In Health Care, 2007 May Be the Year of the Child


To little fanfare, the New York General Assembly and Governor Eliot Spitzer enacted a budget in early April that includes health care for essentially all children.  The budget increased SCHIP eligibility for children in families with incomes up to 400% of poverty ($80,000 for a family of four) and allows families above 400% without other options to purchase the SCHIP coverage at full-cost, which is still cheaper and likely more comprehensive than private options.  Premiums for families below 400% of poverty will be set at $20, $30 and $40 per child depending on income. 

As detailed in a new Georgetown University report, New York is at the cusp of state efforts to expand access to health care for children in 2007.  29 states have enacted or are working on proposals to improve kids' coverage, including better outreach to families with children eligible but not enrolled in public programs, increasing income eligibility for SCHIP and easing administrative barriers to make it easier for children to enroll and remain enrolled in public programs. 

The 300% Standard: An important trend among states is increasing the income eligibility for SCHIP, with 300% of poverty becoming the new standard.  Of the 15 states with such proposals in 2007, 10 seek to increase eligibility to 300% of poverty or above, as is the case in New York.  Increasingly, states are allowing families above the income limits to purchase SCHIP coverage at full-cost, including Washington and Tennessee which have already enacted such reforms.  Of proposals still being worked on, North Carolina would offer public coverage to children with sliding scale premiums to 300% and allow a full-cost buy-in above that. Ohio is seeking to go further by expanding SCHIP to 300% and subsidizing premiums for children in families up to 500% of poverty.

A Road to Universal Coverage: As we have written in previous editions of the Stateside Dispatch, kids' coverage is seen by many as laying the foundation for universal health care.  Oregon Gov. Ted Kulongoski, who is fighting to enact coverage for children in his state, said, "If you drive the plan into the middle class, it's not just viewed as a public assistance program.  You build a base of support for the program to provide health care for all of us."  The Right, as expressed in a recent Wall Street Journal editorial, fears this precise scenario.  The Journal refers to expanding SCHIP as universal health care "on the installment plan" and urges Republicans to "work to return SCHIP to its original, more modest purposes."



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