Renew SCHIP

Dear Friends and Colleagues;
I am seeking your help in mobilizing support to extend and expand the SCHIP (State Children's Health Insurance Program).
SCHIP was established in 1997 through a bipartisan effort to provide health insurance for several million uninsured children that do not qualify for Medicaid and otherwise would have fallen through the cracks of our so-called "healthcare system."
SCHIP is being funded by the federal and the state government(s) at an ~ 70/40 ratio.
It is set to expire and faces mounting criticism focusing on the following issues: a) including adults, b) including children from families whose income exceed 3-4 the poverty level, c) lack of physicians participation due to low reimbursement, d) allegations that it undermines the private health insurance system.
The AMA and other organizations SUPPORT the reauthorization of SCHIP. President Bush threatens to veto any new bill and objects on "philosophical grounds" to a bipartisan Senate proposal to boost the State Children's Health Insurance program by $35 billion over five years. Bush has proposed $5 billion in increased funding and has threatened to veto the Senate compromise and a more ambitious expansion being contemplated in the House.
Providing health insurance for approximately 4-5 million children has nothing to do with ideology, philosophy or faith. Its a common sense issue: provide primary care services for children now thereby preventing illnesses and costly treatment later in life.
Private insurance companies have FAILED to offer such services. I have spoken with many of my patients about that and have heard the same story over and over: in the beginning the insurance rates are affordable and then progressively increase until they cant afford it anymore.
Lets not get bamboozled by ideological knuckleheads at both extremes of the political spectrum.
Call your Senator and Congressman/woman and demand a reauthorization of the SCHIP program. Call the White House and remind our President that his veto is a veto against our children's health!
Yours
Bernd
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Miami Herald, Posted on Thu, Jul. 19, 2007
For healthy children, better opportunity
More than eight million U.S. children are starting out life with poor prospects because they lack health insurance. This is reason enough to support a federal program with a strong track record of helping Florida and other states provide coverage to needy children. Better yet, Congress appears poised to expand the program. It is the right move when the need to protect vulnerable children is so great.

In a rare instance of bipartisanship, there is widespread support in the Senate and House for an expansion of the State Children's Health Insurance Program. President Bush, however, threatens a veto. He believes the plans under discussion would unacceptably expand ''government-run healthcare.'' Surely there is reason to enact a bill with adequate controls that will significantly increase the number of children with ready access to healthcare.

Unacceptable proposal

The federal program insures children from working-poor families through state plans such as Florida's KidCare. Yet the current annual funding level of $5 billion doesn't stretch enough to cover all eligible children. This is why the Senate and House are discussing plans that would double or triple the funding.

President Bush is proposing a $1 billion increase per year, but that isn't enough. His proposal would result in a reduction in the number of children in the program be cause the funding wouldn't cover rising healthcare costs. This isn't acceptable.

The Senate bill is a compromise agreed upon last week. It would increase funding to $12 billion per year. It would also:

• Be financed by raising the cigarette tax to $1 a pack. This would discourage smoking and promote better health.

• Encourage states to enroll the poorest children and discourage enrollment of higher-income children. This targets the most vulnerable population.

• Leave out a key group that should be covered: up to 750,000 legal immigrant children who are not yet citizens. This is unfair and unhealthy. They should be included.

The House is considering a bigger expansion to $15 billion a year -- the estimated cost of covering all uninsured children.

President Bush and others argue that such an expansion would displace private coverage. But the vast majority of the millions of needy children who would benefit from the Senate plan currently are uninsured or would lose state coverage without increased funding. Tax subsidies proposed by President Bush would most benefit children who already have private coverage.

Insured children are more likely to get preventive healthcare, stay healthier, attend school and avoid the emergency room. Healthy children are better prepared to learn, which improves their future economic prospects. Expanding the federal program should radically improve children's access to healthcare nationwide.


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Miami Herald, Posted on Thu, Jul. 19, 2007
Senate panel OKs child health bill
By KEVIN FREKING
Brushing aside threats of a presidential veto, a Senate committee on Thursday approved a five-year, $35 billion expansion of a children's health insurance program that would be financed through higher tobacco taxes.

A majority of Republicans on the Senate Finance Committee joined all of the committee's Democrats in voting to reauthorize the State Children's Health Insurance Program. The program subsidizes insurance for children and some adults with incomes too high for Medicaid but not high enough to afford private insurance. The vote was 17-4.

"There are more kids without health insurance than there are kids in the first and second grades," said Sen. Max Baucus, D-Mont., the committee chairman. "Americans overwhelmingly support getting kids covered."

The additional spending the committee approved would bring total SCHIP funding to $60 billion over five years - double what the administration has proposed. The tax on a pack of cigarettes would increase by 61 cents to help pay for the expansion. Taxes on cigars and chewing tobacco also would jump.

The committee's Democratic leaders had wanted to add $50 billion to the program, and their House counterparts are determined to pursue that amount. The compromise forged by the committee could become extremely fragile if GOP senators are forced to vote on an expansion much beyond what the committee approved.

"I hope they understand it takes 60 votes to get anything done in the United States Senate," said Sen. Charles Grassley, R-Iowa.

The 60 votes would be needed to overcome a filibuster. Baucus said he believes his proposal has enough support to overcome such a hurdle, as well as a promised veto from the president.

"The vote speaks for itself," Baucus said.

Lawmakers said the $35 billion expansion would allow 6.6 million people to maintain their current health coverage, and it would provide coverage for another 3.2 million uninsured children.

