SCHIP and pre-existing conditions....

• Question about SCHIP and children with pre-existing conditions - whorn
  • SCHIP and pre-existing conditions.... - Observer
  • This should answer... - DW

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I found this website while trying to look up some more info and thought I'd share it.

http://www.ncsl.org/print/health/CRSSbyS0807.pdf

I'm now thoroughly confused on the arguments against expanding it.  It does require proof of citizenship (states responsibility to document), so I'm not quite sure how that means it will allow illegal immigrants access - at least any more access than they already have to medicaid - however they get it.  It also seems to state that the limit on income will be determined by the states - which would somewhat answer the question I posted below.  I've heard interviews on television with those against the expansion quoting the $88,000 limit.  (which I did not see mentioned, but I certainly have no idea what's discussed in Congress).  As I said below, for a family whose living expenses are relatively low, $88,000 is a lot of money, but for a family who lives where the living expenses are insanely high, $88,000 does not go as far. 

Observer, or any others, have  you found a site that explains why some are against it? 

11,000 million children will be covered.

The only problem is...they are raising the cigarette tax to $.61 a pack. According to Glenn Beck, we will need 21,000,000 NEW smokers to cover the program. Kinda ironic....use something that is unhealthy to give coverage to keep the kids healthy.

I don't know what they are thinking. I think the government has their heads in the sand.  Every time they tie a new program to smokers, more smokers quit. How are they ever going to cover all these children if another couple thousand people quit smoking?

I absolutely think this program will not work like they think and in a couple years, if not next year, they will be raising taxes on everyone because of the shortfall in the planned coverage.

Sheesh! How did these people ever complete college????? They have no sense.

Sorry, I'm still venting from the SCHIP garbage that was on today. They absolutely want to pass this immediately without looking at amendments, etc. They want an additional 11 million children covered ( nothing wrong with that) EXCEPT they want to put it on the smokers to pay for it. Now, with the way they are trying to get smokers to quit, I would think that's a stupid and absolutely wrong idea.

Like James Webb (NC) stated, "Do we really want an unhealthy habit to pay for a healthy habit?"What happens when the smokers quit because of all the taxes they have to pay to keep these programs going? Who is going to pay for it if every smoker quits? You have nothing to back it up. There would be a black hole and eventually, every citizen would have to pay for it.

I agree totally with his statements.  Why is it they expect an unhealthy habit to cover healthy habits? It makes no sense. At least this rep has his head together, yet the others don't think about the future costs.

When are the  American citizens going to wake up and start thinking for themselves? Why, oh why, do we keep voting in people who don't even think for themselves, just vote by party affiliation?

Glenn Beck stated we have to keep the phone lines to Washington and keep calling in to our reps to stop the nonsense (sp). I agree.

I watched the jerk put in the Senate by fellow voters from my state today and I had to turn him off  (I didn't vote for him-he knows nothing). I am going to write to the newspapers in that area and ask them WHY did they vote for him? Betcha my answer will be "He gave us so much money to get our projects done." "He's the son of our late governor." "He's from our area." That's no reason to vote for somebody. If it is, then I must be totally wrong for voting the way I do. I vote who I think will do the best job, not if he's from our area. That's part of  the problem with politics today.

I'll get off my  now. Thanks for reading. I promise no more venting today.

did not pass.It was 32 ayes to 65 nays.

All Things Considered, October 3, 2007 · President Bush has made good on his promise to veto a bill to expand a popular children's health insurance program, saying the bill could lead the nation toward a system of socialized medicine.

But backers of the measure, who are working to override the veto, say the president doesn't understand how the bill would actually work.

At issue is the State Children's Health Insurance Program, known as SCHIP. It currently covers about 6 million children in families that earn too much to qualify for the Medicaid program for the poor, but not enough to afford their own, private health insurance. The bill the president vetoed would have added $35 billion to the program over the next five years — enough to cover about 10 million children total.

"I believe in private medicine," Bush told an audience in Lancaster, Penn., on Wednesday morning. "I believe in helping poor people, which was the intent of SCHIP, now being expanded beyond its initial intent. I also believe that the federal government should make it easier for people to afford private insurance. I don't want the federal government making decisions for doctors and customers."

Not Administered by the Government

But SCHIP isn't the kind of program where government officials make medical decisions. Under SCHIP, children are enrolled in private health insurance.

"Typically, children have a choice from among competing private health-insurance companies," says Stan Dorn, a senior research associate with the Urban Institute, a Washington-based think tank. "There's no federally specified benefits package. There's no individual entitlement."

The president also complained that the bill would cover too many children who don't need federal help. "This program expands coverage, federal coverage, up to families earning $83,000 a year. That doesn't sound poor to me," the president told the Lancaster audience.

Dorn says that's not exactly right, either. "This bill would actually put new limits in place to keep states from going to very high-income levels. SCHIP money would no longer be available over 300 percent of the federal poverty level, which is about $60,000 for a family of four."

The president gets to make the $83,000 claim because New York had wanted to allow children in families with incomes up to four times the poverty level onto the program. That is, indeed, $82,600. The Department of Health and Human Services rejected New York's plan last month, and under the bill, that denial would stand. White House officials warn, however, that the bill would allow a future administration to grant New York's request.

Health Care Confusion for All

Still, Dorn says the real irony is that the bill, which was negotiated largely by Republicans in the Senate, goes a long way toward meeting the goals that Bush said he wanted for the program.

