Children’s health insurance: a moral obligation?

Posted on September 10th, 2007

Archived in Health insurance

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UPDATED FEB. 5, 2008 – New Census figures show that nearly 9 million children – more than 1 in 10 — in the United States don’t have health insurance. A showdown is brewing over the 10-year-old federal program that offers health coverage to low-income children, and religious leaders of all faiths are among those pushing to expand it. Both houses of Congress voted to expand funding by $35 billion, a move that President Bush vetoed twice.

The debate takes place as states are pushing to expand the number of children covered by SCHIP, a program that, along with Medicaid, has cut the number of uninsured children by a third. States are trying to enroll more children by simplifying application procedures, raising income caps and reaching out to families who may not know they can get coverage. Advocates say children’s health coverage is a moral obligation and a critical step toward ensuring a healthier future for children and saving the country billions of dollars in uninsured medical costs. Critics say expanding the program will allow too many families who have private medical coverage to switch to the public SCHIP program.

What’s new

  • In early February 2008, President Bush proposed expanding funding for SCHIP by $20 billion over five years in the 2009 budget. His plan would limit eligibility to children in families that earn no more than 2 1/2 times the poverty level – a limit many SCHIP advocates dislike and which some states’ rules already exceed. Bush twice vetoed congressional efforts to expand funding by $35 billion.
  • On Sept. 7, the U.S. government rejected New York State’s bid to expand its SCHIP program to the children of families who make up to 400 percent of the federal poverty level — $68,680 for a family of three. New York Gov. Eliot Spitzer said the state might sue after the government showed it intended to enforce stricter SCHIP rules issued on Aug. 17. The rules may force a showdown between states trying to expand the number of children covered by SCHIP and the federal government’s desire to trim the SCHIP program. Right now, 17 states offer coverage to children in families whose incomes are above 250 percent of the poverty level; the new rules severely restrict their ability to do that. (See a Sept. 7, 2007, Associated Press story posted by Newsday.com.)
  • On Aug. 28, 2007, the U.S. Census Bureau issued new figures that show that the number and percentage of uninsured Americans – and children – rose again in 2006. The number of uninsured in 2006 was 47 million (15.8 percent) and the number of children was 8.7 million (11.7 percent). The number and percentage of uninsured blacks and Hispanics rose, but the number of uninsured non-Hispanic whites did not. Read the report.
  • The House and Senate have both passed bills reauthorizing SCHIP, whose funding runs out Sept. 30. The House passed the Children’s Health and Medicare Protection Act, also known as CHAMP, (HR 3162) and the Senate passed the Children’s Health Insurance Program Reauthorization Act of 2007 (S 1893). The two houses are working to resolve differences between the bills. See a side-by-side comparison from the Kaiser Family Foundation. (Read the bills by searching for them by number at Thomas.) The two houses will now work out differences between the bills. At the same time, President Bush has threatened to veto either version of the SCHIP bills. (See a July 19, 2007, Washington Post story.)
  • A March 2007 New York Times/CBS News poll found that 84 percent of Americans said they support expanding SCHIP to cover all uninsured children, and a majority said the lack of health insurance for many children was a “very serious” problem for the country. (See a March 1, 2007, New York Times story.)
  • States are moving to expand health coverage for children. As of June 2007, 31 states plus the District of Columbia had put in place new coverage for children or announced plans to do so. Some are working toward universal health coverage for children. The level of funding the federal government gives the SCHIP program is critical to the success of these efforts.

Why it Matters

Helping the uninsured gain access to health care is a moral obligation for society, according to religious leaders of all faiths. On the secular level, the monetary costs to society are staggering. Medical care for the uninsured cost $125 billion in 2004, and government dollars paid 85 percent of those costs, according to a Kaiser Family Foundation report.

National sources

Northwest Northeast Northwest West Southwest Midwest South Southeast East

GOVERNMENT

The Centers for Medicare and Medicaid Services administers the State Children’s Health Insurance Program. Contact officials through director of media affairs Jeff Nelligan, 202-690-6145, oeabox@cms.hhs.gov.

