Washington or patients can win on SCHIP — it’s up to us

In the coming weeks, Congress will vote on reauthorizing the State Children’s Health Insurance Program (SCHIP). On the surface, this is an opportunity to reauthorize a program that has successfully provided health insurance for millions of children from low-income families. However, if one digs deeper, one will see that this is truly the opening volley in a renewed debate: Washington-controlled bureaucratic medicine versus patient-centered healthcare.

When SCHIP was created a decade ago, those who could not afford private insurance and were ineligible for Medicaid coverage were left with few options. As part of the Balanced Budget Act of 1997, Congress appropriated $40 billion to help states address these needs. However, despite such a large sum of funds, SCHIP began experiencing trouble in 2002 as certain states’ annual spending surpassed their annual federal allotments. It was not until recently however, that the total pool of money began to dry up and states no longer could look to roll over funding to cover the gaps.

One of the predominant reasons for these shortfalls is that states expanded SCHIP coverage well beyond its original intent.
For example, today 14 states cover adults using SCHIP funding when there are still low-income children within their state without insurance. Six of those states cover adults with no children. Also, some states expanded eligibility to 300 to 350 percent of the federal poverty level.

Fair-minded Americans can agree that our children need and deserve access to quality and affordable health care. That is why few will dispute that we should reauthorize this program. However, there is a bidding war that has begun, equating tax money spent with compassion and quality care. The two are rarely connected. Our children’s health should not be a vehicle for expanding government and establishing what will amount to a new entitlement program — particularly when it will add billions in runaway spending and likely result in a lower quality of healthcare provided to all.

Both the House and Senate will come up with proposals that will amount to billions of dollars in additional funding for SCHIP. On the high end, the House Democrat proposal would reportedly add an additional $50 billion to $80 billion over the next five years and expand the coverage of SCHIP to families with incomes up to 400 percent of the federal poverty level (FPL). At such a level, children in families with an annual income of up to $82,000 would be eligible for taxpayer-funded coverage — not exactly low-income. This would include 90 percent of children who are already covered under private insurance.

The Senate’s proposal looks like it would cost around $35 billion and add nearly a twofold increase on cigarette taxes — a popular target.

More reasonably and responsibly, some House Republicans have recommended an increase of roughly $5 billion over the next five years that would provide eligibility for those up to 200 percent of the FPL. This is the income level SCHIP was originally intended to cover.

Even more positive is a proposal being worked on by other House Republicans that would include fundamental tax reform for the purchase of health insurance that would allow more Americans to be covered, while actually costing the federal government (read: American taxpayer) less.

In the end, the real question to be addressed is: Who should be making personal healthcare decisions — patients and physicians, or Washington?

Fair-minded Americans do not want Washington making their healthcare decisions. They do not want to build a more complicated bureaucracy with their hard-earned tax money. What they do want is affordable healthcare. They want greater choices, and they want portability. And all this can happen if we embrace fundamental reform and a system that ensures patient ownership of health insurance policies.

The SCHIP reauthorization proposal from the left will produce limited benefit at an enormous cost, and we will be ignoring much larger intentions and consequences. We must challenge this current majority, which is plagued with an aversion and fear of free-market principles — patient-centered principles. Congress should be putting Americans in a position to find affordable coverage with their hard-earned money. We can provide the American people with choices and competition that create greater access and affordability.

Everyone wants to protect and provide for America’s children. Nobody has a monopoly on compassion for hardworking American families. But a bad situation does not deserve an even worse solution.

The American people know best, not Washington. Patients and physicians should be making healthcare decisions, not Congress. Let us not embrace a “solution” and leadership that increases government regulation and a Washington-controlled bureaucratic healthcare system.

Let us reauthorize SCHIP with principles that respect patients, families and physicians. That would be a victory for all.

Price is a member of the House Financial Services Committee. Prior to coming to Congress he was in the private practice of orthopedic surgery for over 20 years.

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