Stiff-Arming Children’s Health

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The Bush administration has imposed new requirements on a valuable children’s health insurance program that look so draconian as to be unattainable. Late on a recent Friday while Congress was in recess, a time fit for hiding dark deeds, the administration sent a letter to state health officials spelling out new hurdles they would have to clear before they could insure children from middle-income families unable to find affordable health coverage. Some 19 states may be forced to pull back programs they have started or proposed.

There is a legitimate argument to be had over how far up the income scale the federal-state partnership known as the State Children’s Health Insurance Program, or S-chip, should climb. When it was created, the program focused on children whose family incomes were no higher than twice the poverty level, or about $41,000 today for a family of four. The goal was to cover the near-poor, who earned too much to qualify for Medicaid but not enough to afford private health insurance.

Over the years, the Clinton administration and especially the Bush administration allowed states to extend coverage to higher income levels. Today, New Jersey caps it at 350 percent of the poverty level and New York proposes to go to 400 percent. In reaching out this way, virtually all states have scooped up lots of children who were actually poor enough to qualify for Medicaid but had never been enrolled. The combined result has been a heartwarming drop in the number of uninsured children.

Yet the Bush administration wants to return to a darker age. Its letter to state officials seems intent on virtually eliminating such coverage for middle-income children, or at least drastically reducing it.

http://www.nytimes.com/2007/08/26/opinion/26sun1.html