Kids health bill rouses fear of ‘Hillary-care’

Sunday, July 29, 2007 | 7:03 a.m.

WASHINGTON - Nevada's congressional delegation, which represents a state that ranks among the worst in the nation for providing health insurance for working - class kids, is split over whether to expand government-run health care for children.

Republican Sen. John Ensign, in one of his first acts as a new member of the Senate Finance Committee, voted against the program, drawing praise from conservative organizations and frustration from Nevada Democrats. Republican Rep. Jon Porter has concerns about linking the expansion to Medicare cuts. President Bush has promised a veto.

For many Republicans, expanding government-run health care is a step toward "Hillary-care" - universal health care . They say health insurance should be left mostly to the private sector.

At issue is a federal program that aims to fix the problem of working class parents who earn too much to qualify for welfare, but don't earn enough or have employee benefits to secure insurance for their children.

In Nevada, these are families that earn $40,000 or less annually . Thirty thousand Nevada children have been signed up since Congress created the program a decade ago. Twice that many are believed to be eligible - three in five of the state's 100,000 uninsured youngsters.

Debate in Washington has detoured into a philosophical and partisan battle over the once-popular program, which is credited for cutting the number of uninsured kids by one-third nationwide.

Nancy Whitman, director of Nevada Covering Kids and Families, a non profit group established to go to PTA meetings, churches and community centers to enroll families, said funding for the program should be expanded. "We're all going to pay the price if children don't have access to health care," Whitman said.

The debate began this year when Bush proposed increasing the budget for the State Children's Health Insurance Program, known as SCHIP, by $1 billion annually for five years.

Congressional Democrats disagreed, and the Congressional Budget Office warned that failure to increase the budget more substantially would force nearly 1 million kids nationwide out of the program. Millions more children would never have a chance to be covered.

A bipartisan group of senators crafted an alternative that proposes boosting funding by $7 billion annually, using a 61-cent s -a-pack tax on cigarettes. The proposal cruised out of the Senate Finance Committee 17-4. Ensign voted No.

The Democratic-led House is entertaining an even larger expansion. The proposal would boost the budget by $10 billion annually, slightly more than the amount the Congressional Budget Office said is necessary to cover existing kids and reach the 6 million still uninsured. It would be paid for with a 45-cent cigarette tax and cuts to Medicare Advantage, a premium health care plan for seniors.

Republican leadership is aligned with the president, asserting that government should not play such a leading role in health care , which is better left to the private sector.

Republican lawmakers also argue that working class families will drop their private coverage if they have the chance to get health care for free from the government.

The Congressional Budget Office agrees that about one-third of the new enrollees will opt out of private insurance for government care, but argues that those additions are a modest trade-off for covering children who would otherwise go without doctors and dentists. It also says the premium medicare program could be trimmed to rein in costs.

Spurring on the Republicans are limited-government groups, including Americans for Tax Reform, headed by anti-tax crusader Grover Norquist, which warned senators that it may consider the vote when assessing lawmakers' overall performance on tax issues.

Norquist singled out Ensign among those who voted against the bill "for having the courage to stand on the side of taxpayers."

Ensign, in an interview last week, said Congress instead should be working to put families into private insurance by offering tax incentives and deductions so health care is more affordable.

"This expansion of SCHIP is just a big step toward socialized medicine - what Hillary Clinton was trying to do," he said, referring to the campaign the then-First Lady led in 1994.

He said the question comes down to: "Do you believe the private sector is more efficient, or a Washington-controlled government health system? I believe the private sector does better."

Porter said Nevada should work to cover more children, but he is "adamantly opposed to cutting benefits for seniors." He voted no in committee.

Nevada has a greater portion of uninsured children than all but a few states, and Nevada Check Up, as SCHIP is called in the state, has made strides to get them enrolled - slowly.

Nevada has been unable to enroll enough kids to use all the money it gets from the program, now about $40 million annually. Because the federal funding comes with a use-it-or-lose-it-clause, states that lag forfeit their allotment to those with more kids enrolled. In the early years, the state transferred as much as $17 million back to the federal government.

Democratic Rep. Shelley Berkley was stunned last week to learn that Nevada's unspent insurance money has been sent to other states, and that June was the first month in 10 years the state met its enrollment goal.

"I have uninsured children, sick children, in my district and were turning back money?" Berkley said in an interview.

Whitman and state officials say they face many hurdles in enrolling families: Nevada's transient population isn't familiar with resources, working parents are reluctant to ask for welfare, rural communities don't have enough doctors who are willing to participate in the program.

Whitman said her office has made great strides enrolling Hispanic families and is now concentrating on blacks, Asians, Caucasians and Native Americans whose enrollment is not as robust.

Whitman's office will also receive a boost after Assembly Speaker Barbara Buckley, a champion of the program, secured funding to beef up outreach. Until recently, the outreach office consisted of Whitman in Las Vegas and a partner in Northern Nevada .

"I've got one of the highest uninsured rates in the country, kids going to school with a mouthful of cavities, kids going to school sick as dogs because parents can't take them to the doctor," Buckley said. "I'm not going to rest until I make sure this program is implemented properly."

State supporters say even with the slow start, the program should be expanded so Nevada can try to reach the tens of thousands of children who remain uncovered.

Mary Wherry, deputy administrator for the Division of Health Care Financing and Policy in Nevada, has been following the debate in Washington.

"I think Congress is undecided about where they want to go in terms of ownership of health care in America," Wherry said. "We really believe Congress should pass legislation If you don't add more money, then how do we continue to cover the other 75,000 we haven't reached yet? ... How do we grow?"

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