Sen. Jay Rockefeller (D-W.Va.) (Photo by Mark Murrmann/ZUMA Press)

The Democrats’ proposal to terminate the Children’s Health Insurance Program would hike health care costs for some of the country’s low-income families, likely increasing the number of uninsured kids in the name of expanding coverage, several health policy experts and state health officials warned Friday.

Under the sweeping health reform bill passed by House Democrats last weekend, CHIP would cease to exist at the end of 2013, instead shuffling those kids into Medicaid or private insurance plans on a proposed insurance marketplace, called the exchange.

Image by: Matt Mahurin

Stan Dorn, senior health policy researcher at the Urban Institute, said there are certain advantages to scrapping CHIP. Both Medicaid and exchange plans, for example, would never require congressionalreauthorization — a process CHIP is subjected to every few years, he pointed out. But due to CHIP’s affordability, Dorn said “it’s clear” that kids “are much better off” under CHIP than they would be under private exchange plans.

“It’s not even a close question,” Dorn said during a children’s health care forum on Capitol Hill Friday.

Studies suggest Dorn’s concerns are valid. One analysis, conducted by Watson Wyatt Worldwide, an actuarial research firm, found that families living between 175 and 225 percent of the federal poverty level pay just 2 percent or less of treatment costs under CHIP. Under the proposed exchange plans, researchers found, those same families would pay up to 35 percent of their children’s health costs.

Nate Checketts, director of Utah’s CHIP program, noted that the move to more expensive exchange plans would only discourage low-income families already pinching pennies in the economic downturn. “Unless there’s a mandate, I don’t think those low-income families will sign up for it,” saidChecketts.

CHIP was created in 1997 with broad bipartisan support and renewed for five additional years last February. The popular program is designed to cover children in low-income families that are ineligible for Medicaid. The House bill would both expand Medicaid and dismantle CHIP, sending some kids currently covered under the program into Medicaid plans and others into private plans on the exchange.

The Senate Finance Committee also initially proposed to terminate CHIP when it unveiled its legislation in September. However, the committee last month approved an amendment, sponsored by Sen. Jay Rockefeller (D-W.Va.), to reauthorize the program through 2019.

Supporters of the House proposal argue the advantages of centralizing control over CHIP coverage. Because CHIP is managed by states, there is a fear among some lawmakers that lean economic times could lead to sharp CHIP cuts in some spots, leaving those kids without any coverage at all. Those fears were almost realized earlier this year when California, facing a severe budget squeeze, temporarily froze new CHIP enrollment. Some health policy experts have pointed out that it’s probably not a coincidence that many House Democrats pushing the CHIP repeal are from California, including Speaker NancyPelosi, Rep. George Miller, who chairs the Education and Labor Committee, and Rep. Pete Stark, who heads the Ways and Means health subpanel.

Rep. John Dingell (D-Mich.) has also defended the plan to terminate CHIP, arguing in a recent email that “enrollment of kids increases when the entire family can be enrolled under one plan.”

Checketts agrees, pointing out the difficulties that can arise when family members’ health coverage is scattered across different programs. “It is a good goal,” he said, “to get families on a single source of coverage.”

Yet some analysts have concluded that affordability is the more significant factor to ensuring coverage.

The advantages of providing families with low-cost access to health coverage for their kids, Dorn said, “significantly outweighs the benefits of putting parents and kids in the same health plan.”

Other children’s health care advocates are agnostic. Jocelyn Guyer, co-executive director at Georgetown University’s Center for Children and Families, said Friday that, while CHIP has proven “a great success,” getting affordable coverage for kids is more important than what program provides it.

Ron Pollack, executive director of Families USA, a consumer health care group, also indicated that affordability is more critical for ensuring children have health insurance. “What are the out-of-pocket costs, and what is the care that they’ll receive?” Pollack asked, without endorsing either the House or Senate approach to CHIP.

If an analysis by the Congressional Budget Office is correct, the Senate’s plan to salvage CHIP is the more affordable option. Examining the Senate Finance Committee’s initial proposal to repeal CHIP, CBO Director Douglas Elmendorf noted last month that “some of those children would be eligible for subsidized coverage in the exchanges but would not be enrolled in an exchange plan.”

The reason, Elemndorf explained, is “at least in part to the higher premiums and higher out-of-pocket costs that they would typically face in such a plan.”

“Like many other important reforms included in the underlying bill, the Kucinich amendment is the object of attack by the insurance industry,” Kucinich wrote in a letter. “Unlike other reform measures, Leadership has chosen to strip the Kucinich amendment of the protection it deserves.”

Kucinich’s provision, which would allow states to set up single-payer health care systems modeled after Medicare, passed the House Education and Labor Committee in July, but was stripped out by Democratic leaders as they pieced together their final bill from the various committee proposals. Kucinich concedes that the provision represents “incremental reform.” “But,” he adds, “it allows the country to move incrementally in the direction that is needed.”

