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Childrens Health Program Covering More Adults Than Children

Washington- Bush administration proposal was met with opposition as Children's hospital patients marched on Capitol Hill. They fear the proposal will limit the eligibility of low-income families with sick children for federal support through the State Children's Health Insurance Program.

The families who took to the streets in Washington put a face to the policy debate on the floor of Congress. They share two things in common: their children got sick and they couldn't afford health insurance. They describe it as every parent's worst nightmare and hope to help other families avoid it by fighting for Medicaid legislation. And they came armed with stories of survival.

State Children's Health Insurance Program (SCHIP) seems to cover more adults than children. This waiver from the Bush administration is a break from its administration position. SCHIP was initially intended as a children health insurance program.

SCHIP funnels funds through states to families that cannot afford health insurance but earn too much to qualify for Medicaid.

"The children and families are here as personal eye witnesses to how important children's hospitals are," said Lawrence McAndrews, head of the non-profit group the National Association of Children's Hospitals that arranged the Washington trip for the child advocates and their families.

At 5 years old, Joseph Greenwood's heart failed. After a complicated heart transplant and medical bills that reached the lifetime insurance cap, his family -- an upper-middle class family of 4 -- turned to Medicaid.

Fourteen states now cover adults through the State Children's Health Insurance Program. Wisconsin is one of them. On May 30, the state got a Medicaid waiver that would allow it to continue that practice.

The coverage of adults through the insurance program has become an important point of contention. The program subsidizes health insurance coverage for more t han 6 million people, including about 639,000 adults.

A bill renewing and enhancing the State Children's Health Insurance Program is due to be referred next week to the full Senate by the Finance Committee. Congress will consider renewing the politically popular program before it expires on Sept. 30.

Some lawmakers, particularly Republicans, have said the coming legislation should refocus the program on children at 200 percent of poverty or below _ $34,340 for a family of three. They say that insuring adults takes money that is needed for poor children instead.

While others want the program to be expanded by $50 billion, reduce bureaucracy for immigrant children applicants and give incentives to states to reach out to uninsured. With these measures it can close the gap of the three million eligible children who remain uninsured.

National Association of Children's Hospitals supports reauthorization and increased funding for the SCHIP. NACH head McAndrews hopes the SCHIP legislation provisions are approved so that "all children are covered with proper policy matched with appropriate funding."

Senate Finance Committee ranking member Chuck Grassley (R-Iowa) said that the Bush administration "is having a hard time getting its act together." Grassley said, "On the one hand, the administration, like many members of Congress, doesn't believe this program should cover adults. On the other hand, the administration has approved and continues to approve adult coverage waivers." Committee Chair Max Baucus (D-Mont.) said, "There are a lot of ideological statements being made about how (SCHIP) should and should not work, but in practice, the administration is continuing to approve state waivers that run counter to their stated concerns."

Congressional Democrats propose to amend eligibility requirements to include families with an income 250% above the poverty line and add additional funding from $5 billi on to $15 billion a year.

Republicans oppose the increase, saying that it is a drastic deviation from the actual objective of the program and arguing that any expansion of the program could substitute public for private coverage, possible creating a larger welfare state.

Both parties are in favor to reauthorizing the bill, but how it expands financially and who it will cover are still a large part of the debate.


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