Here is the result of deadlock in Washington: Children still showing up in emergency rooms for primary care.
Thats the view of Bill Pike, director of public policy and community affairs with Carondelet Health Network in Tucson, Ariz. Pike spoke in an interview last week as President Bush was vetoing the latest measure approved by Congress to expand the State Childrens Health Insurance Program. It marked the second time this year that Bush has used his pen to nix a broadening of SCHIP; lawmakers failed to override the first veto.
Pike said that in the wake of the vetoes, Congress is unlikely to approve any compromise legislation that expands coverage or changes eligibility for aid. The most likely course, he said, would be to extend the current program and make adjustments to maintain current levels of participation.
This outcome wont result in more children showing up in the ER, but it means the status quo will continue of uninsured children using the ER as the first source of medical care, Pike said.
At deadline, the viability of the program was uncertain. Late last week, Congress approved another temporary spending measure that will keep SCHIP at its current spending levels, but a reauthorization deal for the program has yet to be worked out.
Some activity to extend the program took place last week, but nothing was resolved. The latest news was the Senate had worked in a one-year extension of SCHIP into a measure to reform the Medicare program.
To keep the program running through next year, the Congressional Budget Office last week estimated that the federal government would have to spend an additional $800 million in 2008.
The bill Bush vetoed would have reauthorized SCHIP for five years at $35 billion above the programs baseline of $25 billion. The action caused the usual uproar among congressional Democrats and healthcare groups.
The veto is wrong, and we urge Congress to extend SCHIP and protect a program that has made a difference in the lives of millions of children, said Richard Pollack, executive vice president of the American Hospital Association.
But with a formal extension of the program still out of reach, providers continue to wring their hands about the continued lack of stable funding for SCHIP. The uncertainty going on between Congress and the White House has got us all worried, said James King, president of the American Academy of Family Physicians. Were waiting, were calling, but yet nothings happened.
King, who works in a family medicine group practice in Selmer, Tenn., says he doesnt know what the ultimate outcome will be for his SCHIP patients if the program doesnt get adequate funding in his state. When these kids come in to see me, will they have coverage for tests or medicines they need?
Robert Hopkins, an associate professor of medicine and pediatrics with the University of Arkansas for Medical Sciences College of Medicine, hasnt heard of any hospitals or physicians in his area curtailing services for SCHIP patients. Yet, I am certain that the managers of the state Medicaid agencies and SCHIP programs are pulling their hair out, Hopkins said.
He added that several parents of children who receive coverage through Arkansas SCHIP program have expressed concerns about affording care in any situation besides an emergency.
Jennifer Siciliano, assistant vice president of government relations with Inova Health System, Falls Church. Va., said she couldnt speculate on what Congress will come up with. The bottom line is we want to ensure that kids have access and are covered, she said.
The bill Bush vetoed last week would have funded the program using tobacco taxes, resulting in coverage for 10 million children in total compared with the 6 million children now covered. The Senate and House approved the legislation nearly a month ago. In a written statement to Congress, Bush said that the bill does not put poor children first, and it moves our countrys healthcare system in the wrong direction.
Congress in this latest attempt tried to amend certain provisions to make it more veto-proof, such as phasing childless adults out of the program within one year instead of two and taking more steps to prevent substitution of SCHIP coverage for private coverage, as well as ensuring that illegal immigrants would not obtain coverage. Yet, the White House continues to oppose the funding levels and eligibility requirements that Congress has proposed, in addition to the tobacco tax.
House members decided to hold off on an override attempt until January.