to have access to specialists if needed. SCHIP has achieved a reduction in the ethnic disparities that exist in child health care, closing the gap in coverage between white and minority children.

While well worth the investment on public health grounds alone, studies have shown that SCHIP actually lowers the cost of providing health care to children. Without health coverage, children are more likely to seek treatment only when symptoms become severe and to utilize more expensive emergency departments. The results are higher Medicaid expenditures, the exacerbation of emergency room overcrowding, and higher costs for people with insurance. In the end, we pay more for a reactive plan than we do for the inclusive, proactive plan offered through SCHIP.  

Despite all it has accomplished, there are still 9 million children who do not have health insurance; 6 million of which are estimated to be eligible for SCHIP but not currently enrolled. We must close this gap. We must renew our commitment to those most vulnerable in society and provide the leadership needed ensure no child goes without necessary health care.

Unfortunately, the Bush Administration has already made clear it would prefer to short change SCHIP. President Bush included in his budget only $30 billion over the next five years, an amount that according to the Congressional Budget Office would not be enough even to fund current enrollment levels. His plan would force states to tighten income requirements, cap enrollment levels or increase premiums and co-pays.

The President’s plan is a giant step backwards and sends the wrong signals about our country’s obligation to ensure all children have high quality health care. Exhibiting ideological stubbornness, he is determined to claim that SCHIP is “government run medicine,” despite the fact that almost every child covered by SCHIP has insurance through a private insurance company. 

Congress, as part of the budget resolution passed earlier this year, has already set aside $50 billion for this program over the next five years. As we consider legislation in the coming days, we must fulfill this commitment to our children. Any SCHIP reauthorization should not only include a reliable source of funding but should also allow states the flexibility needed to improve and expand their programs. I believe most of my colleagues in Congress share this goal, and I look forward to passing legislation that fully meets the health needs of our children.