ACADEMICS

  • Barbara B. Blum is a senior adviser and former director of the Research Forum on Children, Families and the New Federalism at the National Center for Children in Poverty at the Mailman School of Public Health at Columbia University in New York. She is an expert on health care access for indigent children. Contact 646-284-9618, bbb10@columbia.edu.
  • Gary Gunderson is director of the Interfaith Health Program of the Rollins School of Public Health at Emory University in Atlanta. An ordained American Baptist minister, he is the program chair for the American Public Health Association caucus on Faith Community and Public Health and a consultant to the United Methodist Bishop’s Initiative on Children and Poverty. Gunderson is the author of Deeply Woven Roots, about religious congregations’ roles in building healthy communities. Contact 404-727-5242, ggunder@emory.edu.
  • Alexandra E. Shields is director of the Harvard/MGH Center on Genomics, Vulnerable Populations and Health Disparities. She has a master’s degree in systematic theology from Boston College and has 15 years’ experience working on issues involving the uninsured. Contact 617-724-1048, ashields@partners.org.

  • John J. DiIulio Jr. is Frederic Fox Leadership Professor of Politics, Religion and Civil Society and a professor of political science at the University of Pennsylvania. He served as the first director of the Bush administration’s White House Office of Faith-Based and Community Initiatives and has written a book, Godly Republic: A Centrist Blueprint for America’s Faith-Based Future, scheduled for release in October. DiIulio says SCHIP should be expanded “for compassion’s sake.” Contact powerjr@sas.upenn.edu.

THINK TANKS

  • Diane Rowland is executive director of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, which tracks SCHIP. Contact her in Washington, D.C., 202-347-5270.
  • Karen Davenport is director of health policy at the Center for American Progress, a think tank dedicated to improving lives “through ideas and action.” As a senior program officer at the Robert Wood Johnson Foundation, she developed and managed national programs to expand health insurance coverage for children. Contact kdavenport@americanprogress.org.

  • Robert E. Moffit directs the Center for Health Policy Studies at the Heritage Foundation. He has written critically about the proposed SCHIP expansion. Contact through the foundation’s media office, 202-675-1761, or its general email, staff@heritage.org.

ADVOCACY / RESEARCH ORGANIZATIONS

  • Cover the Uninsured lobbies to reauthorize and expand SCHIP and is a project of the Robert Wood Johnson Foundation, which coordinates the efforts of businesses, health care providers, faith leaders, unions, educators, and community organizations. It has a national interfaith advisory board, a FAQ on SCHIP and a clickable map with links and information on Cover the Uninsured events in each state. Contact 202-572-2928, info@covertheuninsured.org.
  • The Children’s Defense Fund has urged expansion of health insurance for children, including the expansion of SCHIP. In 2007 it created a toolkit for faith communities interested in promoting health coverage for children. It posts links to state offices around the country. Contact Religious Action Coordinator Matt Rosen, 202-628-8787, mrosen@childrensdefense.org.
  • Karen Davis is president of the Commonwealth Fund, a foundation which promotes better access to high-quality health care, particularly for the children, the uninsured and the poor. She wrote that SCHIP should cover children in families whose income is up to three times the poverty level. It’s based in New York. Contact 212-606-3800, kd@cmwf.org.
  • Jennifer Beeson is co-director for government affairs for Families USA, a nonpartisan group that focuses on health-care consumer issues. She urged participants at Ecumenical Advocacy Days, a March 2007 gathering in Washington, D.C., to “use your moral arguments and your faith arguments” to lobby for expansion of SCHIP. Families USA works with the National Council of Churches on SCHIP advocacy. Contact 202-628-3030.

  • The Campaign for Children’s Health Care wants to make affordable health coverage available to all children. Its dozens of partners include both religious and secular organizations, including many professional medical organizations.

RELIGIOUS

The Interfaith Health Program at Emory University posts a page of denominational health contacts.

