POLICY/HEALTH PLANS: SCHIP passes the Senate, but I think for now Medicare Advantage is safe…for now

A version of SCHIP that doesn’t touch Medicare passed the Senate last night. It has a veto proof majority. Of course it now has to be reconciled with the house bill that raises more taxes and cuts Medicare Advantage. So this will now go one of two ways. Either the bills will get reconciled along the lines of the Senate bill and probably get signed by Bush, or the emerging bill will have a hack at Medicare Advantage and get vetoed.

My guess is that it’ll be the latter. It’s just too tempting for the Democrats to provoke the veto and then campaign on the fact that Republicans hate children. (Some temporary extension for the current SCHIP will be worked out as it expires in the background).

Meanwhile despite all the rhetoric remember this:

The Congressional Budget Office says the Senate bill would cover 3.2 million uninsured children, including 2.7 million who are currently eligible but not enrolled. The House bill, it said, would cover 4.2 million children, including 3.8 million already eligible for benefits. In addition, both bills would provide money to prevent 800,000 children now on the program from losing coverage.

According to KFF there are 8 million uninsured children today. So we’re only talking about covering up to half of currently uninsured kids. Which makes all the rhetoric about socialized medicine a little overblown. Even though unlike some of the more timid moderate Democrats I’m happy to say that socializing the insurance side of health care —as in putting everyone in one pool — would be a very good idea.

Meanwhile, perhaps the recent pressure on managed care stocks is a little over done? (Far be it from THCB to recommend a buy on UNH, but it’s at $48 which is way below where it’s been for a while!)

UPDATE: AHIP isn’t taking any chances, Its headline in its propaganda this morning is (I shit you not) "House Votes to Push Millions of Seniors out of Medicare Advantage"  Click thru and you can see a video of my favorite lobbyist telling only a small number of lies in 44 seconds. Did you know that Medicare Advantage is a "safety net" for seniors? Neither did I….

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5 replies »

  1. What exactly is the definition of “fully funded”? Perhaps when the last SCHIP dollar crowds out the last kid from his family’s health plan into government dependency?
    And how come it’s evil for corporations to have their hands out for taxpayer dollars but not for unions or non-profits? Hey, at least they all agree it’s fine to tax the poor smokers some more!
    But I agree with Ms. Mahar that it’s cruel to shuffle kids between healtlh plans just because the state has determined an arbitrary income cut-off for the families. The answer (and I am not the only genius to figure this out) is to eliminate the tax prejudice between employer-sponsored and individual health plans with a refundable tax credit for those who drop below the cut-off so they can keep the health plan of their choice.
    Let’s call it “RudyCare”.

  2. Stuart–
    The big problem is not that parents are too lazy to sign eligible kids up for Medicaid or SCHIP.
    Some states haven’t fully funded their SCHIP programs so eligible kids are not allowed to sign up. (At one point, Florida had a long waiting list. The press got wind of it and Florida solved the problem by eliminating the waiting list. At that point no one knew how many eligible kids were shut out of the program.)
    Another problem is that kids may be eligible for Medicaid or SCHIP one month, ineligible the next because one of their parents gets a job that puts them just over the income limit for either Medicaid or SCHIP.
    (In some states you are not eligible for SCHIP if you are a family of four earning over $40,000–before taxes.) Then a parent is laid off–and the child is eligible again. You can imagine the bureaucratic nightmare involved in being dropped from the program, re-enrolling, then being dropped again.
    One reason to expand SCHIP is to cover kids who are now uninsured for, say 6 months of the year, temporarily insured, then uninsured again. These kids need cosistent healthcare.

  3. As Mr Browning knows very very well, if you’re campaigning on something, or for that matter making a movie about it, a fact doesn’t actually have to be true–just something that gets repeated enough.
    If i was a Republican trying to win re-election in 2008 I would be doing anything I could to get The White House to back down on this one–before “Republicans hate children” becomes a fact like “Democrats are soft on crime” and “Welfare Queens drive Cadillacs”.
    The only problem with saying that their parents didn’t sign them up is that if they had, those programs would have been cut further and closed to enrollment–as happened to SCHIP in many states. I believe the right calls that an “unfunded mandate”–easier to ignore the mandate than get the funding.
    And sure I must hate old people even as I steadily become one. But let me recount a tale of when the greatest health economist (Vic Fuchs) was once challenged on exactly this point (in my earshot). The questioner said “But if you apply limits to care that’s ‘rationing” and more people are going to die”. He said, “No, more people are going to die sooner”.
    So Mr Browning, what’s it going to be, more kids with their whole life in front of them living with more disease and dying sooner, or more very frail elderly having a more dignified end coming a couple of months earlier than if we continue to pour money into heoric measures to keep them alive?
    Or have you finally made your peace with little Mikey Moore and decided that Medicare (whether Canadian or American)should pay the medical establishment whatever it wants whenever it wants for whatever it says it needs to do to anyone? Good that we’re living in a bottomless pit of taxpayer dollars.

  4. Of Mr Holt’s 8 million uninsured children … 70 percent already qualify for Medicaid or SCHIP, their parents have just not bothered to sign them up.