Expanding CHIP Could Be the Best Option for ‘Patching’ the Safety Net, Los Angeles Times Columnist Writes

If President Bush and Congress "truly want to start patching the health care safety net, it may be time for CHIP to grow up," Ronald Brownstein writes in his weekly Los Angeles Times column. During its "brief life," the CHIP program has proven "it's possible to reach ... working families at a reasonable cost," as "committed" states have established "an efficient infrastructure of insurers, HMOs, and community clinics," Brownstein says. He adds, "It would take little to make this infrastructure more available to working poor adults ... All that's missing is the money." Brownstein outlines the "divergent" views on how to expand coverage to adults, including how Families USA and the Health Insurance Association of America have proposed expanding either CHIP or Medicaid to adults earning 200% of the federal poverty level, or $30,000 per year for a family of three. Sens. Olympia Snowe (R-Maine) and Edward Kennedy (D-Mass.) plan to introduce a similar proposal this week, Brownstein writes. For his part, President Bush maintains that states can expand coverage to adults using "money already available [through CHIP] for children." He also has proposed a $2,000 annual tax credit for low-income families to purchase private coverage. Although some advocates for the uninsured question whether a tax credit is the best way to expand coverage, Brownstein writes that a tax credit "isn't without value." He adds that such a proposal "would reach some low-income workers who recoil from any government program ... as a form of welfare." In addition, if lawmakers want to gain Bush's signature on coverage expansion, they might have to compromise on the tax credit, Brownstein writes. Brownstein surmises, "Negotiating the details of such a deal is what legislators get paid for. The larger point is that Washington now has the money to reach more of the uninsured, and in CHIP, a successful model for doing so" (Brownstein, Los Angeles Times, 3/19).