Anchorage Daily News

The Bush administration has unfortunately begun clamping down states' ability to expand Medicaid, the government health insurance for poor people, The New York Times reported this month.

The feds in August put similar restrictions in place on states' expansion of the State Children's Health Insurance Program. Also known as SCHIP, the program serves children and pregnant women whose families are not so poor as to qualify for Medicaid, but are still low to middle income.

States were free to set their own eligibility rules before this. But the federal government can exert controls because it pays much of the cost of both Medicaid and the related children's coverage, known in Alaska as Denali KidCare.

The federal government's decision to put the squeeze on government insurance for lower and middle-income families needs to be reversed.

The children's health insurance program is America's best shot at getting health care to kids from working families that can't afford to buy their own policies for their children. They're caught in a gap. People earning a little less could qualify for free care. People earning a little more could afford to buy their own policies.

Everyone deserves basic health care. The children's insurance is popular, and the public accepts it. It likely saves money, by encouraging people to get preventive care, rather than waiting until a health problem blows up into an expensive disaster.

Alaska is not in any danger of hitting federal ceilings at the moment, but that's because we're doing only the minimum for children's health insurance. There are proposals to expand our program, including one to ensure universal coverage of Alaska's children, which could be thwarted by the Bush administration's misplaced priorities.

Under current Alaska rules, we allow families earning 175 percent of the federal poverty level into the free children's insurance program. Other states open theirs to families earning double the poverty rates, or more. For a family of four, 175 percent of the poverty level in Alaska is about $45,000 -- a modest income when you need to buy health insurance for your children. There isn't a lot left after the cost of basics, like housing, food, transportation and medical care.

Two Anchorage legislators, Sen. Bill Wielechowski and Rep. Les Gara, introduced a bill last year that would have allowed Alaska families earning up to double the poverty level to qualify for free children's coverage through Denali KidCare. Those earning more could buy coverage on a sliding fee scale.

With federal matching contributions, this would have cost Alaska about $600 per child, according to Rep. Gara. What an incredible bargain -- but the bill went nowhere.

Two things have happened over the past year that make it more hopeful Alaska's legislators will expand the children's insurance plan.

First, the national presidential elections have made it clear: Better and affordable health care are at the top of voters' agendas. Every candidate, regardless of party, has some sort of plan to offer.

Second, a health advisory council appointed by Gov. Sarah Palin has recommended upping Alaska's coverage to include children in families earning double the poverty level.

That help wasn't there last year.

Congress, which has supported covering more children under SCHIP, needs to persevere with that effort and overturn the administration's Medicaid restrictions as well.

And Alaska's legislators should go ahead and add not-quite-poor children to our own Denali KidCare coverage. Most states offer coverage for more children than Alaska does. Since the feds pay the majority of the cost, this isn't an area where it pays to lag so far behind.

BOTTOM LINE: Help out more working families with children's health insurance.

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