President Bush’s threat to veto a bipartisan-supported bill to expand the Children’s Health Insurance Program was ignored this week by Congress, who passed the measure.
Drafted over the last six months by senior members of the Senate Finance Committee, the bill is intended to cover the millions of children who will go uninsured if no action is taken when the program expires on September 30th. Eight million children in the U.S. currently lack healthcare coverage, including more than 1.3 million in Texas alone, and 7.4 million are insured under the present program. If not vetoed, the new plan would reduce the number of uninsured children by half — 4.1 million — over the next five years, according to the Congressional Budget Office.
Texas, arguably, may be one of the states most affected by the outcome of changes to the CHIP, with 25% of its total population going without any health insurance whatsoever. Between 2001 and 2003, 21% of Texas children were uninsured, twice the national average of 11%. Cuts in 2003 to the national program discontinued benefits for 36% of Texas’ CHIP caseload; further cuts may absolutely devastate the state’s already-strained healthcare system.
The bill, which is supported by the Democratic majority in Congress, Republican lawmakers, and many governors of both parties was approved, despite presidential protests. “There is no question that the president would veto it,” said White House spokesman Tony Fratto earlier this month.
The bipartisan plan would be funded by increasing the federal excise tax on tobacco products, giving the program $35 billion over the next five years, in addition to the $25 billion already slotted. The Democrats originally asked for even more — $50 billion over the next five years.
In contrast, the President’s proposal would add only $5 billion to CHIP’s budget in the same amount of time. Spokespersons for the White House say the plan would insure non-poor children, encouraging parents to drop private coverage and depend on government subsidies. Additionally, the bill does not include Bush’s suggestions for altering the tax treatment of health insurance, making coverage more affordable to millions.
Republican Senator Charles E. Grassley (IA), says he would gladly consider tax proposals, but “it’s not realistic to think that can be accomplished before the current children’s health care program runs out in September.”
But Texas doesn’t have the luxury of losing funding to CHIP, where more children are uninsured than in any other state, according to the Texas Hospital Association. Its percentage of uninsured is the worst in the country, and 86% of Texas voters in 2006 supported making health insurance more affordable and accessible to the wider population. Nearly nine out of ten believed the state should have a responsibility in increasing health insurance access, as a portion of the costs of the uninsured are borne by those who have insurance through higher premiums. In fact, annual health insurance premiums were $1,551 higher in Texas than the national average due to unreimbursed costs of caring for the uninsured, according to a 2005 Families USA study.
The uninsured tend to seek routine care at hospitals, where they cannot be refused an evaluation. These costs, then, are often carried by local taxpayers and by those with health coverage. This is particularly a problem in Austin, Dallas, and Houston, where many travel from rural areas of the state to seek care. But, in contrast to what many believe, most of those who are uninsured in Texas — eight out of ten — are working individuals who simply cannot afford coverage.
To add to the chorus of organizations reporting poor healthcare in the state, the Kaiser Family Foundation released a report stating that the uninsured are “less likely to have a regular source of care, to delay or forgo needed care, and to miss out on preventative care due to lack of coverage.” The American Hospital Association chimed in to state adults who lack health insurance are more likely to report “poor” or “fair” health than adults with coverage. In Texas, that means 27.6% of uninsured reported “poor” or “fair” health. Children are not depended upon to accurately report their own state of health, but translate those results into the juvenile population, and Texas — let alone the rest of the country — has a serious problem, indeed.
Many — uninsured and insured — eagerly anticipate the final outcome of this bill, as it will eventually affect nearly everyone, in some way or another. Premiums for those who already have health coverage may go down due to decreased deflected costs; increases in the budget to CHIP would allow millions of children to have insurance whose families currently cannot afford it. What is absolutely certain is that a response must be made, and soon, by Congress, to a healthcare crisis slowly crushing the nation.
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