SCHIP Expansion Would Cause Problems
State Children's Health Insurance Program
As both chambers of Congress debate expanding the State Children's Health Insurance Program (SCHIP), the National Center for Policy Analysis explains how this expansion will be costly for children, seniors and the poor.
The Senate bill would expand eligibility to children in families with incomes up to 300 percent of the federal poverty level, or $62,000 for a family of four. House Democrats would raise income limits even higher -- to 400 percent of the poverty level ($83,000 for a family of four) -- well above the median income.
"Congress is looking to move the middle-class into taxpayer-provided health care," says NCPA Senior Fellow Devon Herrick, who co-authored the report. "This is a costly expansion, and seniors and the poor will have to shoulder the burden."
The Senate bill would increase spending by $35 billion over five years and the House Democrats would increase spending by more than $50 billion. Yet SCHIP expansion would do nothing to increase enrollment among children who are already eligible, and most of the additional children are already covered by private insurance. According to the Congressional Budget Office (CBO), of the children who are uninsured for an entire year:
-- More than one million children currently qualify for public coverage but are not enrolled.
-- Another 1.1 million do not qualify because they are illegal (or temporary) immigrants.
-- About 403,000 are income-eligible immigrants who have not been legal residents long enough to qualify for Medicaid benefits.
-- In families earning 200 percent to 300 percent of the poverty-level income, 77 percent of children already have private coverage, according to the CBO.
-- In families earning 300 percent to 400 percent of poverty, 90 percent of children are already covered by private health insurance.
Both chambers pay for this expansion, in part, by an increase in the tobacco tax, which disproportionately impacts the poor. The House has also targeted cutting Medicare Advantage plans, which help low-income seniors. In addition, there are other, non-monetary costs that have to be taken into account. For example, children will have less access to health care because most SCHIP enrollees experience restrictions to care not felt by children enrolled in private insurance plans.
"Funding for this effort will come from people who have less income than the families who are purported to benefit," said Herrick. "Congress should instead focus on getting more people access to private insurance."
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