Republican vice presidential nominee Gov. Sarah Palin styles
herself as a fierce protector of children and families, but her record on
health insurance for children and pregnant women raises doubts about her
In her acceptance speech at the Republican National
Convention, Palin had a special message for the parents of children with
special needs: “I pledge to you that if we are elected, you will have a friend
and advocate in the White House.”
During last night’s vice presidential debate, Palin promised
to make special needs children one of her top three priorities, if she is
elected. She also told the audience that she and her husband know what it’s
like to raise children without health insurance.
“[There were times] in our marriage in our past where we
didn’t have health insurance and we know what other Americans are going through
as they sit around the kitchen table and try to figure out how are they going
to pay out-of-pocket for health care? We’ve been there also so that connection
was important,” Palin said.
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Yet for all her folksy winks and jokes about hockey moms,
Palin’s record as governor suggests that she may not remember the bad old days
as clearly as she claims.
As governor of Alaska,
Palin could have restored health insurance to 1200 Alaskan children and 530
pregnant women for less than one million dollars at a time when her state had a
$1.3 billion surplus. She did not do so.
Republican presidential nominee John McCain has a similar
record of hostility towards government run health insurance for low income
children. When Democrats proposed in 2007 to expand the State Child Health
Insurance Program (SCHIP) to cover 10 million more children, McCain voted
against the plan and praised President Bush for vetoing the bill.
By contrast, Democratic presidential nominee Sen. Barack
Obama and Sen. Joe Biden supported attempts to renew and expand insurance
through SCHIP, the federal program that pays 70% of the cost of state-run child
health insurance programs across the country.
SCHIP is credited with reducing the number of uninsured
children in the United
States by 2.7 million from its inception in
1997, despite rising unemployment and poverty levels.
In 2008, Palin had the opportunity to increase access to Alaska’s SCHIP program,
known as Denali KidCare, a program for families who make too much to qualify
for Medicaid but cannot afford private insurance.
Gov. Palin has been in office for less than two years. Her
track record on children’s healthcare is short; however, her failure to act on
child health insurance is very revealing. Despite significant public pressure,
Palin declined to support the bill that would have extended medical coverage to
an additional 1200 children and 530 pregnant women for a mere $875,000.
Palin claims to be an advocate for children with special
needs. Poor children are at heightened risk of disability and chronic illness.
So, any policy that pushes healthcare out of reach of low income families is a
double whammy for those with special needs.
The fight over Denali KidCare is about how poor you have to
be to qualify. The program originally covered children whose families made up
to 200% of the federal poverty level.
Under Gov. Frank Murkowski, the threshold was cut back to
175% percent of the federal poverty level. Eligibility was frozen at the dollar
figure that constituted 175% of the federal poverty line at the time the law
was signed with no adjustments for subsequent inflation.
These changes, spearheaded by Republicans in the state
legislature, took health insurance away from many lower middle class families.
By the time Palin took office, the effective cutoff was
about 150% of the current federal poverty guideline. During her first year in
office, the governor quietly signed a bill to unfreeze the eligibility
threshold, which meant that the the maximum income in 2008 would be 175% of the
federal poverty guideline for 2008, not 175% of what the poverty line was in
2003. In 2003 the federal poverty guideline was $23,000 for a family of four,
which meant the family could earn up to $40,250 and still qualify for benefits. Five
years later, the FPG had risen to $26,500, but the maximum income was still $40,250,
a mere 151% of the FPG.
Palin had little choice but sign the bill, because Alaska stood to lose SCHIP
funding for the entire program if the threshold fell below 150% of the 2008 poverty
Children’s healthcare advocates welcomed the measure as a
small step forward. But even after unfreezing, Alaska’s SCHIP rules are among the most
restrictive in the nation.
In the second year of the Palin administration, State Sen.
Betty Davis introduced S.B. 212, a bill to restore the original 200% threshold
for Denali KidCare.
The bill had the support of a broad coalition of health and
social services groups. Planned Parenthood, Catholic charities, faith based
organizations, and the AARP found themselves on the same side of the Denali KidCare
Two hundred people rallied in Anchorage in support of the bill, a massive
turnout by local standards.
The bill passed the Senate and cleared all but the final
committee in the House.
Palin had a golden opportunity to restore health insurance
to 1200 Alaskans for less than a million dollars. All
she had to do was pick up the phone and convey her support, or even her
acquiescence to undecided state legislators.
The fence-sitters were looking to the governor for
reassurance, according a Juneau
lobbyist who pushed for the bill. (The lobbyist asked not to be named because
of agreements with unrelated clients not to be quoted in the media.)
These legislators were under intense pressure from
conservative Republicans and they wanted reassurance from Gov. Palin that she
would sign the bill. Members didn’t want to cash in political capital for a
bill that the governor was going to veto anyway.
Palin failed to act and the bill died in committee. It is
not clear why the governor opposed extending health insurance to poor children.
Some observers speculated that Palin let the bill die because the program
The state of Alaska
does not cover most medically necessary abortions. Therefore, Denali KidCare is
an important source of funding for uninsured pregnant women seeking to
terminate their pregnancies.
Before receiving the vice presidential nomination, Palin had
promised to hold a special legislative session this fall to debate two abortion
bills. Denali KidCare hoped to get their 200% solution on the agenda during the
special session. With the governor off on the campaign trail, it is doubtful
that a special session will be held any time soon.
Palin’s attitude towards health insurance for poor children
is in step with that of her running mate, Sen. John McCain.
When the SCHIP program was set expire in 2007, McCain voted
against a Democratic-backed bill that would have reauthorized and expanded the
At the time, McCain said he opposed the bill because he didn’t
want to raise the federal excise
tax on cigarettes to pay for expanded coverage.
McCain is on the record as opposing expansion of SCHIP to
cover middle class children, which he believes would be a departure from the
program’s original intent.
SCHIP is designed to help families who make too much to be
covered by Medicaid, but not quite enough to buy their own health insurance.
Because health insurance costs have increased much faster than incomes since
the program started in 1997, the target group is getting larger because more and
more people are getting priced out of health insurance.
Democrats in Congress twice failed to achieve a veto-proof
majority for the enlarged SCHIP plan. President Bush vetoed the bills, which
would have extended health coverage to 10 million children. Congress eventually
passed Bush’s stopgap bill which funds the existing SCHIP program through March
It is interesting to note that McCain supports enhanced
medical insurance for embryo-Americans but not for born children. The Arizona senator voted
for a bill to extend SCHIP coverage to fetuses in utero. Obama and Biden voted
against that bill.
Sarah Palin had the opportunity to expand health insurance
to Alaskan children, but she chose not to. She and her running mate have
signaled that they are hostile to any expansion of government-funded healthy
insurance, even for uninsured children. For McCain/Palin, free market ideology
trumps practical solutions.