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Obama signs child insurance bill

WASHINGTON (BP)–President Obama signed into law Feb. 4 a major expansion of a children’s health insurance program a Southern Baptist ethics leader described as a move toward government-controlled health care.

The new president signed the reauthorization of the State Children’s Health Insurance Program (SCHIP) on the same day the House of Representatives gave final passage to the bill. The new law is expected to increase the number of children eligible for coverage under the plan from 7 million to 11 million at a cost of about $33 billion for less than five years.

SCHIP, which was established in 1997, is intended to provide federal funds to states for health insurance coverage of children in low-income families that are not poor enough to qualify for Medicaid but unable to afford private insurance. SCHIP provided $40 billion during its first 10 years.

Among concerns cited by foes of the new law are its inclusion of children in families that already have private health insurance, the lack of a provision clarifying unborn babies are covered and the continued eligibility of childless adults for SCHIP coverage. A significant consequence of these shortcomings is fewer eligible children from low-income families will be enrolled in the program, critics say.

While supporting SCHIP as originally designed, Southern Baptist ethicist Richard Land opposed the new version, calling it “nothing less than a vehicle to advance ‘socialized medicine’ by stealth.”

The president of the Ethics & Religious Liberty Commission (ERLC) said the new law falls short of assuring children from low-income families are covered while making it easier for states to expand eligibility for SCHIP even to families that make more than $100,000 a year. It has been estimated between one third and one half of children enrolled under the SCHIP expansion will be those who are now covered under private plans, he said.

“Wouldn’t the nation’s children be better served by targeting the truly needy for expanded health assistance rather than encouraging some in the middle class to move their children off private insurance and onto government programs?” Land asked in a Feb. 4 commentary.

“The only rational explanation for deliberately designing programs” that move children of families with private insurance to government-underwritten insurance “is to provide a foundation for an increasing government takeover of the health insurance system by using children as a ‘Trojan Horse’ to introduce government takeover of health care, i.e., ‘socialized medicine,'” Land said.

During the White House signing ceremony, Obama called the new SCHIP measure “only the first step.”

“The way I see it, providing coverage to 11 million children through [SCHIP] is a down payment on my commitment to cover every single American,” the president said. “And it is just one component of a much broader effort to finally bring our health care system into the 21st century.”

The failure to amend the legislation to place into federal law a provision for unborn children was tragic, Land said.

During Senate floor consideration, Sen. Orrin Hatch, R.-Utah, offered an amendment to the bill that would have codified a pro-life regulation implemented by the Bush administration in 2002. That rule permits states to extend to pregnant women and their unborn children the use of funds already available under SCHIP. Fourteen states have approved plans to extend SCHIP coverage to the unborn, Hatch said.

The Senate defeated Hatch’s amendment in a 59-39 vote. The amendment would have provided coverage for the mothers not only while they were pregnant but for “postpartum services” 60 days after delivery, Hatch told his colleagues.

The 2002 regulation, which remains in effect, clarified the coverage encompasses children from conception to age 19. Previously, SCHIP coverage was allowed for children age 19 and under.

SCHIP enables states to ask for waivers to cover pregnant women, which can be a time-consuming process. The “unborn child rule” permits states to provide coverage without seeking waivers.

Hatch’s amendment would have heightened protection of the rule by giving it the force of congressionally approved legislation. With the defeat of the amendment, a presidential administration may overturn the “unborn child rule,” as it has become known, without congressional action.

Hopefully, pro-life legislative specialist Douglas Johnson told Baptist Press, the “unborn child rule” will remain in effect, “unless the Obama administration goes back and gratuitously attacks the original regulation.”

Abortion-rights organizations strongly oppose the “unborn child rule,” which represents a different approach than one they favored. The Bush administration rule from 2002 not only clarified that unborn babies from low-income households are covered but also that pregnant women, including those who are undocumented aliens, are as well, Johnson said. Defining pregnant women as children did not fit the purpose of the law, the Bush administration determined, and left some of them uncovered, Johnson said.

The new law also will continue to enable states to ask for waivers to provide coverage for childless adults, in spite of the program’s name and likely at the expense of low-income children, critics say. The new bill will restore adult pilot programs that have expired in some states and will enable those states to receive higher matching funds from the federal government under SCHIP than under Medicaid, according to the Heritage Foundation.

The House approved the final version of SCHIP with a 290-135 vote Feb. 4. Senators voted 66-32 for the bill Jan. 29.

The ERLC opposed two versions of the SCHIP expansion in the last congressional session, each time expressing concern the legislation would mark a significant step toward government-run health care.

President Bush vetoed both versions in 2007, and the House failed to override his action both times. In each case, Congress’ version would have expanded SCHIP by $35 billion over a five-year period, and the president’s proposal would have increased it by $5 billion.
Tom Strode is Washington bureau chief for Baptist Press.