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October 04, 2007


Perhaps you could enlighten us, Brendan. The McClatchy article of which you're so enamored reports, "The bill maintains current law. It limits the program to children from families with incomes up to twice the federal poverty level — now $20,650 for a family of four, for a program limit of $41,300 — or to 50 percentage points above a state's Medicaid eligibility threshold, which varies state to state." But nowhere that I can find in the McClatchy article does it explain what is the difference between the President's proposal to add $5 billion to S-CHIP and the Democrats' proposal to add some $40 billion to the program, and how the Democrats' adding the additional $35 billion simply "maintains current law."

The FactCheck.org article that McClatchy links to says, "The House bill would extend coverage to a total of 7.5 million people, 5 million of whom are uninsured, while the Senate bill would reach 6.1 million, 4 million of whom are uninsured, according to CBO reports." Is that simply maintaining current law, as McClatchy states?

I'm not trying to be argumentative; I'm genuinely confused. There seems to be more to the story than the vaunted McClatchy article reports.

I believe that it means the bill maintains current law in limiting SCHIP provision to double the federal poverty line without a waiver from the federal government.

If the formula remains the same, where are the 5.8 million new enrollees coming from? Is it too much to ask that articles like McClatchy's explain this stuff?

BTW, though the provision requiring waivers for SCHIP above twice the federal poverty line may stay the same, one can expect that waivers will be more liberally granted under a Democratic Administration than under Bush. I wonder if the cost estimates for the Democrats' proposal took into account the effect of a liberalization of the granting of waivers. Where's the analytical reporting that deals with these issues? Not in McClatchy, I'm afraid.

Here's the answer to the first question from Jason Furman of Brookings (the answer to the second question is surely no b/c it's speculative):

(1) The President supports a proposal that would reduce annual spending on SCHIP relative to inflation and reduce the number of covered children and pregnant women by 840,000 according to the Congressional Budget Office (CBO).

You might ask how the $5 billion increase in spending over 5 years promised by the White House could result in more uninsured. The answer is that for technical reasons the CBO baseline assumes $5 billion in nominal dollars annually going forward, something depicted in the flat green line in your previous post. But spending at this baseline would fall relative to general price inflation and plummet relative to health spending growth. As a result, under CBO’s baseline the number of people covered would fall from 7.4 million in 2006 to 3.5 million in 2017, despite an increase in the eligible population.

(2) The Democrats and a substantial number of Senate Republicans support a proposal whose principal focus is covering low-income children who are currently eligible (3.2 million according to CBO) plus expanding coverage modestly to new children (600,000 according to CBO). In total 85 percent of the coverage expansion is for those who are already eligible but are not getting coverage either because the funding limits assumed in the baseline are projected to be reached leading states to turn away currently eligible children or because families simply do not sign up for the coverage that is available to them.

It's nice to see you responding, Brendan.

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