Sunday, September 30, 2007

Julia's Musings: SCHIP and North Carolina

This weekend the buzz on the Hill was “where can the House find at least fifteen votes to over ride the expected Presidential veto of SCHIP?” On September 28th during the White House Briefing, Dana Perino stated that the President is still planning to veto the SCHIP expansion legislation passed this week by Congress. Ms. Perino went on to say “the President is saying, let's take care of the neediest children first, let's not put scarce federal dollars towards a program that was meant for the poorest children and let it creep up to middle income families with incomes up to $83,000 a year.”

Here are the facts regarding the federal poverty level. The compromise legislation passed this week states the following:

Places a limitation on the matching rate for states that propose to cover children with effective family income exceeding 300% of the federal poverty line.

The current federal poverty level, for a family of four, is set at approximately $20,000. That would mean 300% of the federal poverty level is approximately $60,000, not $80,000 as the Bush Administration has stated repeatedly. Many states will probably not set the level of coverage at 300%, but it should be up to the state to decide how best to provide insurance for its uninsured children.

Another concern expressed by the Bush Administration is that people with private insurance will move to state sponsored insurance if this legislation takes effect. I have seen no research that substantiates this claim. What I did find is that for children who loose their SCHIP insurance due to a family earning increase, have difficulty finding insurance.

Cover the Uninsured, a project by the Robert Wood Johnson Foundation has research that demonstrates the following;
Nearly 3 in 10 children are uninsured if their family head is employed by a firm with fewer than 10 workers. This compares with 9.3 percent uninsured among children whose family head is employed by a firm with 1,000 or more workers.
More employers are divesting themselves of insurance coverage for employees. This means it is increasingly becoming the responsibility of the individual to find private insurance for their families. If you have a child with a disability, the cost of insuring that child can be a serious financial burden for the family.

On the issue of raising taxes to cover health insurance for children, the Bush Administration continues to state that this expansion is a new tax on Americans. The reality is that the expansion is being funded by an increase of sixty one cent tax on tobacco products.

Why is this important to North Carolina? Well, while they fight it out in Washington, DC, we have our own expansion program waiting for their decision. NC Kid’s Care, our expansion program passed the state legislature during the long session. This program received a state appropriation in the 2007-2008 fiscal year of $368,000, funding earmarked for the Department of Health and Human Services to create a report that identifies a cost-efficient and cost-effective method to increase coverage for children whose families are between 200% to 300% of the FPL (Federal Poverty Level). An additional appropriation of seven million dollars in the 2008-2009 fiscal year was appropriated to implement the expanded health insurance program. If SCHIP does not survive the veto over ride then our state will not be able to expand coverage to more uninsured children.

How does the current SCHIP program affect children with disabilities in our state? Nationally, 10% of all children insured by SCHIP have a disability. NC Health Choice has two levels of health plans. The first is the core plan which covers durable medical equipment and medical supplies. There are no statistics regarding how many children with disabilities are covered by this plan. We do know that there are 1,397 children currently covered by the Special Needs Plan in our state. That is 1,397 children who require extensive services outside of the core plan. Children with disabilities are among our most vulnerable population and are the most difficult to insure due to their complex medical needs.

If the President is serious about improving the health of children around the world, as he stated during his recent United Nations address, he can start that process at home by signing the SCHIP bill that is headed to his desk this week.

More information:

White House Press Briefing:

Federal Poverty Level Information:

North Carolina 2007 Appropriations Act:

Interesting Comparison of FPL in California versus other states:

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