Words, Actions at Odds on Children's Health Care

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Words, Actions at Odds on Children's Health Care

U.S. Poised to Take Back $1.1 Billion Despite Bush's Vow

 

By Ceci Connolly

Washington Post Staff Writer

Saturday, September 25, 2004; Page A05

 

In his convention address in New York, President Bush announced a new

$1 billion initiative to enroll " millions of poor children " in two

popular government health programs. But next week, the Bush

administration plans to return $1.1 billion in unspent children's

health funds to the U.S. Treasury, making his convention promise a

financial wash at best.

 

The loss of $1.1 billion in federal money means six states

participating in the State Children's Health Insurance Program face

budget shortfalls in 2005; it is enough money to provide health

coverage for 750,000 uninsured youngsters nationwide, according to two

new analyses by advocacy organizations.

 

" If the Bush administration really cared about covering uninsured

children, one of the things it could do immediately is make sure this

$1 billion is used for SCHIP, " said Debra Ness, president of the

National Partnership for Women and Families. " The irony is this

president talks constantly about not leaving any child behind and how

he is going to cover so many kids. In truth, that ended up being

false. He's just moving money around. "

 

Over the objections of the National Governors Association and a

bipartisan coalition of lawmakers, Bush opposes giving states more

time to spend the money. In previous years he supported an extension,

but he struck it from this year's proposed budget. Even if Bush

belatedly endorses a bill extending the SCHIP spending deadline, it

will come at a price: Congress is required to trim $1.1 billion

elsewhere in the budget if it lets states keep the money.

 

SCHIP, created in 1997, is a federal-state initiative widely popular

among public officials and the private sector that provides $40

billion in health care matching funds to states over 10 years. Despite

its popularity, the most recent Census Bureau data show that 8.4

million American children remain uninsured, prompting Bush to declare

his desire to enroll many more in SCHIP.

 

" America's children must have a healthy start in life, " he said in his

convention speech. " In a new term, we will lead an aggressive effort

to enroll millions of poor children who are eligible but not signed up

for the government's health insurance programs. We will not allow a

lack of attention, or information, to stand between these children and

the health care they need. "

 

The statement was one of the few new health ideas Bush has introduced

in the 2004 campaign, and it sparked enthusiasm in social policy

circles. Soon, however, state officials, budget analysts and

children's advocates discovered there was no new money for SCHIP.

 

" When you do outreach, it doesn't help if there's no money to cover

people, " said Ron Pollack, whose liberal consumer group Families USA

calculated the impact of the $1.1 billion reduction. Based on current

formulas, that translates into coverage for 2,500 children in the

District, 13,900 in Maryland and 6,600 in Virginia.

 

Initially, states had difficulty enrolling many of the millions of

children eligible for the program. In some instances, language

barriers or a parent's reluctance to register with the government

prevented broad participation; in other cases states had devised

complicated multi-page applications or were unwilling to spend their

portion of the funds.

 

But SCHIP enrollment has steadily risen from fewer than 1 million in

1998 to the current 5.8 million, and most experts say states are

depleting previous years' surpluses.

 

" SCHIP spending is now exceeding annual allotments, " said Edwin Park,

a senior health policy analyst at the Center on Budget and Policy

Priorities. According to the center's analysis, six states will drain

those surpluses this year if the $1.1 billion is returned to the

Treasury as planned at midnight Sept. 30. By 2007, 17 states are

projected to run out of money.

 

Kevin Keane, spokesman for the Department of Health and Human

Services, said the vast majority of states estimate they cannot spend

their entire 2005 federal allocation. If some states have shortfalls,

he said, the HHS secretary can shift some funds. Keane said the

administration views the president's new " Cover the Kids " campaign as

an additional $1 billion for SCHIP. The money will be distributed over

two years in grants to some states, community groups and religious

organizations, he said.

 

" The president believes we need to try a new, community-based approach

to enrolling children in SCHIP, " Keane said. " The Cover the Kids

campaign is his vision for more effectively reaching eligible children

and getting them enrolled. "

 

To Pollack, even the name of Bush's initiative is " extraordinarily

disingenuous. " For several years, he noted, the Robert Wood Johnson

Foundation has run a 50-state outreach project called " Covering Kids

and Families. "

 

© 2004 The Washington Post Company