CHRISTIAN

  • Abigail Rian Evans is a professor of practical theology at the Princeton Theological Seminary in Princeton, N.J. She wrote Redeeming Marketplace Medicine: A Theology of Health Care (Pilgrim Press, 1999). Contact 609-497-7972, abigail.evans@ptsem.edu.
  • The Rev. John Baumann, a Jesuit priest, is executive director of the faith-based PICO National Network in Oakland, Calif. He was among the signers of an interfaith letter sent in June to Senate Majority Leader Harry Reid in support of SCHIP legislation. Contact 510-655-2801, jbaumann@piconetwork.org.
  • The Rev. Eileen Lindner is deputy general secretary of the National Council of Churches USA. She also is chairwoman of the national interfaith advisory board for Cover the Uninsured, a nonpartisan campaign to focus attention on the need for health coverage for all Americans. Read the NCC’s March 6, 2007, news release urging expansion of SCHIP. Contact 212-870-2333, elindner@ncccusa.org.
  • Richard Land is president and CEO of the Southern Baptist Convention’s Ethics and Religious Liberty Commission and a member of the national interfaith advisory board for Cover the Uninsured. He has said that the nation’s children should receive the health care they need and supports expansion of SCHIP. Contact Kerry Bural at 615-782-8419, kbural@erlc.com.
  • Sister Carol Keehan is president and chief executive officer of the Catholic Health Association, which is working to improve children’s health care coverage through a partnership with the Campaign for Children’s Health Care. Contact 202-721-6321.
  • The Rev. Linda Hanna Walling is executive director of Faithful Reform in Health Care, which calls lack of access to needed health care a moral crisis in America. Contact 216-685-0796 or by email through the group’s Web site.
  • Dr. Miriam Burnett is medical director of the African Methodist Episcopal Church and associate director of Faith and the City in Atlanta. She has called health coverage for children necessary for public health. Contact 404-614-6398, jspe@faithandthecity.org.
  • The Rev. Bill Calhoun, co-pastor of Montview Boulevard Presbyterian Church in Denver, was among several religious leaders who met with key U.S. senators Aug. 2, 2007, in support of the CHIP program. Contact 303-355-1651 ext. 102, calhoun@montview.org.
  • Pastor Derrick Harkins of 19th Street Baptist Church in Washington, D.C., also met with the U.S. Senators. Contact 202-829-2773, office@nsbcdc.org.

JEWISH

  • Rabbi Steve Gutow is executive director of the Jewish Council for Public Affairs and a member of Cover the Uninsured’s interfaith advisory board. Contact 212-684-6950.
  • Rabbi David Saperstein, director of the Religious Action Center of Reform Judaism, was among religious leaders who met with U.S. senators to discuss SCHIP. Contact 202-387-2800, rac@uahc.org.

MUSLIM

  • Sayyid M. Syeed, national director of the Islamic Society of North America, says it is a religious obligation to provide children with appropriate health care, and a member of the national interfaith advisory board for Cover the Uninsured Week. Contact 317-839-8157 ext. 222, syeeds@isna.net.

OTHER

  • The American Medical Association advocates renewal of SCHIP and has launched a three-year program aimed at ending what AMA President-elect Nancy Nielsen calls the tragedy of the nation’s uninsured (an estimated 9 million of whom are children). The program’s Web site outlines the push. Contact through AMA media relations, 312-464-4430.

  • The American Cancer Society plans to devote its entire $15 million advertising budget this year to Americans’ lack of health coverage, which can have devastating effects on cancer patients’ health. See an Aug. 31, 2007, New York Times story. Contact 1-800-ACS-2345 or 404-417-5860.

Background

POLLS

  • An August 2007 national poll conducted for the Robert Wood Johnson Foundation found strong support for SCHIP, including among conservatives.
  • The August 2007 Kaiser Health Tracking Poll found that 34 percent of Americans identified health coverage for the uninsured as the health issue they would most like presidential candidates to talk about.
  • A March 2007 New York Times/CBS News poll found that 84 percent of Americans said they support expanding SCHIP to cover all uninsured children, and a majority said the lack of health insurance for many children was a “very serious” problem for the country. (See a March 1, 2007, New York Times story.)
  • According to a March 2007 Center for American Progress poll, 69 percent of Americans say it is the federal government’s responsibility to guarantee health coverage for all Americans, and 28 percent say it is not.
  • PollingReport.com posts national opinion polls about health care.

ARTICLES

Regional sources

IN THE NORTHEAST

  • David Cutler is a professor of economics at Harvard University. He wrote the book Your Money or Your Life: Strong Medicine for America’s Health Care System (Oxford University Press, 2004), which looks at issues involving access to health care. Contact 617-496-5216, dcutler@harvard.edu.
  • Jonathan Gruber is a professor of economics at Massachusetts Institute of Technology in Boston. He looks at the efficiency of the nation’s current system for delivering health care to the indigent. Contact 617-253-8892, gruberj@mit.edu.
  • Jacob S. Hacker is an assistant professor of political science at Yale University in New Haven, Conn. He is a member of the Washington, D.C.-based Economic and Social Research Institute’s advisory panel on “Workable Strategies to Expand Health Coverage.” Contact 203-432-5554, jacob.hacker@yale.edu.
  • Ellen Beaulieu is an associate provost for planning and assessment at the University of New England’s College of Health Professions in Portland, Maine. She is an expert on public health care policy. Contact 207-797-4523.
  • Stuart Altman is a professor of national health policy at Brandeis University in Waltham, Mass. He is an economist whose research interests are primarily in federal and state health policy. Contact 781-736-3803, altman@brandeis.edu.

