Bush Administration Proposes Making Fetuses Eligible for CHIP Program; Opponents Call Plan a Legal ‘Ploy’ to Erode Abortion Rights
HHS Secretary Tommy Thompson said on Jan. 31 that the Bush administration will soon issue a proposed regulation that would make a fetus at any stage of development eligible for health coverage under the CHIP program, marking the "first time that a federal program has attempted to define childhood as beginning before birth," the Washington Post reports. The CHIP program provides health insurance to low-income children from birth to age 19 whose families' income exceeds the requirements for Medicaid (Cooperman/Goldstein, Washington Post, 2/1). Although Medicaid covers pregnant women of all ages, the federal government only requires states to cover women up to 133% of the federal poverty level; state CHIP programs often have higher income ceilings (Kaiser Daily Reproductive Health Report, 7/6/01). The regulation, which is slated to be published in the Federal Register "in the coming weeks," would "clarify the definition of 'child'" under the CHIP program to say that states can include coverage for "children from conception to age 19" (HHS release, 1/31). This change would permit states to expand their CHIP programs to allow pregnant women to access publicly funded prenatal and delivery care (Toner, New York Times, 2/1).
No More Waivers Needed
The CHIP program currently only covers pregnant women under age 18, although states can receive permission to cover older pregnant women through the program. For example, New Jersey and Rhode Island have received such federal waivers (Kaiser Daily Reproductive Health Report, 7/6/01). Under the administration's proposal, states would not have to seek a federal waiver to expand their CHIP programs to include pregnant women, although they could choose to apply for a waiver in order to "sidestep the abortion debate," federal officials said. States would also not be required to extend coverage to a fetus because the CHIP program allows states to set their own eligibility requirements (HHS release, 1/31). After the proposal is published in the Federal Register, it will be open to public comment and possible changes before final approval. The regulation does not require congressional approval, but several members of Congress said they will propose legislation that would extend the CHIP program to cover prenatal care, thereby making the proposal "moot," the Post reports.
'Not About Abortion'
Many women's groups and abortion-rights advocates have "denounced" the administration's proposal as "a ploy to create legal grounds for outlawing abortion" by ascribing personhood to a fetus (Washington Post, 2/1). However, Thompson said that the issue is "not an abortion debate" and is only about providing prenatal care to pregnant women, the Boston Globe reports (Kirchhoff/Leonard, Boston Globe, 2/1). "Prenatal services can be a vital, lifelong determinant of health, and we should do everything we can to make this care available for all pregnant women," Thompson said (Marinucci, San Francisco Chronicle, 2/1). But the New York Times reports that Thompson made the announcement about the proposed regulation after discussing President Bush's "commitment to ensuring that 'unborn children' were 'welcomed' and 'protected.'" Several members of Congress who oppose the regulation said that it is clearly rooted in abortion politics. Rep. Henry Waxman (D-Calif.) said that the Bush administration could have shown its commitment to prenatal care by broadening public health coverage to pregnant women instead of fetuses (New York Times, 2/1). Sen. Barbara Boxer
(D-Calif.) added, "It's unfortunate [Thompson] has taken the wonderful issue of prenatal care and turned it into (a debate on abortion)" (San Francisco Chronicle, 2/1). Thompson, however, said, "How anybody can now turn this into a pro-choice or pro-life argument, I can't understand it," he said (Shaw,
Newsday, 2/1).
Pro and Con
Abortion-rights advocates sharply criticized the CHIP proposal, stating that the regulation is "part of an administration attempt to undermine the legal status" of abortion (McQuillan,
USA Today, 2/1). For instance, Kate Michelman, president of the National Abortion and Reproductive Rights Action League, said, "The whole effort throughout the country to ascribe rights to the fetus, separate and apart from the woman, is an attempt to create a legal patchwork, and over time to roll back Roe v. Wade" (Kemper, Los Angeles Times, 2/1). But many antiabortion and religious groups expressed support for the proposal.
National Right to Life Committee spokesperson Laura Echevarria "applauded" the proposal, stating, "It has to do with health care more than anything else" (Lueck, Wall Street Journal, 2/1).
