ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Wednesday, January 29, 1997 TAG: 9701290009
SECTION: EDITORIAL PAGE: A-6 EDITION: METRO
PRESIDENT Clinton's ideas for health-care reform took such a hammering four years ago that it seems unlikely he'll lead another charge for universal health coverage. It would be helpful, though, if he'd use his upcoming State of the Union speech to encourage bipartisan congressional support for universal health coverage for children.
The need for such coverage, already urgent, may be made more so by national welfare reform. While moving parents who receive Aid to Families with Dependent Children off the rolls and into jobs, welfare reform will also increase the numbers of children caught in a health-care crack. Their families will no longer qualify for Medicaid. But neither will they have enough income (or the kind of employer) to pay for private health-care insurance.
About 10 million children of working-poor American families already are caught in this crack, according to the General Accounting Office.
In response to the problem, many states have expanded eligibility for Medicaid. Others have encouraged public-private partnerships, such as the Comprehensive Health Investment Program (CHIP) in Virginia. Started in Roanoke, it provides basic and preventive health services for low-income children in 10 Virginia cites. Volunteer clinics, such as the Bradley Free Clinic in Roanoke, are another response aimed at the working poor.
Changes in federal law, including passage of the Health Insurance Portability and Accountability Act of 1996, better known as Kassebaum/Kennedy, have narrowed by a little the health-care gap for children.
But none of these efforts has solved the problem, and it's doubtful patchwork programs can provide the health-care safety net that all children need.
Clinton has indicated he'll support a national initiative to assure health coverage for all children. Several proposals for kids-only coverage have been crafted in Congress. The president needs now to give some direction.
Would he, for instance, support a tax increase - say, a 75-cent per-pack tax hike on cigarettes - to support a plan aimed at guaranteeing that all children have access to affordable health insurance? With entitlement programs such as Medicare due for major revisions to keep them financially sound, could a Medicare-type entitlement program for children be fashioned so it wouldn't cause headaches down the road? (Generally speaking, health care for kids is cheaper than for the elderly, and offers dividends down the road.)
How best to align a federal initiative with efforts by states and the private sector to extend health coverage to more low-income children? How also to ensure that states and the private sector don't pull back, figuring they can dump health coverage for children into Washington's lap?
These are thorny problems. But Clinton should not feel so snake-bit by health-care reform that he shies from venturing into the briar patch. Ensuring that all children have access to good medical care, including preventive care, should be one of the nation's, and President Clinton's, priorities.
LENGTH: Medium: 55 linesby CNB