Since I previously read the GAO report on SCHIP, I found the allegations made by Factcheck in this article to be fascinating. So I decided to read the GAO report again and see if I agree with their assessment. Maybe I missed something. Let me start out with the first false claim that FactCheck makes in the second paragraph.

He said it “would result” in covering children in families with incomes up to $83,000 per year, which isn’t true. The Urban Institute estimated that 70 percent of children who would gain coverage are in families earning half that amount, and the bill contains no requirement for setting income eligibility caps any higher than what’s in the current law.

This is an interesting rebuttal to Bush’s claim that the SCHIP program will result in covering children up to $83,000. They are saying that the administrators of the SCHIP program are not “required” to expand the program the coverage limits. The point about the Urban Institute estimate is interesting but not relevant to the discussion of expanding the income coverage limits. The GAO report does show that the SCHIP program has a history of expanding coverage beyond the recommended levels and until recently the SCHIP program had a surplus of funds available. The GAO also says that SCHIP administrators allowed some states to spend funds than they were not allocated. This resulted in the situation as described in the second paragraph of the GAO report.

some states have consistently spent more than their allotments, …

Since the present spending trends threaten to exceed available funding, the option to further expand the coverage limits at this time is a moot point. Despite the funding problems this did not stop several states from attempting to expand the coverage further. Several states have a history of expanding coverage limits and they have shown the motive to further expand the coverage limits. The only ingredient they are missing is the opportunity. It is reasonable to assume that once the funding is attained, New Jersey or New York will quickly ask for higher coverage limits and the SCHIP program will start covering children in families making up to $83,000. This is not a big step for New Jersey since they allow families with incomes of $72,275 already. Since funding appears the limiting factor to expanded coverage, I think FactCheck is stretching the truth more than George Bush. In fact I would be quite comfortable in arguing that every politician fully expects that the coverage limits will be expanded once the expanded funding is passed.

The second false claim that FactCheck points out is about the differences between “poor” and “low income”. I find that the quibbling over this statement to be particularly annoying. I regularly volunteer with Habitat for Humanity and out of necessity I know the difference between poverty and low income definitions. The importance of this subtle distinction is something only politicians can love. This debate on the semantics of poverty classifications does serve the purpose of not talking directly about whether the SCHIP program has lost its sense of direction. Is improved health care for children still an important issue for SCHIP? Is it necessary that a government health insurance program have a defined sense of direction? How bad does a government health care program have to be before we say that we need something better rather than just larger? These questions are the proverbial elephants in the room and are not lost to the folks who wrote the GAO report. If you look at the GAO report you will find:

1. In Table 5 the present SCHIP program provides coverage for a large number of adults. Several states cover more adults than children. One of the most common scenarios I see in working with low income people is a single mom with several children. Huh, how does this happen?
2. In Figure 2 of the GAO report you can see that Florida and Texas have the largest percentage of uninsured children. Since these states are two of the more populous states, there are a lot of uninsured children. How is the increased funding supposed to help these states? I don’t ever hear those states campaigning to increase the income limits. Do they have problems with children’s health care that are significantly different than other states?
3. 87% of the people enrolled in the Minnesota SCHIP program are adults. Minnesota also has one of the lowest rates of uninsured children. What does additional SCHIP funding mean for Minnesota?  If children’s health care problems are the same in every state, maybe we can get Texas and Florida to out source their children’s health care to Minnesota.
4. At the end of the report, the GAO questions the “financial sustainability of public commitments”. In laymen’s terms, the GAO is asking if it is good public policy to allocate federal funds to the states who consistently overspent their allocation? Is this good government? They also ask whether the federal government is responsible for the states who have over-promised future health services? Is this the model for a sustainable universal health care system?

Generally I find FactCheck to be a welcome addition to the debate on a variety of subjects but this was a weak piece. It is just that I expected to see more convincing evidence of false claims from the fact checkers.

FactCheck.org: Bush’s False Claims About Children’s Health Insurance