War between the states over health insurance

Tom Curry National affairs writer • Profile • E-mail

WASHINGTON - It’s the War Between the States, but this time without bayonets and cavalry charges.

The clash over the Children’s Health Insurance Program (CHIP) is being fought largely between members of Congress from high-income states, such as Maryland, versus members from low-income states, such as South Dakota and Mississippi, which rank near the bottom in median household income.

President Bush vetoed the CHIP bill Wednesday.

Democratic House leaders are postponing consideration of the veto for two weeks, until Oct. 18.

In the meantime, the Democratic Congressional Campaign Committee is hammering with radio ads and robo-calls eight GOP House members who voted against expanding CHIP.

Arguing over the two-week delay
During House debate Wednesday, Rep. Pete Stark, D-Calif., looked over at Republican members and told them the two-week delay was "a time-out. You go to your room and think about the mistake you made, and when you're ready to apologize and come back and set things straight, you can come out of your room."

House GOP Leader John Boehner said that if Democrats were serious about resolving the dispute, "we'd have the veto override vote today, we'd have it right this minute" so the two sides could begin to bargain over a compromise.

The bill that the president vetoed would have allowed states to extend coverage to families with incomes of three times the poverty level.

Thus, a family of four, with two children, earning $61,332 would be eligible for CHIP.

In South Dakota, where the median household income is only $42,791, giving such a benefit to a family with an income of more than $61,000 seems excessive, according to Sen. John Thune, R-S.D.

“Low-cost, efficient states such as South Dakota ... end up subsidizing higher costs in inefficient states,” complained Thune during the Senate debate.

Eligibility varies from state to state
Some states, such as South Dakota, currently offer CHIP only to people with incomes up to twice the federal poverty threshold, which is $20,444 for a family of four with two children.

So in those states, families with income of $40,888 are eligible.

But other states, such as Maryland, which has the highest median household income in the nation, provide CHIP coverage to people with incomes three times the poverty line.

On the decisive Senate vote to push ahead with expansion of the CHIP program, where both senators from a state voted for CHIP expansion, they came from states with an average household income of nearly $50,000.

But where both senators from a state voted against CHIP expansion, they came from states with an average household income of under $42,000, including the lowest-income states such as Kentucky, Oklahoma and Mississippi.

The economic clash works between congressional districts, too: House Republican Whip Roy Blunt of Missouri, an outspoken opponent of CHIP expansion, represents a district where the median income is $36,962.

His Republican colleague from New York, Rep. Vito Fossella, who voted to expand CHIP, represents a district that includes Staten Island and part of Brooklyn in New York City. In Fossella’s district, the median income is $62,108, nearly 70 percent higher than in Blunt’s district.

Where $70,000 doesn't go far
Fossella said, “The core concept of CHIP is to give states the flexibility to tailor the program” to their individual needs.

He added that “$60,000 or $70,000 in Staten Island or Brooklyn doesn’t go as far as in other parts of the country.”

But Blunt said the more that Americans found out about the proposed expansion of CHIP to families making more than $60,000, the more they’d scratch their heads in disbelief.

“People will say, ‘What is this? They’re talking about giving free health care to kids whose parents make $66,000 a year?’”

Blunt added, “In Vito Fossella’s district that might not be very much money. In my district, that’s a pretty good income. In my district, people who make that amount of money have anticipated that they’ll insure their kids.”

Blunt said many federal programs face the problem of regional cost disparities. But he said, “Do we want to go back and recalibrate every single government program so that people who live in New York City get a lot more than people who live in Springfield, Missouri, or Tampa, Florida?”

New York presents a special case.

Although the Bush administration rejected New York’s plan to provide CHIP to families who have incomes of four times the federal poverty level — or nearly $82,000 for a family of four — the law would still leave the door open to the next president, perhaps a New Yorker, to grant New York permission to proceed with its more generous coverage.

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