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Tuesday, July 24, 2007

Children's Health Insurance Debate: Did Bushies Lie About Number of Needy Kids?

COLUMBUS (TDB) -- President Bush vows to veto a bipartisan move in Congress to expand the federal Children's Health Insurance Program, and now there is a report that says the White House has vastly underestimated the number of U.S. kids who need coverage. In fact, the report says the Bush Administration claims there are only 4.9 million uninsured kids in America, a number seriously at odds with Census data, which puts the number at 9 million.

In other words, there is a multi-million kid gap, according to the Kaiser Commission on Medicaid and the Uninsured, which describes the White House as cherry-picking data to make its case against expanding the program. (Imagine that: The White House accused of manipulating data to make its case. Does that sound familiar to anybody?)

The Kaiser Commission raised concern about the White House numbers in a FAQ that addresses what it calls key questions about the current debate, and one of those key questions was about the number of American kids who lack health insurance. Here's Kaiser's take:

"Census data reports that there were approximately 9 million children under 18 without health insurance in 2005. Many researchers recognize that the Census data under-estimates the number of individuals covered by Medicaid. Peer-reviewed literature suggest that after adjusting for the under-count, there were about 8 million children without insurance at a point in time during 2004. Of the 8 million uninsured children, about two-thirds are estimated to be eligible but not enrolled in Medicaid and SCHIP.

"The Administration released estimates in June showing 4.9 million uninsured children. These figures are much lower than the 8 million estimate because they represent children who are uninsured for the entire year. Insurance coverage is not static and there may be more children without insurance over the course of a year than uninsured for the entire year. The methodology these estimates used to adjust for the Medicaid under count overstates Medicaid enrollment (resulting in participation rates over 100 percent in some states, and results in an under count of the children remaining uninsured."

Kaiser said the Congressional Budget Office, which is non-partisan, uses the Census estimate to calculate "a higher number of uninsured children" than the White House.

So the old bugaboo that has dogged the Bush Administration since the run-up to the Iraq invasion has cropped up in the CHIP debate -- once again, it stands accused of massaging data to fit the president's political position.


  1. Sounds more like Kaiser is using a broad definition to spin their point, and the Administration is using a narrower definition to spin their point. Nothing new in either case. Kaiser wants government to pony up for 3.1-4.1 million kids that would otherwise be covered by existing plans, thereby exacerbating (purposely) the same crowding out effect seen with SCHIP since '97. Bush at least is giving a hat tip to the same market forces that saved the gov't billions in their Medicare Part D white elephant.

  2. Joe --

    You have brought some needed analysis to bear on this. But I do think the W.H. wanted to make a case that there are fewer uninsured kids than many believe. That buttresses their case against spending more on the program. However, the bipartisan consensus seems to be growing in the legislative branch that CHIP is worthwhile and needs to grow. Bush might have been able to jump in and seize that position, a la Clinton and welfare reform, or play some role in shaping things more to his liking. But it appears he could only object. Now it looks like the train is going to pass him by even if he stands on the tracks waving.

    Maybe the W.H. will prevail? But how? I don't think that floating numbers that few find useful is going to help make the president's case. I think it does damage.