[NYTr] Bush plan would cut health care for 600, 000 California kids

[All the News That Doesn't Fit]

San Diego Union-tribune - September 29, 2007
http://www.signonsandiego.com/news/state/20070929-9999-1n29health.html

Bush plan would cut health care for 600,000 California kids

By Bill Ainsworth

Sacramento - President Bush has vowed to veto legislation Congress
passed this week to expand children's health insurance, but his own
alternative would leave 600,000 California children without coverage
over the next two years, state officials said yesterday.

A presidential veto would also place one more hurdle in front of
Gov. Arnold Schwarzenegger's universal health care proposal, which
counts on more federal money.

"Our state's values have moved to the place where we want to cover
all our children," said Lesley Cummings, who administers Healthy
Families, which is California's version of the State Children's
Health Insurance Program. "But this would move us backward."

Schwarzenegger, who campaigned for Bush in 2004 but has since clashed
with his fellow Republican, has strongly lobbied in favor of the
federal legislation. This week, he spoke with Health and Human
Services Secretary Mike Leavitt on behalf of the bill.

Last month, Schwarzenegger said he was puzzled by the president's
opposition to expanding the federal SCHIP program.

"We all sit there and say 'Where did that come from?' " Schwarzenegger
said.

"You can't go wipe out the deficit on the backs of children."

The legislation, passed with bipartisan majorities in the Senate
and House, would expand the popular State Children's Health Insurance
Program, which aims to cover children of the working poor by adding
$35 billion over the next five years. The extra money, which would
be paid for by a 61-cent per pack increase in tobacco taxes, would
cover 4 million of the estimated 9 million uninsured children in
the United States.

The program currently covers more than 6 million children from
families that cannot afford health insurance but earn too much to
qualify for Medicaid.

Bush is proposing $5 billion in new spending for the program while
reducing the number of eligible children.

The California HealthCare Foundation estimates that Bush's approach
will force the state to drop hundreds of thousands of children from
Healthy Families.

It would do so in two ways: failing to provide enough federal money
to meet the increasing population, and reducing eligibility.

California allows children to enroll in the program if their families
earn up to 250 percent of the federal poverty level. In 2007, that's
the equivalent of $51,000 a year for a family of four.

Bush wants to limit the program to those who earn 200 percent of
the federal poverty level, or $41,000 a year for a family of four.

Schwarzenegger, as part of his proposal to cover California's 6.5
million uninsured residents, wants to expand Healthy Families to
children whose parents earn 300 percent of the poverty level, to
$62,000 a year for a family of four.

The federal poverty level is a national figure, but California has
a higher cost of living than most other states. State officials
contend that those who earn $62,000 a year in a family of four still
qualify as the working poor in California.

A veto appears all but certain, and House Republicans are likely
to block any attempt to override it. The program is set to expire
at midnight tomorrow, but the president and congressional leaders
have agreed to continue current levels of funding through mid-November.

Bush has said the bill moves toward a government takeover of health
care and would include middle-class children who were never supposed
to be covered by the program. He will discuss the legislation in
his weekly radio address today. The White House released transcripts
of excerpts yesterday after Bush taped the address.

"Congressional leaders have put forward an irresponsible plan that
would dramatically expand this program beyond its original intent,"
he said in the taped remarks. "And they know I will veto it. But
it is good that they kept the program running while they try to
work out a more responsible approach."

Critics note that in Bush's 2004 Republican National Convention
speech, he pledged to lead an aggressive effort to enroll poor
children in government health insurance programs.

They also point out that he has vastly increased government health
care in the past. In 2003, Congress approved a huge expansion of
Medicare pushed by Bush that will cost the federal government an
estimated $720 billion over 10 years by subsidizing prescription
drugs for seniors.

The Medicare expansion is dramatically larger than the children's
plan approved by Congress.

"Clearly, there is a crass political calculation that seniors vote
and children don't," said Anthony Wright, executive director of
Health Access, which lobbies for expanded coverage. "But parents
do vote and that will come back to haunt President Bush and
congressional Republicans who support him."

Opponents of the bill contend that expanding children's health
insurance would crowd out employer-sponsored insurance. The
Congressional Budget Office has projected that nationally about 2
million children who otherwise would have private insurance would
join the program if it is expanded.

But Peter Harbage, a health care consultant with the New America
Foundation, disputes that.

For one thing, he said, employer-based insurance is already declining
throughout the nation because of its skyrocketing costs. Between
2001 and 2005, the percentage of Californians who get health insurance
from private employers declined to 58 percent from 61 percent, he
said.

In addition, Harbage said the state has provisions to discourage
people and businesses from dropping their insurance. Children who
enroll in Healthy Families have to be uninsured for three months
before they are allowed to sign up, he said.

Officials in California say vigorous outreach, a simplified application
and Schwarzenegger's focus on health insurance have all helped
enrollment in Healthy Families soar by 15 percent in one year.

Under the children's health insurance program, which had strong
bipartisan support from its beginning 10 years ago, the federal
government pays two dollars for every dollar supplied by the state.

In California, the program contracts with a variety of private
companies, including Health Net and Blue Cross. Parents pay monthly
premiums of between $4 and $15 per child.