A Veneer of Certainty

The 10-year-old program, which is set to expire on Sept. 30, costs the federal government $5 billion a year and helps provide health coverage to 6.6 million low-income children whose families do not qualify for Medicaid but cannot afford private insurance on their own.

About 3.3 million additional children would be covered under the proposal developed by Senate Finance Committee Chairman Max Baucus (D-Mont.) and Republican Sens. Charles E. Grassley (Iowa) and Orrin G. Hatch (Utah), among others. It would provide the program $60 billion over five years, compared with $30 billion under Bush's proposal. And it would rely on a 61-cent increase in the federal excise tax on cigarettes, to $1 a pack, which Bush opposes.

I'm all for fiscal restraint but not at the expense of children's health when such paltry sums are in play. His objection on "philosophic grounds" appear related to a fear that an increase in CHIP eligibility will drive people from private insurance to the government teat. While I can understand wanting people to provide for themselves, I think he's missing a major underlying issue: private health insurance is too expensive for the slice of Americans that will benefit from the program. People think at the margin and will likely choose the cheapest option for the best benefit. Would expansion of CHIP create increased competition with private health insurance and drive down costs in the private sector? Maybe, be I'm not counting on it. I'd expect that the private side would just shift costs onto their customers who have the ability to pay.

And while I doubt the CHIP/excise tax combo is revenue neutral, that buck-per-pack would likely go a long way, at least until the number of smokers drops far enough.

At any rate, this refusal to invest in the next generations of Americans really pisses me off. Another nail in the coffin of the Bush 43 legacy, seems like.