Published 12:00 am Sunday, February 8, 2009

Small hand-up becoming a bigger hand-out?

Whether it’s part of an insidious plot or not, SCHIP  is now a lot bigger — and that’s good news for a lot of working families in Mississippi.

Created by Congress in 1997, the Children’s Health Insurance Program now has an “S” at the beginning to make clear states administer the plans and may modify them and add some state money if they choose.

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Mississippi has not expanded the program as other states have. In fact, an issue here has been people finding out about it and getting through the bureaucratic maze for enrolling — which has included that a child be uninsured for a year before becoming eligible.

As conceived, the program was to ease the financial vise many young families face. Too “wealthy” to be considered for Medicaid’s free health services, they were too poor to afford deductions for family coverage if offered through their employers and especially too poor to purchase health plans on the private market. Another motivation for starting the program was that people completely dependent on government programs had no incentive to work toward independence if getting a job meant losing health care for themselves or their children. SCHIP allowed children in families with incomes up to 200 percent of the federal poverty level to enroll children, expecting copays from parents in the upper ranges.

Of course, as things go with government programs — no matter how well-intended — there are now more uninsured people in America than there were when SCHIP was created and the largest proportion consists of children.

So Congress has been working for two years to expand SCHIP, even challenging former President George W. Bush to invoke a veto — which he did. President Barack Obama sees things differently and on Wednesday signed a bill that will reauthorize and expand SCHIP to an additional 4 million children. “In a decent society, there are certain obligations that are not subject to tradeoffs or negotiation, and health care for our children is one of those obligations,” he said. Notably, the measure passed both chambers with bipartisan support.

Gov. Haley Barbour has said the priority should be making sure all Medi-caid-eligible families are served before those up the income ladder receive benefits and, on a national scale, he says he doesn’t believe the legislation was properly crafted. Others see the expansion to 11 million children — and family incomes perhaps as high as $88,000 in some states — as the first definitive step in transitioning to a health-care system totally operated from Washington, D.C.

Bad news for smokers. The expansion is to be funded by a 62-cents-per-pack increase in the federal cigarette tax.

Time will tell if, as many predict, this expansion will cause children to leave private insurance plans to enroll or snowball into a system such as England’s or Canada’s.

For the present, though, it’s clear enough that more than 2.6 million American jobs have disappeared since the recession began in December of 2007 and the pace, if anything is quickening.

As things stand, parents will seek and get health care for their children when it’s needed. If they are uninsured, clinics and hospitals write the expense off as uncompensated care and then increase charges for patients who pay. In some way these expenses can and must be paid. SCHIP is not a bad program, especially in these economic times. In all times, however, people willing to work and try to move up the financial ladder shouldn’t be pushed back down.