If Education and Labor Chairman George Miller (D-Calif.) is right about there being no floor amendments, this plea could be Kucinich’s last shot.

Update (4:46 p.m.): Democratic Reps John Conyers (Mich.), Eric Massa (N.Y.), Neil Abercrombie (Hawaii), Janice Schakowsky (Ill.), Lynn Woolsey (Calif.) and Raúl Grijalva (Ariz.) have also signed the letter.

Miller and fellow leader Rosa DeLauro (D-Conn.) said the dozens of closed-door caucus meetings and private consultations between leaders and the different sub-groups of House Democrats are replacing the need for amendments to be debated and voted upon on the House floor.

That might be true, but it’s sure to alienate the countless constituencies that are drooling over the opportunity to alter the bill on the chamber floor. And wait ’til the Republicans hear …

Sen. Jim Inhofe has called global warming a "hoax." (WDCpix)

Can targeted federal investments in green energies and technologies create jobs and pull the United States out of its current economic funk?

That’s the message coming from a growing number of economists and Washington policymakers, who are urging Congress to make green investments a focus of legislation — expected to be debated next month — that would inject hundreds of billions of dollars into the flailing economy. Not only would such investments, as part of of a new stimulus package, boost jobs and drive development in the short-term, these experts say, but they would go a long way to make the United States more competitive in the decades to come.

Illustration by:Matt Mahurin

The issue has been a thorny one in Washington, where many Republicans — and a few well-placed Democrats — view environmental protectionism as a threat to economic progress. Indeed, the Bush administration has been a leading proponent of this theory. In 2008 alone, the White House has pushed efforts to expand offshore oil drilling, tap Western oil-shale reserves and permit mountain-top miners to destroy miles of valley streams — all done to relieve burdens on various traditional industries.

But now — with the economy in turmoil, oil prices in dramatic flux and lawmakers coming to accept the realities of the global warming crisis — many experts argue that the best way to tackle these problems is with an enormous federal investment in green industries. That transition would not only wean the country from an addiction to filthy fossil fuels, it would cut now-vital oil imports from the volatile Middle East. An increasing number of experts contend that the environmental-technology industry will be the next big boom, creating enormous economic growth for those countries at its forward edge. As lawmakers mull another economic stimulus package, these sources say, renewable technologies should be central to any plan they develop.

Energy efficiency projects, like retrofitting existing buildings, would be a good place to start, according to Robert Pollin, an economist at the University of Massachusetts, Amherst. He pointed out that those projects can begin immediately, helping the nearly 400,000 construction workers estimated to have lost their jobs in the last year.

“The first priority for now, in terms of short-term big kick in the energy area, is energy efficiency,” Pollin told the House Education and Labor Committee last Friday. “You’ll get the most jobs. It’ll be done fast. The technologies are there. And you will fight global warming. You will increase energy independence. You will create a lever against future rises in the price of oil.”

Daniel C. Esty, an environmental economist at Yale Law School, agreed, saying there are enormous opportunities to outfit old structures with better windows, insulations, water heaters and other technologies. “There’s an economic logic in improving energy efficiency in almost every building in America,” Esty said.

According to Pollin’s analysis, every $1 million invested in the green sector would create 16.7 domestic jobs. By contrast, Pollin found, the same $1 million in tax cuts returns 14.0 jobs; for military programs the return is 11.0 jobs, and for oil and natural gas development the figure drops to 4.4 jobs.

The reason for the sharp disparities, Pollin said, is two-fold. First, green businesses tend to be more labor intensive than most other industries. And second, the money tends to stay in the country, as opposed to moving abroad for outsourced services and imported goods.

Environmentalists hope that message reverberates in Washington. “For a long time, people on the right made it seem like environmental protection and job creation were competing objectives,” said Nick Berning, spokesman for Friends of the Earth, an environmental group. “It’s just not true.”

Slowly, this message is sinking in. At the start of this month, as part of its $700-billion bank bailout, Congress extended popular tax breaks on renewable energies like wind and solar. Still, many economists — including Federal Reserve Chairman Ben Bernanke — agree that, despite the bailout effort to get the banks lending again, Washington should provide another Main Street infusion to create jobs and prop up states struggling with budget shortfalls.

Ron Blackwell, chief economist at the AFL-CIO, argues that an effective stimulus bill would have to be in the $300-billion range. “If housing prices continue to fall like the way they’re falling,” he said, “[and] people continue to lose the jobs the way they’re doing, then all of the effort that Congress made to stabilize our credit markets by committing this [bailout] money will be lost.”

