Vol. 41, No. 5

A Note from the Chairman Emeritus

States have been called the laboratories of our democracy. They’re places where policy experiments are carried out. If the experiment is successful, the lessons are often applied nationwide.

A More Perfect Constitution – A Q&A with Larry Sabato

America’s favorite political scientist talks about his new book, “A More Perfect Constitution.”

So Far, So Good

When the Medicare Modernization Act was signed into law in December 2003, there were many predictions of problems implementing the new drug benefit.

Prescribing a Financial Fix for Post-Acute, Long Term Care

As greater numbers of patients and residents enter our nation’s long term care system, it is imperative that our policymakers address America’s entitlement programs.

Entitlement Reform: The 800 pound gorilla that’s being ignored in the 2008 campaign

When asked what they would do about fixing entitlement spending, with just a few exceptions, the current presidential candidates quickly retreat into clichés.

Leading the Way: Health Care Reform

California’s Health Secretary discusses Governor Arnold Schwarzenegger’s plan to reform health care in their state.

It’s Not Just in California

A look at some of the other health care reforms being pushed by Republican Governors around the country.

Schwarzenegger’s Health Care Plan: A Bridge too Far, or a Bridge to Nowhere?

The key question is not whether the Governor’s plan is good politics, but whether it is good policy.

Health Care Reality Check

The goal of any reform plan should be the same as the Hippocratic Oath: First, do no harm.

From Barefoot Doctors to Red Envelopes

China’s health care system is weighed down by a legacy of government control.

Should SCHIP be Expanded?

Yes, the program is working, and America’s families need the coverage.

Should SCHIP be Expanded?

No, it will result in bigger government, not better care for our children.

The Backpage: Above All, Try Something

It is common sense to take a method and try it. If it fails, admit it frankly and try another. But above all, try something.

Ripon Profile of Judy Biggert

We must work very hard to earn back the respect and trust of the American people.

Should SCHIP be Expanded?

No, it will result in bigger government, not better care for our kids.

Lacking the overwhelming bipartisan accord that created the State Children’s Health Insurance Program nearly a decade ago, Democrats in Congress have instead opted for a massive liberalization of the program that dilutes its primary mission: covering children. 

This bill, as passed by the House (where there wasn’t a chance to amend the bill) and Senate, clearly isn’t about helping low-income children. If it was, it would have support from both parties and the president would be eagerly waiting to sign it into law. This is a missed opportunity.

Virtually everyone supports providing health insurance to low-income children. But when a federal health program for children starts covering not only families, but childless adults making three and four times the poverty level, it has unmistakably lost its focus. 

It is plain to see that Democrats want taxpayers to fund and the federal government to directly provide health care benefits to millions of more Americans — even for those families making over $80,000 a year. They are using SCHIP as a vehicle, and the children it is intended to cover as a shield, to get one step closer to total government control over our health care system. This kind of medicine needs more than a teaspoon of sugar to swallow. 

The current plan to expand the State Children’s Health Insurance Program is in dire need of a second opinion. Instead of moving further and further away from the core mission, we should be reforming the program to ensure it is truly helping America’s uninsured children. 

Let’s look at some facts about the “new, improved” SCHIP:

1. Shifting, not adding, insurance — The non-partisan Congressional Budget Office stipulates that the proposed expansion of SCHIP would cover an additional 5.8 million Americans at a cost of $35 billion. Alarmingly, CBO also states that more than one out of every three of those individuals (some children and some adults) already has private insurance. Some experts suggest that number is as high as six in 10.

Either way, it is clear that the SCHIP bill does little more than move children and upper-income families from private insurance plans to taxpayer-funded plans. That is why it should not surprise anyone that when HillaryCare first came about, one of three options to obtain universal, government coverage followed this exact model: start with kids, move on to the entire family, and soon you will have everyone enrolled in a government program. 

…when a federal health program for children starts covering not only families, but childless adults making three and four times the poverty level, it has unmistakably lost its focus.

That kind of slow creep is a prescription for the government largess that stifles economies and unduly burdens taxpayers. It is not a prescription for reducing the number of uninsured Americans. 

2. States get more money, but some states don’t — States and children advocates should take a second look at this bill. Because of shoddy funding sources, this bill is likely to harm more states and health care programs than it purports to help. A Heritage Foundation study showed that as many as 28 states, including my home state of Michigan, stand to have a net loss of $10 to $700 million in revenue. 

3. Kids born today lose coverage at age six — Supporters of this SCHIP expansion state that the program is fully funded. However, when you look closely at the details you find a giant funding cliff after five years. In year six, after five straight years of increases, funding reverts to 65% below current levels. That is quite a budgetary slight-of-hand given that the program’s average cost is pegged at roughly $12 billion a year. So, what happens in year six? Do taxes go up to cover the shortfall? Is coverage eliminated for millions of kids that just entered the program? 

4. With apologies to the American Cancer Association: Light up…it’s for the kids — As ridiculous as the assumption that the program costs nothing after five years, is the assumption that there will be 22 million new smokers to pay for this program. Being built upon the foundation of a new federal 61 cent per pack tax on cigarettes, the program will quickly go up in smoke.  

Over the years we have learned that the more we tax any activity, but especially cigarettes, the less likely people are to engage in the activity. To that end, cigarette taxes have been a great health care policy. Even if we forget how terribly regressive this tax is – falling heaviest on lower-income Americans (those ironically targeted for help under SCHIP) – it is clear that a cigarette tax may be the worst possible stream of revenue for an ongoing program. 

This bill is designed poorly, funded poorly and will do little to help lower-income Americans obtain health care coverage. The president should veto this bill and Congress should work in a bipartisan fashion — as we did nearly ten years ago when the program was created — to make certain children in America have access to the health care system.  

Dave Camp represents the 4th  District of Michigan in the House of Representatives. He serves as the ranking member of the Ways and Means Health Subcommittee.