MH Parity Mandate Added to SCHIP, Giving More Children Access to Care

The impact of the change in SCHIP is significant because research has found that while low-income children have much higher rates of mental illness than those in higher-income families, only about 40 percent of states offer full coverage of necessary services for children with complex psychiatric illnesses. Up to 20 percent of children and young adults may have a psychiatric illness at any given time, according to the Department of Health and Human Services, which estimates that the number of affected youth is between 7.7 million and 12.8 million. The department also estimates that two-thirds of all youth with mental illness are untreated. These children are at higher risk to fail at school, have poor employment prospects, have contact with the juvenile justice system, and are more vulnerable to suicide, according to David Shern, Ph.D., president and CEO of Mental Health America.

“Mental health care is a critical component of the range of services that children need for healthy development,” Shern said in a written statement.

Opponents of the measure included former President George W. Bush, who twice vetoed nearly identical measures to expand SCHIP in 2007. Bush, like many other opponents, argued that the expansion would bring many privately insured children under the federal program, in part, because it provides federal matching funds for children from families whose income is up to 300 percent of the federal poverty level and are likely already insured. Some estimates have put the number of such children at about 2.4 million.

Many Republicans also complained that the measure expands coverage to include legal immigrant women who are pregnant and up to 600,000 children of legal immigrants. The previous law had set a five-year wait before children of legal immigrants could qualify for SCHIP coverage. Citizen children of illegal immigrants are eligible for SCHIP; however, illegal adult and child immigrants are eligible only for emergency care under Medicaid.

Democratic leaders countered that most Americans support SCHIP expansion and that it has become increasingly important as the economy worsens and more people lose their jobs.

Critics also objected to the expansion being funded by a 62-cent increase in the federal excise tax on cigarettes, which brings the total federal excise tax to $1.01 a pack. Opponents said cigarette taxes should go to smoking-cessation programs, not children's health care.

The federal funding for the program was set to run out on March 31, but the new law extends federal support for five years.

The SCHIP bill can be accessed by searching on HR 2 at<http://thomas.loc.gov>.▪