My second health insurance access policy concern is the delay in the reauthorization of the SCHIP (State Children's Health Insurance Program). Here again, the House and Senate and President agree on the continuance of this program; but again, the differences lie in the details.

The SCHIP was implemented in 1997 and was slated to run for ten years. The purpose of the SCHIP is to provide health insurance to children who do not meet the poverty level qualification for Medicaid, but whose parents still can not afford health coverage for their children. It is "gap" insurance for millions of children, and is a joint program run by the states with federal revenue.

The reauthorization bill for the SCHIP has gone before the president twice, and has been sent back twice. Veto-override has not occurred either. The president has made it clear that he will reauthorize the SCHIP program, but he will not expand it beyond adding additional federal monies. (In its first ten years, the SCHIP program expanded to provide coverage for adults, as individual states were allowed to extend access to insurance resources once the children at the 200 percent level of poverty were covered first.) In my opinion, the SCHIP is undergoing growing pains, and it does require some reform before its reauthorization; however, if the program is intended for children then it would seem that maintaining its intended purpose would be the core issue. I do feel it is a hard line to draw when it comes to anyone who is uninsured, particularly as parental health is essential for quality of living for all families. How far to expand the program is holding up passage, and meeting the intention of the program no longer seems to be the priority.

The more I understand politics, the more I understand that reform occurs in steps. Government-sponsored insurance like Medicaid and Medicare (as we know them today) are outgrowths of over thirty years of bill debates originally stemming from the Social Security Act of 1935 under President Roosevelt. Further, the formal passage of Medicaid and Medicare occurred only as recently as forty-two years ago as part of the Social Security Act Amendments of 1965. Aid to the disabled under Social Security began as far back as 1956, but its inclusions are now of greater overall benefit.[1] The addition of a prescription drug plan benefit for Medicare passed in December 2003 (the Medicare Prescription Drug, Improvement and Modernization Act [MMA]) but only went into effect on January 1, 2006.

The Iowa caucuses will be upon us next month, and our attention will (and should) be on many issues as America decides its leadership. In the meantime, taking part in the discussion (and contacting our representatives in the House and Senate) regarding these two policies of insurance accessibility still requires our attention. These politicians hold their offices because we elected them. They are to be our voice on the hill. Is your voice represented in the meantime?