Marian Wright Edelman

With 9 million children in America lacking health insurance and reauthorization of the State Children’s Health Insurance Program (SCHIP) pending in Congress before it expires September 30, this is a pivotal year for our children’s health and well-being.

Despite his pledge to provide children — including those affected by Hurricane Katrina — the care and protection they require and deserve, President Bush’s budget proposals would reduce health coverage for millions of children and hamper SCHIP’s capacity to reach those children who lack a health care safety net.

SCHIP requires a significant increase in funding. This highly successful program has provided health care coverage to millions of children over the last 10 years and reduced the number of uninsured children by one third. Ninety percent of those children belong to working families earning too much to be eligible for Medicaid, but not enough to afford private health insurance when their employers do not provide it.

The proposed White House budget for SCHIP of only an additional $4.8 billion won’t be enough even to continue to cover the children enrolled in the program now. It would do nothing to include the 5 million to 6 million children currently eligible for but not enrolled in SCHIP and Medicaid, and nothing to help the 3 million children left behind who are not eligible for any public health coverage.

President Bush has said, “When it comes to health care, government has an obligation to care for the elderly, the disabled and poor children, and we will meet those responsibilities. For all other Americans, private health insurance is the best way to meet their needs.” What’s disturbing about that statement is that there is little evidence that private insurance — a business based on making a profit — has any incentive to cover children living in families caught in the middle who are “health care-poor.” It is also unclear how Health and Human Services Secretary Mike Leavitt’s focus on improving the efficiency of the health care marketplace will advance preventive health care or cover hospital stays and medicine for sick children.

As in other areas of crucial social policy, to even the playing field for America’s poor and minority children and families, the Bush administration is pursuing a child health privatization agenda following the president’s vision of an “ownership society.” I believe this is simply another way of saying, “You’re on your own.”

President Bush believes that “a government-run health care system is the wrong prescription,” yet among the choices of providers under SCHIP, government programs are more cost-effective than private plans. How can a family of four with a $50,000 annual income afford an average of $1,000 per month for private health insurance? President Bush’s answer: “Many working Americans do not have health care coverage, so we will help them buy their own insurance with refundable tax credits” or a standard tax deduction.

Regrettably, President Bush is missing reality. Even with a $5,000 tax credit, private insurance would still be out of the reach of many families. Tax cuts will not help these moderate- and middle-income families keep pace with the skyrocketing costs of health care. If Mr. Bush has his way with tax cuts, more children will lose coverage.

In addition to its flawed approach to tax cuts, the Bush administration is sabotaging the formulation of sound child health care policy by presenting figures that dramatically undercount the number of uninsured children in America. And administration officials and surrogates have resorted to scare tactics by raising the specter of higher taxes, health care rationing and the elimination of choice in health care providers. They suggest that fully funding SCHIP to cover all children would be the beginning of a total government takeover of America’s health care system.

Another bogeyman is the prospect of expanding government programs — as though this would be more harmful than permitting youngsters to die or letting sick children get sicker. With his own submission of a $2.9 trillion federal budget that spends tens of billions on war and includes massive tax cuts for the rich, President Bush’s claim to be committed to reducing the size of government rings hollow.

Mr. Bush needs to exhibit positive leadership on child health care. At stake are the lives, health and educational futures of millions of children. There are too many children who are chronically ill, and many of them are at risk of death without health care. Children sit in classrooms every day unable to learn, read or pay attention to the teacher because of undiagnosed health and mental health problems.

Children are the most cost-effective group to insure in this country. Health care is one of the most basic human rights that any society can provide. It is also one of the most important investments this country can make in its future. Tell Congress and the White House to ensure health coverage for all children by calling 1-800-861-5343 or visiting www.childrensdefense.org.

Marian Wright Edelman is president of the Children’s Defense Fund and its Action Council.