Opinion

Why not insure every child?

The Bush administration should be helping Massachusetts and other states with innovative expansions of health insurance, as it did last year, instead of applying a chokehold to a successful federal program that covers low-income children. Congress needs to provide money to maintain the program and apply it to the millions of young people who still are without health insurance.

Under the bipartisan leadership of Senators Edward Kennedy and Orrin Hatch, Congress created the State Children's Health Insurance Program (SCHIP) 10 years ago to fill one of the most distressing gaps in the patchwork US healthcare system. Many children in financially strapped families had to do without coverage if their circumstances did not fit the stringent criteria of the Medicaid program for poor people.

The children's program relies on a mixture of state and federal funds, combined with premiums paid by families on a sliding scale depending on income. It has been a great success, especially in those states like Massachusetts where the Legislature has financed outreach campaigns to make sure the maximum number of young people is enrolled. Almost 7 million people are covered through SCHIP, 82,000 of them in Massachusetts.

The Bush administration agreed last year to allow the state to expand SCHIP to families earning up to 300 percent of the federal poverty standard ($60,000 for a family of four). The previous limit had been 200 percent. This change was designed to complement the Massachusetts health insurance reform law, which provides subsidized coverage for adults up to the 300 percent level. Because of this enhancement, the children's program in Massachusetts will run out of money in May unless the federal government provides more. Thirteen other states face budget shortfalls.

In his 2007 budget unveiled this month, President Bush proposed minimal increases in SCHIP. But this wasn't a serious plan, shown by the administration's reaction to governors' complaints at a meeting of their national association in Washington this week. Health and Human Services Secretary Michael Leavitt told them the administration was amenable to a quick fix by Congress to forestall a crisis.

It's time to move beyond periodic infusions of cash to a long-term expansion of the program. According to the latest figures from the US Census, 5.5 million children in low-income families are still without health insurance despite the success of SCHIP. The program now costs the federal government a little more than $5 billion a year. Increasing the amount to accommodate higher enrollments would maintain it as a cost-effective way to provide young people with what ought to be a birthright of every American. When Congress reauthorizes SCHIP this year, it needs to give it enough money to leave no American child without the essential protection of health insurance.