SCHIP
Wednesday, July 9, 2008The Church of SCHIPBy Nathan BenefieldCategories: SCHIPMichael Cannon pulls a troubling quote from an advocate of SCHIP expansion, who admits his support is based on faith, not evidence.Of course Cannon is a well-known heathen.
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Thursday, June 19, 2008Big Government in ... Montana?By John LaPlanteCategories: Montana, SCHIPThe effort (which I mentioned a while ago) to funnel children into a government-run health care plan in Montana is one step closer to realization. Initiative 155 has qualified for a spot on the fall ballot. The proposal would expand the state's SCHIP program by making some middle-class families eligible. Currently, only those with incomes at 175% of the federal poverty level qualify; I-155 raises that to 250%. It also uses schools and youth sports leagues, among other organizations, as recruiters for this exercise in government expansion. Given the state's population, the plan to add 30,000 children to SCHIP would mean that 1 in 7 children would be dependent on government. The story is a good example of how federal strings pervert public policy. There are many different ways of expanding the number of children with insurance (and even more importantly, improving their health). But federal matching funds--80% is the number cited here--make SCHIP expansion the "easy" way out.
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Friday, June 6, 2008Iowa Creates "Medical Homes"By Merrill Matthews, Jr.Categories: Insurance Regulation, Iowa, SCHIPIowa Gov. Chet Culver (D) has signed HF 2539, the health reform package finally agreed upon by the legislature. Like many other states, Iowa created a commission to study health reform and agreed upon a fairly ambitious agenda, but in the end, more modest reforms passed, including:
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Friday, May 30, 2008No Cigarette Tax Increase to Pay for Medicaid in South CarolinaSome state leaders still understand economics By Marc KilmerCategories: Medicaid, SCHIP, South CarolinaWhile the South Carolina legislature passed a bill to expand Medicaid and fund it with a cigarette tax, Governor Mark Sanford vetoed the bill and the House failed to override it. Perhaps more interesting than this odd event (given that many states find it politically expedient to burden cigarette smokers to pay for middle class health care) were the comments by House leaders and the governor in opposing the legislation: House Speaker Bobby Harrell: "What kind of message are we sending to our state's future generations? Using this tax to expand a government entitlement program will set up an expectation of non-responsibility and establish an entitlement society. These children will grow up being taught that it is the government's job to care for them." Gov. Sanford: "I can't in good conscious sign off on something that both increases the overall tax burden, and is completely irresponsible in the way it expands a host of Medicaid benefits without any way to pay for them in future years. That gives state government three alternatives to keep providing those benefits: raise taxes, cut other programs or start encouraging people to smoke more to foot the bill." This kind of thinking is rare in most states. Politicians from both parties look upon Medicaid as a good way to decrease the number of uninsured. At least a few in South Carolina haven't bought into this thinking.
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Wednesday, April 30, 2008Congressmen Debate Health CareRep. Shadegg has some common sense ideas By Marc KilmerCategories: Insurance Regulation, SCHIPA bipartisan group of Congressmen met in Cincinnati on Monday to debate health care reform. The Republicans pushed tax credits to cover the uninsured while the Democrats stressed an expansion of government programs such as SCHIP. Congressman John Shadegg (R-AZ) seems to understand the basics of why government care is bad and how the government drives up the cost of health insurance:
Perhaps he should have also included state insurance mandates, which drive up the cost of insurance. As Becerra pointed out, though, the GOP has had eight years to deliver meaningful health care reform and have failed to do so. Shadegg may talk a good game, but his ideas haven't made much headway in Congress.
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Monday, April 28, 2008Trapping Kids in Government ProgramsBy John LaPlanteCategories: Montana, SCHIPAccording to the Bozeman Daily Chronicle, more children in Montana may soon be herded into a government program. "State Auditor and Insurance Commissioner John Morrison," the paper says, "is leading efforts to make more Montana kids eligible for a federal heath-insurance program." Morrison isn't just getting is employees to step-up efforts to enroll children who are currently eligible but not participating. He's also leading the effort to expand the Montana Medicaid program through a ballot measure, Initiative 155. (The Montana Standard has more.) Anyone see a conflict of interest here?
