Congress running out of time
Sticky children's health-insurance issue awaits federal lawmakers

The General Assembly saved the popular PeachCare for Kids program in the nick of time last spring, ponying up $81 million to plug a federal shortfall.

But that only kept the joint state-federal children's health insurance program solvent through the end of June.

Now, Georgia lawmakers' federal counterparts are facing another deadline.

When members of Congress return this week from their annual August recess, they will have until the end of the month to reauthorize PeachCare's parent, the State Children's Health Insurance Program.

Inaction is not an option. The House and Senate either pass a bill and get President Bush to sign it, or health coverage for 6 million American children - including 280,000 Georgians - goes away.

Considering how far apart the politicians are, the task is uphill at best.

With Democrats in control of both congressional chambers, support is there for substantially expanding SCHIP.

But bills passed by the House and Senate shortly before the monthlong break differ in the amount of the proposed increase.

The House bill would reauthorize the program with a huge boost of $50 billion over five years, enough to double the current enrollment.

The Senate version would increase SCHIP by $35 billion, which would serve an additional 3 million kids.

In both cases, the money would come from raising the federal tax on cigarettes.

But the differences between the House and Senate pale in comparison to the gulf separating Democratic congressional leaders from the Bush administration.

The president is calling for a $5 billion increase - not enough even to maintain current enrollment according to the Congressional Budget Office - and is threatening to veto any bill that spends more.

Because of the hefty increases being proposed, both bills have been easy for opponents to attack.

Republicans and fiscal conservatives say either would expand the decade-old SCHIP beyond its original intent: providing health coverage to children in families with incomes too high to qualify for Medicaid but who can't afford private insurance.

"Further expansion will only crowd out private insurers, leading us down the path to socialized health care," said Trevor Martin, director of government relations for The Heartland Institute, a free-market-oriented think tank based in Chicago.

Opponents also have criticized what they say are excesses that would only worsen if the program were greatly expanded. For one thing, they object that some states, not including Georgia, are covering adults when SCHIP was meant just for kids.

"I cannot support a $35 billion expansion of this program so that more adults can receive coverage, and I cannot support paying for that expansion with a tax increase," said Sen. Johnny Isakson, R-Ga.

But Democrats and children's advocates see SCHIP as the answer to the large number of uninsured kids in America.

Allen Essig, executive director of the Georgia Budget and Policy Institute, a research organization that supports a strong social safety net, said the program is a smart investment. For every $1 states spend on children's health coverage, they receive $2.76 from the federal government.

"PeachCare and Medicaid are really good buys," Essig said. "It's mind-boggling to me that our congressional delegation can't see what's good for Georgia taxpayers."

SCHIP supporters also dispute the argument that many of the additional American families that would be covered by an expansion would drop private insurance to go on the government dole.

Dr. Martin Michaels, president of the Georgia chapter of the American Academy of Pediatrics, said families with little left over each month after paying for housing, groceries and utilities are in no position to buy private insurance for their children.

"There is a misconception that families that make $40,000 a year can afford to pay for health insurance for their kids without assistance," he said.

Gov. Sonny Perdue and the state Department of Community Health, which oversees PeachCare, haven't taken a position on the various legislative proposals.

But the agency did send a letter last week to Bush and congressional leaders, signed by more than 100 representatives of health care providers and children's advocates, urging support for reauthorizing SCHIP.

But the odds that a five-year reauthorization bill will pass by the Sept. 30 deadline appear long.

While the less expensive Senate version enjoys support from some Republicans, their House GOP counterparts oppose the House bill in large enough numbers to easily withstand a presidential veto.

The best bet for Congress might be the safety valve represented by adopting a "continuing resolution."

Such a step, common with congressional spending bills, would fund the program at its current level until a compromise can be reached.

E-mail Dave Williams at dave.williams@gwinnettdailypost.com.