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Children’s Health Insurance: Just the Facts

Bills to expand the State Children's Health Insurance Program demystified.

This nation’s health system is broken, with costs as well as the number of uninsured Americans rising rapidly. An exception to these bleak trends has been the success of the State Children’s Health Insurance Program, or SCHIP. Enacted in 1997, the program has provided millions of previously uninsured children with health care coverage and cut the uninsured rate among children by one-third.

Last week, the Senate Finance Committee passed legislation to reauthorize and expand SCHIP. This week, two key House committees introduced a separate and even bolder plan. The proposals would cover from 4 to 5 million uninsured children respectively, sustain and strengthen the program, and be fully offset to maintain fiscal discipline.

Yet the president has threatened to veto both bills. He claims they spend too much and expand “government-run” programs, and he raises “philosophical” concerns. This posturing flies in the face of his previous support for adding a drug benefit to Medicare, which cost seven times as much with no offsets. His rhetoric ignores the public-private partnership that is SCHIP: Most states insure kids through private plans. And even compassionate conservatives such as Senators Grassley and Hatch object to the idea of allowing millions more children to become uninsured because of a blatantly partisan philosophy.

But this is no time for partisan ideology. The current program is set to expire September 30. If Congress doesn’t reauthorize SCHIP with higher levels of funding, hundreds of thousands of children stand to lose access to affordable health care.

To help navigate the debate, the Center for American Progress has compiled the facts on children’s health insurance. From congressional testimony to reports on the effects of budget shortfalls on minority children, children’s health care benefits and a series of interactive maps, CAP has SCHIP covered.

How does SCHIP work?

The program covers kids in families with incomes too high for Medicaid but too low to afford private or employer-sponsored insurance. With funding both from the federal government and from their own treasuries, states can decide whether to create a separate SCHIP program, expand Medicaid, or both. States have the flexibility to set income eligibility limits, and most states cover children in families with incomes of up to 200 percent of the federal poverty level. Any money that states don’t use can be redistributed to other states that face shortfalls.

How is SCHIP helping children?

A look at the numbers shows just how successful SCHIP has been in the past 10 years…

  • 6 million children enrolled over the course of a year.
  • 4.1 million children enrolled in June 2007.

…but also how far we still must go to achieve affordable coverage for all:

  • 9 million children are still uninsured.
  • The White House estimates that 1.1 million currently uninsured children are eligible for SCHIP or Medicaid…
  • …But the Congressional Budget Office estimates that 5 million to 6 million currently uninsured children are eligible for SCHIP or Medicaid.

How has SCHIP helped minority children?

As CAP reported earlier this year, minority children would be disproportionately affected if the program is not reauthorized and if reauthorization does not include funding to enroll currently eligible children:

More than 80 percent of uninsured black children and more than 70 percent of uninsured Hispanic children appeared to be eligible for SCHIP or Medicaid based on 2003 eligibility rules. Meanwhile, 60 percent of uninsured white children appeared to be eligible.

82.4: percentage of black children with health insurance in 1996.

88.7: percentage of black children with health insurance in 2005.

71.9: percentage of Hispanic children with health insurance in 1996.

80.3: percentage of Hispanic children with health insurance in 2005.

Children with health insurance are much more likely to be immunized and receive preventive care that can keep them healthier in the long run. SCHIP and Medicaid have made remarkable steps toward decreasing disparities for minority children, but the programs need more federal support to continue their successes.

How can we help SCHIP cover more children?

The House and Senate are both considering expansions of SCHIP. Here’s how they break down:

Senate

$35 billion: additional funding to be distributed to states over the next five years under the Senate plan.

4.0 million: additional children who would gain coverage.

61 cents: tax increase per pack of cigarettes to fund expanded children’s health insurance under bipartisan Senate plan.

17: number of Senators on the Finance Committee who voted for the funding reauthorization.

4: number of Senators on the Finance Committee who voted against the funding reauthorization.

House

$50 billion: additional funding to be distributed to states over the next five years under the House plan.

5.1 million: additional children who would gain coverage.

45 cents: tax increase per pack of cigarettes to fund expanded children’s health insurance under House plan, in addition to cuts in federal subsidies to Medicare Advantage plan providers.

Bush administration

$5 billion: additional funding to be distributed to states over the next five years under the Bush administration plan.

Several hundred thousand: children who would lose coverage under Bush administration plan to funnel money and children into inadequate private coverage.

The choice is clear. Children’s health should not be sacrificed for the sake of partisan ideology. Every low-income child in America deserves affordable and adequate coverage. Reauthorizing and expanding SCHIP is a good first step toward health care for every child.

Read More about Children’s Health Insurance from the Center for American Progress:


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