Governors Focus on Children's Health Program

The nation's governors discuss the renewal of the State Children's Health Insurance Program (S-CHIP). It's set to expire in September. More than a dozen states could run out of S-CHIP money by the spring.

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Some other politicians say there's a lot of glory in an American program to give health insurance to children. Now they're deciding what do to as that program nears its date to expire in September. At issue is the State Children's Health Insurance Program, better known as SCHIP. It involves the federal government and the states. It's widely viewed as a success, and it covers about six million children per year.

Republicans and Democrats have very different visions for this program's future, and it's a major topic at this week's annual meeting of the nation's governors here in Washington.

Here's NPR's Julie Rovner.

JULIE ROVNER: Susan Molina is exactly the kind of person the Children's Health Insurance Program was designed to help. She's a single mom with two kids, 14-year-old Bernadette and 10-year-old Joseph. After her abusive husband walked out on them seven years ago, Molina went back to school. She eventually worked her way up from cleaning a condominium building in Denver to managing it. Along the way, she also managed to get her kids covered by Colorado's SCHIP program.

Ms. SUSAN MOLINA: It's an amazing program. It's a great program. My kids received great care. I had that insurance card, and I didn't worry about whether they were going to be seen or not or how much money I was going to have to pay. I just had that assurance that I was going to be able to take them and they were going to get the care they needed.

ROVNER: But recently, Molina has become a victim of her own success. When it comes to deciding who will be covered and who won't, each state has its own definition of working poor. Some states, like New Jersey, are relatively generous, covering families with incomes three and a half times the poverty level, or $60,000 a year for a family of three. Molina's kids would still be covered if they lived there. But she's in Colorado, where the upper limit is just over $34,000 a year. Molina makes a bit more than that now, so Bernadette and Joseph have lost their SCHIP coverage. She said their lack of insurance really hit home a few weeks ago.

Ms. MOLINA: My son came home with a fever and kind of a, you know, stomach flu. If I would have had SCHIP then, I could have just taken him right away. But instead I had to wait. That was hard - wait and see if it was going to get worse. Parents shouldn't have to make those kinds of choices.

ROVNER: Molina was in Washington to testify at a U.S. House subcommittee hearing. She told the panel she's looked into buying private insurance for her children, but it's more than she can afford - 200 to $300 a month.

Ms. MOLINA: I don't have that. You know, that would take away from other things. That's two weeks worth of groceries. How can we not work hard to cover our children? We work hard. I'm a single mother, and I'm proud of that. And because I'm so proud, that's why it makes it so difficult.

ROVNER: Democrats, like Illinois Congresswoman Jan Schakowski - back in control of Congress for the first time since the program was created - have set their sites on expanding SCHIP to include more families like the Molinas.

Representative JAN SCHAKOWSKI (Democrat, Illinois): I ask how is it responsible to pass tax cuts that provide the wealthiest one percent of Americans with an average annual tax cut of $146,000 while denying SCHIP to a family with $34,500 in income? Our country has the resources to provide health care to our children. It's only a question of priorities.

ROVNER: But backers of the program know they're facing a formidable task. The biggest problem, of course, is money. President Bush proposed only $5 billion in new funding next year for SCHIP. Analysts say that's only a third of what's needed to cover those currently enrolled in the program, never mind expand it. And if Democrats are going to find the extra money, their own budget rules require them to either raise taxes or cut spending somewhere else.

But just when Democrats are talking about expanding the program, Republicans are talking about scaling it back. For example, President Bush wants states to limit their programs to be more like Colorado's, only covering children in families who earn no more than twice the federal poverty level.

Congressional Republicans agree that might be a needed change. Here's how Georgia Republican Congressman Nathan Deal put it at the House hearing.

Representative NATHAN DEAL (Republican, Georgia): Coming from a state where the median household income is around $42,000, some of the income levels covered by SCHIP programs in other states would to us seem excessive.

ROVNER: Then there's the question of whether certain adults should be covered by SCHIP. When Congress passed the law a decade ago, it allowed states to cover adults in some cases, including pregnant women, parents and childless adults like college students. Fifteen states allow such coverage. But Republicans, like Iowa Senator Charles Grassley, now would like to get back to only covering children.

Senator CHARLES GRASSLEY (Republican, Iowa): When states use funds intended for children - use it, instead, to cover adults - that means fewer dollars available for the youngest of our citizens. These are funds that cannot then be used for kids.

ROVNER: Those issues will be debated as part of the renewal of the SCHIP program, which needs to be done by the end of September. In the meantime, there's a more immediate problem. About 14 states have done such a good job finding and enrolling uninsured children in their SCHIP programs that they're going to use up their federal allotment for the current fiscal year a lot sooner than that.

Georgia is one of those states. Its program, called PeachCare, has a $131 million shortfall, Republican Governor Sonny Perdue told the Senate Finance Committee.

Governor SONNY PERDUE (Republican, Georgia): Without additional federal matching funds, the PeachCare program will be out of federal funds by March.

ROVNER: Since that hearing, Georgia has announced it will freeze enrollment as of March 11th, so Democratic leaders in the House and Senate have vowed to try to add emergency money for SCHIP to a bill aimed at funding the war in Iraq. That bill is expected to come to the floor of both Houses in the next few weeks.

Julie Rovner, NPR News, Washington.

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