October 18, 2007

SCHIP: Fighting Back (against poor childern)

A guest editorial (paid link) in the Wall Street Journal today offers a good, pragmatic response to the SCIHP imbroglio. This point has been made but not emphasized: we know the mean ol' Republicans hate poor kids and want to see them starved and denied health care and all that, but Grace-Marie Turner asks "Will this expansion help or hurt the poorer children the program was designed to serve?"

The answer isn't encouraging.

Already, two-thirds of children who do not have health insurance are eligible for federal help through either Schip or Medicaid. Congress's first priority should be to make sure these poorer, uninsured children are taken care of. Yet states have struggled to get these children enrolled, which means that if there is a stampede to add higher-income kids to Schip, the poorer kids will likely continue to get left behind.

This is why the administration wants states to first enroll 95% of the children now eligible (those in families living on wages that are under 200% of poverty) before they open the program to higher-income kids.

The bill Congress passed, and the president vetoed, overturns that requirement -- an implicit acknowledgment that higher-income children will be the focus of the expansion. Consider that the bill would allow New York to cover kids in families who make up to $83,000 a year, something that would pull federal dollars away from less affluent states so that New York could provide taxpayer-funded health insurance to children in middle-income families.


I suggest this as a good time to fly the pragmatism flag. Earlier Turner says "[T]his debate is not over whether to give poor kids health care, or even over whether this program should continue. Everyone agrees that it should." and I thought "she doesn't read ThreeSources."

Yet, I think the hard-liners are going to get their ideological asses kicked, if they are seen to deny health care to poor kids. Arguments about crowding our private insurance are compelling to me but it's a tough sell. The fact that President Bush wants to cover the poor kids before considering expansion up the income ladder is a good -- and salient -- point, when one is badly needed.

Health Care Posted by jk at October 18, 2007 11:07 AM

JK champions pragmatism as the best strategy to stop government health care for the masses but misses the facts that a) we're already there to large degree and b) it's pragmatism that's made it possible.

"First enroll 95% of children now eligble instead of the 66% already enrolled." And then, I suppose, there's no objection to raising the eligiblity bar still higher?

And to be eligible now you need not be in poverty. Your family can have the resources of TWO impoverished families all to itself and still get the free ride. Not to mention the express escalator that the "Federal Poverty Level" has been on since the '70s.

Pragmatically, it won't be long before Jenna and Barbara Bush are "poor kids."

Posted by: johngalt at October 18, 2007 3:13 PM

I had a hunch that you might not be on board, jg.

Probably not worth rehashing every argument over the last few years around here, but I am seeing that:
-- The collectivists have the perfect demagoguery vehicle here.
-- It is up for renewal, presenting a perfect time to try and expand it.
-- You have zero, nada, zip chance of not renewing it with a small expansion.

Again, I am prepared to fight at the margins, knowing that it means conceding the ground already lost. Overriding the veto or giving today's Democratic party a filibuster proof majority would not help the cause of freedom. An attempt to scale this back will lead to one or both of those unfavorable outcomes.

Posted by: jk at October 18, 2007 4:08 PM

After the Rockies won both games of a home double header versus the Dodgers on September 18th dagny asked me, "Do you think the Rockies will make the playoffs?" I said, "No. Their chances are slim squared."

That's not quite as bad as "zero, nada, zip chance" but they were still long odds that paid out. I've learned not to say "never."

Posted by: johngalt at October 19, 2007 2:48 PM | What do you think? [3]