SCHIP

We usually like to point out good news from state health reformers, partly because it helps break down the mindset that fixing health care is Mission Impossible. Today however we've got some bad news: the demise of a brief experiment to make sure that every child in Hawaii has health insurance.

Gov. Linda Lingle's administration cited a budget shortfall as its reason for ending the seven-month old program. A state health official said that families were dropping private coverage so they could get into the state-subsidized plan.

The state said it would stop paying two weeks from now, on Nov. 1, but the private partner Hawaii Medical Service Association (part of Hawaii's Blue Cross Blue Shield) said it will keep the program intact through at least the end of the year, financing it from reserve funds. The state had been paying $50,000 a month, or about $25 per child, with about 2,000 children under age 18 currently enrolled. To be in the HMSA Keiki Care plan, a child had to be uninsured for the previous six moths and not be elibile for other state or federal coverage, such as Medicaid or the Hawaiian SCHIP program.

What would you do with $700 billion? (Aside from buying the fabric ($2.10 a yard) needed to make 3.6 billion golden parachutes.)

Here at the New Health Dialogue, we like to talk about how a quality health care system will actually save us money. But while watching the ups and downs of the Wall Stree bailout plan all week, we couldn't resist indulging in a little health care spending fantasy. So we asked our director Len Nichols how he might spend $700 billion.

Backpack? Of course. Lunchbox? Certainly. Shoes with wheels in the heel? Maybe. But health insurance? Definitely.

That's the message the Robert Wood Johnson Foundation hopes to convey as it kicks off its annual Cover the Uninsured Back-to-School Campaign with a report highlighting the importance of health insurance to children's health.

The study, conducted by researchers at the University of Minnesota, found that children with insurance were three times more likely to have visited a doctor in the past year and highlighted the importance of public programs like Medicaid and SCHIP for ensuring children's access to needed care. For example:

Birmingham, Alabama, has announced an ambitious program to cover the city's 5,000 uninsured children through a mix of public-private partnerships blending public funding, philanthropy and an arrangement with a local children's hospital planning a major job-creating and revenue-producing expansion.

The plan isn't a comprehensive solution to all the health problems in the state—Alabama ranked 42 in CQ's 2008 Health Care State Rankings—but screening and covering young people is a sensible step.

Mayor Larry Langford said the city will put up $150,000, and the Blue Cross Blue Shield of Alabama's Child Caring Foundation will match the funds. Eligible low-income children will be enrolled in Medicaid or the state's All Kids program; others will get care through the foundation, the Birmingham News reported.

"It's wrong that we allow these children to go unprotected. It's wrong that we make mothers and fathers worry every day about something as basic as health care,” Langford said.

Iowa this week took a big bipartisan step toward covering uninsured low-income kids, but without yet settling the question of how to pay for it. The Bush Administration last year vetoed bipartisan legislation aimed at expanding SCHIP (the State Children's Health Insurance Program) and issued regulations that make it harder for states to broaden SCHIP eligibility on their own. Slightly more than nine million of the nation's 47 million uninsured are children, and two-thirds of the children are eligible for either SCHIP or Medicaid, according to the Kaiser Family Foundation.

Still with a striking 97-0 vote, Iowa's House showed a commendable commitment to covering all kids by 2011. The state has also set a goal of covering kids and adults alike by 2013. The state House bill, similar but not identical to legislation that has passed the state Senate, would cost $30.8 million a year when fully implemented, according to the Des Moines Register.