Inside the Children's Health Insurance Fight

Last week, President Bush vetoed a proposed expansion of the State Children's Health Insurance Program, calling it part of an effort to "federalize health care." Farai Chideya examines the debate with Marian Wright Edelman, founder and president of the Children's Defense Fund.

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FARAI CHIDEYA, host:

From NPR News, this is NEWS & NOTES. I'm Farai Chideya.

Last week, President Bush vetoed a proposed expansion of the State Children's Health Insurance Program or S-SCHIP. That move has sent health care professionals and activists right to the front doors of Congress. In a moment, we'll speak with the policy analyst who supports the president's veto.

But first, Marian Wright Edelman. She's founder and president of the Children's Defense Fund. Welcome.

Ms. MARIAN WRIGHT EDELMAN (Founder and President, Children's Defense Fund): Thank you.

CHIDEYA: So give us a sense of how many children could have been added to the rolls and from what economic backgrounds they had come.

Ms. EDELMAN: Well, nine million plus children are uninsured, and one of the things I think is important for people to realize is that this is a very modest bill that the Congress has sent to the president who vetoed it. It would reach only three to four million of the nine million uninsured children. And 90 percent of those children play by the rules, live in households that play by the rules, who work every day, and don't get private employee insurance. And so this is a modest bill that the president has vetoed, but it still leaves six million children behind.

CHIDEYA: How specifically could this affect African-American families?

Ms. EDELMAN: Well, there are millions, one in - millions of uninsured African-American children. One in seven babies who are black, one is born uninsured. We have low birthrate rates that disproportionally affect black children because mothers don't get pre-natal care. And one of the things we had wanted very much in a bill that we have been supporting - and in the CHIP bill - was to see that all pregnant women and children get covered so that children don't start off with two or three strikes against some. But black babies are disproportionally affected by the lack of insurance, and that's a disgrace.

CHIDEYA: You've been working for years on issues affecting children. Is there also a problem of children being underinsured? How does that fit in to this larger discussion that we're having now?

Ms. EDELMAN: There are millions more children who are underinsured. One of the things that bothers me very much that is not, again, fixed in this CHIP Reauthorization Bill that the president vetoed is that there are two classes of children. Medicare - Medicaid children get comprehensive benefits, including dental and mental health benefits. In CHIP, those children are not guaranteed those same benefits.

You can have two children in the same family - one eligible for SCHIP, one eligible for Medicaid - and one child can get guaranteed benefits and the other cannot. And we wanted very much to see that every child gets guaranteed dental care and mental health care.

Those Katrina children are still out there waiting. They will not all be helped by this bill. Those children who are underinsured in places like Prince George's County can't find a dentist.

We've had children die from tooth abscesses. I know of three this past year -two of whom were black - dying unnecessarily because they could not get dental care, could not find a dentist.

And so millions more are underinsured, and that is just not right in this country. God did not make two classes of children. This CHIP bill takes very modest steps, and the president is even vetoing that. That's not correct.

CHIDEYA: Is there any element of parents not knowing what exactly their children are eligible for? How much of this - obviously, there's the political side, which we'll return to - but are there parents who don't even know what benefits their kids could get?

Ms. EDELMAN: Absolutely, there are many parents who don't know what benefits their children can get. And dealing with two separate bureaucracies, we would like to make it one. And our All Healthy Children Act would make it simple. We've had children die because they fall through the bureaucratic cracks. And these are parents who did know what was right, did try every way we know how -say, in a place like Texas - to get their children back on care.

One young man, 12 years old, died because his mother who had multiple sclerosis - intelligent, tried very hard, started three months before the re-eligibility enrollment procedures. We were going to throw them off the rows, applied a dozen times, and still could not get through the computer system and the bureaucratic barriers and so Devonte died.

So many parents don't know because of poor outreach, because this is not designed to make it easier rather than hard in many of our states. But many parents who do know are spending all their time trying to get their children health care, and we make it so hard, and we need to simplify those bureaucracies.

CHIDEYA: Turning back to the politics, who are the coalitions that will try to either get the veto overturned or find a new way to reauthorize and expand this program?

Ms. EDELMAN: Well, I think that one should be clear that this is a broad bipartisan coalition that is supporting a very modest CHIP bill, which the president is vetoing. Republicans in the Senate put together us a bill that has $35 billion as a minimum down from the 50 billion that the House put in. But Senator Grassley from Iowa - hardly a flaming liberal - really has worked with Senator Baucus. And on the outside, we have had - even the health insurance industry and the American Medical Association and the pediatricians and the labor unions. And so this is a very broad coalition, all of whom recognize that investing in children will save lives, will save taxpayers' money. The president has been putting out facts that are simply not true - either he hasn't read it or he has not understood what is involved. This is not an attempt to socialize medicine or to have government control to many of the people medicine.

Many of the children who are in the CHIP program and in the Medicaid program are served by private providers it is absolutely wrong to say that this bill is trying to cover a lot of middle class people up to 83,000. That's not in this bill. He should read the bill. This is a very modest next step to build on the progress that states have been making. And so I just hope that the president's wrong-headedness here will be corrected, and that we will find the votes in the House to override it. We have the votes in the Senate on both sides of the aisle to override it. But this is not a partisan issue. This is an issue that will save lives, save taxpayers' money, and that the overwhelming majority of the American people support.

CHIDEYA: Well, Ms. Edelman, thank you for your time.

Ms. EDELMAN: Thank you.

CHIDEYA: Marian Wright Edelman is the founder and president of the Children's Defense Fund in Washington, D.C.

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