US govt pushes for limited SCHIP coverage

The US federal administration has written to the individual states to outline its proposals for restricting the States Child Health Insurance Program (Marketletters passim), following the passage of legislation by the Democrat-controlled Congress to expand the scheme to cover households with incomes of up to three times the federal poverty line. The harder line taken by the Republican administration is especially difficult for party colleague Arnold Schwarzenegger, California's Governor, who is attempting to use an expanded SCHIP to help finance universal health care coverage in the largest US state by population.

President George W Bush has promised to veto SCHIP renewal legislation that would expand the program, instead ordering states to tighten eligibility rules. These include checking that a household on more than 250% of the federal poverty level have been uninsured for at least one year, to avoid creating an incentive for people to drop their private coverage in order to get the government-provided package. Other conditions are: charging co-payments that are similar to locally-available private health insurance plans; ensuring that the proportion of employer-based health plans that cover children in the low-income group does not drop more than 2% over a five-year period; and states must enrol 95% of uninsured children in households below 200% of the federal poverty level. The latter standard has not been met by any of the US states, although Vermont, with a small population, has achieved 92% coverage of the federal target.