Tag Archives: S-CHIP

Arnold Schwarzenegger, Blog Roundup, Environment, Health Care, San Diego, San Francisco

October 20, 2007 Blog Roundup

Today’s Blog Roundup is on the flip. Let me know what I missed.

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Dianne Feinstein: Simply
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Health Care

S-CHIP Battle Escalates

Another thing the Governor is missing while jetting to China is the major showdown over S-CHIP, with California signed on to an 8-state lawsuit against the federal government.

Several states said Monday they would challenge the Bush administration in federal court over its new rules that block the expansion of a health insurance program for children from low-income families.

Arizona, California, Illinois, Maryland, New Hampshire, New Jersey, New York and Washington are joining in the litigation, either as plaintiffs or by filing supporting briefs.

The states object to rules issued by the Bush administration in August that make it harder for them to provide coverage to children in middle-income families by limiting the total income of families who participate.

The states accuse the administration of overstepping the federal government’s authority to set income limits for participants in the State Children’s Health Insurance Program.

It’s amazing that, in this day and age, states have to sue the government so they can provide health insurance to needy children.  But this case puts extra pressure on the Bush Administration to pass the bipartisan bill expanding S-CHIP, which is politically popular.  It also puts pressure on Republican House members, who are all that’s standing in the way from this bill becoming law through a veto override.  Smart Democratic challengers are already making this a defining issue in next year’s elections.  The DCCC is targeting House members with radio ads, and today CA-26’s Russ Warner will hold a rally at David Dreier’s San Dimas office, to protest his vote against S-CHIP.  850,000 children in California alone will be negatively impacted by this vote, so it’s a huge issue here.  Details for the rally on the flip.

“WE CAN NOT REMAIN SILENT WHILE DAVID DREIER TURNS HIS BACK ON OUR KIDS, LEAVING THEM UNPROTECTED WITHOUT EVEN BASIC HEALTH INSURANCE COVERAGE.”  -Russ Warner

WHAT

Join Democrat and 26th District Congressional Candidate Russ Warner, parents and child health advocates for a rally in front of
David Dreier’s San Dimas office on Tuesday, Oct. 2 at 11 am.

Tell David Dreier you object to his vote against the reauthorization of the State Children’s Health Insurance Program (SCHIP). Tell him to stand for children and not with President George Bush and Big Tobacco.

WHY

As a result of this vote, hundreds of thousands of California families will likely lose health insurance for their children in the coming months.  Currently 850,000 children in California receive health care coverage through the SCHIP program in California, called Healthy Families.

Taxpayers in the 26th Congressional District will have paid $1.3 billion for the cost of the Iraq War through 2007.  For the same amount of money, health care could have been supplied to 149,373 children, according to the National Priorities Project.

WHEN/WHERE

Tuesday, Oct. 2, 11:00 a.m.
Congressman David Dreier’s Office
510 East Foothill Blvd.
San Dimas, CA 91733

Bring A Home Made Rally Sign And Your Voice. Stand Up and Be Heard!

Health Care

California Democratic Challengers Will Not Soon Forget This Vote

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I’ve been late on my Congressional roundup for September; I’ll probably get it up by the end of the week.  But I did want to wait and see which way House Republicans would vote on expanding SCHIP, a priority for the state and for the Governor.  Voting to leave sick children out in the cold is almost impossibly cruel, and will get the great big spotlight it deserves in 2008.  So how did they vote?

Mary Bono voted yes.  That’s it.  Every single other California House Republican voted to deny poor children health insurance.  John Doolittle, no.  Jerry Lewis, no.  Ken Calvert, no.  Gary Miller, no.  Brian Bilbray, no.  And David Dreier, not only no, but here’s a quote:

“It dramatically expands the welfare state,” said Rep. David Dreier, R-Calif.

I think Russ Warner just got the ammo he needed.  Somehow Republicans think this vote won’t boomerang back on them.

Because a veto is expected, much of the attention Tuesday was on the political fallout. Rep. Tom Cole, R-Okla., chairman of the Republican congressional campaign committee, said Republicans will support a less costly compromise. “I don’t think it will be a decisive bill in the 2008 elections,” he said.

They’re wrong.  And even though I believe that the Democratic majority is committed enough to this program that they will keep voting on it until they get a veto-proof majority (they’re 24 votes away as it is), this vote will not be forgotten.  The ads will be written.  And the price will be paid.

Arnold Schwarzenegger, Health Care

Schwarzenegger Does The Right Thing, Writes The President To Expand S-CHIP

4 Comments

I’ve said a number of times that if the Governor was serious about health care reform, he needed to follow the lead of other Governors and demand that the President reverse his decision to both veto S-CHIP expansion and make it nearly impossible for states to help provide health care to as many children as possible by putting onerous new eligibility requirements on the states.  I’m pleased to say that he has followed through on one of these goals, and today Schwarzenegger and Gov. Spitzer of New York write to the President.

