Health officials in Maryland are working with state Comptroller Peter Franchot to identify children eligible for, but not enrolled in, the State Children’s Health Insurance Program (SCHIP). The comptroller’s office will use state income tax records to locate families whose incomes qualify their children for enrollment.
The heads of eligible households will then be notified by letter that SCHIP coverage is available to their children.
The initiative comes as the result of a bill, known as the “Kids First Act,” passed in April by the Maryland House of Delegates in an effort to encourage more working-poor families to enroll their children in the state health insurance program.
‘A Waste of Resources’
Under early forms of the bill, eligible parents who did not enroll their children in the state program or seek an alternate form of coverage would have been disqualified from claiming a child deduction on their state income tax. That mandate was stripped from the bill in committee.
Analysts are criticizing the initiative, calling it a waste of resources. John R. Graham, director of health care studies at the Pacific Research Institute in San Francisco, said, “Parents who have children eligible for SCHIP are responsible for getting their children the help they need. Most of these letters will be ignored by the recipients.
“It will have no impact whatsoever,” Graham said.
The program is a larger version of one implemented by a Maryland county last October. Howard County officials seeking to help identify and obtain coverage for nearly 20,000 uninsured residents asked Franchot for assistance in locating those who were eligible for the state program. Franchot agreed to assist the county and subsequently offered to do the same for the rest of the state.
‘Misuse of Tax Records’
Twila Brase, president of the Minnesota-based Citizens’ Council on Health Care, also strongly criticized the plan. She says the Maryland government is planning to go on “a fishing expedition” through the confidential tax records of its citizens. She notes tax records “are for paying taxes, not for targeting citizens with government marketing programs.
“Most people already know there are government programs,” Brase said. “Clearly, many people don’t want to join them.”
Brase said people choose not to sign up for various reasons, including the burden of applying, the stigma associated with taking a government handout, and the requirement that they share very personal data with the government.
Brase says the person who doesn’t sign up for a government program has a right not to. “There’s no crime here, but a person’s tax record could eventually become a tool to penalize citizens for failing to sign up for government health care, or refusing to buy health insurance when a state agency declares their income sufficient to pay for it,” she said.
‘Target Reasons,’ Not Individuals
“The public wants consent before anyone takes a look,” Brase said, citing a Gallup poll from 2000, “Public Attitudes Toward Medical Privacy.” The poll of a random sampling of 1,000 people showed 95 percent of Americans believe consent should be required before personal financial information is disclosed.
Privacy concerns have not stopped some organizations from endorsing the program. “I think it’s a great idea,” said Vincent DeMarco, president of the Maryland Citizens’ Health Initiative. “Using the comptroller’s facilities is wonderful.”
Brase disagreed, saying, “The people of Maryland need to stand up and oppose the government’s planned intrusion into their tax records.
“If the government wants more people insured,” Brase added, “they need to target the reasons people aren’t signing up, not the people who conscientiously pay their taxes.”
Rather than expend resources to move more people into government-run health care, Graham said, it would be “better for the state to support low-income individuals’ premiums for private health insurance that they can keep whether or not they have a job.”