In response to Mr. Bill Sali's submission concerning SCHIP to the Idaho Statesman on March 19, 2008, I would like to clarify valuable points surrounding the MUST PASS SCHIP expansion and continuation. 

Although SCHIP is in dire need of financial support, we must first determine why the expected number of enrollees was not met.  When SCHIP was initiated and hit the ground running-the program failed to run.  Why?  Well, after working for a local low-income hospital and a community health center, the reasons were clear and here is what I know.  The State of Idaho did not allow SCHIP to be marketed through the State's Health and Welfare Department; nor did they allow Health and Welfare employees to openly share their knowledge of the program.  The burden of enrollment and education was placed on agencies already struggling financially, such as community health centers, hospitals, schoolteachers, homeless shelters, counselors, and through various grants.  All of these entities, might I point out, rely on federal and state funds.  Why not allocate the funds to Health and Welfare to manage their own federally awarded [and matched] program?  The obvious goal was, and has been met-to reduce the number of enrollees in order to discontinue the program.

To further educate the public on SCHIP, Mr. Sali pointed out in his recent publication, "2 million children the proponents wanted to add to SCHIP have private health insurance." Well, duh!  Most Americans/Idahoans do not realize SCHIP is granted flexibility in terms of allocation.  Over the course of SCHIP's life span, Idaho implemented different levels of coverage.  There was CHIP-A[ccess Card], which provided families with access to private health insurance, and higher income brackets, premium assistance.
 
"An eligible child qualifies for up to $100 a month in premium assistance.  Families of 3 or more eligible children may receive up to $300 a month.  Children in families whose income is between 133% and 185% of federal poverty guidelines may be eligible.  Parents are responsible for premium payments, co-pays, and deductibles." Idaho Department of Health & Welfare

The CHIP-A program assisted a single child family of three making $23,412 annually.  According to the U.S. Department of Health and Human Services and Idaho's Joint Economic Committee January 23, 2008 report, "the average premium for individual coverage was $5,254" in 2005.  Based off this number, the single child family of three making $23, 412 would take home $18,158 per year-with one member insured.  Now lets factor in one variable affecting every American's wallet-fuel.  Taking the same family and deducting one tank of gasoline ($3.06 x 13gallons = $39.78) for their economical car each week for an entire year, the proud family would have $16,089 to take home for food, utilities, rent, car insurance, life insurance, daycare, clothing, and entertainment.  Now how many Idahoans can afford to support themselves and two people off $1,340.75 per month with these reasonable expenses?  Not many.   

Additionally, SCHIP in Idaho had another tier of assistance.  CHIP-B, in 2005, cost "$15 per month for each eligible child" with the family being "responsible for co-pays on some services."  The program was designed to assist uninsured children "at or below 185% of poverty."  So considering the family of three (one child) mentioned before, at 185% of poverty the family would then be earning $25,896 annually.  Deduct the cost of one monthly $15 payment, one monthly $20 copay, and one $39.78 weekly tank of fuel-the family now brings home $1,950.62 per month.  Factor in the same reasonable expenses and this family cannot purchase a home, or a newer car for that matter.  

Now that we've outlined the details of Idaho's SCHIP program and how it affects a single child family of three, we must analyze the numbers provided by Mr. Sali in his publication.  Sali mentioned the average income of Idahoan's at $46,000 annually and this is also the national average.  The Census Bureau reported in 2004 11.5% of Idahoans are BELOW poverty levels.  This means only 11.5% of Idaho's population would need full SCHIP coverage.  The remaining enrollees would only need partial assistance.

Additionally, Sali referred to Pelosi's proposed eligibility income increase to $63,000.  Sali failed to identify the fact Federal Poverty Guidelines were designed by the Department of Agriculture's food budget in the 60's by a Social Security employee by the name of Mollie Orshansky.  The formula does not factor in inflation or cost of living increases or expenses.  In all truth, the guidelines only consider "the average dollar value of all food used during a week."  So, food consumption determines our child[ren]'s eligibility for SCHIP?  Now we are entering a whole new arena. 

