A CHIP Off the Old Blockhead


So you were surprised? Blame it on your short memory. If it were longer, life would have fewer surprises. Consider George Bush and health insurance for children. He likes children, he loves money and he hates the thought of federal help for medical care. Current events come first; the history lesson later.

In July it was reported that Mr. Bush is determined to block a major expansion of the Children’s Health Insurance Program. CHIP, as it is known, is a federal-state program that was created to provide health insurance to low-income families who earn too much to qualify for federal health programs but not enough to pay for health insurance. When CHIP money is allotted to a state the state must use it within 3 years.

In 1997, CHIP’s first year, Congress allocated $48 billion to the program. In 2007 Congress wants to increase CHIP’s funding so that more children can receive benefits. When Mr. Bush hears talk of more medical benefits for children he conjures up an image of a bunch of camels pushing their noses under the tent where the affluent are seeing doctors but paying for the visit themselves.

To improve CHIP the House has voted to spend $75 billion over the next 5 years, the Senate has voted to spend $60 billion and Mr. Bush wants to spend $30 billion. Mr. Bush isn’t simply being penurious. He’s considering the consequences of insuring everyone. He thinks once the 9 million children in the United States who have no health insurance get insurance, everyone will want it and then we’ll have the federal government running our health care system.

Mr. Bush is not only concerned about poor children taking advantage of the affluent. He’s also concerned about how Democrats want to pay for the program. They want to increase taxes on tobacco from $.33 a pack to $1.00 a pack and they want to decrease payments from Medicare to private insurance companies who care for the elderly.

According to a New York Times report, Allan Hubbard, an assistant to Mr. Bush said if the bill became law, we’d be closer to a "single-payer health care system with rationing and price controls." Mr. Bush’s attitude towards health care does not comes as a surprise to those with memories that go back as far as the time when he was governor of Texas. That’s when CHIP was born.

In 1997 Texas was allotted $561 million that it was required to spend in full by 2000. According to the Dallas Morning News, mid-way through 2000 Texas had only spent $112 million leaving $449 million unspent. By June 2000, 123,000 Texas families had applied for assistance but only 27,000 children had been enrolled. According to the Children’s Defense Fund Report, Texas ranked 45th among the states enrolling children in CHIP. Texas was one of only 8 states where the number of children with any form of health insurance declined from 1997 to 1999.

Failure to implement CHIP was not Mr. Bush’s only success in protecting Texans from the greedy needy. His other successes were described by U.S. District Judge William Wayne Justice. On August 14, 2000 Judge Justice entered a ruling on a case that had been filed against Texas for its failure to live up to a 1996 consent decree involving other health care programs. The judge gave Mr. Bush a report card that looked a lot like ones he probably got in grade school. It had lots of "needs improvement" on it. He said Mr. Bush had failed to improve children’s access to Medicaid, checkups under the program’s managed care arm were inadequate and fewer than 10 percent of children were receiving immunizations. He said the state had failed to inform indigent families about the availability of health services. He said managed care plans to whicH some indigent Texans had been assigned were not providing the required services and 1 million eligible individuals had received no dental care. In response to the judge’s findings Mr. Bush said: "[W]e’ve got a good record in signing up children for Medicaid and we’re going to continue to do so." He must have been thinking of something the judge had overlooked.

Mr. Bush’s opposition to the increased funding is because, as he explains it, it is a step "down the path to government-run health care for every American." There is not a child in the country who lacks medical benefits who would want that to happen even if additional funding might save some of their lives. And, on the bright side of things, if the additional funding is vetoed, some children will end up dying thus reducing the number of children who are uninsured.

CHRISTOPHER BRAUCHLI is a laywer in Boulder, Colorado. He can be reached at: Brauchli.56@post.harvard.edu

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