Families Brace for SCHIP Demise

Carolyn Taylor, a full-time nursing assistant and medical technician, works hard to ensure that she is able to provide for her 11-year-old son Keith. But on Monday, she — along with thousands of others — took time off to rally in support of the State Children's Health Insurance Program.

"The rally was to let Bush know we need health insurance for our children," said Taylor, a Baltimore resident. "We wanted to let President Bush know we are real people. He said there would be no child left behind. Well, we're getting left behind unless he continues SCHIP."

Gathering on the White House lawn and the steps of Congress, the throngs were joined by children who pulled red wagons filled with over a million petitions, urging Congress to expand health insurance coverage for children.

Yet, it appears that the effort may be in vain after Bush vetoed a bill on Wednesday that would have renewed and expanded SCHIP.

The program, which provides health insurance for children from families who earn too much money to qualify for Medicaid, but not enough to afford private insurance, was created in 1997 to address the growing number of children in the United States without health insurance coverage. It currently provides coverage for over 6.6 million kids.

Health policy experts now say low and moderate income families like the Taylors will be hit the hardest if the veto stands, and individuals fear the social and financial consequences.

"Families will experience both financial and emotional burdens trying to deal with their children's health problems, with little societal support or encouragement," said Shoshanna Sofaer, professor of health care policy at Baruch College in New York.

Expand... or Expire

Though the program officially expired on Sept. 30, emergency funds currently allow the program to continue — at least for the time being.

Congress has already passed legislation which would reauthorize and expand the program by adding $35 billion over five years, and covering an additional 4 million children — a plan funded by raising the federal cigarette tax by 61 cents to $1 per pack.

But the veto means that the program's only hope is redemption by a Senate that has already shown only marginal support for the measure.

"This program has been very successful in terms of increasing insurance coverage and access for children," said Kathleen Adams, a professor at the Rollins School of Public Health at Emory University in Atlanta. "There are 12 states which will not have enough funds to even maintain their current coverage without renewal and increased allotments.

"Unless these states use emergency funds, many children will be thrown off of insurance coverage, literally overnight."

And this is what many parents and experts are worried about.

Tobi Drabcyk, who lives with her husband and four children in Walkersville, Md., said she would not be able to afford health care for her children unless they were covered by SCHIP.

"We are a family of six," she said. "My husband works full time as a maintenance supervisor at an apartment community. If we paid for insurance through his work, it would cost us $700 to $1,000 a month. My husband's salary is only $36,000 a year, and we can't afford private insurance. It would almost be food off of our table."

Taylor said she is in the same situation.

"If SCHIP is not renewed, it would really hurt," she said. "It would be a strain to the family, because I would have to put my son on my health insurance plan, and would have to spend over one-fourth of my income to insure my son and myself."

Many health policy experts agree that the veto presents a dire situation for these families.

"If the veto is sustained by Congress, more children will be uninsured than before; they will get less care, especially preventive care, and care for chronic childhood diseases, like asthma," said Sofaer. "The health and development of many low and moderate income children will be compromised, with serious consequences for their individual futures."

Pulling Away the Safety Net

Over the past decade, SCHIP has reduced, by one-third, the number of uninsured children in low income households — a drop from 22 percent to 15 percent, according to a report by the Commonwealth Fund.

But the success of SCHIP is perhaps more apparent on a personal level.

Taylor, whose son has been insured under SCHIP since he was one, says Keith "has been able to go to the doctor and receive care, because he has insurance. His doctor has been able to prevent him from getting sick, and to treat things early, which has kept him out of the emergency room."

Drabcyk recounted her constant concerns when her two oldest children were not insured. "They missed some of their shots, which I worried about. Now, with SCHIP, they are all caught up.

"I used to wonder what would happen if they fell and broke their arm, and had to go the emergency room. Would they send me away? How would I pay for it? As a mother, knowing my children are insured under SCHIP, gives me a peace of mind."

But now that these families may be forced to face such realities again, their feelings of frustration are quickly turning to anger at the Bush administration.

"It's not fair that the president has vetoed the bill, because he has health insurance, and all the politicians have health insurance," Taylor said. "It's ridiculous. We live in the richest country. It doesn't make sense we have to suffer, and we can't afford to have healthy children."

Drabcyk agreed. "I doubt President Bush has ever spoken to a family who uses SCHIP," she said. "We just need a little bit of help. We would gladly pay for private health insurance if we could afford it, because we would have more choice and better doctors. But it's not an option for people like us.

"As a mother, my children are my first priority, and I think that all children should be the nation's priority."