October 19, 2007

October 19, 2007 | Commentary on Health Care

How to Insure Kids (Once the Shouting Dies Down)

Move over, Iraq war. There's another issue in town that raises the temperature of the body politic: Children's health care.

Political rhetoric doesn't get any more heated than what we heard after the President vetoed Congress' proposed expansion of the State Children's Health Insurance Program (SCHIP). To Sen. Ted Kennedy, it was "the most inexplicable veto in the history of the country," not to mention "incomprehensible," "intolerable" and "unacceptable." Speaker Nancy Pelosi scolded Bush for not "giving assurances to America's working families that if they work hard and play by the rules, we are their partners in raising the next generation of Americans and investing in the future."

Prior to the veto, Sen. Olympia Snowe (R-Maine) said she was "outraged by the news that the President is considering a veto of this legislation." But that was downright mild compared to the tongue lashing from Rep. Pete Stark (D-Calif.), one of the bill's primary authors. "The simple and sad truth," Stark thundered, "is that President Bush doesn't want children to have health insurance."

It's easy to forget that, even for an issue as emotional health care, it wasn't so long ago that the lions could lay down with the lambs.

On May 6, 1999 liberal Rep. Jim McDermott (D-Wash.), sporting a lifetime rating of only 2% from the American Conservative Union, shared the podium at The Heritage Foundation with conservative Rep. Jim Rogan (D-Calif.), whose lifetime ACU rating of 92% qualified him as McDermott's ideological polar opposite. McDermott and Rogan were there to unveil their bipartisan proposal to create a refundable 30% tax credit to offset part of the cost of health insurance. The credit would be available to families with incomes as high as $60,000.

"Not only would this proposal provide a tax benefit for those who need it most," McDermott explained, "it would also encourage health care consumers to be cost-conscious when choosing their health insurance plans so they could maximize the value of the credit."

McDermott, who then (as now) proudly advocated a single-payer health system, explained why he was willing to bend a little: "If there is a way for us to guarantee universal coverage without single-payer -- through a plan based on tax credits, Clinton-care or Medicare for all -- I am willing to look at the proposal, as long the plan guarantees access to quality care that is affordable."

One month later, the lions and lambs once again frolicked together, this time on the opinion page of The Washington Post. The self-described "ultimate political odd couple," House Majority Leader Dick Armey and Rep. Stark, wrote: "We think Congress should create a new refundable tax credit to enable all Americans to buy decent health coverage." Such a credit, they argued, "could bring about near universal coverage without new mandates or bureaucracy" and enable the uninsured "to shop for basic coverage that suits their individual needs and is portable from job to job." Armey and Stark envisioned "a gradual transition to a world in which individuals are free to obtain the kind of insurance they want, regardless of where it's purchased."

Significantly, McDermott convinced several senior Democrats on the tax-writing Ways and Means Committee, including Stark, who now chairs the Health Subcommittee, to support the tax credit approach. He also secured the support of a then unknown backbencher from San Francisco. That backbencher, the current Speaker of the House, now has it within her power to determine whether the next phase of the battle over children's health coverage ends in a Rose Garden signing ceremony, or another round of campaign attack ads.

If, as is now expected, the House sustains the veto of the expanded SCHIP bill, what then? Oddly enough, if lawmakers would just deep-six the rhetorical overkill, Congress could wind up with a far better bill than the vetoed measure; helping millions more working families get and keep the health coverage they want.

An alternative approach is waiting in the wings. Sen. Mel Martinez (R-Fla.) is floating legislation that mirrors the plan that last January brought together a diverse coalition of organizations, including liberal advocacy groups like Families USA and AARP, health provider organizations like the American Medical Association and the American Hospital Association, business groups like the Chamber of Commerce, and my own conservative think tank.

This approach would do two things. First, it would maintain the SCHIP program's historical focus on children in families at or slightly above the poverty level and give it resources to identify and enroll more of the half million SCHIP-eligible kids who still lack health insurance. Second, it would create a tax credit for families with income between two and three times the federal poverty level (up to an annual income of $62,000) for the sole purpose of securing health coverage for their children. This much-needed tax relief would enable the 10.5 million children in these families to gain or retain their private coverage.

As Martinez argues, rather than "putting more people on a government-run program" and in many cases "forcing them to drop their current coverage, let's advance tax credits to ... help families with employer-based insurance add their children to their existing policies" or, for those lacking coverage, "provide the resources necessary [for them] to go out and purchase health care."

When the consensus agreement was announced in January, Ron Pollack of Families USA, who has worked tirelessly to increase health coverage for children, observed that: "This historic agreement transcends traditional political ideological boundaries to break the gridlock about expanded health coverage for the uninsured." The agreement, he counseled, "should serve as a model for Congress and the President ...on both sides of the aisle, at both ends of Pennsylvania Avenue, to work together."

Amen.

Can't we all just get along, for the sake of the kids?


Michael Franc is vice president of government relations for The Heritage Foundation (heritage.org).

About the Author

Michael Franc Distinguished Fellow
Government Studies

First appeared in RealClearPolitics