On the campaign trail, then Senator Obama set a course for universal coverage of children through the State Children’s Health Insurance Program (SCHIP) and opposed an individual mandate. H.R. 3962, as introduced by the House leadership, repeals the SCHIP program in 2014 and includes an individual mandate.
Moreover, the bill would send millions of young, healthy adults into Medicaid which will increase the cost of insurance for every one with private coverage because of the cost shift and “crowd out effect” associated with Medicaid.
The Pelosi bill not only diverges from the President’s policies but is inconsistent with itself. The individual mandate has been repackaged as “individual responsibility” that is enforced through a tax on those individuals without “acceptable health care coverage.” But H.R. 3962 actually makes it easier for a family to simply pay the tax and remain uninsured because under Section 305, any child born without “acceptable coverage” is automatically enrolled in Medicaid and will continue to be eligible for Medicaid at least for a year, regardless of family income.
How does an entitlement to Medicaid regardless of family income promote individual responsibility? Or, is this policy really one of the secret deals with the insurance companies that allows them to avoid covering high risk pregnancies and the first year of life which are generally more expensive than coverage of older children?