"It's limited the ability to go up the income scale. It's focused resources on the poorest uninsured kids. It's imposed new duties on states to prevent government funds from crowding out employer coverage," Dorn says.

In other words, the bill addresses all of the president's complaints, including his concern that families with private coverage now will drop it in favor of government-subsidized care.

But it's not just the president who is confused; Democrats are, too. Last week, at a news conference, House Majority Leader Steny Hoyer told the story of 12-year-old Deamonte Driver, the Maryland boy who died earlier this year after an untreated abscessed tooth turned into a brain infection.

"He had a toothache," Hoyer said, "but he didn't have health insurance, and his folks could not access dental care."

Actually, Deamonte Driver did have health insurance. He had Medicaid. His mother just couldn't find a dentist who would accept that Medicaid coverage — which is a whole different problem.

Meanwhile, Congress has continued funding for the SCHIP program through mid-November while the bigger battle plays out. A House override vote on the president's veto is now scheduled for Oct. 18.

Link to article:  http://www.npr.org/templates/story/story.php?storyId=14962685

I agree that the bill is a bit confusing, but I think it's great so many of us are actually looking into it to find out what it is really about.  I think the New York Times article below clarifies the income guidelines pretty well.  I also want to say that I heard that if we go with Bush's $5 billion plan for SCHIP it will be grossly underfunded, as apparently, it is already underfunded and many kids who qualify with the current income guidelines cannot get on SCHIP, so I hope he is willing to at least compromise and give more money to the program if his veto isn't overridden.  It's for a good cause, darn it!

"Oct. 16 — It is the $83,000 question: Could children with that amount of family income qualify for subsidized health insurance under the bipartisan bill passed by Congress and vetoed by President Bush?

When the House votes Thursday on whether to override the veto, Republicans will insist that the answer is yes. They will express outrage that rich children could get coverage from the government while hundreds of thousands of poor children still go uninsured.

Democrats say it is a total distortion for Mr. Bush and his Republican allies to say that the bill allows coverage with family incomes up to $83,000 a year.

Who is right? Each side appears to overstate its case. The bill does not encourage or prohibit coverage of children with family incomes at that level.

Of the 6.6 million children now covered by the program, most come from families with incomes well below $83,000, and the bill would give states financial incentives to sign up low-income children who are eligible but not enrolled.

In general, children with family incomes below the poverty level ($20,650 for a family of four) are eligible for Medicaid. The State Children’s Health Insurance Program is meant for families with too much income to qualify for Medicaid, but not enough to afford private insurance.

Mr. Bush said Monday that the bill would expand eligibility for the program up to $83,000.

But Senator Orrin G. Hatch, Republican of Utah and an architect of the bill, said Tuesday that the president’s argument was specious. “About 92 percent of the kids will be under 200 percent of the poverty level,” Mr. Hatch said at a news conference with supporters of the bill, including the singer Paul Simon.

Another Republican author of the bill, Senator Charles E. Grassley of Iowa, said the White House claims were “flatly incorrect.”

States establish income limits for the child health program. A recent survey by the Congressional Research Service found that 32 states had set limits at twice the poverty level or less, while 17 states had limits from 220 percent to 300 percent of the poverty level. Only one state, New Jersey, has a higher limit. It offers coverage to children with family incomes up to 350 percent of the poverty level, or $72,275 for a family of four.

In New York, which covers children up to 250 percent of the poverty level, the Legislature this year passed a bill that would have raised the limit to 400 percent of the poverty level, or $82,600 for a family of four. The Bush administration rejected the proposal, saying it would have allowed the substitution of public coverage for private insurance.

States that cover middle-income children often charge premiums and co-payments on a sliding scale, so the coverage is not free.

While the bill passed by Congress would not prohibit states from setting the income limit at $82,600, it would set stringent new standards for such coverage.

In general, after Oct. 1, 2010, a state could not receive any federal money to cover children above 300 percent of the poverty level unless a vast majority of its low-income children — those at or below 200 percent of the poverty level — were already covered. To meet this test, a state would have to show that the proportion of its low-income children with insurance was at least equal to the average for the 10 states with the highest rates of coverage of low-income children.

Moreover, if a state was allowed to cover children over 300 percent of the poverty level, the federal payment for those children would, in most cases, be reduced. New Jersey and New York would be exempt from the cuts if they met the bill’s other requirements.

Citing that provision, the White House said Oct. 6 that the bill included a “grandfather clause” allowing higher payment rates for children above 300 percent of the poverty level in New Jersey and New York.

Jocelyn A. Guyer, a researcher at the Health Policy Institute of Georgetown University, said: “This is a wildly contentious political issue, but it’s largely a theoretical question. More than 99 percent of children in the program are below three times the poverty level, and New York is the only state that has expressed any interest in going to four times the poverty level.”

Suzanne Esterman, a spokeswoman for the New Jersey Department of Human Services, said that 3,000 of the 124,000 children in the state program — about 2.4 percent — had family incomes exceeding three times the poverty level.

Some of the current confusion can be traced back to a bill introduced in March by Senator Hillary Rodham Clinton of New York and Representative John D. Dingell of Michigan, both Democrats. They would have explicitly allowed all states to expand eligibility to families making four times the poverty level. But the bill passed by Congress did not go that far." -by Robert Pear