Opinion

That's the problem: President Bush suggests uninsured children go to hospital emergency rooms for their care President Bush suggests uninsured children go to hospital emergency rooms for their care.

After the Senate Finance Committee approved an expansion of the federal Children's Health Insurance Program to cover nearly 10 million kids, President Bush offered a strange rationale for threatening to veto it.

"People have access to health care in America," he told an audience in Cleveland. "After all, you just go to an emergency room."

As any executive of a Houston hospital can attest, that is precisely the problem created by the high number of uninsured people in the United States. Texas has the highest rate of uninsured children in the nation, and Harris County the highest in the state. Those who lack insurance coverage frequently delay seeking medical care until they are seriously ill. Then they swamp hospital emergency rooms that are required by law to treat them even if the patient has no ability to pay.

Since emergency care is far more expensive than a scheduled visit to a doctor or clinic, hospitals wind up with large costs that they then pass on to insured patients using their overtaxed facilities. As a result, insurance companies raise their rates ever higher to cover the increased payouts, making their policies too expensive for more working families. The result is a health care system spiraling out of control and more children left unprotected and in poor health.

The senators who voted 17-4 to expand the S-CHIP understand the situation. Their plan would boost funding for S-CHIP from $25 billion to $60 billion for the next five years with the aim of covering 3 million more children. The measure would provide a uniform eligibility level of three times the poverty line for a family with four children, $51,510. The increase would be primarily funded by a steep hike in federal taxes on cigarettes and other tobacco products

The Bush administration insists on holding the increase to $5 billion over the five year period, a level that U.S. Sen. Charles Grassley, R-Iowa, said would not even maintain the current number of children enrolled.

Administration officials claim that expanding the program would undermine the insurance industry. But having more children insured would lower costs passed on to private insurers and employers.

Perhaps the most dubious reason cited by the White House for opposing the increase concerns the tax hike on cigarettes, which would go up from 39 cents a pack to a dollar. According to spokesman Tony Fratto, it would unfairly penalize the poor "to finance a new subsidy for the middle class." He didn't mention that higher tobacco taxes would likely reduce teen access to cigarettes and lower the health care costs of treating millions of Americans for respiratory disease and cancer caused by smoking.

America's health care system is broken. Expanding S-CHIP is a stopgap measure that would expand the number of Americans with access to health care.