The administration reacted to the vote by saying that sending the president a bill he cannot sign puts at risk millions of needy children who would lose health insurance when the program's funding expires Sept. 30.

"We are ready to renew our commitment to low-income children today, but we cannot agree to a gradual government takeover of health care - and neither will the American people," said Health and Human Services Secretary Mike Leavitt.

Some dissenters on the committee believe the legislation raises taxes unnecessarily and does not do enough to refocus the program on low-income children.

"The Democrats are playing a game of reverse Robin Hood with this legislation," said Sen. Trent Lott, R-Miss.

The program began 10 years ago. It was generally designed to help families whose income does not exceed 200 percent of the poverty level, or $34,340 for a family of three. But several states have extended coverage to children with higher incomes and to adults. The latter expansion has particularly incensed some lawmakers who disapprove of waivers the Bush administration has granted to those states.

The SCHIP program is going in the opposite direction from where it should be going, said Sen. John Ensign, R-Nev., who voted against the proposal along with Lott, Jim Bunning, R-Ky., and Jon Kyl, R-Ariz.

The Senate proposal would gradually move adults who don't have children out of the program. States would have the option to cover them through Medicaid. The federal government also would lower the percentage, or matching rate, that it pays for parents' coverage. In addition, the federal government won't be allowed to grant new waivers to states allowing them to cover parents. But states will have the option of providing coverage to pregnant women through SCHIP.

Congressional Budget Office officials testified that spending on adults would drop by $1 billion over the next five years under the Senate proposal.

"We've been handed a mess by this administration," said Sen. Kent Conrad, D-N.D., referring to the adult coverage. "This takes steps to change that. That's a fact."

Several advocacy groups are supporting the higher tobacco tax because it would not only fund the program's expansion, but because higher taxes also lead to less smoking.

For every 10 percent increase in the price of cigarettes, overall cigarette consumption drops by about 4 percent, and the rate drops even more for children.

"Research shows a clear health benefit from higher tobacco taxes," said William Carr, executive director of the Campaign for Tobacco-Free Kids.

Overall, the federal tax on a pack of cigarettes would go up to $1 a pack

The tax on cigars is much more complicated to calculate. But Norm Sharp, president of the Cigar Association of America, said the tax for large cigars could go from a cap of about 5 cents a cigar to a cap of $10 a cigar.

"We're looking at cigars going up in price at retail 2.5 times to 3 times current prices," Sharp said.

"How do we explain that, justify that, or do we even care?" Lott said at one point when asking colleagues about the tax increase on cigars.

"A $10 cap on a very expensive cigar would not be terribly onerous," Baucus replied
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Miami Herald, Posted on Thu, Jul. 19, 2007
Bush rejects children's health plan boost
BY CHRISTOPHER LEE
President Bush on Wednesday rejected entreaties by his Republican allies that he compromise with Democrats on legislation to renew a popular program that provides health coverage to poor children, saying that expanding it would enlarge the role of the federal government at the expense of private insurance.

The president said he objects on philosophical grounds to a bipartisan Senate proposal to boost the State Children's Health Insurance program by $35 billion over five years. Bush has proposed $5 billion in increased funding and has threatened to veto the Senate compromise and a more costly expansion being contemplated in the House.

''I support the initial intent of the program,'' Bush said during an interview after a factory tour and discussion on healthcare with small-business owners in Landover, Md. ``My concern is that when you expand eligibility . . . you're really beginning to open up an avenue for people to switch from private insurance to the government.''

The 10-year-old program, which is set to expire Sept. 30, costs the federal government $5 billion a year and helps provide health coverage to 6.6 million low-income children whose families do not qualify for Medicaid but cannot afford insurance on their own.

About 3.3 million additional children would be covered under the proposal developed by Senate Finance Committee Chairman Max Baucus, D-Mont., and Republican Sens. Charles Grassley of Iowa and Orrin Hatch of Utah, among others. It would provide a total of $60 billion over five years, compared with $30 billion under Bush's proposal. And it would rely on a 61-cent increase in the federal excise tax on cigarettes, to $1 a pack, an increase Bush opposes.

Grassley and Hatch, in a joint statement this week, implored the president to rescind his veto threat. They warned that Democrats might seek an expansion of $50 billion or more if there is no compromise. They also said Bush should drop efforts to link the program's renewal to his six-month-old proposal to replace the long-standing tax break for employer-based health insurance with a new tax deduction that would help people pay for insurance regardless of whether they get it through their jobs or purchase it on their own.

''Tax legislation to expand health insurance coverage is badly needed, but there's no Democratic support for it in the SCHIP debate,'' said Grassley, the ranking Republican on the finance committee. ``In the meantime, our SCHIP initiative in the finance committee takes care of a program that's about to expire in a way that's more responsible than current law and $15 billion less than the budget resolution calls for.''

But Bush said he was not persuaded.

''I'm not going to surrender a good and important idea before the debate really gets started,'' Bush said. ``And I think it's going to be very important for our allies on Capitol Hill to hear a strong, clear message from me that expansion of government in lieu of making the necessary changes to encourage a consumer-based system is not acceptable.''

The Senate committee is scheduled to consider the compromise legislation today, and the House is expected to try to pass its own version before the congressional recess in August.

Rep. Rahm Emanuel, D-Ill., the Democratic caucus chairman, said he was ''bewildered'' that Bush was fighting expanded funding for a program supported by Republicans and Democrats alike. ''This is the chance for him to finally be a uniter and not a divider,'' Emanuel said.

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