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Advocates Push to Extend Children’s Health Insurance Program

May 28, 2007 at 6:30 PM EST
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JUDY WOODRUFF: And now, the fight over extending a government health insurance program for children. Susan Dentzer of our Health Unit has the story. The unit is a partnership with the Robert Wood Johnson Foundation.

CLASS (singing): Red, yellow, black and white…

SUSAN DENTZER, NewsHour Health Correspondent: At this recent gathering at a Kansas City Church, the focus was on kids.

REV. RAYFIELD BURNS, Metropolitan Missionary Baptist Church: It is our shared vision that all children will have the access to quality, affordable health care.

SUSAN DENTZER: Baptist Minister Rayfield Burns gave the opening meditation before an audience of concerned citizens and advocates for children’s health.

REV. RAYFIELD BURNS: How can we refuse not to put our arms around them and be a blessing for them?

SUSAN DENTZER: Similar events are taking place across the country under the auspices of groups like the PICO National Network, a faith-based organization.

REV. KIM ROSS, One Spirit Methodist Church: Cover all children. Bless all children.

SUSAN DENTZER: This one at the city’s Metropolitan Missionary Baptist Church was part of an interfaith move to press for health insurance for all of America’s kids. Methodist Minister Kim Ross gave the political call to action, urging steps at the federal level on the State Children’s Health Insurance Program, or SCHIP.

REV. KIM ROSS: Congress still needs to quickly reauthorize SCHIP. And here in Missouri, our elected officials need to put our state back on track, back on track to covering all children.

Debate in Congress over SCHIP

SUSAN DENTZER: The push to frame kids' coverage as a moral issue comes at a critical time. Here in Washington, Congress will soon begin debating whether and how to extend SCHIP, the joint federal and state health insurance program for children. Enacted 10 years ago, the program will expire unless Congress renews if by September 30th.

That prospect has sparked a broader debate over expanding publicly funded health insurance, like SCHIP, as one means of providing health coverage for all Americans.

Democratic Senator Max Baucus of Montana heads the Senate Finance Committee.

SEN. MAX BAUCUS (D), Montana: My view is that, fundamentally in our country, we have to find ways to create health insurance coverage. We're the only country in the industrialized world that does not have universal coverage. I think the Children's Health Insurance Program is another step to move toward universal coverage.

SUSAN DENTZER: That's what worries the Bush administration, says Health and Human Services Secretary Michael Leavitt.

MIKE LEAVITT, Health and Human Services Secretary: There are many who would like to use the Children's Health Insurance Plan to be the engine that pulls the train of universal federal insurance. People don't want Washington running health care. They do aspire, all of us aspire to have every American with access to a basic insurance policy at an affordable rate.

DOCTOR: I'm going to lift something behind you, OK?

SUSAN DENTZER: The outcome of this debate could have a major impact on the SCHIP programs in Missouri and other states.

DOCTOR: Can I look in this ear?

SUSAN DENTZER: Like Medicaid, the program covers 28 million poor children, SCHIP is a partnership between the states and the federal government. It covers kids whose parents are not poor but have low to moderate incomes. Six million children are now enrolled.

That means that, all together, Medicaid and SCHIP now cover 45 percent of America's children. One is 3-year-old Christopher Bell. He and his mother, Ebony, came to Children's Mercy Hospital in Kansas City recently for treatment of his asthma.

DOCTOR: Work on it. Put this over your head.

Decreasing the number of uninsured

SUSAN DENTZER: Christopher's is just the sort of family Congress set out to help with SCHIP.

DOCTOR: You're doing so good.

EBONY BELL, Mother of Christopher Bell: Come on, baby, go with Mama. Come on.

SUSAN DENTZER: Ebony Bell works as a paraprofessional at a Kansas City public school and earns just over $10 an hour in her 30-hour-per-week job.

EBONY BELL: Here, you do it.

SUSAN DENTZER: Christopher Bell was previously covered by Medicaid, but since Ebony got a recent raise, her income is too high for him to qualify. But for $15 a month in premiums, Bell recently learned she can buy coverage for her son in SCHIP. Bell says she's grateful, since, without the coverage, Chris' asthma medicine could cost almost $200 a month.

EBONY BELL: Be good, you hear me?

They say no child should be left behind for school; then, no child should be left behind for health care. All of them should be covered.

SUSAN DENTZER: For the first decade of the SCHIP program, Congress appropriated $40 billion and offered it for states at attractive terms. Both Medicaid and SCHIP require state contributions, but the states have to put up less to get SCHIP dollars from the feds. Beth Griffin is executive director of the advocacy group Citizens for Missouri's Children.

