Thursday, April 24, 2008

SCHIP to Shore

There have been lots of posts about the State Children's Health Insurance Program (SCHIP) here in the Neighborhood, focusing on Mike Rogers' opposition to efforts to expand affordable health insurance for children of working families. (For a refresher, see Bull-SCHIP Excuses, SCHIP of Fools or Let the S-CHIPs Fall).

SCHIP is a joint federal/state program that helps working families purchase affordable health insurance. Please note that it isn't welfare, it isn't a handout, and it isn't socialized medicine. SCHIP has been a success since its start in 1997, and has enjoyed strong bipartisan support. Last year when it was time to renew the program, many legislators wanted to expand SCHIP coverage.

Then along came a vicious little directive from the Bush Administration via the Centers for Medicare and Medicaid:

Under the Aug. 17 directive, states cannot expand the Children’s Health Insurance Program to cover youngsters with family incomes over 250 percent of the federal poverty level ($53,000 for a family of four) unless they can prove that they already cover 95 percent of eligible children below twice the poverty level ($42,400).

Moreover, in such states, children who lose or drop private coverage must be uninsured for 12 months before they can enroll in the Children’s Health Insurance Program, and co-payments in the public program must be similar to those in private plans.

This directive was not only an example of pure meanness (forcing children to go without health insurance for a YEAR when switching to SCHIP) and statistical impossibility (there is no way to "prove" that 95% of eligible children are participating - The Urban Institute has a good summary of the methodological issues).

It also smelled like a violation of the 1996 Congressional Review Act, which requires federal agencies to keep Congress informed when they (agencies) change the rules. Senators Olympia Snowe (R-ME) and John Rockefeller (D-WV) asked the GAO for a ruling on the legality of the CMS directive, and guess what?

The GAO found that the new policy “amounts to a marked departure” from a longstanding, settled interpretation of federal law. It is therefore a rule and, under a 1996 law, must be submitted to Congress for review before it can take effect, the opinion said.

The Congressional Research Service agreed, finding that "an abrupt change of course requires a rulemaking to substantively alter those practices and relied upon interpretations."

This was reported by the New York Times ("President is Rebuffed on Program for Children"), but by and large the MSM has ignored the story.

Former FBI agent Mike Rogers prides himself on being a law & order kind of guy. He also loves to talk about how he works to protect children. Wonder when he'll fess up to supporting a violation of a federal law -- or to turning his back on the 170,686 uninsured children in our state.

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