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Americans’ Fight for Health Insurance

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A friend bubbled over with joy as she told me the news that she and her husband were starting a small business. But she qualified it with, “Of course, we have to figure out the health insurance.” Of course.

They have a sixteen-month-old baby boy, and they’d like to keep their current pediatrician. Once they begin a small business, they might not be able to keep this pediatrician—and they’re liable to see their health care costs go up. She worries about drug costs, too. Last year their baby came down with a mysterious cough that required some heavy-duty antibiotics. But they’re one of the lucky families in America: they may be struggling with the high cost of health insurance, but they have it.

Although poverty has gone down slightly: in 2006 it was 12.3 percent, down from 12.6 percent in 2005, median incomes have not been rising and since 2000, the median household income is $1,000 less (U.S. Census Bureau). Combine this with a lack of health insurance and the picture becomes pretty grim. Today close to 47 million Americans don’t have health insurance at all.

And the numbers of uninsured Americans simply keeps rising: in 2005, the number of uninsured Americans was 44.8 million and rose to 47 million in 2006, according to a recent New York Times article. More employers are not providing insurance or cutting back due to high costs. Workers who can’t afford it are going without it altogether. For those who don’t have it, emergency rooms are used instead, which tend to be even more costly than going to a general practitioner. Another friend of mine was out of work and lacked health insurance. When she went in for a simple—though absolutely necessary—surgical procedure, she wound up with a huge bill. It took her three years to pay off the debt on her credit card.

The numbers of uninsured children have grown, too, to 8.6 million, under the current administration, which has tightened its control over funding for low-income groups. This came at the same time that employers have lessened their coverage for dependents.

The House and Senate recently passed an expansion of the current State Children’s Health Insurance Program (SCHIP), a joint federal-state effort to reduce the numbers of uninsured children. It aims to cover kids whose family income is too high to qualify for Medicaid, but too low to afford costly private coverage. The Senate bill covers 3.2 million uninsured children, while the House bill covers 4.2 million. But both bills only aim to prevent children already in the program from losing coverage.

These bills are likely to affect the elderly as well. According to a recent report in AARP Bulletin, here’s how it breaks down:

  • Funding: Senate bill provides an additional $35 billion for SCHIP; the House $50 billion. President Bush wants only another $5 billion over the current $25 billion cost.

  • Tobacco tax: Senate bill raises cigarette tax by 61 cents to $1 a pack. House bills wants a 45-cent increase.

  • Cuts to Medicare: House bill reduces planned payments to private Medicare Advantage plans by $157 billion over ten years. Senate bill does not address Medicare.

  • Assistance for low-income Medicare beneficiaries: House bill would help pay out-of-pocket costs for prescription drugs.

  • Doctors: House bill increases payments to doctors who treat traditional Medicare patients by $65 billion over ten years.

Ironically, the “poverty level,” as it’s defined by the Census Bureau, is about $20,000 for a family of four, but anyone knows that a family even making $40,000 are living close to the poverty line in many areas of the country.

 In the past, SCHIP allowed families with incomes no higher than twice the poverty level, or about $41,000, to qualify. But both the Clinton and Bush administrations have previously allowed states to extend coverage to higher income levels. For example, in New Jersey, the state caps it at 350 percent of the poverty level. This helps children who had never been enrolled in Medicaid.

The Bush administration recently sent out letters to state health officials imposing new requirements on the program, which would eliminate or greatly reduce coverage for middle-income children and those living close to the poverty line.

In September, the House and Senate will meet to work out a plan. Let’s hope they can come to a fair and equitable agreement—and truly insure all children. It may be a cliché, but it’s true: children are our future.

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