( - promoted by Isaac Smith)
In my real life, I work on health care policy. I try to stay on top of public transit issues in my spare time just because I am that sort of nerd. This week, both the House and Senate are taking up a bill to reauthorize the State Children's Health Insurance Program (SCHIP). The CHAMP bill (S 1893/ HR 3162/maybe HR 976 for parliamentary reasons that even wonks find boring) would, House-side, make some serious cuts to Medicare Advantage and increase the federal tax on tobacco by 45 cents to pay for the program; the Senate version would increase tobacco taxes 61 cents per pack (current tax is 39 cents p/pack). SCHIP is a federal/state health insurance program that covers kids with family incomes too high for Medicaid but too low for private health insurance. The authorization for the entire program runs out on September 30. That doesn't mean that all the kids covered under will lose health insurance on the 30th -- many programs that are unauthorized receive annual appropriation. And Congress is likely to pass a temporary extension before it expires. But, it does mean that some kids will get the short end of the stick if the reauth doesn't pass. Fourteen (14) states -- Maryland among them -- have essentially run out of money for SCHIP. |
| The program is a federal/state share - the federal government pays 70% and the state pays 30%. Kids with family incomes up to 200% of the federal poverty level (FPL) are eligible -- that's about $34,000 for a family of three. States can apply to CMS for waivers to cover kids with higher family incomes, pregnant women, and the parents of eligible kids. As a high-cost-of-living state, MD applied for a waiver to cover kids and pregnant women with higher incomes. And every year since 2000, MD has overspent its SCHIP allotment. In order to keep the program running, MD has received "unallotted funds." That is, if other states haven't spent all their funds, they go back into a big pot where they are redistributed. This has caused quite alot of wrangling among members from (mostly) high-cost urbanized states v. (mostly) lower-cost less densely populated states. The reauth is important to MD. About 9% of kids in MD -- some 140,000 -- are uninsured at some point during the year. Two-thirds are from families with incomes up to 300% of the FPL. Given that MD has long-standing, concentrated poverty, coupled with high rates of childhood asthma and (finally declining) childhood lead exposure, it is important that the state be able to provide routine preventative care. Without it, these kids are at risk of mental retardation, untreated asthma which lead to inactivity (and worse), which may lead to obesity, which may lead to diabetes, which is linked to cardiovascular disease, renal failure (but then you can get Medicare -- oh the irony!), blindness, etc. MD tried to cover more citizens with the Fair Share bill last legislative session. But it ran aground of federal ERISA rules (I'm not a lawyer and don't even pretend to play one so I'll leave that alone). The reauthorization is a chance to ensure that the most at-risk kids in MD aren't given the shaft. Again. If you're interested in the bills, you can visit the Senate Finance Committee and the House Energy and Commerce Committee. And call your rep and Mikulski and Cardin to remind them how important it is not just to extend the program -- thereby continuing the funding shortfall -- but to reauthorize it at a level that will cover all eligible kids. |
