President George W. Bush gestures as he addresses the employees at Micron Technology Virginia in Manassas, Va., Tuesday, Feb. 6, 2007, on fiscal responsibility and the fiscal year 2008 budget. (White House photo/Paul Morse)
By Jim McLean
KHI News Service
TOPEKA, March 5
A Kansas senator and congressman could play key roles in reauthorizing a popular federal program that in the past decade has extended health coverage to more than 6 million children.
U.S. Rep. Dennis Moore, the 3rd District Democrat, and U.S. Sen. Pat Roberts, a Republican, have committee assignments that put them in the center of the reauthorization debate but likely at odds with President Bush.
The president”s proposed budget would reduce federal payments to states that cover children in families earning twice the poverty level. Bush has called for increasing spending on the State Children”s Health Insurance Program, or SCHIP, by $5 billion over five years. But critics, including most of the nation”s governors, say the president”s plan would force them to cut back coverage for thousands of children. Many states, with federal blessing, have extended the coverage to children in families earning more than 200 percent of
federal poverty guidelines.
The Congressional Budget Office estimates an additional $13 billion to $15 billion is needed over the next five years to maintain SCHIP at current enrollment levels.
Kansas Gov. Kathleen Sebelius” top health care priority this legislative session has been to extend SCHIP coverage to families earning 300 percent of poverty level.
The SCHIP program is “overwhelmingly” popular with the public, according to a New York Times/CBS News poll reported Friday.
“Eighty-four percent of those polled said they supported expanding the current program to cover all uninsured children, now estimated at more than eight million. A similar majority said they thought the lack of health insurance for many children was a “very serious” problem for the country,” the Times reported. The nationwide telephone poll of 1,281 adults was done Feb. 23- 27, and had a margin of sampling error of plus or minus three percentage points, according to the Times.
Moore is a member of the House Budget Committee. Roberts is on the Senate Finance Committee. In addition, Moore is the policy co-chair for the Blue Dogs, a group of fiscally conservative Democrats committed to balancing the federal budget and reducing the national debt, which now totals more than $8.7 trillion.
“We don”t want to put our kids in a hole so deep they can”t climb out,” Moore said explaining his commitment to offsetting new spending with budget cuts or tax increases.
U.S. Sen. Pat Roberts
Those who are pushing for a significant increase in SCHIP spending, say winning the support from Moore and his fellow Blue Dogs will be critical.
“That group is going to play a pretty influential role in this discussion,” predicted Gary Brunk, executive director of
Kansas Action for Children
, a non-profit advocacy group that lists reauthorization of SCHIP among its highest priorities.
Roberts, a slightly right-of-center Republican who often can be counted on to follow President Bush”s lead, also is seen as a barometer of what is possible in Congress this year.
The senator has already said the president”s proposal is inadequate. But he also has signaled that the $50 to $60 billion increase that some Democrats and child advocacy organizations are seeking is unrealistic.
“We”ll fund SCHIP and we”ll fund it at a greater level than the president has requested,” Roberts said recently in an interview with Kansas Public Radio. “Will it be enough for everybody? No. Will it be a better increase? Yes.”
Building on success
The SCHIP program is widely viewed as a success. The Kansas program, which currently costs about $63.2 million a year, covers 35,000 children whose families make too much to qualify for Medicaid but not enough to afford private health insurance.
U.S. Rep. Dennis Moore
“The SCHIP program has significantly decreased the number of kids in Kansas who do not have insurance,” said Sheldon Weisgrau, a senior policy analyst for the Kansas Health Institute. “If you go back to the year 2000, between then and now the rate of un-insurance for Kansas kids has gone down by about 25 percent.”
Even so, he said, approximately 48,000 Kansas children still lack health coverage. KAC and other child welfare organizations support Sebelius” proposal to expand SCHIP so that children in families earning up to three times the federal poverty rate
$61,950 annually for a family of four
would qualify for some level of state-subsidized coverage. The current Kansas eligibility limit is two times the federal poverty level.
Under the governor”s proposal, additional federal funding would be needed to fund the addition of children in families that earn up to 235 percent of the federal poverty level, about $47,000 for a family of four. But that additional federal money won”t be available unless Congress significantly increases SCHIP funding.
The governor”s proposal also would allow families that earn three times the federal poverty level and more to purchase SCHIP coverage for what it costs the state to offer it
about $140 a month per child.
“Lack of access to insurance is not just a problem of low-income working families it”s a problem that crosses into the middle class, certainly the lower middle class,” Brunk said. “All kids should have insurance and if what it takes is an infusion of state dollars to make that possible, I think that is a worthy investment.”
But some Kansas legislators
particularly Republican House members
say the governor”s expansion plan would make the program too generous. They are opposed to expanding SCHIP and Medicaid eligibility because they fear it could make the programs unaffordable in the future.
“We need to be very careful of who we are bringing into that so we don”t take them off private insurance, so we don”t make the state responsible for something they could pay for but chose not to,” said Rep. Bob Bethell, R-Alden, chairman of the House Social Services Budget Committee.
Many legislators in both parties are saying that before eligibility is expanded more needs to be done to get children who already are eligible for SCHIP and Medicaid into the programs. Currently, about 70 percent of the state”s uninsured children are eligible for one or the other of those programs but are not enrolled.
Reauthorization not in question
Most congressional observers agree SCHIP will be reauthorized. The question is: at what level?
If Congress were to approve President Bush”s proposal
which appears unlikely
there wouldn”t be enough money to serve children already enrolled in SCHIP let alone expand eligibility as Sebelius and several other governors are proposing.
“I”d like for it to go higher than that,” Roberts told KPR. “I”m not happy with the figure in the budget.”
Referring to the president”s proposal as “insufficient,” Moore said he supports a substantial increase in SCHIP but does not want to exempt the program from the pay-as-you-go rule adopted by the House”s new Democratic leadership, which requires spending increases be offset by revenue increases or cuts in other programs.
“I”m talking about cutting some wasteful program someplace else or finding increases,” Moore said. “We”re going to have to make some choices. I can”t tell you yet what those choices might be, but we”re going to make them.”
Brunk said he is thankful that SCHIP appears to have broad bipartisan support in Congress. But he said there is no guarantee the budget for the program will be increased to the level that he and other child welfare advocates believe that it should be.
“It”s by no means a done deal,” he said. “There are lots of things out there that are sort of begging for more funding.”
-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.