How the House Stimulus Bill Undercuts Parental Authority

Written by Dennis Smith


smith_dennis_sm.jpgJanuary 26, 2009
by Dennis Smith
Buried in the economic stimulus legislation is a provision further undercutting parental authority and expanding control of taxpayer dollars by family planning clinics. No doubt these provisions are embodied in the economic stimulus package because their congressional sponsors believe that they would not be enacted if considered separately on their own merits.

Expanding Eligibility

Section 5004, "State Eligibility Option for Family Planning Services," would make Medicaid into a virtual money-machine for family planning clinics. The federal government already provides a 90 percent match rate for family planning services in Medicaid. States therefore have little at stake in Congress's oversight and accountability of Medicaid. Under Section 5004, eligibility and benefits can be expanded in several ways:

More Loopholes

Section 5004 will also reverse current law in respect to state benefit flexibility. Since the enactment of the Deficit Reduction Act of 2005, states have had the authority to offer "benchmark plans" and were allowed by federal law to provide coverage that does not include family planning services. Some religious organizations believe low-income families should be able to participate in a health benefit program that does not include contraceptives or sterilization. In a statement on reauthorization of the State Children's Health Insurance Program (SCHIP), for example, the Catholic Medical Association recommends that "at a minimum, state and federal regulations should permit parents to have access to SCHIP funds to enable them to choose health insurance coverage that does not conflict with their values and that does not separate funding mechanisms from parental oversight."[1] Under Section 5004, that choice would not be available to parents of children on Medicaid.

Finally, the legislation provides a special "safe harbor" protection to the state of California. Under procedures dating back to the Clinton Administration, California created an eligibility process that bypasses the county welfare agencies. As a result, California is allowed to provide coverage to individuals--including immigrant populations--who are not eligible for Medicaid. The Bush Administration attempted to bring California into conformance with standard eligibility procedures. Section 5004 would allow California to continue to use the same procedures that have been abused in the past.

A Hidden Agenda?

A radical social agenda does not belong in the economic stimulus package. At a minimum, congressional sponsors should be required to present it for a full debate with the potential for amendments in the House of Representatives and the Senate. It should not be buried in the economic stimulus package.
Dennis G. Smith is Senior Fellow in the Center for Health Policy Studies at The Heritage Foundation.

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