Health Care: The Year of the Child
More evidence of how states are driving health care reform is the massive expansion of health care coverage of children in the states. It received little fanfare, but the New York legislature approved a budget in April that includes health care for essentially all children. SCHIP coverage was extended to children of families within income up to 400% of poverty (roughly $80,000 per year for a family of four) and allows richer families to buy into SCHIP coverage.
This follows a wave of states, highlighted by a new Georgetown University report, working to expand access to health care for children in 2007. 29 states have enacted or are working on proposals to improve kids' coverage.
New York along with Illinois AllKids program are the leading edge of change, but many states are looking to make covering all kids up to 300% of poverty, the standard for decent coverage by a state. 10 states in 2007 are proposing the 300% standard with other families able to buy in at full-cost, including Washington and Tennessee which have already enacted such reforms.
The Road to Universal Coverage: As we've highlighted at Progressive States, kids' coverage is seen by many as the first step to covering their parents as well. Oregon's Gov. Ted Kulongoski, fighting for a health plan in his state, recently said:
"If you drive the plan into the middle class, it's not just viewed as a public assistance program. You build a base of support for the program to provide health care for all of us."
The Right is quite aware of this danger, as a recent Wall Street Journal editorial warned. The Journal refers to expanding SCHIP as universal health care "on the installment plan" and urges Republicans to "work to return SCHIP to its original, more modest purposes;" i.e. keep it an unpopular welfare program rather than a program that the middle class also values.
A lot of folks are debating plans for national health care, but step by step, it's actually being done in the states.
I still see approaches to health care, like Clinton's, that start with children as too incremental. I can see an incremental approach that progressively expands Medicare by, say, knocking the age progressively lower. And I could see if such a plan also started by throwing in kids. But otherwise, it's actually a bar to change, as it poses a problem that we can "solve" without actually doing anything toward universal health care. The idea has to be to unite us toward the universal, so that, say, the lack of child care is a symptom of the problem, a force toward other ends.
John
http://www.haberarts.com/
May 7, 2007 8:54 AM | Reply | Permalink
Except that once middle class families are part of a government program providing health care for their children, the obvious question is why not have one covering the parents too?
In fact, many states are already jumping from covering kids to covering adults. Illinois is following up its AllKids program with a plan, backed by real money, to extend coverage to adults as well.
There are a lot of health care advocates who are obsessed with the idea that incremental reforms will somehow block further reforms, but the actual history is that states that take some action on health care or generally the most likely to take further action the next year and the next.
May 7, 2007 9:57 AM | Reply | Permalink