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January 22, 2009
By Dennis G. Smith
Buried in the economic stimulus legislation is a provision
further undercutting parental authority and expanding control of
taxpayer dollars by family planning clinics. No doubt these
provisions are embodied in the economic stimulus package because
their congressional sponsors believe that they would not be enacted
if considered separately on their own merits.
Section 5004, "State Eligibility Option for Family Planning
Services," would make Medicaid into a virtual money-machine for
family planning clinics. The federal government already provides a
90 percent match rate for family planning services in Medicaid.
States therefore have little at stake in Congress's oversight and
accountability of Medicaid. Under Section 5004, eligibility and
benefits can be expanded in several ways:
Section 5004 will also reverse current law in respect to state
benefit flexibility. Since the enactment of the Deficit Reduction
Act of 2005, states have had the authority to offer "benchmark
plans" and were allowed by federal law to provide coverage that
does not include family planning services. Some religious
organizations believe low-income families should be able to
participate in a health benefit program that does not include
contraceptives or sterilization. In a statement on reauthorization
of the State Children's Health Insurance Program (SCHIP), for
example, the Catholic Medical Association recommends that "at a
minimum, state and federal regulations should permit parents to
have access to SCHIP funds to enable them to choose health
insurance coverage that does not conflict with their values and
that does not separate funding mechanisms from parental
oversight." Under Section 5004, that choice would not
be available to parents of children on Medicaid.
Finally, the legislation provides a special "safe harbor"
protection to the state of California. Under procedures dating back
to the Clinton Administration, California created an eligibility
process that bypasses the county welfare agencies. As a result,
California is allowed to provide coverage to individuals--including
immigrant populations--who are not eligible for Medicaid. The Bush
Administration attempted to bring California into conformance with
standard eligibility procedures. Section 5004 would allow
California to continue to use the same procedures that have been
abused in the past.
A Hidden Agenda?
A radical social agenda does not belong in the economic stimulus
package. At a minimum, congressional sponsors should be required to
present it for a full debate with the potential for amendments in
the House of Representatives and the Senate. It should not be
buried in the economic stimulus package.
Dennis G. Smith is Senior
Fellow in the Center for Health Policy Studies at The Heritage
Show references in this report
Press release, "Statement on SCHIP
Reauthorization," Catholic Medical Association, January 15, 2009,
(January 22, 2009).
Buried in the economic stimulus legislation is a provision furtherundercutting parental authority and expanding control of taxpayerdollars by family planning clinics.
Health Care Initiative of the Leadership for America Campaign
Dennis G. Smith
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