Protecting Insurance Companies on the Backs of the Poor, Part 2

crossposted from unbossed

Part 1 of this report may be found here. Part I included testimony by a woman about her family's struggle to provide health care to their children. For all follow-up posts, consider the testimony against this woman's lived experience. This part covers opening statements at the April 9, 2008 hearing. Statements of witnesses are in the next two posts.

The August 17 Bush Administration directive is akin to many other Bush Administration stealth strategies to undermine, repeal, and destroy laws that have been enacted by Congress and signed by the President. In this case, it seeks to prevent the extension of health coverage to children in poor families by placing requirements on the states, which, while they sound plausible,  are unattainable and are intended to make it impossible to provide SCHIP coverage to children who live in poverty.

This post will lay out key parts of the statements and testimony at that hearing. In addition to mandates in the August 17 directive, it also had other provisions that have caused concern among the states. One is the requirement that 95% of those families with income below 200% of the poverty rate participate before SCHIP is extended to those with income to the 250% poverty rate.

First, Here are the statements of the legislators:

Statement of Senator John D. (Jay) Rockefeller IV (D-WV)

A cornerstone of the Children’s Health Insurance Program has always been state flexibility. And at time of growing economic uncertainty, we should be making it easier – not harder – for states to cover those working families who are in need of assistance. This is particularly true since many employers may be reducing private coverage because of increasing economic pressures.

That’s why I’m so frustrated with the Bush Administration’s August 17 directive that has placed an unobtainable mandate on states. In my judgment, its aim is simple: to make it virtually impossible to provide greater access to health insurance for children.

To be blunt: the August 17 directive is a solution to a problem that doesn’t exist, except in the mind of Washington bureaucrats.

It’s clear to this Senator, and great many others on this committee, that the real genesis for this directive can be found in last year’s CHIP Reauthorization negotiations. When the Bush Administration realized it wasn’t going to get its way because an overwhelming bipartisan majority in Congress was committed to doing the right thing by our children – they resorted to the only options left open to them: veto and administrative fiat.

With the stroke of a pen, and for less than $100 in postage -- the Administration has unleashed a tidal wave of financial uncertainty that will be measured in the loss of billions of dollars in state-aid, and hundreds of thousands of children being denied access to health insurance.

Statement of Senator Max Baucus (D-Mont.)

We remain committed to reauthorizing the program in a way that will increase the number of kids covered. We still seek to give millions of kids a better future.

That commitment is at the heart of my concerns about the letter that CMS sent to the states on August 17, 2007. The so-called "CHIP directive" will limit enrollment. And that is the wrong direction.

It will limit states’ ability to provide their poor kids with access to health care. And that is the wrong approach.

The restrictive nature of the policies in the directive will leave states little flexibility to expand CHIP coverage in the ways that Congress intended when it created the program in 1997 or in ways that CMS has approved since then.

Quite simply — imposing hurdles to CHIP coverage means that fewer kids will get the health care that they need. It denies millions of kids that better future.

Some may think that the August 17th directive will not have much of an impact. For them, let me tell you about the situation in my home state of Montana.

Folks in Montana would like to expand CHIP eligibility as a way to provide more kids with access to health care. There is a ballot initiative under development that would raise CHIP eligibility to 250 percent of poverty. That would be an expansion from Montana’s current level of 185 percent of poverty.

Such an increase would add nearly 30,000 kids to the rolls in Montana. Last month, Montana’s CHIP enrollment was just over 16,000 kids. Montana is poised to almost double its CHIP enrollment. Montana is poised to dramatically decrease the number of uninsured Montana kids. Montana is poised to give thousands of kids a better future.

But the August 17th directive has Montanans nervous. Montanans are worried that the directive will prevent the expansion. Montanans are nervous that the administration will keep almost 30,000 kids in our state uninsured.

Opening statements by Sen. Orrin G. Hatch, UT and Sen. Charles Grassley, IA are not up on the website yet.

The other parts in this series are:

Part 1

Part 3

Part 4