BETH GRIFFIN, Citizens for Missouri's Children: In the late '90s, we had about 12 percent of our children uninsured. And with the implementation of SCHIP, that number went down to 6 percent, so it was a big success.

SUSAN DENTZER: Missouri took advantage of an SCHIP option that allowed states to cover families with incomes up to three times the federal poverty level. Steve Renne is the state official who oversees Missouri's SCHIP program.

STEVE RENNE, Missouri Department of Social Services: We are pretty generous in the income level that we go to, and I think that is reflective of the general support for trying to make health insurance available for children.

Alternative to private insurance

SUSAN DENTZER: Missouri families earning up to about $62,000 a year for a family of four can buy SCHIP coverage, usually at premiums far below what they pay for private insurance.

One family who's gotten coverage is that of Marisa Chavez, a Kansas City single working mom with three kids. Chavez's 12-year-old daughter, Michelle, was recently diagnosed with a mental health condition, and she's been treated here at Children's Mercy Hospital in Kansas City.

Chavez, a medical technician, had private health insurance at her previous hospital job, but she switched to a new position at higher pay. She now makes $41,000 a year but says she can't afford her new company's private health insurance. Now, the fact she'll pay just $180 a month in premiums for SCHIP coverage is a godsend.

MARISA CHAVEZ, Mother of Michelle Chavez: I don't even have money to save for my children's education, so when there's something like this out there to help you out, it's a relief.

DOCTOR: And did they give you two inhalers?

SUSAN DENTZER: Studies show coverage under Medicaid and SCHIP improves kids' health. One clear result is fewer asthma-related attacks for kids like Shatavia Thomas. Along with her mother, Cassandra, the toddler came to Kansas City's Samuel U. Rogers Health Clinic recently for a checkup.

MARISA CHAVEZ: At night, sometimes she'll just be sleeping, and she'll try to take her breath, and she'll stop. And it scares me, because I don't know if it's because of just normal things babies do or if it's because of the asthma.

SUSAN DENTZER: Clinic doctor Padma Krishna put Shatavia on a so-called asthma action plan. It's aimed at minimizing attacks and costly trips to hospital emergency rooms.

DOCTOR: It needs to be in this zone. It's called green zone.

SCHIP short on money?

SUSAN DENTZER: But about 120,000 Missouri kids are still uninsured, and nationally an estimated two million more kids are eligible for SCHIP but not enrolled. One key reason is the program has run chronically short of money; that issue is now at the heard of the SCHIP debate in Washington.

The Bush administration has proposed spending $34 billion on SCHIP over the next five years, an amount it says will accommodate all kids now on the program. But Democrats and some Republicans say as much as $75 billion will be needed, not only to cover kids now on SCHIP, but also to get all eligible children enrolled.

SEN. MAX BAUCUS: I'm chagrined and even astounded at the administration's suggestion that we cut back on coverage for kids.

SUSAN DENTZER: Baucus says the $75 billion is needed not only to cover kids now on the program, but also to get all kids eligible for SCHIP enrolled. Also at issue is future eligibility for SCHIP and whether to keep the program focused on low-income kids or expand it higher up the income scale.

For example, the Bush administration wants to limit coverage to families at twice the federal poverty level, or $41,300 for a family of four.

MICHAEL LEAVITT: We want to reauthorize it. We want to focus it where it was intended, and that is for children in low income.

SUSAN DENTZER: But that could mean Missouri would have to scrap its coverage of somewhat better-off families.

BETH GRIFFIN: The president's proposal doesn't go far enough, and it will cause Missouri to cut back, I'm afraid, on coverage for kids.

SUSAN DENTZER: By contrast, some bipartisan congressional proposals would actually expand eligibility further, to families earning up to $82,600 for a family of four. The Bush administration says that could contribute to further shrinkage of private health coverage. It points to a new Congressional Budget Office study that says that, for every 10 kids who've gone on SCHIP, up to five have lost private insurance.

MIKE LEAVITT: One thing we know is that, when you put people on government programs, that those who are on private insurance diminishes.

SEN. MAX BAUCUS: I'm just very, very nervous about the administration's efforts to try to tilt the balance more in favor of private at the expense of public. There's got to be a balance.

SUSAN DENTZER: Back at Metropolitan Missionary Baptist, religious leaders said their goal was simply to make certain that all kids got health coverage, public or private, and soon.

RELIGIOUS LEADER: Now, you older people tell me, which one of these children shouldn't have health care? Cover all the children; they're all God's children.

SUSAN DENTZER: The House and Senate are expected to begin work on SCHIP legislation next month.