By Jim McLean
KHI News Service
TOPEKA, April 25
Representatives of a newly formed 50-member coalition are urging the Kansas congressional delegation to support a significant expansion of the State Children”s Health Insurance Program.
Lead by
Kansas Action for Children
, the coalition of nonprofit organizations
which has a diverse membership ranging from the Kansas Hospital Association and the state affiliate of the Kansas Heart Association to AARP Kansas
has three main priorities:
*
Congressional reauthorization of the SCHIP program, which is set to expire at the end of September;
*
An increase in funding of up to $50 billion over five years; and
*
Continued flexibility for states to design their own programs and set their own eligibility limits.
“I can”t imagine that it won”t be reauthorized, but we don”t want to take anything for granted,” said Kansas Insurance Commissioner Sandy Praeger, who appeared with coalition members at a Statehouse news conference on Wednesday.
SCHIP was created 10 years ago to provide coverage to children in families that earn too much to qualify for Medicaid but not enough to purchase private health insurance. The program covers 6 million children nationally and about 35,000 in Kansas, where it is known as HealthWave.
Size of expansion at issue
It is generally assumed that Congress will reauthorize the popular program, but a national debate is underway about whether it should be expanded. Advocates of expansion say that giving states more money and flexibility to set eligibility limits as high as three times the federal poverty level
annual earnings of $61,950 for a family of four
would extend health coverage to millions of uninsured children. But the Bush administration and other critics of expanding the program say it would be too expensive and would require taxpayers to subsidize coverage for families that could afford to purchase private insurance.
President Bush proposed an SCHIP funding increase of $5 billion over five years, an amount that virtually everyone agrees would be insufficient to cover all the children currently enrolled in the program.
Both the U.S. House and the U.S. Senate
which Democrats control by slim margins
have adopted budget resolutions calling for an increase in SCHIP funding of up to $50 billion over five years, providing it is offset by either spending cuts in other programs or tax increases.
Roberts a key
Two members of the Kansas congressional delegation are directly involved in the debate because of their committee assignments: Republican Sen. Pat Roberts, a member of the Senate Finance Committee, and Democratic Congressman Dennis Moore, a member of the House Budget Committee.
Both have said they support increasing SCHIP funding beyond what President Bush has recommended. But neither has been specific about how much of an increase or how to pay for it.
During a recent interview in his Washington, D.C. office, Roberts said he had concerns about expanding the program too much.
“I”m more worried about the universe of what we”re trying to do with SCHIP and its original purpose,” he said.
Roberts said he was strongly opposed to a proposal gaining currency in some circles to cut Medicare Advantage payment rates to offset increased SCHIP spending.
Medicare Advantage services are provided through private health plans. In the regular fee-for-service program, Medicare reimburses providers directly. A recent study showed that Medicare Advantage payments average 12 percent more than fee-for-service payments.
But Roberts said cutting Medicare Advantage payments could potentially reduce options for beneficiaries in rural areas.
“Congress intended to invest more funds for the Medicare Advantage program,” Roberts said. “Why on earth would you want to cut back on a program that for the first time in a long time has recognized the disparity in Medicare coverage and options in our rural areas?”
Roberts wasn”t as definitive when asked about another funding alternative being touted by some in Congress
a proposal to raise the federal cigarette tax by as much as 61 cents per pack.
Roberts said he would be hard-pressed to support the excise tax increase, but he didn”t close the door on the possibility.
“You have to remain flexible and at least take a look at your options,” he said.
Roberts voted against a non-binding resolution calling for a cigarette tax increase, but it passed 59-40. The author of the amendment, Sen. Gordon Smith, R-Ore., said it would raise as much as $35 million in SCHIP funding.
Gary Brunk, KAC president, said the coalition doesn”t have a position on how best to fund an expansion of SCHIP. But he said the $50 billion increase the coalition is advocating would be enough to cover most of the 46,000 uninsured children in Kansas.
“It”s a doable goal,” Brunk said. “People of goodwill can make it happen.”
Kansas currently spends about $63.2 million a year on SCHIP. About 70 percent of that comes from the federal government.
-Jim McLean is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
jmclean@khi.org
or at 785-233-5443, ext. 110.