To further support Pelosi's proposal, the very Federal Poverty Guidelines we speak of are separately calculated for Alaska and Hawaii due to mainland access and cost of living.  In other words, our Idaho family of three is comparable to Pelosi's home state of California when determining the level of poverty.  California's cost of living is much higher.  The average household income in California is slightly higher at $51,312.  The difference in average income is a tad more than the average premium for individual health coverage ($5,254 annually). 

May I remind you the SCHIP design is flexible by state.  So, if Pelosi identifies a need for higher incomes in the State of California, so be it.  Idaho's children should not divert to the emergency department for services or be denied coverage simply because of another state's need.  Frankly, Mr. Sali-did you know between 2004 and 2005, California had the largest increase (94,000) in SCHIP enrollment?  The need is there!  Sali goes on to further claim "700,000 adults are enrolled in SCHIP" while receiving "children's health care."  Again, Sali fails to publicize the flexibility of the federal funds at the state level meaning-some states chose to use excess funds to insure a small percentage of adults.  If we do the math, 700,000 adults is less than 1% of the total U.S. population.  Are we micromanaging the flexibility of the program to dilute the greater benefits, Mr. Sali?    

Mr. Sali also mentions the declining number of enrollees each year and this is odd he would mention this considering recent economic losses are mostly blamed on the Bush Administration.  The Kaiser Commission reports in a Medicaid and Uninsured report dated December 2006, "the rate of enrollment growth then slowed significantly due to declining state revenues during the economic downturn that led states to adopt policies restricting and reducing enrollment growth."  This further supports previous claims that our own Department of Health and Welfare was not permitted to increase numbers through referrals and education!  Again, federal expectations were met with decreased enrollment.

Where were we?  Oh, yes, now we must examine the Sali approach to politics and that is illegals are no-legals.  As SCHIP is managed through Department of Health and Welfare offices, state employees beg for simpler eligibility processes.  In case Idahoans are not aware, the Department of Health and Welfare is not a well-oiled machine.  We ask why, but money is always the answer.  Therefore, a proposal was brought forth to minimize the eligibility headache by using simple social security verification.  Sali states the use of Social Security numbers is "notoriously abused in employment" so therefore we shouldn't use them.  If this is the case, why must I have my social security card and number if it does not serve the purpose of identification?  Mr. Sali offered no other suggestions or solutions so now I ponder the purpose of his existence in Congress.  If I needed a reporter, I'd send Popkey for less money. 

This leads me to my final battle with Mr. Sali.  "The Democrats plan to pay for expanded SCHIP?" he questions.  Why yes we do.  From what it looks like, the Democrats are the poorer political party fighting for a large number of the population, or large districts of people, as the Declaration of Independence would call it.  The idea presented would be to increase cigarette and cigar tax.  Sali disliked this idea by claiming we would then need to boost the number of American smokers to support SCHIP, however, he failed to recognize the leading cause for pediatric office visits-ear infections.  The primary cause of "otitis media" is second-hand smoke.  By increasing the tax imposed upon smoking tobacco we are reducing the number of doctor visits for SCHIP children.  It is estimated "American's spend $5 billion on ear infections" each year.  If we consider half of those children's parents eliminate the exposure to second hand smoke, we have funded nearly 15% of the proposed SCHIP expansion.  Add on increased tobacco tax and we've funded over half the expansion. 

To conclude, I would invite Mr. Sali to do some more research on this topic and present us with some thought out ideas as opposed to reporting his inability to participate in Congress' efforts and failing to support America's children another day.  Although, it brings me great satisfaction to know Mr. Sali is covered.  I mustn't loose sleep over that dilemma any more. 

Respectfully, to the future politicians of our great nation,

M. Jane Zirnheld
Canyon County Democrat

The Canyon County Democrats are fielding seven highly qualified candidates in the 2008 elections.  See candidates-state for legislators and candidates-local for county commissioner.

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