The Campaign Spot

Hillary’s Plan for “Free” Health Insurance For Families Making Four Times The Poverty Level

Hillary is introducing legislation to expand S-CHIP.

“Making health care accessible and affordable for all children will keep kids healthy, save lives, control costs, and end heartache and worry for so many parents,” Clinton said today. “This plan is practical and fiscally responsible – it will honor our values and prevent kids from needing more costly healthcare in the future.”
Six million children are already eligible for the State Children’s Health Insurance Plan (SCHIP) but not enrolled. Clinton’s legislation includes incentives for states to expand children’s healthcare to those who are not eligible, and identify and enroll uninsured kids that already qualify for coverage.
The Children’s Health First Act allows States to expand children’s health coverage to families up to 400 percent of the Federal poverty level (which is $70,000 for a family of three) through the State Children’s Health Insurance Program (SCHIP) and receive increased Federal payments.
This legislation offers a new affordable coverage option for both families and employers by allowing them the opportunity to buy health insurance coverage through SCHIP. And it provides new incentives to strengthen and protect employer-sponsored coverage, something more than 50 percent of children enjoy today.

I have one or two claps for a lawmaker in the Senate who’s running for president introducing legislation to enact their policy goals. I’m getting a little irritated with those who are essentially arguing, “I have a whole bunch of fantastic ideas, but I can only make them happen once I’m elected to head the executive branch; there’s no point in bothering to introduce the legislation now and starting the groundwork.”
Unsurprisingly, Hillary doesn’t put a price tag on her proposal.
First of all, Hillary ought to acknowledge that several states have already expanded S-CHIP — although not quite as much as Hillary would in this legislation. These expansions are what’s causing these states to have shortfalls, in fact:

Income Eligibility. The original intent of SCHIP was to help low-income, uninsured children whose families earned too much for Medicaid but not enough to purchase private coverage. The law defines as “low income” those children whose family’s income is below 200 percent of the Federal poverty line (FPL), or $40,000 for a family of four.[12] Of the 14 projected shortfall states, seven have set SCHIP eligibility above 200 percent of the FPL.[13] Of those seven, four states (Maryland, Massachusetts, Missouri, and New Jersey) are at or above 300 percent of FPL, or $60,000 for a family of four.[14]

As that Heritage report notes, states that have expanded their coverage the most are the ones reporting funding shortfalls. Surprise!
Secondly, at what income level do we as taxpayers feel comfortable telling someone, “no, we’re sorry, you should pay for your child’s health insurance?”
I’m looking at the 2006 guidelines, and it says that four times the poverty level for a family of 3 in the 48 contiguous states and D.C. would be $66,400. (From Hillary’s release, apparently it got bumped to $70k this year.) For a family of four, it’s $80,000.
This would be expand a program designed to help the poor to created taxpayer-funded health insurance for some folks who I don’t think can be called “poor” by any stretch of the imagination. They may not be wealthy, they may not be having an easy time meeting their expenses, but with the average annual wage at $36,952 in 2005, I don’t think they’re who the program was designed for.
The second thing is, the “C” in S-CHIP is for “children,” so you would think that this program helps states pay for the health insurance of children. Wrong. As Heritage notes:

Adult Eligibility. Moreover, some of the projected FY 2007 shortfall states use SCHIP funds to cover adults.[16] Five of the 14 shortfall states—Illinois, Minnesota, New Jersey, Rhode Island, and Wisconsin—cover parents, pregnant women, or childless adults.[17] According to the General Accountability Office, “Adults accounted for an average of 55% of enrollees in the shortfall states” in FY 2005.[18] While the Deficit Reduction Act prohibited the Secretary of Health and Human Services from approving any new state waivers to cover childless adults, existing waiver states are exempt. As a way to prioritize those shortfall states that remained focused on children, states were prohibited from applying DRA redistribution funds toward coverage of non-pregnant adults, but the redistributions since then have not been limited in this way.[19]

Okay, if you’re a non-pregnant, childless adult, why is your health insurance being covered by a Children’s Health Care plan?
Before we decide to create an across-the-board federally-funded health insurance system for everyone making four times the poverty level, could Senator Clinton address whether she thinks current S-CHIP funds are being used properly? And if she thinks they aren’t, could we do something about that first?

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