The federal Centers for Medicare and Medicaid Services (CMS) is proposing new rules that will set Medicaid and state programs back forty years. These rules, which are being promulgated without proper review, impose eligibility standards that would both deny health care to vulnerable children and pregnant women and greatly restrict the flexibility of states to reach your administration’s stated goals of efficiently providing coverage. The rules must be withdrawn […]

California and New York cover more than 1.4 million children and pregnant women using State Children’s Health Insurance Program (SCHIP) funds – nearly one out of every four SCHIP recipients in the country. We have a long and productive relationship with CMS in leveraging SCHIP to innovatively provide maximum benefit with minimum resources.

We agree with your push for states to be a force for change in the delivery of health care to tens of millions of our fellow Americans who remain without meaningful coverage. But as you rally governors to do more to help fix our broken health care system, your administration has repeatedly modified existing Medicaid and SCHIP rules, harming states’ capacity to help you achieve our shared objectives.

The recently proposed SCHIP rules will reverse longstanding agreements with the states and reduce the number of children who receive health care. We strongly urge you to reconsider these recent policy changes, which simply diminish state flexibility.

Caring for children really isn’t a Democratic or Republican issue.  The Bush Administration wants to have it both ways, shirking the responsibility for health care onto the states while making it impossible for the states to carry out such a mission.  The White House has an ideological obsession with not allowing this successful program to be expanded; then people might think they can actually receive health care from a government program they pay for in taxes.  The horrors!  Good for the Governor on this one.

Arnold Schwarzenegger, Health Care

Crunch Time For Healthcare Reform

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Dan Weintraub notes that legislative leaders are meeting today with the governor about the future of healthcare reform.  Here’s his thumbnail sketch:

The Republican lawmakers have been pretty clear about their opposition to mandates and taxes, which both the Democrats and the governor have as the centerpiece of their plans. But if you leave the Republicans out, then a pay-or-play employer mandate appears to be the only option that can pass on a majority vote, and the governor says he opposes that narrow approach. It looks as if they are going to have to regroup and think about taking the issue to the ballot with a different tax structure, no employer mandate and a broad coalition of support…

We know that Sen. Perata has been subdued about the chances for anything happening this year.  And we know that anything resembling a fee will be written off by the no-new-taxes Republicans, even when the governor is attempting to rally support for a fee structure that allows hospitals to get federal money for every dollar they put into an insurance pool.  The other major stumbling block is the fact that Republicans and business interests will almost certainly sue the state over whatever proposal is passed into law, either for violating the ERISA statute that prevents states from regulating employer-based plans, or for imposing fees on businesses that would require a 2/3 vote in the legislature.  That will happen no matter what gets passed, and yet nobody talks about it.

over…

(To me that’s a good thing; employer-based healthcare ought to be severed in favor of something more flexible and more portable.  Otherwise more of the problems will exist with people not feeling able to leave jobs because they need to keep their insurance.  You also get this annoying tactic of resisting a truly universal system by arguing “If my employer doesn’t give me dental care, nobody should have it.”  Employers may need to pay into a system, but it should not be employer-based; that’s a relic of a system from the 1940s, and it’s bad for employees and competitiveness.)

It’s clear that the eyes of the nation are upon California as they attempt to deal with the healthcare crisis.  At precisely the right time, the Census Bureau reported a major increase in the nation’s uninsured, to 47 million, including 600,000 new children.  As I’ve said for a while, if the governor really wants to pass something this year he needs to speak up about the effort to cripple any effort at S-CHIP expansion, which is something his health care proposal relies upon heavily.  Today New York Governor Eliot Spitzer came out strongly against this morally misguided blockage by the Bush Administration to insure all children; Schwarzenegger has had little to say on this since June, when he called it one of his top federal priorities.

The prospects for a legislative solution are very up in the air right now, so anyone that believes reforming the system must begin now might want to apply some pressure on their represenatives in Sacramento.

Health Care

Ideology Over Healthy Families

2 Comments

Really, this Administration is bucking to go down in history as the world’s most callous collection of people.

The Bush administration, continuing its fight to stop states from expanding the popular Children’s Health Insurance Program, has adopted new standards that would make it much more difficult for New York, California and others to extend coverage to children in middle-income families.

Administration officials outlined the new standards in a letter sent to state health officials on Friday evening, in the middle of a month-long Congressional recess. In interviews, they said the changes were aimed at returning the Children’s Health Insurance Program to its original focus on low-income children and to make sure the program did not become a substitute for private health coverage.

The S-CHIP program works, states want more of their kids to be covered, and in the long run it’s far more affordable than allowing the uninsured to use the emergency room as their primary care physician.

Doesn’t matter to this President.  Wouldn’t want people to get the idea that they can get decent health care. (over)

California wants to increase its income limit to 300 percent of the poverty level, from 250 percent. Pennsylvania recently raised its limit to 300 percent, from 200 percent. New Jersey has had a limit of 350 percent for more than five years.

