Funding for children’s health insurance is critical

By state Sen. Dede Feldman

In today’s polarized political climate, there are few issues that unite Democrats, Republicans, businesses, doctors, insurance companies, hospitals and consumer advocates. But over the past 10 years, a solid consensus has emerged in New Mexico, and across the nation, that we need to ensure that our children have health insurance and the early care it brings.

A key element of federal funding for such insurance has been the State Children’s Health Insurance Program – more commonly known as SCHIP. It is now at risk in Washington as the president reverts to an ideological objection to the program as “government-run” health care while the House and Senate debate the proper level of funding.

For New Mexico, the stakes are high. Not only are tens of thousands of children, parents and adults at risk of losing their coverage or of not being able to sign up for new programs recently authorized by the Legislature, but the long-sought holy grail of health care reformers here – universal coverage – may become much more difficult to grasp.

For the past year, as the number of uninsured New Mexicans has increased and the price of premiums has continued to grow, a health coverage task force created by the Legislature and governor has been meeting to see whether we can move toward universal coverage. One fundamental point of agreement among business, health-care providers, insurance folks and others on the diverse task force has been that the state needs to take advantage of Medicaid, SCHIP and other federal programs that currently match state funds at a handsome level (roughly three federal dollars to every state dollar). All of the models analyzed by the task force, be they market-based or single-payer, rest on SCHIP and the Medicaid program.

The broad agreement over the SCHIP program extends to the New Mexico Senate as well. During the past session, the Senate unanimously passed a memorial, sponsored by Kent Cravens, R-Albuquerque, calling on Congress to reauthorize and adequately fund SCHIP. The memorial acknowledges the value of the program in preserving child wellness, preventing and treating childhood disease, improving health outcomes and reducing overall health costs.

For years, with the help of our congressional delegation, New Mexico, like many other states, has utilized waivers to broaden the program to include more parents and working adults who are without insurance.

Bush threatens a veto

Suddenly, however, the Bush administration is threatening to veto any SCHIP reauthorization that exceeds $5 billion – an amount that sounds like a lot but isn’t enough to allow any expansion to the 6 million uninsured kids in the United States who are already eligible but not signed up for SCHIP.

Nationwide, the veto threat is already igniting broad-based opposition from chambers of commerce, parents organizations, pediatricians, medical societies and even insurance companies, because the program provides coverage through the very private insurance companies the president is trying to protect.

Senate and House committees have passed SCHIP reauthorization bills, with funding levels ranging from $35 billion to $50 billion. The Senate bill was co-authored by Jeff Bingaman, D-N.M. It would provide $176 million for New Mexico children next year, with increases in succeeding years, providing tens of thousands of additional New Mexico children and adults with health care for the first time.

The bill also includes an initiative Bingaman has been championing for years that would allow 10 states to test a program that would automatically enroll children in SCHIP if they have been deemed eligible for another public program, such as those that provide school lunches or food stamps. In addition, it would increase outreach to Native Americans and offer bonus payments to do Medicaid enrollment, which is of special concern in New Mexico where we have tens of thousands of children eligible but not enrolled.

Clearly, it is an extremely important bill to New Mexico.

Financing for the Senate bill would come from an increase in federal tobacco taxes, which health advocates like Dr. Ronald Davis, president-elect of the American Medical Association, say is a “win-win” because the additional taxes have a deterrent effect on potential young smokers.

The Senate Finance Committee overwhelmingly passed the bill on a bipartisan basis last week, by a 17-4 margin – something that bodes well for getting votes needed to override of a potential veto.

On the House side, Rep. Heather Wilson, R-N.M., voted against a SCHIP reauthorization bill in spite of her earlier letter to the budget committee urging it to continue to expand the program. Wilson said her opposition stemmed from the House funding mechanism, a reduced reimbursement rate for Medicare HMOs.

Bush, earlier, indicated his opposition to increased cigarette taxes, the Senate Financing mechanism.

New Mexico needs SCHIP

Poll after poll shows that about two-thirds of Americans, in principle, are willing to pay more taxes to provide health care for all. And even more relevant to SCHIP is the recent poll by the Campaign for Tobacco-Free Kids. It reveals that 70 percent of Americans support a 30-cent-per-pack increased cigarette tax for expanding health coverage to American kids. Slightly less, 67 percent, support a 75-cent-per-pack increase.

New Mexico ranks next to the bottom when it comes to the percentage of children without insurance. We desperately need SCHIP reauthorized at a substantial level if we want to get out of the cellar and begin to get serious about a universal system.

Feldman chairs the Legislature’s Interim Health and Human Services Committee. She is a member of the Health Coverage for New Mexicans Committee.