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Thursday, April 24, 2008Arizona's Addiction to Unhealthy Government HandoutsGovernor Napolitano Ignores the Real "Cost Shift" By John R. GrahamCategories: Arizona, Medicaid, SCHIPI wonder why the Wall Street Journal insists on running op-eds that are sure to infuriate its loyal readers (like myself). This morning, Arizona Governor Janet Napolitano trotted out the tired old argument that President Bush is unfairly tightening the screws on states' social programs, especially state children's health insurance programs (SCHIP) and Medicaid. Gov. Napolitano's wants to talk about "Washington paying its bills." In her worldview, "the beauty of SCHIP is that its a federal-state partnership," and President Bush's policy of demanding that states to enrol kids in families below 250% of the Federal Poverty Line before giving those states more of our money means that "states must now carry the additional burden of providing health care for these children." Arizona ranks a miserable 42 out of 50 in the U.S. Index of Health Ownership's ranking of government health programs. It is truly dependent on residents of the other 49 states (or at least 41 of them) to finance its profligacy. So perhaps it's not surprising that Gov. Napolitano is desperate to keep her states' place at the trough. Her op-ed is perfectly co-ordinated with the Democratic Congressional majority's attack on the President's proposed regulations to impose fiscal responsibility on Medicaid and prevent states from gaming the system. Do these people really believe that the federal government has a source of money that the states do not have? Or if taxpayers in Arizona want to subsidize health care for fellow citizens, that it makes more sense to send their taxes to DC first, and back to Arizona only after the Center for Medicare & Medicaid Services in Baltimore has taken its cut? Of course not: They just want you to think that when the state government makes the federal government pick your right pocket, instead of the state picking your left pocket directly, you are somehow being "relieved of the burden" of paying for other people's health care. I have written that the federal government must drastically change the way it funds Medicaid. The current mechanism virtually guarantees that states will spend beyond our means. The real "cost shift" is from taxpaying citizens to bloated government health care. And Gov. Napolitano's op-ed demonstrates that perfectly.
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Monday, April 21, 2008New Medicaid Policy IllegalBy Marc KilmerCategories: SCHIPLast week the Government Accountability Office released a formal legal opinion that the CMS policy announced last year that tightened SCHIP eligibility is illegal.
CMS said that notwithstanding GAO's opinion, the policy will remain in effect. Of course, 22 states are suing the Administration to overturn the policy, so ultimately the courts will decide. The rules are sensible; after all, why should a government health care program be extended to the middle class when poor kids are going uncovered? But governors (and their allies in Congress) want the "free" federal money, so it's unlikely that rules to this effect would ever pass Congress.
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Thursday, April 17, 2008Maryland Using Tax Records to Search for Medicaid RecipientsBy Marc KilmerCategories: Maryland, SCHIPIf you are eligible for the Maryland Medicaid program or the Maryland Children's Health Insurance Program (MCHP), expect to see a letter from the government informing you of that. How do they know? They will use your tax records, of course. Sure, you thought that information was only used to determine how much you owe the government in taxes. You may have thought that since the Maryland tax forms explicitly state:
Perhaps they forgot to mention that the Revenue Administration Division can request tax return information to administer state welfare programs. I guess that was just an oversight.
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Wednesday, April 16, 2008Clinton Presidency Means SCHIP ExpansionSays she'll sign SCHIP bill in first 100 days By Marc KilmerCategories: SCHIPDuring a speech to newspaper editors in Washington, DC, Hillary Clinton laid out plans for her first 100 days in office. Among them:
This is no surprise, but it is probably an indication that a Clinton Administration would be more receptive towards state efforts to expand SCHIP. Although lax in earlier years, the Bush Administration has lately pushed states away from including adults in their children's health insurance programs and tried to focus states on covering the poorest children. It is unlikely that this direction would be continued under Clinton.
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