Will Bush sink SCHIP boost for kids?


WASHINGTON (JTA) – From restricting abortion access to lowering the church-state wall, the Bush administration’s right-leaning domestic agenda is often at odds with the Jewish community’s decidedly liberal views.

But with bipartisan support in Congress building to expand a program that supplies health coverage to millions of otherwise uninsured children, Jewish organizations thought that they had found an easy opportunity to forge common ground with the White House.

Not so fast.

President Bush announced last month that he had philosophical problems with bills in both houses of Congress aimed at expanding the State Children’s Health Insurance Program, or SCHIP, and planned to veto the measures.

In expanding eligibility, he told the Washington Post, “you’re really beginning to open up an avenue for people to switch from private insurance to the government.”

Despite Bush’s veto threat, the U.S. Senate and the U.S. House of Representatives passed respective measures last week reauthorizing and expanding the program – with many Jewish groups cheering on lawmakers as they broke for the summer.

“It’s one of those core moral issues the Jewish community understands very viscerally,” said Hadar Susskind, the Washington director for the Jewish Council for Public Affairs, an umbrella body that works to coordinate public policy positions among 14 national Jewish organizations and more than 100 local communities. “When politicians stand up and say they care about children, the working poor, this is where we see it.”

The push to renew and expand the children’s insurance program also has the support of the National Council of Jewish Women, B’nai B’rith International, the Reform movement and the United Jewish Communities, the national arms of the network of local charitable Jewish federations. Other backers include some of the giants of children’s advocacy groups, including the American Medical Association, the March of Dimes and the American Academy of Pediatrics.

The program, launched in 1997 and considered one of the successes of the Clinton administration, provides funds to states to insure children whose parents cannot afford private insurance but who earn too much to qualify for Medicaid. Numbers vary depending on the source, but advocates say the program currently reaches 6 million to 7 million children and that the expansion would cover 3 million to 5 million children currently uninsured.

Bush’s veto threat was a surprise, but his objections are not new – they were outlined in his budget, handed down in February, which proposed shrinking aspects of the insurance program.

In a fact sheet, the White House pointed to states that use their matching funds to bring the program to families who earn more than the federal guideline of 200 percent of the poverty level, or $41,300 for a family of four. Under Bush’s new guidelines, states that fund health care for families who earn more than that would not received SCHIP funds.

The White House also targeted those states that use SCHIP funds to cover parents of children who are eligible. Those states argue that keeping children healthy while neglecting their parents does not make sense. The Bush administration counters that the program was designed to help children, not adults, and says three states insure more adults than children through SCHIP but does not name them.

Bush’s proposal effectively cuts the program’s funding. It adds $4.8 billion to the existing $5 billion a year program over five years, a 4 percent increase well below the 7.7 percent inflation rate attached to health insurance.

The bill passed in the Senate boosts the program by $35 billion over five years. The House version increases it by $47 billion.

Advocates of the program’s expanded funding say they are baffled by the argument in some conservative circles that SCHIP represents a move toward socialized medicine. Most states, advocates say, administer the program through private insurers.

“It’s a program that’s been in existence for 10 years, and it’s a proven effective program,” said Sammie Moshenberg, NCJW’s Washington director.

Talk of a philosophical objection unsettled some Jewish leaders.

“This is not a college philosophical debate, this is caring for children who don’t have health care,” Susskind said.

Others were happy to step into the moral fray.

“In the Talmud, we learn in the ‘Ethics of Our Fathers’ that without physical sustenance there can be no learning,” Rabbi David Saperstein, head of the Reform movement’s Religious Action Center, said at an Aug. 2 news conference on the Senate side of the Capitol. “If we fail America’s children this year, it is the failure of our moral vision and political will.”

No one would speculate on the record as to why Bush has turned on the program, despite entreaties from Republican lawmakers and governors who back the Senate version.

Some say the president, confronting an adversarial Congress for the first time, feels liberated. With Republicans out of power, the White House no longer has to worry about the political viability of its initiatives. Bush has not stopped threatening vetoes since January; in his first six years in office he vetoed only one bill.

Bush might not win this fight. The House version passed Aug. 1 by a relatively narrow 225 to 204, but the Senate version won by a vote of 68 to 31 – just over the veto-proof 67.

Rachel Goldberg, B’nai B’rith’s director of senior advocacy, predicted Bush would come around.

“It’s the details that the president is questioning,” she said. “I have no doubt he supports access for low-income kids for health insurance.”

The Senate version earned Republican support because of its lower price tag and proposed funding mechanism through increased taxes on tobacco.

The House version funds SCHIP by gutting Medicare Advantage, a Bush administration initiative Democrats opposed because it routed some of the federally funded elderly health care program through private insurers at greater cost.

United Jewish Communities supported both versions, but raised questions in a letter to Democratic leaders in the House about a provision in its bill that freezes funding for skilled nursing facilities.

“Jewish Aging Facilities will not be able to retain and recruit the staff they need to provide older adults with the care and services they require,” the letter said.

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