When I first heard the Democrats’ proposal to increase the number of children covered (from 6.5 to 10 million) at a cost of $50 million (later, reduced to $35 million), I expected to hear more details regarding why these enrollment and funding levels were desirable, or necessary. My expectations were never met! In fact, there was a strange lack of curiosity, on the part of both healthcare providers and the media, regarding how these lofty goals were established, and why.

I knew that , in 1997, SCHIP was intended to cover families with incomes too high to qualify for Medicaid. SCHIP enrolled more than 6 million low-income children, at a cost of about $5 billion per year. That works out to total expenditures of $50 billion to cover 6.5 million kids for ten (10) years. The Democrats’ proposal was to spend an additional $35 billion, over five (5) years, or an additional $7 billion per year, raising yearly expenditures to $12 billion per year. The additional money would come from increasing the federal tax on cigarettes (a seeming “horn of plenty” for money to fund new programs). Also, the 3.5 million new enrollees included some families who already had private health insurance. About a quarter of the states spent the majority of SCHIP funds to cover adults, not children. Most states had not enrolled but a fraction of the low-income families who qualified before any expansion of eligibility.

So, with the above facts known (or available), what justified the $35 billion for up to 10 million kids? More important, why pick such huge increases (more than doubling yearly expenditures) and why sweep in families known to already have health insurance? My theory is that the levels were selected to ensure a veto! Approaching an election year, the Democrats were willing to put the healthcare of millions of poor kids at risk in order to create a phony issue for the next election. Speaker Pelosi and Majority Leader Reid were quick to castigate President Bush, and the Republicans who voted against overriding the veto, as not caring about children. The rhetoric surrounding both vetoes was scalding, with promises that Republicans who voted with the administration would be sorry, and they would be held accountable during the next election.

But, I may be mistaken. Tell me again about why we need $35 billion and 10 million kids??? Any other plausible theories that fit these events?