Are the Democrats Creating a National Healthcare System?

Tuesday - July 31, 2007

Are the Democrats Creating a National Healthcare System?

The Washington Times and Rush Limbaugh claim that the Democrats are drastically expanding government sponsored health care via the SCHIP or State Children's Health Insurance Program. Limbaugh's accusations are here and the Washington Time's op/ed is here. Not only do these two sources claim the program is being expanded, it will also no longer require citizenship to be eligible for these benefits. Also, Limbaugh and the Times imply that by doing away with this requirement, this new healthcare program will encourage more illegal immigration.

So are they right? Or are they exaggerating the case? Let's go to the source legislation (H.R. 3162), as it is currently configured in the House to see.

Is the program being expanded?

Section 131 states:

SEC. 131. OPTIONAL COVERAGE OF OLDER CHILDREN UNDER MEDICAID AND CHIP.

(a) Medicaid-

(1) IN GENERAL- Section 1902(l)(1)(D) of the Social Security Act (42 U.S.C. 1396a(l)(1)(D)) is amended by striking `but have not attained 19 years of age' and inserting `but is under 19 years of age (or, at the option of a State and subject to section 131(d) of the Children's Health and Medicare Protection Act of 2007, under such higher age, not to exceed 25 years of age, as the State may elect)'.

Obviously, this does make the eligible pool larger, if the state decides to raise the age ceiling. And what government bureaucracy doesn't like to get bigger?

Section 132 reads:

SEC. 132. OPTIONAL COVERAGE OF LEGAL IMMIGRANTS UNDER THE MEDICAID PROGRAM AND CHIP.

(a) Medicaid Program- Section 1903(v) of the Social Security Act (42 U.S.C. 1396b(v)) is amended--

(1) in paragraph (1), by striking `paragraph (2)' and inserting `paragraphs (2) and (4)'; and

(2) by adding at the end the following new paragraph:

`(4)(A) A State may elect (in a plan amendment under this title) to provide medical assistance under this title, notwithstanding sections 401(a), 402(b), 403, and 421 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, for aliens who are lawfully residing in the United States (including battered aliens described in section 431(c) of such Act) and who are otherwise eligible for such assistance, within either or both of the following eligibility categories:

`(i) PREGNANT WOMEN- Women during pregnancy (and during the 60-day period beginning on the last day of the pregnancy).

`(ii) CHILDREN- Individuals under age 19 (or such higher age as the State has elected under section 1902(l)(1)(D)), including optional targeted low-income children described in section 1905(u)(2)(B).

So now legal residents are eligible for the program who meet the qualifiers. Once again, this potentially opens this program to a larger number of people.

Section 2111 raises the eligibility ceiling:

SEC. 2111. OPTIONAL COVERAGE OF TARGETED LOW-INCOME PREGNANT WOMEN.

`(a) Optional Coverage- Notwithstanding any other provision of this title, a State may provide for coverage, through an amendment to its State child health plan under section 2102, of assistance for pregnant women for targeted low-income pregnant women in accordance with this section, but only if--

`(1) the State has established an income eligibility level--

`(A) for pregnant women, under any of clauses (i)(III), (i)(IV), or (ii)(IX) of section 1902(a)(10)(A), that is at least 185 percent (or such higher percent as the State has in effect for pregnant women under this title) of the poverty line applicable to a family of the size involved, but in no case a percent lower than the percent in effect under any such clause as of July 1, 2007; and

`(B) for children under 19 years of age under this title (or title XIX) that is at least 200 percent of the poverty line applicable to a family of the size involved;

Low income has been redefined up, with rates of 185% and 200% above the poverty line.

Title VI of the bill improves coverage:

TITLE VI--OTHER PROVISIONS RELATING TO MEDICARE PART B

Subtitle A--Payment and Coverage Improvements

SEC. 601. PAYMENT FOR THERAPY SERVICES.

SEC. 602. MEDICARE SEPARATE DEFINITION OF OUTPATIENT SPEECH-LANGUAGE PATHOLOGY SERVICES.

SEC. 603. INCREASED REIMBURSEMENT RATE FOR CERTIFIED NURSE-MIDWIVES.

SEC. 604. ADJUSTMENT IN OUTPATIENT HOSPITAL FEE SCHEDULE INCREASE FACTOR.

SEC. 607. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL HEALTH COUNSELOR SERVICES.

SEC. 608. RENTAL AND PURCHASE OF POWER-DRIVEN WHEELCHAIRS.

SEC. 609. RENTAL AND PURCHASE OF OXYGEN EQUIPMENT.

SEC. 610. ADJUSTMENT FOR MEDICARE MENTAL HEALTH SERVICES.

SEC. 611. EXTENSION OF BRACHYTHERAPY SPECIAL RULE.

SEC. 612. PAYMENT FOR PART B DRUGS.

Is the program open to illegal immigrants?

The program is being expanded to cover legal residents, as seen in Sec. 132. But, I can find no clause that suggests that illegal immigrants would be covered under this program. Though, if you can find such a clause, please email me and set me straight.

Conclusion

One can safely assume as more drugs and treatments are covered, then the cost of the program will increase.

One question I do have, is what is a program designed to give poor children access to medical care doing covering family planning and marriage services? Those features can be found in Title VIII and Sec. 607. Does this bill cover children or is this meant to expand the program beyond it original intent? These services are incidental to medical coverage for children.

As to the original questions I first posed. Does the bill drastically increase the scope of SCHIP? The answer is a resound yes. Children up to the age of 25 (yes, think about that) can now be covered. Legal residents can now be covered. Means testing guidelines have been greatly liberalized and what is covered has now been expanded.

Now to the second question. Are illegal immigrants allowed to be covered under this program? From what I've read, I can find no evidence to support this claim. What has happened though, is the program has been expanded from applying only to citizens to applying also to legal residents. Why this program would be expanded to cover non-citizens is beyond me. I thought the ideal immigrant was already self-sufficient. If the amnesty crowd ever gets their way though, millions of people would be eligible for this program

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