Taking Care of Our Own

As you know, the Bush Administration has moved boldly to protect the insurance industry from the State Children’s Health Insurance Program, or “S-chip.” The Bushies have attached tough new strings to the program to prevent states from expanding coverage to children of middle-income families. Many of these strings are designed to prevent families already covered by private insurance from dropping it and moving to the subsidized programs.

However, most of the middle-income children the Administration wants to keep out of the program are not covered by private insurance, either.

This Associated Press story from Texas explains the problem:

… The Houston teaching assistant’s 18-year-old twins were bumped in May from the state Children’s Health Insurance Program, known as CHIP in Texas. The overtime she worked pushed the household income above the program’s limit. The boys relied for six years on the program, which covers kids to age 19.

The Pacheco twins are among thousands of children whose families’ incomes are too high to qualify for CHIP but still can’t afford private insurance. While some in Texas are hoping to raise the limits to allow more coverage, President Bush and some in Congress want to keep the income ceilings intact.

This week, the administration directed states to make children wait a year before enrolling in the program, a guideline aimed at preventing families from dropping private insurance to enroll in CHIP.

About half of the estimated 1.4 million uninsured children in Texas don’t qualify for CHIP. Some are undocumented, some have pre-existing conditions that keep them from getting private coverage, and others are like the Pachecos whose incomes prevent them from enrolling in CHIP.

Children’s advocates in Texas had hoped that one day the state would raise the income limits, which in the state is 200 percent of poverty level, or $41,300 for a family of four.

“The largest growth of uninsured has been in the middle class,” said Barbara Best, executive director of Texas Children’s Defense Fund. “Families earning $50,000 to $60,000 a year can’t afford private health insurance. Why can’t they benefit through the system as well?

In 2005, the average cost of life insurance in Texas was was $9,100 per family, about $760 a month. I assume it’s higher now.

Officials also said states can’t enroll children in families who earn more than the CHIP income limit until 95 percent of children who qualify for CHIP or Medicaid are enrolled in those programs.

Last year, 41,523 children covered by CHIP left because their family income exceeded CHIP income limits, according to the Texas Health and Human Services Department.

A department study found 1 percent of the 2003 average monthly new enrollees, 21,295 kids, had dropped private insurance to get CHIP coverage.

But, that 1 percent is taking bread out of the mouths of health insurance executives. BTW, via a quickie google search I learned that health insurance profits are booming.

The dwindling number of Americans still covered by employee-subsidized health care are sheltered from the realities of health insurance cost. Texas is one of the states without those nasty “regulations” righties sneer at that prevent health insurance companies from refusing to cover sick people, yet it also has the highest percentage of uninsured citizens — 27.1 percent — of any state. The high percentage of uninsured has an unfortunate impact on Texas.

Regarding S-chip, this op ed from today’s Orange County Register expresses the Bushie POV:

A Bush administration policy that would make it less easy for states to expand a children’s health insurance program well beyond the low-income children it was designed to cover has been greeted with outrage.

The most logical explanation is that some legislators really want the government to “crowd out” private insurance as a prelude to replacing it with an all-inclusive government program that covers everybody. …

… The government has already allowed states to offer the program to families above the official poverty level of $20,650 for a family of four. Most states now offer it to those at double that level, or $41,300 a year. Some states are at 250 percent ($51,625), and New York wants to offer it to families at quadruple the poverty level, up to $82,600.

At such levels, however, a subsidized government program starts to look better to people who already have private health insurance. Thus the “free” (i.e., taxpayer-paid) insurance starts to “crowd out” private insurance.

The Bush administration would make states that want to offer the program to families at more than 200 percent of the poverty level wait until 95 percent of those at or below the 200 percent figure are covered before they expand it.

That has states eager to expand a program – with “free” federal money – howling on behalf of “the children.” Enough already.

Spoken like a man who’s never had to buy private insurance for a child with a pre-existing condition. Attempt to buy, I should say.

See also: “Stiff-Arming Children’s Health

Charity Nation

Last week I wrote that in the past two years more than a million American have volunteered to help restore the Gulf Coast, yet they aren’t making much of a dent. Today Douglas Brinkley writes in the Washington Post:

Over the past two years since Hurricane Katrina, I’ve seen waves of hardworking volunteers from nonprofits, faith-based groups and college campuses descend on New Orleans, full of compassion and hope.

They arrive in the city’s Ninth Ward to painstakingly gut houses one by one. Their jaws drop as they wander around afflicted zones, gazing at the towering mounds of debris and uprooted infrastructure.

After weeks of grueling labor, they realize that they are running in place, toiling in a surreal vacuum.

Two full years after the hurricane, the Big Easy is barely limping along, unable to make truly meaningful reconstruction progress. The most important issues concerning the city’s long-term survival are still up in the air. Why is no Herculean clean-up effort underway? Why hasn’t President Bush named a high-profile czar such as Colin Powell or James Baker to oversee the ongoing disaster? Where is the U.S. government’s participation in the rebuilding?

And why are volunteers practically the only ones working to reconstruct homes in communities that may never again have sewage service, garbage collection or electricity?

Eventually, the volunteers’ altruism turns to bewilderment and finally to outrage. They’ve been hoodwinked. The stalled recovery can’t be blamed on bureaucratic inertia or red tape alone. Many volunteers come to understand what I’ve concluded is the heartless reality: The Bush administration actually wants these neighborhoods below sea level to die on the vine.

