Health Care -- Obstructing Children's Health Care

February 2, 2009

by Faiz Shakir, Amanda Terkel, Satyam Khanna, Matt Corley, Benjamin Armbruster, Ali Frick, Ryan Powers, and Igor Volsky

HEALTH CARE

Obstructing Children's Health Care

On Wednesday, the House is expected to pass the Senate version of the State Children's Health Insurance Program (SCHIP) reauthorization bill. The legislation renews the joint state-federal program, spends an additional $32.8 billion to expand coverage to four million more children and gives states the option of extending health coverage to legal immigrant children. "Governors, business executives and consumer advocates lobbied for the expansion, arguing that more and more families have sought the assistance in this weakened economy," notes the Washington Postl. "During this economic turmoil, it is critical that we maintain and strengthen this important lifeline to our nation's children and that we help financially strapped states respond to the growing need for affordable health-care coverage," said Cindy Mann, executive director of Georgetown University's Center for Children and Families. Yet despite the broad consensus, the bill passed the Senate on the heels of "rancorous debate," as Republican lawmakers introduced numerous amendments to water down the legislation and limit its reach. GOP lawmakers in both the House and the Senate objected to a provision allowing states to eliminate the five year waiting period for immigrants to obtain health coverage and criticized the bill for expanding eligibility to too many low-income children.

DENYING THE AFFORDABILITY PROBLEM: Republicans maintained that no expansion should occur until the very poorest children -- those at 200 percent of the Federal Poverty Line -- are covered and argued that expanding children's health insurance would force millions of children with private coverage into a public program. But as a new report by the Robert Wood Johnson Foundation and the Urban Institute concludes, health insurance costs have risen so much that even for families at 300 percent of the Federal Poverty Line, employer sponsored insurance premiums for family now make up as much as "19 percent of income on average for a family of four." Indeed, health insurance premiums have grown faster than paychecks, placing health insurance out of reach for many working class families. Despite 44 states facing budget shortfalls and many "scrambling for months to cut aid to schools, universities and, increasingly, residents who rely on the state for medical care," Republican were concerned about too many children being 'crowded into' public coverage. But as the Center for Budget and Policy Priorities explains, "crowd-out is not the same as voluntarily dropping private health insurance for public program coverage." In fact, a "Congressionally-mandated 10-state evaluation of SCHIP found that while 28 percent of newly enrolled children had private coverage before joining SCHIP, half of them — or 14 percent —lost their private insurance for involuntary reasons before enrolling in SCHIP, such as when parents lost their jobs or became divorced or employers stopped offering health insurance fordependents." As Sen. Olympia Snowe (R-ME) pointed out, "It's the cost of private insurance that excludes them from having coverage. More and more Americans are losing coverage because they can’t afford it. Small businesses can't afford to provide it."

DENYING THE PROBLEM OF LEGAL IMMIGRANT CHILDREN: During a debate about expanding health care coverage to more children, Republican lawmakers tried to turn the conversation to immigration reform. Explaining his support for a provision that currently subjects most legal permanent residents to a five-year ban on eligibility for Medicaid and SCHIP, Sen. Orrin Hatch (R-UT) said, "I simply cannot support a CHIP bill that allows states to cover legal immigrant children when there are 6 million at the 200% level and below eligible for [S]CHIP and Medicaid. These children ought to be our first priority." But since the five-year waiting period was instituted in 1996, immigrant children and pregnant women with no other source of coverage have been prevented from obtaining essential health care. The ban has contributed to "higher costs for emergency room visits and poorer health outcomes," "exacerbated the disparity in health coverage between immigrants and native citizens," contributed to the increasing uninsured rates among immigrants, and "shifted the burden of covering this population to states and local safety net providers." But the argument for including tax-paying non-citizens in the SCHIP program is as much economic as it is moral. Forcing immigrant children to go five years without seeing a medical professional only increases SCHIP's costs once the now sicker children become eligible for insurance. In fact, diagnosing and treating childhood diabetes or asthma before those conditions progress, improves the health status of the patient and saves money on costly treatments within the system.

