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Shriver Center, November 7, 2007: SCHIP Override Fails, Congress Must Assert Its Own Ideology

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In a vote taken on October 18, the U.S. House of Representatives failed to override the president۪s veto of the bill reauthorizing and expanding the State Children۪s Health Insurance Program (SCHIP). Amidst new national polls showing over 80 percent of Americans in support of the bill and over 70 percent willing to pay new taxes for it, the vote was 273-to-156 to override the veto, just 13 votes shy of the needed supermajority. In the Illinois delegation all the Democrats and the Republicans Ray LaHood and Mark Kirk voted for the override. The remaining Republicans voted with the president and against the children۪s health insurance bill: Judy Biggert, Jerry Weller, Donald A. Manzullo, John Shimkus, Timothy V. Johnson, and Peter Roskam.

Congress has temporarily extended the existing SCHIP program to November 15. Another round of negotiations between Congress and the White House and another attempt to pass a bill are expected before the November 15 deadline.

The president۪s main arguments against the expansion of SCHIP are baseless, and they are a failed attempt to cover naked ideology. The president and his supporters would rather have the children affected by his veto uninsured than have them covered by insurance supported in part by the federal government. Apparently he feels that appeasing the small group of people who oppose a bill that 80 percent of the country favors politically salient.

First, the president fears that the expansion of coverage for children would attract parents to government-supported insurance and away from employer-supported insurance. However, two-thirds of kids who would be newly covered by SCHIP do not have access to private health insurance, according to the Congressional Budget Office. SCHIP is these kids۪ only option. Expansion provides a choice between private and public insurance only for those who have access to private coverage.

Mechanisms in the bill make it hard for children already covered by private insurance to switch. As for the children who are not enrolled in private insurance but have access to it, there are good reasons to allow them to choose instead to enroll in SCHIP. A new report by the Urban Institute shows that the private-sector insurance for these kids is increasingly inadequate. More and more parents cannot afford it. More and more employers cannot afford to offer it. The fact is that the private sector is not doing the job, and, with or without the option of SCHIP coverage, hundreds of thousands of children are losing employer-supported coverage every year. To claim that the SCHIP expansion is a government invasion of the private market is simply incorrect: it is a rescue strategy to fix a failure of the private market to serve children in working families adequately.

Second, the president complains that the SCHIP expansion is for the middle class. Most of the SCHIP expansion would reach families in the $40,00060,000 range (family of four), two to three times the official poverty level. But nonideological researchers agree that the official poverty level is far below real poverty. Twice the official level is more realistic. When we consider whom the SCHIP expansion would affect, this realistic understanding of poverty is critical. Inadequate health coverage is pushing more families from the middle class as the burden on their incomes increases their economic instability. SCHIP will help keep them in the middle class. Moreover, whether or not one calls these families middle class, the inescapable reality is that the children do not now have insurance, either because they do not have access or because what they have access to is too expensive for their parents to afford.

And, third, the president argues that an expansion does not make sense when many already-eligible children (in the lower-income groups) have not yet enrolled. Most of the spending in the bill targets already-eligible children for enrollment and coverage. In fact, the bill already contains the solution to the under enrollment problem and provides for excellent incentives and support for enrollment efforts.
None of the president۪s arguments have substance. His stance can be reduced, indeed he reduces it himself, to the ideological position that, as a matter of public policy, government-supported insurance for children is to be shunned and is worse than no insurance. Rightly the vast majority of Americans disagree. The ideology that matters, and that trumps all the others, is that children must receive adequate health care. In the negotiations that will now take place, Congress must hold firm to that ideology and produce a reauthorized SCHIP program that supports full enrollment and significant expansion.

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