Before making such a change, Mr. Smith said, states must demonstrate that they have “enrolled at least 95 percent of children in the state below 200 percent of the federal poverty level” who are eligible for either Medicaid or the child health program.

Deborah S. Bachrach, a deputy commissioner in the New York State Health Department, said, “No state in the nation has a participation rate of 95 percent.”

The President is mandating these participation rates, but offering no budgeting for them.  It becomes a self-fulfilling prophecy, designed for states to be unable to meet the 95% number and therefore restricting health access for children.

Basically what the President is saying here is that the system is working too well.  They speak about competition but they don’t want S-CHIP to ever compete with private insurance (mainly because it would blow the doors off of it).

To minimize the risk of such substitution, Mr. Smith said in his letter, states should charge co-payments or premiums that approximate the cost of private coverage and should impose “waiting periods,” to make sure higher-income children do not go directly from a private health plan to a public program.

If a state wants to set its income limit above 250 percent of the poverty level ($51,625 for a family of four), Mr. Smith said, “the state must establish a minimum of a one-year period of uninsurance for individuals” before they can receive public coverage.

There’s another provision that says if private insurers start losing customers to S-CHIP then the higher coverage would be slashed.  This despite the fact that insurers have never seen such a drop, and if they did it’d be their own fault for denying coverage to so many based on pre-existing conditions.

This is an important moment for the nation.  At a time when health care is the number one domestic policy, when tens of millions have been added to the ranks of the uninsured, and when this President has done virtually nothing about it in 6 1/2 years, he’s putting up a firewall designed to make sure your kids aren’t covered.

Health Care

Working Families Need Health Care Too

1 Comment

I’ve been watching the debate in the Congress over expanding S-CHIP (the State Children’s Health Insurance Program) today while waiting for my plane travel to Yearly Kos, and I’m reminded of how dishonest Republicans are on this issue.  They created the block grant program to give states the ability to cover children, and now when it’s become popular and successful, and state governors want to expand it more, they suddenly want to stop it.  And they’re using the familiar “this would let illegal immigrants get free health care” canard to try and submarine the bill (incidentally, it doesn’t).

It’s important to chronicle this, because it’s the opening salvo in the battle to change the health care system in this country.  In California we’re gearing up for health care reform, and today The California Budget Project and the UCLA Center for Health Policy Research released a joint report that ably shows the consequences of maintaining the broken status quo on health care as the Republicans want to do:

…many families spend a substantial amount on health care premiums and out-of-pocket costs, and could face financially devastating medical expenses if they are not adequately protected.  The report, “What Does It Take for a Family to Afford to Pay for Health Care?” (available at www.cbp.org and www.healthpolicy.ucla.edu) recommends that health care reform proposals – such as those proposed by the Governor and Democratic legislative leaders – ensure that families can realistically afford premiums and out-of-pocket costs, such as copayments and deductibles.

The report recommends that proposals fully subsidize health care coverage for those who earn up to 200 percent of the poverty line ($41,300 for a family of four) because the cost of housing, food, and other necessities leaves these families with few or no resources to contribute toward health care costs.  The report also determines that families need incomes near 300 percent of the poverty line ($61,950 for a family of four) just to afford typical health care costs.  Because some families face much higher out-of-pocket health care costs, the report recommends that policymakers consider providing subsidies for families with incomes higher than 300 percent of the poverty line.

This is EXACTLY what the expansion of S-CHIP would do, and yet Roadblock Republicans and the Bush Administration are concerned with defeating it solely on ideological grounds.  They don’t want America to see a health care system managed in a public way that works.  They fear people will see the differences between a system that gives people the choice for affordable care and a private for-profit system that values limiting care above everything, and opt for the former.  They don’t want government to work, and they will do everything in their power to make it malfunction.

(I do take issue with the idea that “the governor’s proposal,” which has no cap on affordability or any floor on coverage, would necessarily help needy families.)

Here are some of the key recommendations of the report:

Limiting families’ out-of-pocket costs.  Some insured families have very high health costs because they have very high copayments, deductibles, or other out-of-pocket costs.  Some of these costs are predictable (for example, if a family member has a chronic illness), but some can be unexpected (for example, as the result of an accident or unexpected illness).  Placing limits on out-of-pocket costs is as important as premium subsidies in ensuring affordable health care.

Taking into account expenses families face, such as housing and child care, when determining how much families can afford to pay for health care.  Because families face very different costs, such as housing and child care, income alone is an imprecise measure of what families can afford to spend on health care.

An average adult with private health coverage pays almost $800 a year on premiums; a family of four spends $1,800.  Poor families cannot cope, and forget about it if they actually want to USE their coverage.  We know that almost half of all bankruptcies are due to health care costs.

Californians need to send a strong message to Congress and the President to wholeheartedly support the continuation of S-CHIP.  And they need to send the message to our Legislature that we need real health care reform that allows working families to have the peace of mind of medical coverage while also being able to survive financially.