MOVING AHEAD ON AFFORDABLE HEALTH REFORM: The swift passage of children's health shows that comprehensive health reform is possible, despite the complexity of the problems. But we cannot stop here; the current economic crisis demands that we reform the broken health care system. Rahm Emanuel, the White House chief of staff, has declared that "you never want a serious crisis to go to waste." As Nobel Prize-winning economist Paul Krugman points out, "F.D.R. was able to enact Social Security in part because the Great Depression highlighted the need for a stronger social safety net. And the current crisis presents a real opportunity to fix the gaping holes that remain in that safety net, especially with regard to health care."

RADICAL RIGHT -- LOYAL BUSHIES CREATE BUSH-CHENEY ALUMNI WEBSITE, AIMS TO 'HELP BUILD A LASTING LEGACY': Even before President Bush left office, he and his loyal Bushies were hard at work shaping his legacy, comparing him to Abraham Lincoln and claiming his failed policies were smashing successes. Work on his presidential library has also been increasing in recent months. The newest installment of "George Bush is a wonderful person" is now online: the Bush-Cheney Alumni Association website. All Bush employees, appointees, interns, campaign donors, and volunteers are eligible to join. The site's mission is to be "a forum in which alumni can stay connected and help build a lasting legacy for President George W. Bush and the Bush-Cheney Administration." The site contains a considerable amount of hagiography, with the highlighted "Bush Record Documents" compilations called: "Praise For President's Accomplishments" and "More Praise For President's Accomplishments." Many of the articles were written by conservative columnists or former Bush aides. These loyal Bushies have also set up several Facebook pages, including "Bush Cheney Alumni" and "Bush-Cheney Administration Alumni." Users on those sites have left comments such as: "Is it too soon to miss them?" and "Got a kiss from W yesterday at his farewell ceremony at Andrews :o(."

IRAQ -- AUDITOR: RECONSTRUCTION IN IRAQ WAS A FAILURE: Today, Special Inspector General for Iraq Reconstruction (SIGIR) Stuart Bowen will release a book, published by the bipartisan Commission on Wartime Contracting, that "concludes that the U.S. reconstruction effort in Iraq was a failure, largely because there was no overall strategy behind it," the Washington Post reports. The book, called "Hard Lessons," portrays "in colorful detail" the internal Bush administration fights over responsibility for reconstruction, detailing "an argument between Rumsfeld and Rice in the fall of 2003 during which each said the other was in charge of supervising the Coalition Provisional Authority." There are now 154 open criminal investigations into allegations of bribery, conflicts of interest, bid rigging, and theft from the wars in Afghanistan and Iraq. The book is hardly the first reporting of the massive waste in Iraq funding: In 2007, a SIGIR report found $5.1 billion in expenses for Iraq's reconstruction were charged without any documentation, and a Government Accountability Office report cited another $10 billion in wasteful or poorly tracked spending. Last year, the GAO Comptroller testified that a "significant" amount of U.S. funds were being funneled to Sunni and Shi'ite militias. Bowen said that many of the same mistakes will likely happen in Afghanistan. "None of the substantive changes in oversight, contracting and reconstruction planning or personnel assignments that Congress, auditors and outside experts proposed as the Iraq debacle unfolded has been implemented in Afghanistan," the Post reports.

ENERGY -- ECONOMIC RECOVERY PLAN'S BOLD MOVE TO REPOWER AMERICA: President Obama's recovery plan makes a bold investment in the modernization of our electricity infrastructure, in order to transform an often-overwhelmed patchwork of balkanized regional networks into a national "smart grid" based on Internet-like technology. In addition to a $20 billion investment in smart grid deployment, the recovery plan offers $2 billion in grants to promote a subtle but key shift in electric utility regulatory policy that "decouples" energy industry profits from demand. Electric utilities traditionally make higher profits when they sell more electricity to consumers. The key problem is that this discourages utilities from promoting conservation and efficiency -- instead, the more wasteful their consumers are, the better. So demand goes up, utilities build new, expensive, and polluting power plants, and still costs rise. Utility shareholders' interests are pitted against the rest of society. In response, several states have implemented policies that decouple profitability ("recovery of prudent fixed costs of service") from demand ("retail sales"), by using public funds and rate adjustments to guarantee an expected annual profit for the utility company and to subsidize investment in energy efficiency. Obama's economic recovery package contains $2 billion in state-level block grants that will be released "only if the governor of the recipient State notifies the Secretary of Energy that the governor will seek, to the extent of his or her authority, to ensure" that decoupling and energy efficiency incentive programs will occur.

