E-LIBERAL

Tuesday, August 21, 2007

The Real Protectionism: Favoring Private Insurers at the Cost of Children's Lives

According to this article in the New York Times, Republicans have decided to oppose America's most popular health insurance program - by stealth. Not brave enough to oppose SCHIP in Congress, the Bush administration is bringing in rules that would prevent states from expanding the program to cover more impoverished children.

And they're keeping it nice and quiet. This policy was announced, not in a press conference or news release, but in a letter sent to state health officials from bureaucratic non-entity Dennis G. Smith, the director of the federal Center for Medicaid and State Operations. On a Friday. At 7pm. In the middle of the August holiday period. States received no advance warning and were not consulted on the change in policy.

The letter says that states must demonstrate that they've enrolled 95% of eligible children below 200% of the Federal Poverty Level before they can extend the program - something that no state has ever achieved, and that the President's insufficient budget proposal effectively prevents. The letter goes on to say that:
  • states must prove that individuals have been uninsured for a minimum one-year period before they qualify for the program
  • states should charge co-payments or premiums that approximate the cost of private coverage
  • states must prove that the number of privately insured children in the target group has not decreased by more than 2% over the previous 5 years
The letter concludes with a threat - states that have already been granted federal approval to expand SCHIP to children above 250% of the FPL must amend their state plans to reflect the new rules within a year or face 'corrective action'.

The collective effect of this is a directive which protects the existing corrupt practices of the private health care industry against an affordable, comprehensive health plan that is the only option for many of the working poor. SCHIP has reduced the number of uninsured children in America by one third since 1997. In the same period, private health insurers have increased profits and premiums while the numbers of uninsured and underinsured citizens have increased.

The Bush Administration says its new policy is aimed at preventing the expansion of SCHIP, but its combination of underfunding and impossible-to-meet rules undercuts the entire program. Fortunately, it looks like states are gearing up to fight back. What is certain is that the fight will be tough.

SCHIP is the most visible (and immediately tragic) component of the Bush administration's war on state health initiatives, but there are others. Trade policy- always an area given to undermining programs that help ordinary people- mirrors the Administration's approach to SCHIP. A new report by the Americans for Democratic Action Education Fund, Trading Lives, finds that global trade rules currently being negotiated threaten states' ability to pursue innovative health care reforms. Private insurers that dislike aspects of public programs may try to characterize them as 'disguised barriers to trade' and seek to insert limiting provisions in US trade agreements - again, a method that relies on a lack of Congressional scrutiny and democratic process.

This is the Bush Administration's true face. They say they want free trade, but what they really want is trade that benefits their friends. They say they want to expand access to health care but what they really want is to expand their funders' profits. Congress must deny them on all counts, and put the interests of the American people first.

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