Vote Nearing in Battle Over Kids' Health Care

Nikki and Seth Nelson with their son, Alexander, 1, at their home in Salisbury, Md. Alexander has suffered a string of illnesses, including a tear-duct problem that required surgery that the State Children's Health Insurance Program paid for. (Photos By Melina Mara -- The Washington Post)
By Christopher Lee
Washington Post Staff Writer
Sunday, October 14, 2007

Single parent Donna Johnson, an office manager for a private school near Baltimore, lives on $42,000 a year and counts herself lucky that she doesn't have to work two jobs to afford health insurance for her children.

The reason, she says, is that for $57 a month, Maryland allows her to enroll her son Evens Cross, 12, and daughter Josie Cross, 9, in its version of the State Children's Health Insurance Program, which accepts families earning as much as three times the poverty level: $51,510 for a family of three. That's a lot cheaper than adding the kids to her individual HMO policy, which she said would jack up her monthly $200 premium to $500 or more.

"It helps out abundantly," said Johnson, who owns a townhouse in Pikesville. "It covers their eye exams, it covers their annual physicals, and if they get sick, it covers that. Their doctor knows them. If there is a problem, the doctor will take my call . . . You sleep better, because anything can happen. And if you don't have insurance coverage, who are you going to turn to?"

All over America, there are families like the Johnsons, living on the edge financially and working hard to make ends meet. Many have full-time jobs but seldom take vacations. They meet monthly bills for basics such as food, car insurance and housing but have little or nothing left for dining out, college savings or band uniforms.

Without affordable health coverage for their children, many say, insurance costs and medical bills would threaten to break the family budget.

It is families like these who are at the center of the political controversy in Washington that will come to a head Thursday when the Democratic-led House attempts to override President Bush's veto of an expansion of the children's health program that Congress passed last month by sizable bipartisan majorities. The fight, playing out in television and radio ads and in plenty of arm-twisting on Capitol Hill, is over how much money to spend -- and on whom to spend it.

At a current cost of $5 billion a year, SCHIP provides health coverage to about 6.6 million people, including 6 million children. It was designed for families that earn too much to qualify for Medicaid but not enough to buy insurance on their own. The new legislation would expand the decade-old program by $35 billion, for a total of $60 billion over the next five years -- enough to boost enrollment to 10 million kids.

The president has repeatedly criticized the proposed expansion as an excessive governmental intrusion into health care that would siphon middle-class families away from private insurance. He favors a more limited $5 billion increase, for total funding of $30 billion over the period, although recently he said he might be willing to go higher. Bush believes the program should focus on serving children from families that earn less than twice the poverty level: $34,340 for a family of three and $41,300 for a family of four.

For families on the edge -- neither comfortably middle class nor truly low income -- Thursday's vote is not just one of the most dramatic political skirmishes of the year but also a referendum on whether people like them deserve the government's help in making sure that their kids have health coverage.

Four years ago, Renee Hall, a client service representative for a home health aide company in Columbus, Ohio, did just what Bush fears. She switched her two children to Ohio's SCHIP after growing weary of fighting her private insurer for reimbursement of $800-a-month medical bills for treatment of her son Kevin's severe asthma.

"The cost was just unbelievable," she said.

After nearly three years and a few pay raises, Hall learned that her family no longer met Ohio's income eligibility limit of twice the poverty level. So she put Kevin, 14, and her daughter Kenee, 16, back on her employer-provided coverage. Her monthly premium soared from $36 to $500.


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