Washington, D.C.'s only progressive talk radio station is going out of business. OBAMA 1260 -- which features syndicated hosts such as Ed Schultz, Stephanie Miller, and Bill Press -- will be switching to financial news starting next week. The program director said he "thought the station could work because of enthusiasm over Obama, but that ratings collapsed to a level that could not be measured after the election."

Health and Human Services Secretary nominee Tom Daschle wrote to Senate leaders yesterday regarding his income tax returns. "I am deeply embarrassed and disappointed by the errors that required me to amend my tax returns. I apologize for the errors," Daschle said. The Senate Finance Committee will meet at 5 p.m. today with Daschle.

"Businesses are faring much better" in the Senate version of the economic recovery package, the AP reports today. The Senate bill, which is being debated this week, "has billions of dollars in business tax credits not included in the House plan" that passed last week. For instance, the Senate package offers $15.5 billion more than the House for “money-losing companies to get refunds of taxes paid on profits in previous years."

The Justice Department is "bracing for a broad doctrinal shift in policies from those of the Bush administration, department lawyers and Obama administration officials say." Under Eric Holder -- who is expected to be confirmed as Attorney General today -- the Department transition is "expected to be more stark than that of a transition from one party to another."

The New York Times editorial board writes that "Americans deserve a full accounting" of the politically-motivated hiring and firings of U.S. Attorneys in the Bush administration. "The scandals of the Bush Justice Department will not be put to rest until all of Mr. Bush's aides who have been subpoenaed provide Congress with the information it needs, in public and under oath." More

In an op-ed in the Minneapolis Star-Tribune, Gov. Sarah Palin (R-AK) writes, "I am dismayed that legislation has again been introduced in Congress to prohibit forever oil and gas development in the most promising unexplored petroleum province in North America -- the coastal plain of the Arctic National Wildlife Refuge, in Alaska."

The New York Times reports that "[d]espite soaring unemployment and the worst economic crisis in decades, 18 states cut their welfare rolls last year, and nationally the number of people receiving cash assistance remained at or near the lowest in more than 40 years." Michigan "cut its welfare rolls 13 percent, though it was one of two states whose October unemployment rate topped 9 percent."

And finally: In November, a Craiglist ad popped up looking for a Republican "with a history in some aspect of the adult entertainment industry" to run against Sen. David Vitter (R-LA), who admitted to frequenting a DC escort service. It appears that someone has now taken up the challenge: porn star Stormy Daniels. The "Draft Stormy" website says that she is a "champion of entrepreneurism, a fighter for decency and the embodiment of pure libertarianism."

"Some relief for homeowners facing foreclosure is in the pipeline," CBS News reports, after the House Judiciary Committee passed a bill last week to "allow bankruptcy judges to order banks to reduce mortgage payments."

THINK PROGRESS: Israeli Foreign Minister backtracks on commitment to force Jewish settlers out of the West Bank

WONK ROOM: Center for American Progress President John Podesta cautions industry: President Obama "intends to fulfill" his "promise of energy transformation."

BEAT THE PRESS: The Washington Post's Outlook section publishes economic nonsense by Amity Shales.

THE SEMINAL: Thirty-four conservative senators oppose the economic recovery plan.

OREGON: Task force considers a tax on driving.

CALIFORNIA: California is about to shut state offices every other Friday due to the recession.

ECONOMY: States are cutting welfare rolls amidst the sour economy.

"This plan is a spending plan. It's not a stimulus plan."
-- Sen. Jim DeMint (R-SC), 2/1/09, on the economic recovery plan

VERSUS

"Countering a deep economic recession requires an increase in government spending to offset the sharp decline in consumer outlays and business investment that is now underway."
-- Conservative economist Martin Feldstein, 1/17/09

Think Progress

Obstructing Children's Health Care

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