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Spokane, Washington  Est. May 19, 1883
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Our View: Federal expansion of health care program overdue

Two years ago, President Bush vetoed legislation that would’ve expanded health care coverage for children, and Congress was unable to muster the votes for an override. But the issue is back, and Congress is on the verge of adopting a similar bill, with a long-overdue sweetener for Washington state.

Following earlier action by the U.S. House of Representatives, the U.S. Senate on Thursday passed a bill to bolster the popular State Children’s Health Insurance Program. The bill would cover 4.1 million more children, bringing the total to 11 million. The cost is $32.8 billion over 4 1/2 years and is to be paid for with a 61 cent tax on a pack of cigarettes.

This still leaves 5 million uninsured children, but it’s a tremendous gain for SCHIP, which was created in 1997 to help cover children from families whose income was too high to qualify for Medicaid and too low to buy private insurance. It’s a tribute to the program that while the percentage of children covered by private insurance has declined in the past 12 years, the overall percentage of those who are covered has risen. The number of uninsured children has dropped dramatically under SCHIP. Those facts belie the criticism that the expansion merely amounts to trading private care for public care.

The bill is even better news in Washington state, which through a quirk in the law has not gotten its fair share of SCHIP funds over the years. In 1994, the state, via Medicaid, became one of the few to cover more kids. Three years later, SCHIP was created, but the law blocked states from shifting eligible kids from Medicaid to SCHIP. This matters because the feds match dollars at a higher rate for SCHIP than for Medicaid. In short, Washington couldn’t stretch the dollars as far.

The no-transfer rule had the unintended consequence of punishing those states that were leaders in providing health care for children, and Washington state politicians have been trying to rectify that. Over the life of SCHIP, the state has had to forgo an estimated $200 million. U.S. Sen. Maria Cantwell has worked hard to convince key colleagues, such as Senate Finance Committee Chairman Max Baucus, that the inequity had to be addressed. She secured the fix two years ago, but it was a casualty of the veto.

In 2008, the state was allocated $79.9 million in SCHIP funds, but could only use $44 million, Cantwell says. In 2009, it will have an estimated $94 million and can use it all when the bill becomes law. An estimated 496 more children could become eligible for SCHIP in Spokane County.

It’s about time.

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