Sep 04 2007

Opinion: Backers of health plan for kids have other motives

They've proved that their cause is more about a government monopoly than about needy children.

Washington's rhetoric often fails to match reality, a truism reaffirmed by Congress' recent move to expand the State Children's Health Insurance Program (SCHIP), a 10-year-old program created for kids in low-income families.

Again and again, political proponents of SCHIP expansion insinuated that opponents were heartless, while their own motives were as pure as the program's purpose: to give health coverage to needy children who lack it.

But expansion advocates just as consistently voted down amendments designed to keep the program's focus on serving uninsured poor kids.

The vote tallies reveal that SCHIP expansion has little to do with either children or poverty.

Back in July, a Heritage Foundation study found that a leading SCHIP expansion proposal would actually give "free" (taxpayer funded) coverage to some families considered so wealthy they will have to pay the alternative minimum tax (AMT). Levied on high-income households, the AMT was created to block "the rich" from avoiding their fair share of taxes.

It takes a great deal of chutzpah to wrap yourself in the rhetoric of helping poor kids while crafting a bill to extend public health assistance to tens of thousands of families being taxed for excessive wealth. Yet Washington never seems to run a chutzpah deficit.

In response to the Heritage report, Sen. John Thune, R-S.D., tried to amend the Senate bill to bar families that pay the AMT from getting public assistance under SCHIP. What did the Senate do? It voted down the Thune amendment, 57-42.

Apparently, a majority of the Senate doesn't care about concentrating your tax dollars on helping the needy. After all, that's not where the votes are.

It gets worse. Whether or not a child is already covered by private health insurance doesn't matter to a majority of our senators either. A major criticism of SCHIP expansion is that it pushes children out of superior private coverage and into the public, taxpayer-funded program.

According to the Congressional Budget Office, this "crowd-out" effect may be as high as 50 percent. In other words, for every two children who would get coverage under SCHIP, one child would lose private health insurance coverage. As you go up the income scale, the "crowd out" gets worse, moving more and more kids out of private coverage and into the government health system. It's a tremendously inefficient way to combat the problem of uninsured children and is mind-bogglingly expensive for taxpayers, as well.

To address the "crowd-out" of existing coverage, Sen. David Vitter, R-La., offered an amendment to exempt individuals who already have employer-sponsored health insurance from eligibility for SCHIP coverage. What happened? Vitter's amendment was beaten -- big time -- by a vote margin of 64-35.

One thing's pretty clear. Most senators don't mind spending taxpayers' dollars to insure the already insured. Undermining the private health insurance coverage of families with children is just fine with them.

And if you thought it couldn't get any worse, you're wrong.

In recent years, several states have expanded their SCHIP programs to include adults, such as those who live with eligible children. These program expansions dilute SCHIP's focus, taking federal dollars and other resources away from needy children and increasing the "crowd-out" problem.

Sen. John Ensign, R-Nev., came up with a simple solution: Stop states from spending SCHIP money on adults (except pregnant women) until they have first enrolled most all (95 percent) of the eligible poor children. Common sense? Yes. But the Senate shot even this proposal down on a 55 to 43 vote.

Perhaps the most revealing Senate vote came on an amendment from Sen. Tom Coburn, R-Okla., a physician who knows a thing or two about our nation's health system. If the Senate insists on making children in middle-class families eligible for public assistance, Coburn asked, why not at least try to do so in a way that would disrupt their existing private health coverage as little as possible?

Coburn proposed requiring states that want to use SCHIP funds to aid non-poor families to do so by helping them pay for private employer-sponsored health coverage. Coburn's amendment failed by a vote of 62 to 37.

So ignore the politicians' rhetoric on SCHIP. Instead, look at what they approved and what they rejected. It becomes clear that expanding SCHIP isn't so much about helping poor, uninsured children get the coverage they need. Rather, it's an effort to chip away at private health coverage and move more and more people into a government-controlled health program.

The needy children, one fears, are just heart-rending props, meant to distract attention from the fact that Congress is moving ever closer to creating a government monopoly over health care.

Andrew Grossman is a research editor at the Heritage Foundation, where Robert Moffit directs the Center for Health Policy Studies. They wrote this article for McClatchy-Tribune News Service.