Child Health at center of national debate

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Leaders are in gridlock as deadline to renew federal funding nears
By Jerry Zremski NEWS WASHINGTON BUREAU CHIEF
Updated: 09/10/07 6:54 AM


Derek Gee/Buffalo News
Kelly Scozzaro holds Gabrial, 2, with Julian, 5, in the background. Both sons’ medical expenses are covered by Child Health Plus.

Brian and Kelly Scozzaro were paying upwards of $500 a month for medication to keep their young son Gabrial’s allergies and asthma under control.

As a result, even though both Scozzaros have good jobs, the South Buffalo family was feeling squeezed.

“We were practically on the brink of bankruptcy,” Kelly Scozzaro said.

But that was before she and her husband got promotions and before the family enrolled its children in Child Health Plus, the state-federal children’s health insurance program that’s aimed at helping working families.

“It was pretty much a godsend,” Kelly Scozzaro said. “They pay everything — the co-pays, the medicine . . . When they told me we didn’t have to pay anything, I almost started crying.”

But Child Health Plus now finds itself at the fulcrum of Washington’s debate over the American health care system and how involved the government should be in it.

The federal program that spawned Child Health Plus will expire Sept. 30 unless Congress reauthorizes it, and Democrats and Republicans remain deeply divided over how to do that.

Democrats want to expand the program to many more middle-income families, but President Bush has vowed

to veto any broad expansion of the program, saying it would cost way too much and, in essence, be the beginning of socialized medicine.

“Democrats want to raise taxes by at least $54 billion to fund a massive expansion of government-controlled health care,” Rep. James McCrery, the top Republican on the House Ways and Means Committee, said last month. “This is not just about helping low-income children. They are spending government funds to lure middleclass families to opt out of private health coverage.”

New York State finds itself at the center of the debate over the program, thanks to its own efforts to vastly expand Child Health Plus, its version of the State Children’s Health Insurance Program, which is the focus of the Washington debate.

Friday, the Department of Health and Human Services rejected the state’s proposal to expand Child Health Plus, saying the state was stretching the program beyond its purpose of serving working low-income families that earn too much to qualify for Medicaid.

Mirroring national debate

But Republicans such as Rep. Thomas M. Reynolds, R-Clarence, and Rep. Randy Kuhl, R-Hammondsport, said the new federal policy could actually hurt low-income children.

Meanwhile, Democrats who advocate expanding the program saw an earlier administrative ruling that foreshadowed that decision as a shot across the bow aimed at them.

“I think [President Bush] overstretched his bounds, as he always does on his signing statements,” said Rep. Louise M. Slaughter, D-Fairport.

But by trying to extend the program to middle-income families, New York was endangering the program’s service to the poor, Kerry Weems, acting administrator at the Centers for Medicare and Medicaid Services, said in rejecting the state’s proposed expansion.

“I cannot conclude that New York is effectively and efficiently using available resources to serve that core population, such that expansion to higher income levels would not divert resources from serving the core population,” she said.

The debate over New York’s plan to cover 70,000 additional children is, in essence, a microcosm of the national debate over the program known as SCHIP.

House Democrats passed a bill last month that would add $50 billion to SCHIP, funded through a higher tobacco tax and cuts to the popular Medicare Advantage HMO program. The bill would allow New York to provide coverage to almost all of its 400,000 uninsured children, which includes about 16,500 in Erie and Niagara counties.

“Expanding SCHIP to cover 11 million children [nationwide] isn’t just the right and moral thing to do,” House Ways and Means Committee Chairman Charles B. Rangel, D-N.Y., said when the bill passed. “In terms of being fiscally responsible, everybody would tell you that having a kid exposed to preventative care actually costs less money than just ignoring care they need.” Meanwhile, the Senate approved a smaller SCHIP expansion, costing $35 billion and funded exclusively through a tobacco tax expansion.

The two houses still have to merge those two bills, and that may not be easy, given that Democratic leaders are at loggerheads over whether to include the Medicare reform proposal in the final bill.

‘The clock is ticking’

As if that alone wouldn’t make it difficult enough to reauthorize the program by the Sept. 30 deadline, Bush has threatened to veto either version of the bill.

“As a general matter, the legislation is structured in a way that clearly favors government-run health care over private health insurance,” the Bush administration said in a statement about the House version of the bill. “The result of this approach would be a dramatic encroachment of governmentrun health care resulting in lower quality and fewer choices.”

Given that the House and the Senate are divided and the president is opposed to what both are doing on the issue, supporters of the program are getting nervous as the Sept. 30 deadline approaches.

“It’s the typical congressional situation where there’s lots of intensity on both sides of the issue and the clock is ticking,” said Dennis Whalen, Gov. Eliot L. Spitzer’s deputy secretary for health and human services.

Slaughter said, though, that Congress and the president are not likely to let the program expire. Instead, all sides will likely agree on a temporary extension of the program while the debate on its long-term future — and the debate over the government’s proper role in health care — continues.

Kelly Scozzaro has strong feelings on the fact that Congress and the president have not been able to agree on how to reauthorize the program. “I think it’s ridiculous,” she said.

jzremski@buffnews.com
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