Patrick denounces limits on children's healthcare program

Governor Deval Patrick yesterday called on President Bush and Congress to revoke new rules he said would deny health insurance to thousands of Massachusetts children and hurt the state's effort to provide coverage for all its residents.

The restrictions imposed by the Bush administration are "dumb" and would "weaken, if not kill" the State Children's Health Insurance Program, Patrick said. The national program, funded jointly by the state and federal governments, covers 6.6 million children nationally and 90,500 in Massachusetts.

"It's a step in the wrong direction and has to be prevented," Patrick said at a news conference at the Martha Eliot Health Center in Jamaica Plain.

At the same event, Senator John F. Kerry announced that he and Senator Edward M. Kennedy had introduced legislation on Thursday to overturn the new Bush administration rules, which would likely restrict the program to children in families with lower income than Massachusetts and 17 other states currently enroll. Although other governors have also criticized the new rules, prospects for the legislation are unclear, because Bush is expected to veto it.

"This is a fight for our fundamental values," Kerry told the crowd gathered in the lobby of the health center. "We are going to get these policies turned around."

Both the Senate and House have already passed bills to expand funding for SCHIP by billions of dollars, and allow enrollment of children from higher income families. But Congress has yet to resolve differences in the bills, and Bush has threatened to veto any expansion, saying he wants the program to focus on the poorest children. Authorization and funding for the program is scheduled to run out at the end of this month.

Yesterday, a Bush administration spokesman called Patrick's comments "unfortunate."

"The SCHIP program has been a significant success in providing health coverage for low-income children across the nation," said Jeff Nelligan, a spokesman for the federal Centers for Medicare & Medicaid Services, known as CMS. "The focus of CMS, and the core purpose of SCHIP, is to take the poorest of kids and kids without insurance and move them to the head of the line."

The program serves families like that of Myrca Augustin, a 27-year-old single mother of four children, ages 3 to 8. Augustin works two jobs as a nursing assistant but can't afford the health insurance offered through one of those jobs. "I'm just over broke," she said.

Without SCHIP, she said, she would find some way to get her children healthcare, but "it would be a very big struggle." Her expenses include tuition at Bunker Hill Community College, where she is taking classes in the hope of getting a better job.

As part of healthcare reform, Massachusetts expanded SCHIP eligibility to children in families earning up to 300 percent of the federal poverty level, or $61,950 for a family of four. The change was made last year with federal approval and brought coverage to about 14,000 additional children. The program serves children whose families make too much to qualify for Medicaid but cannot afford private insurance.

Federal officials say the new federal rules would not affect anyone already in the program. But the rules would make it extremely difficult for most states to enroll more children above 250 percent of poverty. Massachusetts officials said they do not know how many children in that income bracket are eligible but not enrolled.

The rules are also designed to ensure that the program is not substituting for private insurance. Patrick protested two provisions in particular yesterday, one that requires children to be without insurance for a year before becoming eligible and another that requires the state to show that the number of children insured through private companies has not dropped more than 2 percentage points over the previous five years.

"These rules will inevitably lead to delays in care for many children, and would also discourage families from enrolling in SCHIP altogether," Patrick said yesterday. "Many parents will be forced to bring their children to emergency rooms, driving up the cost to the system as a whole."

If the rules aren't reversed, he said, "we will be forced to deny coverage to thousands of children."

Asked whether the administration was willing to buck the federal government and fund the program entirely with state money, Patrick said, "We'll cross that bridge when we come to it."

Alice Dembner can be reached at Dembner@globe.com.