A cruel blow

THE ISSUE

President Bush has twice vetoed expansion of the State Children's Health Insurance Program even though it has support among many of his fellow Republicans, and the number of uninsured in the United States is growing.

It's not likely that more children will be covered by health insurance in the coming year under a federal-state partnership that President Bush and some of his congressional allies deem too expensive. In Alabama, there could be cuts in the number of children now covered because of state budget concerns.

The State Children's Health Insurance Program, commonly referred to as SCHIP, received just enough money from Congress recently to continue in a flat-funding mode for another year. Democrats and some Republicans had hoped to expand coverage through a tobacco tax that would create a $35 billion price tag for the expanded coverage. The reliance on a tobacco tax is part of the problem, but we have to wonder at the administration's resistance to providing health care to more children.

The usual flak about "socialized medicine" has surfaced in the course of the funding debate, though the Medicare health insurance most retired Americans rely upon certainly qualifies as such under that dubious moniker.

Critics say expanding SCHIP to families with incomes of $40,000 and more undermines the intent of the program, which is to provide medical coverage to poor children. But that argument doesn't hold water. The average cost of family health insurance has reached almost $11,000 a year, according to a survey by the Kaiser Family Foundation. That is beyond the financial capabilities of most middle-income families. And the number of companies offering health insurance coverage to employees and their families is shirnking. Only 60 percent of U.S. companies offer coverage today, compared to 69 percent in 2000. Most of those offering coverage to employees have at least 200 or more workers, according to the bipartisan National Coalition on Health Care.

Relying solely on a tobacco tax to fund the expansion of SCHIP is politically naive and financially risky. Besides, if one of the goals of the federal government is to encourage people to stop smoking, this seems cynical. And if fewer people are using tobacco each year, well, funding will fall short.

But that doesn't mean expanding SCHIP should be abandoned. Some compromise on funding is in order, and some sobering reality checks about the affordability of health care in America are mandatory for lawmakers - especially Republican lawmakers.

The United States is becoming a nation of haves and have-nots where health care is concerned, and that's unacceptable.