IN THE EAST

  • James R. Tallon Jr. is president of the United Hospital Fund of New York and chairman of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, which tacks SCHIP. Contact 212-494-0700, jtallon@uhfnyc.org.
  • Edmund D. Pellegrino is professor emeritus for the Center for Clinical Bioethics Medical Center at Georgetown University in Washington, D.C. He has written the section “The Good Samaritan in the Marketplace: Managed Care’s Challenge to Christian Charity” for the book The Changing Face of Health Care: A Christian Appraisal of Managed Care, Resource Allocation and Patient-Caregiver Relationships (Eerdmans, 1998). Contact 202-687-5397, pellegre@georgetown.edu.
  • The Rev. David Brown, pastor of Dubbs Memorial United Church of Christ in Allentown, Pa., is chairman of Congregations United for Neighborhood Action, a federation of faith-based institutions working to improve conditions for people in Pennsylvania’s Lehigh Valley. CUNA has called investment in children’s health care a moral imperative. Contact 610-435-7281, uccdubbs@verizon.net.
  • Mark Pauly is chairman of the health care systems department at the Wharton School at the University of Pennsylvania in Philadelphia. He is an expert on medical economics, health policy and health insurance. Contact 215-898-2838, pauly@wharton.upenn.edu.

IN THE SOUTHEAST

  • William Custer is an associate professor of risk management and insurance at Georgia State University’s Robinson College of Business in Atlanta. He is an expert in employee benefits, health care financing and health insurance. Contact 404-651-3041, wcuster@gsu.edu.
  • Ken Thorpe is chairman of the health policy and management department at Emory University in Atlanta. He is an expert in health care financing, insurance and health care reform. Contact 404-727-3373, kthorpe@sph.emory.edu.

IN THE SOUTH

  • Sarah Shuptrine is president and CEO for the Southern Institute on Children and Families, based in North Carolina but with affiliates throughout the South. The institute is a nonprofit organization that works with business leaders to try to improve children’s quality of life, including access to health care. Contact 803-779-2607, sarah@kidsouth.org.
  • Dr. Regina M. Benjamin is founder and CEO of Bayou La Batre Rural Health Clinic in Bayou La Batre, Ala., and a member of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, which tracks SCHIP. Contact 251-824-4985.
  • Larry Churchill is a professor of medical ethics at Vanderbilt University Medical Center and a professor at the graduate department of religion at the Vanderbilt Divinity School in Nashville, Tenn. An expert on the justice and allocation of health care resources, he wrote Self-Interest and Universal Health Care: Why Well-Insured Americans Should Support Coverage for Everyone (Harvard University Press, 1998.) Contact 615-936-2686, larry.churchill@Vanderbilt.Edu.

IN THE MIDWEST

  • Katie Merrell is senior analyst at the Center for Health Administration Studies at the University of Chicago. She is an expert on the nation’s health care financing system. Contact 773-702-1877, k-merrell@uchicago.edu.
  • Catherine McLaughlin is director of the Economic Research Initiative on the Uninsured at the University of Michigan in Ann Arbor. The three-year initiative has been conducting research aimed at increasing understanding of the interaction between health, the labor market and the uninsured. Contact Jacqui Hinchey at 734-936-6842, jhinchey@umich.edu.
  • Tim McBride is a professor of health management and policy at St. Louis University’s School of Public Health. He focuses his research on Medicare reform, the uninsured and insurance markets, rural health and long-term care. Contact 314-977-4094, mcbridet@slu.edu.

IN THE SOUTHWEST

  • The Rev. John Wester, the Catholic bishop of Salt Lake City, has called expansion of the SCHIP program “a moral imperative.” Contact through the diocesan office, 801-328-8641.
  • Dr. Ron J. Anderson is president and chief executive officer of Parkland Health & Hospital System and a member of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, which tracks SCHIP. Contact 214-590-8000.
  • Dr. Arthur Kaufman is co-director of the University of New Mexico Health Care Plan in Albuquerque. The plan is a managed care model that serves uninsured residents of Bernalillo County, N.M. Contact 505-272-2165, AKaufman@salud.unm.edu.

IN THE WEST/NORTHWEST

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