S-CHIP Spin: Taxes and Illegals

The State Children's Health Insurance Program (S-CHIP) saga keeps getting more complex, with the llatest news that the White House wants to keep states like New York from raising the eligibility ceiling for the program. Though the White House thinks that S-CHIP is a problem because it may replace private insurance for some, that's not Randy Kuhl's position.

The last post on the (S-CHIP) dealt with Randy Kuhl's charge that it will cut Medicare benefits. Kuhl also says that the bill will "increase taxes on private health insurance policies, and make it easier for illegal aliens to get government-funded healthcare." Like the Medicare charge, there's a grain of truth in that spin, but it's fundamentally wrong.

The tax increase that Kuhl crticizes amounts to roughly $1/year for each insured person. That dollar will be used to fund research into the effectiveness of drugs, devices and treatments. Even the private insurers agree that the research is a good idea - they just argue about how to fund it.

The concern over illegals getting Medicaid is a result of S-CHIP's repeal of the requirement for documented proof of citizenship for all Medicaid recipients. Again, there's more here than meets the eye.

Before the Deficit Reduction Act (DRA) of 2005, states weren't required to collect documented proof of citizenship for Medicaid recipients. In the run-up to the DRA, the Health and Human Services Inspector General recommended [pdf] some common-sense methods for states to better document the immigration status of Medicaid recipients. In the DRA, Congress went far beyond those recommendations. It mandated the use of hard-to-get documents, and made that requirement an up-front one.

The result was a mess. A report study in one state (Virginia) [pdf] showed that the requirement mainly caused more cost in the program and delays in getting health care. Most important: emergency room visits, the most expensive way to provide care, went up after the DRA requirements were enacted. Administration costs for Medicaid also went up, because applicants needed help getting documents like certified copies of birth certificates, which cost $25-50.

In the DRA, Congress didn't do its homework before writing legislation. New York is the only state in the nation that's had a long-term policy of verifying citizenship status for Medicaid recipients. The Kaiser Family Foundation has issued a report [pdf] showing how New York is able to do a decent job of verifying citizenship while still getting people enrolled. To pick one glaring example, New York automatically enrolls newborns without further checks, since a baby born on US soil is a US citizen.

The DRA requirements are a classic example of "sounds good" legislation that doesn't work. If the S-CHIP repeal of those requirements is signed into law, Congress needs to go back to the drawing board to find a practical, workable solution to the issue of illegals getting Medicare.

Of course, this lengthy explanation is a lot harder to understand than the one-liners in Kuhl's press release. Kuhl is facing the accusation that he doesn't want to insure children. His spin -- he's protecting seniors, keeping taxes on insurance down, and keeping illegal immigrants from getting benefits -- sounds good, but doesn't hold up under scrutiny.


Kuhl couldn't care less. This is all about campaigning for votes. Voters that are more likely to vote for him are seniors from the southern tier. Anyone young, has left the southern tier, or is a democratic voter up in the rochester area. Once again, this is about him protecting his southern tier, base which is aging, rather than younger people who care about this. Just another way to make this North vs. South.

The Southern Tier (with the exception of this writer) is not as aged as you might think. The Corning area houses in my estimation the most powerful company in the 29th - Corning Inc. Because of this, the area is full of young college graduates of all types of races, religions, sexual preferences, etc.

My oldest child lives in Pittsford, so I read the D&C on the average of 4 times per week. It seems like just a few months ago they did a front page story on Sunday of all the young people leaving Monroe County for better opportunities elsewhere.

My 24 year old daughter who is a young professional and lives in Pittsford is a solid Republican. My 21 year old son who lived in Irondequoit for 18 months is also solidly Republican.

If you have facts on what you said, please point me to the web site(s). If not, I feel you are just stating your "gut" opinion about where the old and young people live and who they'll vote for.

While thank God for the relatively cosmopolitanism which Corning, Inc. has spurred in the Southerntier, make no mistake. Population continues to leak and yes, it is an advancing-in-age demographic.

The only "hard fact" I know is that the 29th as a whole is older than the average for NY and the US. This is based on 2000 census data reviewed for some posts last year.

Since I, too, think the Southern Tier is a bit older than the Rochester suburbs, I'll see what I can dig up to confirm or deny that view.

And, from the polling data I've seen, younger people nationwide are trending Democratic rather than Republican. But, again, I don't have specific data for the Southern Tier. I don't think that registration information is kept by age, so the only way we'd find this out is by making some assumptions looking at the new registrants in the 29th. So, we'll probably never know that one with a great degree of certainty.