Kids' Health at Risk as Politicians Argue

Thousands of Ga. families locked out of a successful insurance program.

June 17, 2007 — -- Michael Post is a Georgia preacher who believes in less government and more personal responsibility. But he says having a daughter with severe autism has taught him he must depend on government for some things.

Therapy for his daughter Cadence, who is 4, costs $25,000 per year, roughly half the family income. She would not be getting that therapy if it were not for a government insurance program for children called SCHIP, or State Children's Health Insurance Program, that is funded with both federal and state dollars.

Michael Post and his wife Connie believe the investment taxpayers are making now will be paid back to them when Cadence grows up.

"We have a lot of hope for our daughter that she can be pulled out of this prison of autism," Michael Post said.

"Our goal for Cadence is to help her reach a measure of independence so she can give back," said Connie Post. "That is what we want for her. But if she does not have early intervention, then there is little or no hope for that."

Families Are Locked Out

The Posts are lucky to have SCHIP insurance. In Georgia, where they live, the rolls are now closed. Families not already enrolled are locked out. Georgia was the first state to run out of money, but other states are in trouble.

The SCHIPS program has become a victim of its own success. It was designed for familes who earn too much to qualify for Medicaid, but too little to afford private insurance. But in many states like Georgia, there were far more of those families than there was money available.

Congress recently voted Georgia an additional $121 million in emergency funds, but it is not enough for Georgia to completely open the rolls. It is opening only an additional 15,000 slots, just a fraction of the demand.

The Willinghams are not so lucky. They too are eligible for SCHIPS, but they are locked out. Each month they must find $800 to buy medicine for their son Shane, to prevent his seizures.

"I mean, we have to buy his medicine," said his mother Carla Willingham. "And there's nothing we can do, nothing we can do to help him."

For now, Shane's doctor is picking up the tab out of his own pocket. Dr. Marty Michaels and his staff at the Peeds Care Clinic in Dalton, Ga., have put together a fund to help Shane and other children like him.

'Emergency Situation'

"Right now, we basically have an emergency situation in Georgia," said Michaels. "Those of us on the front lines have already seen the impact of that. We've seen children admitted to the hospital that would not have had to be admitted had they been covered and had they had their daily medications."

And he said the crisis is costing taxpayers money.

"Failing to insure children is false economy," he said. "You do save some money up front because you don't pay the premium for that child, but in the long run you pay more for emergency room visits, unneccesary hospitalizations and medical complications."

Democrats in Congress want to add $50 billion to the SCHIP program, which they say will cover all nine million uninsured children in America. But the Bush administration wants to add just $5 billion, an amount most analysts say will not even allow coverage to continue for all children currently enrolled.

Georgia's Republican Gov. Sonny Perdue is siding with the Democrats on this one.

"Obviously, it's going to take more than the $5 billion to continue this program as we know it today," he said. "We understand the healthcare dollar spent to keep children healthy is less dollars that we will spend later on. I think that is conservative."

President Bush's Secretary for Health and Human Services, Michael Leavitt, agrees children need insurance, but said the SCHIP program is the wrong way to provide it.

"We ought not to make it the engine that pulls the train to a government-run health care system," he said. "And that is what those who would expand it radically would have it become. ... When Washington takes over health care, you end up with fewer choices, long waiting lines and higher taxes."

Child health advocate Ron Pollack of Families USA called that analysis "a disgrace."

"Most children today have their health coverage through their parents' employer," he said. "That's not going to change. ... What this debate is about is to provide a safety net for children in families where the parents simply can't get coverage in the workplace because it's not offered there and they simply can't afford coverage on their own."

'You Feel Like You're In a Hopeless Place'

Adam and Diane Harrison of Dalton, Ga., are one such family. Their 15-month-old son Elijah needs an operation to repair his urethra.

Adam says Elijah should have had the surgery at a year old, but his surgeon refuses to see him until he has insurance. The family's income is too high to qualify for Medicaid, and they are frozen out of the SCHIP program.

"It's hard for me to comprehend," said Adam. "He needs this, and I can't provide it for him. You feel like you're in a hopeless place for your child. I'm sure a lot of people feel that way that don't have insurance."

Adam is disabled from a back injury and collects Social Security. Diane works at WalMart, and has recently reduced her hours and her income. She hopes that will make her eligible for Medicaid.

It means the family must do without birthday presents and cut back on groceries, but they see no other choice.