children's health and politics

Congress and the president are planning to butt heads this week over a children's health bill that would expand SCHIP, a state run program which insures kids that aren't poor enough to get Medicaid but also aren't rich enough to otherwise get coverage.

On the surface, it looks like a decent enough bill - the feds would increase funding from $25b over the next five years to $60b, adding about 4 million uninsured kids to its roster. Conservative groups say the number would probably be lower, especially as a lot of parents will be dropping their current plans to take advantage of SCHIP's cheaper deal, but that doesn't get me all hot and bothered. I'm still for the bill.

But something does irk me - as it does Bush (yes, sometimes we see eye to eye!): while the bill lets states cover more kids, it lets them cover more middle income kids without making sure the really poor kids get insured first.

The president wants states to first make sure a large percentage of kids in families living at 200% of the poverty level or below get covered before kids above the 200% marker get the state health plan (I think the number Bush had out was 85% of the poorer kids).

Supporters of the bill say that's ludicrous - that the president's quota is impossible to reach and would just mean other families couldn't take advantage of SCHIP. Now, I've never worked in public health, but I have worked in public education and so I wonder - while it may be hard to get all poor kids into a health plan, it can't be impossible. After all, almost all families sign their kids up for school, right?

Here's even a way to help them out - assign a healthcare counselor to each school to liase with the state tax bureau (so you know which families would qualify) and the state's medicaid and schip offices - then give that worker an incentive to sign up all kids not already covered. Is there something I'm missing?