Last month, House Democrats passed a $58-billion spending package containing a number of provisions to increase green-industry funding. Senate Republicans killed the measure, which the White House had threatened to veto in any case. Most of the GOP opposition, though, was directed at other provisions, including new funding for infrastructure projects and state Medicaid programs.

With the economy still in trouble, Democratic leaders stress the urgency of returning to some new stimulus bill. “It’s clear that it has to be done,” said Rep. George Miller (D-Cal.), chairman of the House Education and Labor Committee, “and it’s going to be done by the Congress in relatively short order.”

Upper-chamber Democrats are pushing for green investments as well. In a speech from the campaign trail Tuesday, Sen. John Kerry (D-Mass.) blasted the Bush administration for “years of denial and delay” on the green economy front — a delay allowing countries in both Europe and Asia to take the lead on environmental innovations.

“There are 750,000 green jobs in the U.S. today,” Kerry said. “In 30 years we can have six times that many. The choice is simple: we can be left behind, or we can lead.”

Yet Congress shares responsibility for the country’s slow adaption to green-industry trends. For decades, for example, the Michigan delegation, led by 27-term Rep. John Dingell (D), defeated efforts to increase Detroit’s fuel economy standards. This week, the Bush administration announced that it may use some of the $700 billion bailout to help the Big Three automakers, who are failing, largely from business plans that focused on gas-guzzling SUVs. Meanwhile, as climate change became more pronounced in recent years, the Senate’s most powerful voice on the environment for much of the last decade was James Inhofe (R-Okl.), a conservative who says global warming is “a hoax.”

Still, the green-economy push, once limited to environmentalist circles, is reaching wider audiences. Perhaps most prominent, New York Times columnist Thomas L. Friedman has evolved into one of the country’s loudest proponents for green investments. “When this bailout is over,” Friedman wrote on Sept. 28, “we need the next president — this one is wasted — to launch an E.T., energy technology, revolution with the same urgency as this bailout. Otherwise, all we will have done is bought ourselves a respite, but not a future.”

There is increasing evidence that Congress must step in with a stimulus plan. The nation’s unemployment rate is 6.1 percent — up 1.2 percent since January — and many experts expect that number to rise to at least 8 percent by the end of next year. Housing prices have plunged 20 percent from their peak, and are expected to fall another 10-15 percent in coming months. Home equity has evaporated with the sinking housing market, leading to a slump in retail sales. Home foreclosures are up 71 percent from a year ago. And consumer confidence is at its lowest point since records have been kept.

Democrats still hope to pass their stimulus bill when they return to Washington for a lame duck session after the elections. Those efforts seemed to get a boost Monday, when House Speaker Nancy Pelosi (D-Cal.) announced that President George W. Bush has voiced willingness to compromise on legislation. “Now we must find what is both fiscally responsible and politically possible,” Pelosi said.

But if Friday’s House hearing was any indication, that might be tougher than she hopes. No Republican even bothered to show up.

Rep. Barney Frank (D-Mass.) recently said that Democrats would be willing to delay the legislation until January rather than settle for a weak bill. With both unemployment and foreclosure rates on the rise, however, lawmakers might not have the luxury of postponement. Indeed, experts are warning that time is of the essence — both for the economy and the environment.

“The green sector is the future of this economy,” Pollin said. “We may not have any future unless we build that green sector starting now.”

Taxpayers will remember that the first round of stimulus efforts came in the form of direct-to-the-door rebate checks — $600 for individuals and $1,200 for married couples. This time around, lawmakers are focusing on infrastructure projects, social services like unemployment insurance and direct aid to states, many of which are struggling with budget deficits. There’s even an emerging effort to have green-energy investment a central focus of the bill.

During a hearing of the House Education and Labor Committee on Friday, Democratic leaders conveyed a sense that, given the current economic conditions, Congress will have little choice but to pass something soon.

“It’s clear that it has to be done,” said Rep. George Miller (D-Cal), chairman of the panel. “And it’s going to be done by the Congress in relatively short order.”

Not that it will be easy. In September, House Democrats passed a $58-billion stimulus package that included many of the same elements now under discussion. Senate Republicans blocked the measure, and President George W. Bush had vowed a veto.

The cost of the evolving package remains up in the air, but economists are floating figures ranging from $150 billion to $400 billion.

This week, White House spokeswoman Dana Perino indicated that Bush would be open to some form of stimulus, but she seemed to reject the ideas included in the House-passed bill. That could set the stage for a post-election partisan showdown.

With that in mind, Rep. Barney Frank (D-Mass.) has already said that Democrats are prepared to push their efforts into January if they can’t move the bill in November, according to Associated Press.

Look here next week for a short series on what measures the Democrats hope to include in their package — including green energy, infrastructure and aid to states — and how those provisions might work to get the economy back on its feet.