Mint SCHIP

The House just passed an expansion of the State Children's Health Insurance Program (SCHIP) by a vote of 289-139, which is a very solid majority. I was wondering how it was funded, and I guess it's through that same sin tax.

SCHIP currently covers over six million children whose parents earn too much to qualify for Medicaid — the federal health insurance program for the poor — but who can't afford private insurance. The bill's supporters say the legislation would extend the program to an estimated four million additional children, paying for it with a 61-cent-per-pack increase in the federal tax on cigarettes.

Passing an expansion of SCHIP early in Obama's presidency, House Majority Leader Steny Hoyer said, would be "a very dramatic and important statement that change has come to America."

"Children are our treasure," said Rep. John Dingell, D-Michigan. "The (SCHIP) bill is only the beginning… We must not stop until all Americans qualify for quality, affordable health care."

I'd rather you taxed millionaires or financial transactions, but there's a certain logic to expanding health care by discouraging bad health outcomes. If less people abuse cigarettes in the process, you are saving health care money on the way in as well as raising revenue. Still, this is an incremental reform and only a gateway to the needed overhaul of the system.

Here's Obama's statement:

"In this moment of crisis, ensuring that every child in America has access to affordable health care is not just good economic policy, but a moral obligation we hold as parents and citizens. That is why I'm so pleased that Democrats and Republicans in the House of Representatives came together to provide health insurance to over ten million children whose families have been hurt most by this downturn. This coverage is critical, it is fully paid for, and I hope that the Senate acts with the same sense of urgency so that it can be one of the first measures I sign into law when I am President," said President-elect Obama.

The problem with this is that it didn't pass in 2007, when President Bush vetoed it twice. Because having that in place before the downturn would have meant that the programs would not have been cut to ribbons in the states:

Even as President-elect Barack Obama plans an ambitious push to expand health coverage nationwide, states are slashing health services to their poorest residents amid the economic downturn.

The unprecedented cuts in public assistance come as millions of Americans are losing their jobs and health insurance.

In many cases, the cuts are so deep that even the massive federal rescue package being assembled on Capitol Hill may not be enough to restore services being eliminated in the burgeoning crisis, health officials warn.

And the faltering economy has all but killed trailblazing state campaigns to expand coverage for the working poor -- once seen as hopeful signs for national healthcare reform.

This injection of money is going to help, but in many ways the damage has been done.

One additional point. The most controversial portion of the SCHIP debate is whether or not the children of immigrants should be covered. The xenophobic right thinks that "illegals" shouldn't reap the benefits of citizenship, even though we're talking in most cases about kids who were born here and are legal residents. In addition, having untreated kids running around could be a public health issue, and there's value (and even savings) in treating everyone with vaccinations for communicative diseases, for example. Simon Rosenberg says that this is a good reason to pass comprehensive immigration reform so we don't keep returning to these narrow debates:

"That the debate over SCHIP has immediately become a debate about immigration should be a clear warning to the Administration and Congress that progress on many important domestic priorities this year may get caught up in the debate on how to best fix our broken immigration system. It is our belief that rather than having a series of tough and contentious proxy fights on immigration, our leaders should recognize that passing comprehensive immigration reform this year will not only help fix our badly broken immigration system - a priority of many Americans - but may also be the key to unlocking bipartisan progress on a whole range of other domestic and security related issues."

I have to agree.

...roll call here. 40 Republicans joined every Democrat but 2.

(hint: if they can't vote for SCHIP, Bobby Bright and Jim Marshall aren't really Democrats.)