Many New Enrollees Would Be Uninsured

from The Associated Press

By KEVIN FREKING

WASHINGTON (AP) — Congress' proposal to expand a child health care program gives states the financial incentive to expand eligibility for coverage to families of four earning about $62,000 a year.

That's a figure that seldom emerges in the claims and counterclaims being tossed about.

The Bush administration and many Republicans oppose the proposal as a big step toward socialized medicine. They much prefer to cite $83,000 — the ceiling that would apply to families of four only in New York state, and then only if the Health and Human Services Department approves a requested amendment to the state's current SCHIP plan.

Democrats, 45 Republicans in the House, many Senate GOP colleagues and other supporters of the expansion prefer to rattle off the figure $40,000. They say that about 70 percent to 80 percent of enrollees in the program would be children in families with incomes less that twice the poverty level. The poverty level is defined by the Census Bureau as $20,650 for a family of four.

Just what would happen under the bill passed Tuesday by the House, up for a vote later this week in the Senate and then sure to get a veto from President Bush? Here are some of the claims, and what in fact the bill would actually do:

The claim: The proposal would encourage families to substitute public insurance for private insurance.

The facts: The Congressional Budget Office projects that about 3.8 million people would become insured as a result of the bill, and about 2 million more will move from private coverage to public coverage. CBO Director Peter Orszag said the substitution rate of one-third was "pretty much as good as you're going to get" absent a mandate on employers to provide coverage or the insuree to buy it.

The claim: The proposal would allow coverage of families earning $83,000.

The facts: The bill essentially sets an income ceiling of three times the poverty rate for a family of four — $61,950. Beyond that, the federal government would not pay a state its full SCHIP match, which averages about 70 percent. New York state is seeking a waiver that would allow its residents to qualify if their income is not above four times the poverty rate — $82,600 for a family of four. The current administration or future administrations would have to approve that request. New Jersey would still be allowed to cover families with incomes three and one-half times the poverty rate — $72,275 for a family of four.

The claim: The bill would make it easier for children of illegal immigrants to get government-sponsored health coverage.

The facts: Currently, states are required to seek proof of U.S. citizenship before they provide Medicaid coverage, except in emergencies. The states now require applicants to show documents like birth certificates or passports in order to prove U.S. citizenship and nationality. The bill would allow applicants to submit a Social Security number instead.

Michael J. Astrue, commissioner for the Social Security Administration, said that matching a Social Security number with an individual does not allow officials to verify whether someone is a U.S. citizen.

The claim: The proposed 61 cent tax on a pack of cigarettes is a tax on the poor.

The facts: According to a recent analysis by the National Center for Health Statistics, smoking rates are higher for those who live in poverty or near poverty than among wealthier individuals. Also, a more dated analysis cited by the National Center for Policy Analysis, a conservative think tank, states that two-thirds of federal tobacco taxes come from those earning less than $40,000 a year.

(This version CORRECTS the bill sets an income ceiling for a family of four at $61,950, not $61,800.) )