Legislation touted as a way to ensure all American children receive adequate health care may be rolled into the economic stimulus package this month, with congressional leaders pledging to hit the ground running to bolster the economy and protect Americans from the worst of a deepening recession.

But a Catholic health care expert says Catholics should be wary of the rhetoric -- and work to change the fine print -- when it comes to the State Children's Health Insurance Program (SCHIP), a $40-billion federally funded program created in 1997 that provides block grants to states to cover children of the working poor.

In 17 states, SCHIP programs pay for abortions without parental involvement. In most, if not all states, contraception is provided to those 19 and younger, usually without parental notification, said Mike O'Dea, founder and executive director of the Christus Medicus Foundation, a health care reform advocacy group. O'Dea said passage of a new version of SCHIP could quietly enact even more provisions that take away parents' rights to control their children's health care -- and end run the heavy pro-life lobbying efforts already gearing up to oppose "doomsday" legislation such as the Freedom of Choice Act.

'Trojan horse'

"They are going to accomplish this without any noise, and they are going to go to the core of our future of our nation, our children, and they are going to deprive parents of the ability to be in control of their children's health care," O'Dea said.

By expanding SCHIP to higher income brackets and eliminating restrictions on the use of federal funds for abortions, as well as allowing more waivers to include adults in SCHIP, pro-abortion Democrats could incrementally implement many anti-life provisions of controversial national health insurance -- without a major battle, O'Dea warned. "This is a Trojan Horse."

After President George W. Bush vetoed new legislation in 2007, Congress passed a $10 billion appropriation for SCHIP that expires March 31. In a Dec. 10 interview with The Hill, Senate Finance Committee chairman Max Baucus (D-Mont.) said including SCHIP in the economic stimulus legislation would give Congress more time to advance a comprehensive health reform bill, which would include a long-term expansion of the popular children's program.

But O'Dea said SCHIP has morphed beyond its original intent of helping children who were falling through the cracks of the health care system. If the SCHIP income requirements continue to be raised -- as now proposed to 400 percent of poverty level, or approximately $80,000 for a family of four -- many employers may eliminate coverage for the children of their workers, O'Dea said. In some states such as New Jersey, the income limit is already at 400 percent of the poverty level via a federal waiver and adults are included in SCHIP coverage, he said. "If you've got federal and state money available and you raise coverage to 80 percent of the population, why would an employer even cover children under employee health plans?" asked O'Dea.

At present, those states paying for abortion in SCHIP and Medicaid are using state funds except for a few narrow exceptions of rape and incest as allowed under the federal Hyde Amendment, which bars the use of federal funds for abortions. Whether the Hyde Amendment restrictions -- which must be reauthorized every year -- will survive in the next Congress is open to question.

The Alan Guttmacher Institute, a pro-abortion-rights research group, estimates that state and federal expenditures for family planning services totaled $1.85 billion in 2006, an inflation-adjusted increase of 18 percent from 1980. It says federal and state governments in 2006 spent $89 million and funded 177,000 abortion procedures for low-income women. The federal government contributed to the cost of only 191 procedures.

'Bad for children'

In general, Catholic leaders support SCHIP. In a 2007 letter to the House and Senate Budget Committees, the United States Conference of Catholic Bishops (USCCB), Catholic Health Association of the United States (CHA) and Catholic Charities USA urged Congress to adequately fund SCHIP "so that all children eligible for the program get health care." The letter said 4 million children have health care through SCHIP, but another 9 million children are uninsured.

A number of bishops have endorsed O'Dea's proposed reform of SCHIP. Among them, as listed on the ChristusMedicus.com website, are Bishop Fabian Bruskewitz of Lincoln, Neb.; Bishop Curtis J. Guillory of Beaumont, Texas; Oklahoma City Archbishop Eusebius J. Beltran; Baltimore Archbishop Edwin O'Brien; Archbishop Joseph Naumann of Kansas City, Kan.; Bishop Robert F. Vasa of Baker, Ore.; and Boston Cardinal Sean O'Malley.

As originally designed, SCHIP granted funds for health care for families who earned up to 200 percent of the poverty level, but some states have increased the income level using waivers.

Some even have added adults to the children's program. In 2007, roughly 587,000 adults were enrolled, of whom 487,000 were parents, 93,000 were childless adults and 6,500 were pregnant women, a federal research service reported last September. In a welcome development, the federal government has allowed states to extend prenatal coverage so pregnant women can receive coverage for their unborn children if they qualify under SCHIP.

While O'Dea hopes to roll back the contraception and abortion provisions of SCHIP, he says at the very least Catholics need to focus on lobbying the federal government to provide a health insurance option for people of faith. Such an option would provide health insurance that does not include abortion and other procedures contrary to Catholic teaching.

"SCHIP has been portrayed as this wonderful thing for children," said O'Dea.

"It's a bad thing for children because it has all this evil coverage in it. We must make the public aware that SCHIP is not that good, because if it takes kids away from parents, how good can it be in the end?" he said.

Funding abortion

The 17 states that allowed and paid for all or most "medically necessary" abortions -- any abortion with a doctor's approval -- under SCHIP and Medicaid are:

Alaska

Arizona

California

Connecticut

Hawaii

Illinois

Maryland

Massachusetts

Minnesota

Montana

New Jersey

New Mexico

New York

Oregon

Vermont

Washington

West Virginia

Valerie Schmalz is an OSV contributing editor.