With SCHIP Veto, Many APA Children May Be Left Behind
Can Congress override the president's veto to save the popular children's health coverage program?
For Sherry Hirota, health is a family affair. Her Oakland-based community health center provides medical care and insurance counseling to thousands of underserved Asian Pacific American families - most are uninsured when they first walk through the doors looking for help.
Access to health care services is key to healthy families, but it's also a matter of life or death.
Hirota, the chief executive officer of Asian Health Services, has seen countless patients walk in for first time care with the ravages of life-threatening illnesses firmly established.
They get diagnosed with diabetes and many other treatable diseases too late, said Hirota.
In a working class family, what choices do they have? Many of Alameda County's APAs are small business owners who can't afford private health insurance, so AHS has been fighting since 1973 to bridge the gap and save lives.
This month, their jobs became more difficult when President George W. Bush vetoed a bipartisan bill to extend the State Children's Health Insurance Program (SCHIP), a federally funded health insurance program for children of families who fall into the bureaucratic limbo of making too much money to qualify for Medicaid, but not enough to buy private health insurance.
"Asian Americans make up a big portion of the uninsured and will be greatly affected by the absence of SCHIP," said Hirota.
A Historic Veto Override?
SCHIP was created in 1997 to help curb the increasing number of children with no health care coverage. They come from families that work hard to make ends meet. Many have full-time jobs that can only pay for basics like food and housing. For these families, affordable health insurance is a pipe dream without programs like SCHIP.
The program currently costs $5 billion a year and provides coverage for 6.6 million kids 18 years old and younger. Since its inception, the number of uninsured children in the APA community has dropped from 18 percent to 8 percent in 2004, according to a study by Families USA.
AHS has about 1,300 children insured in the Healthy Families Program, the California version of the SCHIP.
"We did some studies in Alameda County and found that immigrants, who make up a high portion of the APA population, lack coverage. These are working class people who are not eligible for Medicaid, so SCHIP was a good fit," said Hirota.
At one point 100 percent of the clinic's children were insured.
"That was fabulous," she said.
Then the money problems began. New estimates from the Center on Budget and Policy Priorities show that 14 states face federal funding shortfalls this year for SCHIP. Though the program officially expired Sept. 30, some states have had to dip into emergency funds to maintain enrollment and care.
Congress had already passed legislation to reauthorize and expand the program by adding $35 billion over five years to cover an additional 4 million children. Increasing the federal cigarette tax from 61 cents to $1 per pack would have funded it.
Though the president said he opposed the expansion because it moved the country a step closer to government-run health care, APA leaders called the veto a blatant disregard for low-income children.
"We sent him a bill that costs $19 million a day to protect American children and he vetoed it. In the meantime, the president is burning through $720 million a day in Iraq," said Rep. Mike Honda in a statement. "The president seems confused about the meaning of fiscal responsibility."
The SCHIP expansion bill was only the President's fourth veto. With the House reconvening Oct. 18, a possible veto override could make history as the first in Bush's career as president.
The Senate approved the increase by a veto-proof margin, but the House fell about two dozen votes short of a two-thirds majority, according to the Associated Press.
Many APA groups say SCHIP's only hope lies in the hands of House members - a reality that is striking fear in many APA families.
'I've got mine, you worry about yours'
AHS hosted a townhall meeting Oct. 11 in Oakland to discuss heightened concerns about health access. At the meeting, concerned parents and community members talked openly about their fears for the future.
One AHS client, a mother of three, talked about falling between the cracks of health care. Ironically, she is a health care provider herself whose employer provides coverage to her, but not her children. Recently, she discovered she makes too much to qualify for the SCHIP program's sliding scale, said Tina Diep of AHS.
"It's a nightmare for her," said Diep.
With so much at stake for APAs, the statistics belie a grim truth - and the culprit is, once again, the Model Minority Myth.
In the Japanese American community, there is a lower uninsured rate, but "there is a lot masked in much of the data," said Rea Pañares, director of the Minority Health Initiatives with Families USA.
Under the APA umbrella, subgroups with large immigrant populations like Korean Americans and Vietnamese Americans have a large percentage of uninsured. Compared to other minority groups, some APAs have higher incomes and higher education levels, which leads to the misperception that APAs face fewer barriers in accessing health care.
But that myth is far from reality.
Recent U.S. Census reports indicate that overall 15.5 percent of APAs and about 21.7 of Native Hawaiians and Pacific Islanders are uninsured.
"We shouldn't be misled that Asian Americans are well served by our nation's healthcare system," said Floyd Mori, JACL national director.
In the wake of the president's SCHIP veto, the JACL issued an action alert to urge House members for an override.
"Newer immigrant communities and their children, who find it difficult to afford health insurance as well as the hard working middleclass of Asian Americans, who also lag in access to health insurance, would see great benefit from SCHIP. We in JACL need to avoid the 'I've got mine, you worry about yours' mind set," added Mori.
President Bush has said he would compromise on funding the SCHIP program, but not up to the $35 billion Congress had initially passed.
But the bill's proponents say any less would not be enough.
"It's really a no-brainer," said Hirota. "It's for our children."
UPDATE
The House of Representatives on Oct. 18 failed to override President Bush's veto of the SCHIP expansion bill.
The House vote was 273-156, short of the 289 needed to override the veto.
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