The Orbis

Issue date: 2/27/02 Section: Undefined Section

On its face, President George W. Bush's decision to extend the Children's Health Insurance Program (CHIP) to cover prenatal care seems a simple, even obvious, choice. Few would argue that the health of a fetus does not have an impact on the later well being of the child. The recently proposed expansion of CHIP, however, has sparked tremendous controversy.

The major point of contention lies in the fact that, in order to extend the program to cover prenatal care, the Bush administration broadened the definition of "child" to cover the time from conception to the point at which the child reaches 19 years of age.

Reproductive rights advocates view the move as political, claiming that it is just another attempt to award legal rights to fetuses, thereby restricting the rights of pregnant women to seek abortions.

Since the 1973 Roe v. Wade decision is based on a woman's right to privacy, rather than on a definition of when life begins, some believe that the CHIP expansion will have no bearing on abortion law.

Others, however, see this as simply the latest development in a growing trend.

In April, the federal government passed the Unborn Victims of Violence Act, giving a fetus the status of victim--separate from the mother--in federal crimes. This decision reflects an increased willingness among states, over 20 of which have similar laws in effect, to award legal rights to unborn fetuses.

Pro-choice advocates fear that, as the legal rights of fetuses grow, they may eventually be seen to outweigh the rights of women.

In response to these allegations, Tommy G. Thompson, Secretary of Health and Human Services, asserted in a letter to the Washington Post, "This is not a debate about abortion. It is about helping states provide vital health care for pregnant women and their babies."

According to Thompson, approximately $3.2 million in funds designated for CHIP is currently going unused, and this action is the easiest way to provide access to the program to those who need it.

The medical issue at stake is certainly a serious one, but the practical effect that the expansion of the program will have on the healthcare provided to low-income expectant mothers is itself a matter of debate.

A major critique of the plan is that the change would not require every state to extend coverage to prenatal care, but would simply allow them to do so.

The program as it currently exists, however, makes it possible for individual states to offer assistance to pregnant women through CHIP funding by applying to the federal government for a waiver. Rhode Island and New Jersey have both successfully done so.

Just a week before the proposed change in regulation was announced, California applied and was given permission by the Bush administration to extend Healthy Families, its version of CHIP, and Medi-Cal to provide insurance to poor working parents as well as children.

As the debate rages, the administration ignores the 11 million children who are still living without health insurance. They and their families can only hope that both sides will be able to lay politics aside long enough to address their needs.

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