AS Congress takes up reauthorization of the federal health insurance program for poor children, members should be wary of program expansions, however well-meaning, that could create a costly open-ended entitlement.
Majority Democrats are talking about increasing the State Children's Health Insurance Program, or SCHIP, by $35 billion over five years. More than 6 million people receive health insurance coverage through the program each year, including about 116,000 Oklahoma children in fiscal year 2006.
SCHIP was created in 1997 to cover children in families whose earnings were too high to qualify for Medicaid but less than 200 percent of the federal poverty limit (about $40,000 for a family of four). The federal government pays about 70 percent of the program's costs; the states pick up the rest.
The problem is SCHIP's original coverage mandate has expanded as states tinkered with eligibility rules to cover more children. A few have obtained waivers from Washington to cover some adults. The danger is the program's block-grant structure could go by the wayside if expansion continues, perhaps leading to an open-ended commitment from the federal government, which is how you define an entitlement like Medicare and Medicaid.
Some think that's what Democrats have in mind — perhaps more. Their proposal "represents a barely hidden agenda,” opinion columnist Michael Gerson wrote in The Washington Post. "Instead of reasonably expanding a successful program, they want to bloat SCHIP beyond its original purposes — to cover more and more adults — as a step toward their utopia of government-run universal health care.” Said Sen. Tom Coburn to The Oklahoman, "Expanding SCHIP is just ‘Hillary Care Part Two.'”
Washington has concern enough funding current entitlements without creating a new one. SCHIP is a worthy program but one that should be carefully targeted to keep it from becoming open-ended and requiring huge tax increases to remain solvent.