Congress and the President are far apart. President Bush has offered to spend an additional $5 billion on children's health insurance over the next five years. The Senate and House want to spend a lot more. Their proposals call for $35 to $50 billion in new spending. The president has warned he's prepared to veto an increase that's that substantial.
Minnesota Commissioner of Human Services Cal Ludeman says it's not for him to comment on what amount is appropriate. He just wants assurances that the program, referred to as SCHIP, will be reapproved.
"It's simply important that Congress reauthorizes SCHIP. We think that obviously the coverage provides families and children an opportunity to stay healthier," he said.
The federal children's insurance program funnels a lot of money to Minnesota. This year the state received $48 million. Rep. Tom Huntley, DFL-Duluth, says that money helped insure a lot of kids. But there are still some 80,000 uninsured children in the state and Huntley says lawmakers are depending on federal dollars to help extend coverage to more of them.
"Just this past session we did some expansions of MinnesotaCare that should lead to about half the uninsured kids in the state being picked up by MinnesotaCare. If we lose the SCHIP money, then those gains won't happen," he said.
No one is suggesting that the federal program will go away. Both the president and Congressional leaders have said it should be reauthorized.
But many states, including Minnesota, are worried that the feds won't approve enough money to keep pace with the rising cost of health care and the growing number of people without health insurance. Just last month the U.S. Census Bureau announced that the number of uninsured Americans rose by 2 million in 2006, with children making up more than a quarter of the increase.
"We've got to have enough money to make sure that not only are we protecting everyone who currently is receiving health care, but that we have enough funding in place so that we can cover people who may yet lose their insurance," said Steve Francisco, the federal policy director with the Minnesota Council of Nonprofits. Francisco says it's also important that Minnesota retains flexibility in how it's able to spend the federal money. Currently half goes to the state's MinnesotaCare program to cover low-income children and some parents. The rest is used to insure pregnant women on Medical Assistance.
Minnesota received permission from the federal government to spend the money not only on children, but also on needy adults. But the reauthorization debate has brought new scrutiny to that kind of spending. The president and some Republicans have argued that the program is intended for children and shouldn't be used as a vehicle to achieve universal coverage.
Sen. Linda Berglin, DFL-Minneapolis, one of the original architects of the state's MinnesotaCare program, says people are flocking to government-sponsored programs because they have no other choice.
"There are those in Washington these days who worry about whether state programs are undermining private insurance," she said. "What they need to understand is that it is the high cost of health care that rises every year that is undermining private insurance."
Berglin says lawmakers should focus on reining in health care costs. But that debate may have to wait for another day. For now, the state is hoping the dispute over children's health insurance spending doesn't result in a big funding cut.