The Children's Health Insurance Program Reauthorization Act expands the State Children’s Health Insurance Program (SCHIP) and reauthorizes it through 2013. SCHIP, founded in 1997, currently provides health insurance coverage to 7 million children from low- and middle-income families that cannot afford private health insurance but are not eligible for Medicaid benefits. The program is jointly financed by the federal and state governments and is administered by the states. The bill expands SCHIP eligibility, enabling states to enroll an additional 4 million children. Coverage for dental and mental health care is guaranteed. The bill permits states to provide Medicaid and SCHIP coverage to legal immigrants, revoking a previous requirement that resulted in a 5-year delay in coverage, and also allows states to cover pregnant women. However, the legislation phases out coverage for certain who are currently covered in some states. The reauthorization also provides federal incentives for states to make intensive efforts to enroll more of the lowest-income uninsured children in Medicaid.
The legislation increases spending by around $30 billion between 2009 and 2013. The increased funding is paid for with a 61-cent increase in cigarette taxes. The program is not open to undocumented immigrants.
The Middle-Class Position:
The Middle Class Supports. Being able to take a child to the doctor for regular check-ups and immunizations is fundamental to a middle-class standard of living. This legislation would put that middle-class building block within the reach of more Americans. Though 8 million children are currently uninsured, SCHIP has been highly successful at shrinking the number of uninsured low-income children, helping reduce the uninsured rate by about one third between 1997 and 2005. However, as employer-provided coverage has declined – only 60% of U.S. companies offered health insurance in 2007 compared to 69% in 2000 – and as premiums rise – premiums have increased 78% since 2001 and health care coverage costs have outpaced increases in wages more than 3 to 1 since 2000 – children are increasingly at risk of going without insurance, especially during a recession in which the ranks of the unemployed have grown by 3.6 million people.
According to the Congressional Budget Office, the legislation’s increased funding would enroll in SCHIP 1.6 million children who would otherwise be unenrolled and uninsured, would prevent 1.8 million children from losing their coverage, and would enroll about 700,000 children newly eligible for coverage under the bill’s broadened enrollment criteria. Expansion of SCHIP is crucial to ensuring that more children, particularly of the aspiring middle class, do not fall into the ranks of the uninsured as the economy worsens and states cut important programs in the face of severe budget crises. Indeed, 22 states have already implemented or are considering cuts that will affect low-income children’s or families’ access to health insurance.
Underfunding SCHIP has consequences, not only for children’s individual health and well-being, but for society as a whole, which bears the cost of preventable emergency room visits from children who never received preventive care. By renewing SCHIP and expanding it to more low- and middle-income children, this bill offers children a healthy start in life.
From the Experts:
“Sharp increases in unemployment have likely added more children to the ranks of the uninsured and put increasing pressure on state health care programs. Making sure that all children have access to health care is an investment in America’s future and will enable kids to have the best chance to learn, develop and succeed in life.” – Nancy Nielsen, President, American Medical Association
“[E]xtensive evidence demonstrates that Medicaid and SCHIP have bolstered children’s health insurance coverage, strengthened access to medical and dental care, and improved children’s health. Other research indicates that improved child health may ultimately lead to better health when children grow up to become adults, so there could be more long lasting repercussions.” – Leighton Ku, Mark Lin, and Matthew Broaddus, Improving Children’s Health: A Chartbook about the Roles of Medicaid and SCHIP
Beyond this Bill:
This legislation will put a significant dent in the number of uninsured children in the United States, but it still leaves millions without access to medically necessary care. At the same time, the American health care crisis extends far beyond children: almost 38 million people over age 18 went uninsured in 2006. A true solution must provide coverage for all Americans.
Percentage of all children who are uninsured: 11.0
Percentage of children in poverty who are uninsured: 17.6
Percentage of uninsured children with no usual place of care: 32
Percentage of children with private coverage and Medicaid or other public coverage with no usual place of care, respectively: 3, 4
Number of children who would otherwise be uninsured by 2013 without this legislation: 4.1 million
Percentage of additional children who would gain SCHIP or Medicaid coverage under the legislation who would otherwise be insured with private coverage at some time before 2013, as estimated by the Congressional Budget Office: 37
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