Lawmakers Refocus Kids Insurance Program

(AP) With the government's blessing, more than a dozen states secured health insurance coverage for adults under a program designed to help poor children. Now, there is not enough money to cover the kids.

More than 10 percent of the participants in the State Children's Health Insurance Program are adults.

The 10-year-old program was slow to catch on at first. Flush with extra money, both the Clinton and Bush administrations granted waivers to states that allowed them to cover parents and pregnant women. But doing that cost money.

The program this year faces a nearly $750 million shortfall. President Bush and many Republican lawmakers say it is time to refocus the program as it was originally intended, on children. Democrats say the solution to the uninsured problem is not removing health care from those who now have it.

The program, with a $40 billion budget over 10 years, enrolls 6 million people, including 640,000 adults.

Rhode Island and Wisconsin were among the first states that got waivers to enroll adults. As a result, Rhode Island, which was supposed to get $72 million for children's health insurance between 1995-2005, actually got $186 million. Wisconsin was supposed to get $355 million; it got $437 million.

Jane A. Hayward, Rhode Island's director of health and human services, said she understands Congress faces financial pressures as more children in other states begin to participate in the program. She also contends that enrolling adults has served an important purpose. When parents get coverage, their kids do, too.

"In Rhode Island, we've always looked at this as being about families," she said. "The adults we've been involved with have been parents or pregnant women, so those adults are not unrelated to the children, for whom we're trying to provide the best possible care."

Jason Helgerson, policy director for Wisconsin's Health and Family Services Department, said his state has resisted attempts to cut back on health coverage for adults even during tough economic times.

"States like Wisconsin that have included covering parents have been more successful in covering kids. Parents, if they have the opportunity to get health care, are more likely to get their kids signed up and navigate through the complexities and challenges of signing up," Helgerson said.

Both states rank among the top 12 in percentage of children with health insurance.

The administration projects it would cost about $9 billion in additional money over the next five years just to cover the program's current population. Democrats, citing other estimates, say the total is closer to $12 billion, at a minimum.

Currently, states that insure adults through the program can continue to do so. Other states are barred by law from expanding to adults who do not have children.

A bipartisan group of 23 senators asked the Senate Finance Committee to continue allowing adults to participate in the program if their states currently allow it.

"In my view, we should be taking actions to fix the uninsured problem, not add to it by preventing states from using SCHIP funding to cover parents and other adults," said Sen. Jeff Bingaman, D-N.M.

Many Republican lawmakers disagree.

Rep. Michael Burgess, R-Texas, introduced legislation on Wednesday that would prevent states from spending their children's health insurance grants on any adults, with an exception for pregnant women. He said covering adults takes money away from children's coverage.

"This inequitable development needs to be stopped dead in its tracks," he said.

Under his legislation, Burgess said Minnesota, for example, would have to terminate coverage for about 35,000 adults. The state could use its own money, but not federal dollars, to provide them with insurance.

New Jersey Gov. John Corzine, a Democrat, said his state covers about 76,000 adults. He says his state _ one of 14 with a program deficit, faces a $114 million shortfall and may have to scale back, beginning in May. Still, he supports allowing states to continue covering adults.

"You get the parent in the door, you get the child in the door," he said.

The program was authorized to get $5 billion this year. Lawmakers hope to add more money in coming months. Who should get health coverage through the program will be a focus of the coming congressional debate.

While many lawmakers complain that the program covers too many adults, it was the government that approved the expansions.

Rhode Island and Wisconsin got waivers from the Clinton administration.

"We're proud to support state innovation and flexibility through these waivers," the Health and Human Services Department said at the time. "Coverage for parents will bring more eligible children into SCHIP so they can get quality health care."

The program proved so popular with low-income adults in those two states that they now spend more money covering adults than kids. So do Minnesota and Illinois, according to the Bush administration.

The Bush administration also approved numerous expansions of the program. For example, Rhode Island and Michigan got a waiver in April 2003 to provide health coverage to pregnant women.

"Michigan and Rhode Island deserve credit for taking advantage of this new, simple option to expand prenatal care to low-income women and their unborn children," said then-Health and Human Services Secretary Tommy Thompson.

The Government Accountability Office said that the states covering adults as a result of federal waivers are Arkansas, Arizona, Colorado, Idaho, Illinois, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Utah, Virginia and Wisconsin.

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