PulseJournal.com

Just a year ago, Congress and President Bush were at odds over the degree to which to expand the State Children's Health Insurance Program.

This year, that fight has devolved into something else for Ohio: It's become a battle over how much flexibility Ohio can have in using its federal dollars.

In December, the Bush administration rejected the state's request to offer health care coverage to children in families with incomes up to 300 percent of the federal poverty level.

The State Children's Health Insurance Program, designed to provide health care coverage to children without insurance whose families earn too much to qualify for Medicaid, instead currently offers health care coverage to children in households with incomes up to 200 percent of the poverty level, the Centers for Medicare and Medicaid Services ruled.

Ohio wants to appeal that directive, and last week Voices for Ohio's Children, an Ohio children's advocacy organization, came to Capitol Hill to urge congressional leaders to push the Bush administration to allow the state to expand coverage. They say their plan would provide insurance for an additional 35,000 Ohio kids.

Those kids would include 3-year-old Seth Novak of Lebanon, who suffers from Down syndrome.

His mother, Paula Novak, testified earlier this month before the Senate Finance Committee's Subcommitte on Health Care that the directive effectively barring the state from implementing its law had kept her son from receiving vital health services.

She said Ohio's coverage expansion had given her and her husband, Jeff, who works in the construction industry, hope that Seth and her other two boys would receive coverage.

But instead, the directive has stopped the expansion in its tracks.

And it's been to her children's detriment, she said.

Seth, who received open-heart surgery in March 2007, missed his one-year follow up. He has missed eye exams, thyroid exams, ear, nose and throat doctor exams to replace tubes in his ears and visits to his speech therapist – a particular concern, because Seth is nonverbal.

"In a country such as America," Novak testified, "it is just not acceptable that they do not have access to affordable health care coverage."

The Centers ruled that states who enrolled 95 percent of uninsured kids below 250 percent of poverty could have the flexibility to spend money on kids up to 300 percent. But Amy Swanson, director of Voices for Ohio's Children, said that's next to impossible. Among the uninsured Ohio kids are the Amish children of Northeast Ohio, whose families avoid such programs.

She's hoping the same lawmakers who last year voted to overturn Bush's veto of a $35 billion children's health care expansion will sign a letter pushing Ohio's expansion to the Bush administration.

"They can send a message to leadership that this is an important thing for our kids in Ohio," she said.

Jessica Wehrman is a Cox Ohio Publishing Washington correspondent.

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