This is a really good article, so please read it all. He concludes that the Bush Administration is deliberately discouraging people from re-populating New Orleans, although he doesn’t draw the conclusion that Digby and I and others have drawn — that the goal is to create a reliably Republican voting block in New Orleans by dispersing the mostly black and mostly poor parts of the population, which mostly votes for Democrats. We’ll see how that turns out in the future.

Brinkley thinks the goal is to prevent people from moving back to areas below sea level that are likely to be flooded again, especially since the feds don’t want to pay to erect better flood protection. That may be part of it, too. And it isn’t just New Orleans that’s not getting fixed. There are people still waiting for help in Alabama and Mississippi as well.

Whatever the reason for government non-action, the Katrina experience ought to put to rest the idea that private charities can replace government welfare, disaster relief and other “safety net” programs. I say ought to; empiricism hasn’t yet stopped a rightie from believing whatever he wants to believe. But for the rest of us, the Katrina experience reveals that sometimes you really do need government. It’s fine for volunteers to cook soup, clear brush, or help re-roof a house. But if electricity and sewage services are never restored to that house, what’s the point?

This web document, which appears to have been written before the Bush II Administration, asks us to imagine what might have happened had there been no federal response to Hurricane Andrew in 1992. Well, now we don’t have to imagine. (But speaking of Hurricane Andrew — George H.W. “Poppy” Bush was president in 1992, and the federal government was slow to respond then, also. Maybe the Bush family carries a “don’t respond to hurricanes” gene.)

Righties like private charities because they don’t want to pay taxes for “welfare.” The Bush Administration likes private charities so much, it diverts tax dollars to them. Michelle Goldberg wrote in Kingdom Coming: The Rise of Christian Nationalism (pp. 107-108):

The diversion of billions of taxpayer dollars from secular social service organizations to such sectarian religious outfits has been one of the most underreported stories of the Bush presidency. Bush’s faith-based initiatives have become a spoils system for evangelical ministries, which are now involved in everything from prison programs and job training to teenage pregnancy prevention, supplanting the safety net that was supposed to catch all Americans. As a result of faith-based grants, a growing number of government-funded social service jobs explicitly refuse to hire Jews, gay people, and other undesirables; such discrimination is defended by the administration and its surrogates in the name of religious freedom. Bringing the disposed to Jesus Christ has become something very close to a domestic policy goal of the United States government. And all this has happened with far less notice or public debate than attended the removal of Terri Schaivo’s feeding tube or the halftime baring of Janet Jackson’s breast.

Goldberg writes that the term “compassionate conservative” comes from the title of a book by Marvin Olasky. This New York Times article from 2000 by Alison Mitchell explains how Olasky influenced Bush’s “thinking” on charity:

Mr. Rove also introduced Mr. Bush to Marvin Olasky—a proponent of 19th century-style charity over the entitlements of the welfare state—whom the governor calls “compassionate conservatism’s leading thinker” in a foreword to Mr. Olasky’s newest book.

Those introductions amounted to the first building blocks of the “compassionate conservative” platform Mr. Bush is running on today: tax incentives that he predicts will lead to an explosion of charitable giving; an emphasis on using religious institutions to deal with poverty, drug abuse and other social problems and a pledge to “usher in the responsibility era,” to replace the notion that “if it feels good, do it.”

The core concept of this platform is that while government has a responsibility to the needy, it does not have to provide the services itself. This approach can be seen in everything from Mr. Bush’s proposals for a tax credit to help people buy health insurance to his call to divert some Social Security payroll taxes into individual investment accounts.

I like the part about “19th century-style charity.” In early 19th century America, local laws usually made some provision to care for the indigent. Generally this worked well enough, especially in communities where everyone knew everyone else. As the nation became more urban and industrialized, and particularly with the great influx of immigrants, the old system proved inadequate. In the latter part of the 19th century private charities, most of them religious, sprang up by the tens of thousands, and for a time it was common for state and local governments to give cash grants to such charities to do social work rather than create public bureaucracies. How well this worked is debatable. African Americans often were excluded from receiving help, for example. In any event some major disasters — notably the Great Mississippi Flood of 1927, the Dust Bowl, and the Great Depression — pretty much swamped the system that Olasky wants to go back to.

Although the hard-core Right vowed to dismantle the New Deal from its beginnings, as I’ve written before most Americans were fine with the New Deal, including Social Security. And in the 1950s they were fine with the GI Bill and mortgage subsidies that helped the Greatest Generation become way more affluent than their parents had been. Nor do I remember a great hue and cry from the general population against Medicare when it was created in 1965. However, Lyndon Johnson’s “Great Society” programs were perceived by white Americans as tax money being spent mostly on inner city blacks. (This was not the whole story, but white poverty in America tends to be rural and invisible.) All of a sudden white middle-class America swung Right and discovered the virtues of self-reliance. All those right wingers who had crusaded against the “welfare state” finally had a big enough audience to swing elections.

But in the 1960s white middle-class Americans thought of themselves as economically invincible, thanks in part to such New Deal reforms as the FSLIC (which would become insolvent during the Savings and Loan Crisis, which was brought about by right-wing faith in deregulation and free markets, but that’s getting ahead of the story). Going back to Depression conditions was unthinkable to a middle class American then.

But I’m not sure it’s quite so unthinkable now. It ain’t the 1960s any more, and I’m not just talking about patchouli oil. Middle class Americans don’t feel so invincible today. And I don’t think American whites are, on the whole, as dog-whistle racist as they were 40 years ago. I suspect Americans are less interested in shrinking government and drowning it in a bathtub than they used to be.