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Face-off ahead on child healthcare

Dr. Michael Paul performs a physical exam on a grade-school-age girl in Cicero, Ill.

KAI RYSSDAL: Government press officers know that if there's something you want to get out there without it getting much press coverage, Friday night's the night to do it. And there's probably no better Friday night than one in the middle of August.

Last Friday the federal official in charge of something called the Children's Health Insurance Program sent a letter to his state-level counterparts, in which he announced the White House is going to make it more difficult for states to expand the program to cover kids in middle-income families.

SCHIP, as it's called, has bipartisan support in Congress. In fact, lawmakers voted to expand it right before they left on their August recess. So we've called our Washington bureau chief John Dimsdale to help figure out what the White House is doing.

Hi John.

JOHN DIMSDALE: Hello, Kai.

RYSSDAL: So, as I mentioned, SCHIP is pretty popular on both sides of the aisle in Congress. Why is the White House trying to limit it?

DIMSDALE: Essentially, they're worried that SCHIP's going to become a creeping, government-run, single-payer healthcare system. You know, it was created to cover children of working parents who earn too much for Medicare but not enough to afford private insurance. So, more than 6 million children are getting healthcare from it. And states have been expanding the eligibility to higher and higher incomes — in some states a family can earn $80,000 a year and have their children covered by government insurance. So that's caused the free-market advocates in the administration to worry that SCHIP will displace private insurance for children. It's called crowding out the insurance companies. Basically, that SCHIP could become another big entitlement program like Medicare or Medicaid.

RYSSDAL: Cut to the chase, John. How much money are we talking about here?

DIMSDALE: Well, the administration has proposed for the next five years $30 billion for SCHIP, and that barely covers SCHIP's costs under the current enrollment, much less any expansion. Congress is looking at nearly twice that amount in order to increase eligibility.

RYSSDAL: Congress, of course, is gone for the next couple of weeks. The White House has made this move as they're on recess. What happens next?

DIMSDALE: Well, this is all gonna come to a head next month. SCHIP expires at the end of September. Both the House and the Senate have passed different versions, and they expand eligibility with the support of a lot of Republicans, I might add. Bush is warning that he'll veto this on the grounds that it's a budget buster. Just add SCHIP to the list of looming political budget battles next month as Congress sends the president lots of budget bills that he says he has no intention of signing.

RYSSDAL: All right. Our Washington bureau chief John Dimsdale. Thank you, John.

DIMSDALE: You're welcome, Kai.

About the author

As head of Marketplace’s Washington, D.C. bureau, John Dimsdale provides insightful commentary on the intersection of government and money for the entire Marketplace portfolio.

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