Health care for children

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Growing up in Florida, I was fortunate to be raised by a loving mother who worked two jobs to provide for me. Our neighborhood was filled with hard-working parents, but my mother was different because she was employed as a domestic for a doctor, who generously provided health care to our family.

Growing up in the segregated South, as African-Americans we were required to use a separate entrance to his office, but in stark contrast to so many families we had basic health care. Today, with 9 million children in America without health-care insurance, far too many of our nation"s children continue to receive their health care through the side door, if at all.

What was true during my childhood continues to be so. Children with health care coverage receive the regular medical check-ups that are a building block for a healthy and productive life. With health insurance, problems can be addressed before they become significant health concerns. Care is received from a physician rather than through an emergency room as crisis demands.

This year, we have an important opportunity to expand health coverage for America"s uninsured children. The State Children"s Health Insurance Program (SCHIP) is up for reauthorization. Reauthorization is not in question. But whether we will build upon SCHIP to strengthen the national health-care safety net or will retreat from ensuring health care to the nation"s children is the cause of a serious clash in Washington.

SCHIP is a joint federal-state program that provides health care coverage for children in families with incomes too high for Medicaid but too low to afford private health insurance. The federal government has set the income threshold at double the Federal Poverty Level (FPL) or $41,300 for a family of four, but has allowed the states flexibility in establishing their own income limits for coverage under SCHIP. Currently, 17 states have exceeded the national standard, with one state — New Jersey — providing coverage to families whose income is up to 3½ times the FPL.

Over the last decade as the economy has grown volatile and private insurance coverage has eroded, the number of uninsured adults has grown by 6 million while the number of children without coverage declined by one-third. Despite this success, present SCHIP funding levels allow coverage for only 68 percent of eligible children.

President Bush has proposed a five-year reauthorization of the program with essentially static funding. This is seen as a way to refocus the program on low-income uninsured children, while encouraging families to buy into private health insurance rather than relying on public programs.

Yet 6 in 7 children on Medicaid or SCHIP have at least one working parent. The problem isn"t that working parents aren"t buying into private health insurance programs. They simply cannot afford it. The president"s proposal fails to open the door for the 6 million eligible children that are without health care.

Maintaining SCHIP"s current funding levels would not provide adequate funding to sustain current caseloads. By some estimates, funding under the administration proposal would fall $7 billion short. As health-care coverage has become a growing financial worry for families all along the economic spectrum, restricting the health-care safety net is shortsighted and bad public policy.

The real issue for SCHIP reauthorization isn"t whether it conflicts with private health insurance, but whether we have the national will to fully address the most basic needs of our children.

Enacted in 1997 by a Democratic president and a Republican Congress, SCHIP offers a blueprint for expanding basic health insurance coverage to uninsured children. Rather than argue over the effect of SCHIP coverage on insurance companies, we should focus on the impact on children.

In 10 years, SCHIP has developed a record of efficiency and success. Reauthorization provides this Congress the opportunity to work jointly to improve the lives of America's children.

SCHIP should be reauthorized at a funding level of $50 billion in new federal dollars, and with provisions that strengthen the flexibility of states in addressing the health-care needs of their children and working families.

To borrow a phrase from Franklin D. Roosevelt, it is an unfortunate human failing that a full pocketbook often groans more loudly than a child in need. We have an important opportunity to ensure that our nation"s children are heard in the debate over SCHIP reauthorization.

A fully funded, flexible reauthorization would not only meet our most basic promise to our children but would also be a big step toward ensuring that no child in America has to go through the side door for basic access to health care.

Bill Bentley is president and chief executive officer of Voices for America"s Children, a national network of 59 member children's advocacy organizations.