NCPA - National Center for Policy Analysis


November 7, 2007

Overlooked in the current debate over expanding the State Children's Health Insurance Program (S-CHIP) into the middle class is the impact it would have on the quality of children's health care, particularly among families who already have superior private insurance coverage, says John S. O'Shea, a practicing physician and a former Heritage Foundation Health Policy Fellow.

A sound policy, says O'Shea, would:

  • Reauthorize S-CHIP for uninsured children in families with incomes at or below 200 percent of the federal poverty level (FPL), or $41,300 for a family of four, while improving outreach efforts to enroll eligible children who do not have private health insurance coverage.
  • Provide tax relief for middle-class families with annual incomes between 200 percent and 300 percent of the FPL, or $41,300 to $61,950 for a family of four, to help them to keep or get private health insurance coverage for their children; such a policy would reduce churning in the private insurance market, enhance portability of coverage, and secure greater continuity of care.
  • Provide incentives for the states to find more efficient ways of using existing federal and state funds to increase insurance coverage; such a policy is embodied in the More Children, More Choices Act of 2007, sponsored by Sens. Mel Martinez (R-Fla.) and George Voinovich (R-Ohio) in the Senate and Reps. Marilyn Musgrave (R-Colo.) and Tom Price (R-Ga.) in the House of Representatives.

The available evidence shows that S-CHIP has not performed well in terms of health care coverage, access to care and quality of services.  Congress should be aware of the hazards of disrupting the superior private health coverage of millions of American families and should instead focus on helping poor families with children, stabilizing and expanding the coverage of those who have insurance through the private sector, and improving the quality of health care for all children in America, says O'Shea.

Source: John S. O'Shea, "SCHIP Will Not Improve Quality of Kids' Health Care," Heritage Foundation, WebMemo #1687, November 2, 2007.


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