You have to be a strong woman to stand against expanding SCHIP. It is the biggest domestic fight of the Bush II era. Rich Lowry bolsters my resolve on the issue:


“At bottom, the argument is about whether the government will extend public coverage further up the income scale — including to families already with their own insurance — in a push toward national health insurance. All children below the poverty line ($20,650 for a family of four) are eligible for Medicaid. So the argument over SCHIP is not about “poor kids.” Congress enacted the program in 1997 to help cover kids whose families aren’t poor, but still can’t afford insurance, basically in the income range of up to 200 percent of the poverty line. …


“The problem is that, as families earn more, they are more likely to have private insurance, and SCHIP lures them from private insurance onto government insurance. In a paper published by the National Bureau of Economic Research, economists Jonathan Gruber and Kosali Simon found that, as eligibility expands, ‘private insurance coverage is reduced by 60 percent as much as public insurance coverage rises.’ The CBO estimates that the reduction in private coverage is as much as 50 percent — in other words, for every 100 children enrolled in SCHIP, 50 children are dropped off private coverage.


“The technical term for this phenomenon is ‘crowding out’; the nontechnical term is ‘socializing medicine.’ Since the federal government picks up two-thirds of the tab for state-administered SCHIP programs, states have an incentive to expand coverage to better-off families — for every $1 they spend on the benefit, the feds pony up $3.”


The irony is that, despite the rhetoric, the SCHIP debate distracts our attention from the kids who need our attention the most: poor kids. Lowry notes:


“Meanwhile, there are 5.5 million poor or near-poor kids — roughly 60 percent of all uninsured kids — who are eligible for public insurance now, but aren’t enrolled in public programs. These unenrolled kids are likelier to come from single-parent or no-parent families and families where all parents are unemployed. They are a hard-to-reach population, but the focus should be on them rather than families with the wherewithal to fend for themselves.”