Framing SCHIP Expansion: Ideology and Policy Legacies
Year: 2013
Type: preprint
Abstract: This paper examines the framing of three phases of the expansion of publicly funded health insurance coverage for US children: the expansion of Medicaid eligibility in the 1980s, the creation of the State Children’s Health Insurance Program (SCHIP) in 1997 and the contentious debate over the reauthorization and expansion of SCHIP between 2007 and 2009. The frames used by proponents of expanding Medicaid eligibility for pregnant women and children were (1) the morality of providing care to innocent and vulnerable children (2) the long-term cost-effectiveness of primary and preventive health services for pregnant women and children and (3) health-care access as an investment in the future US workforce. These frames were used again to argue for the creation of a separate children’s health insurance program in 1997 with the addition of the frame of the “hard-working” parents whose children would benefit. My analysis of Congressional hearings on SCHIP reauthorization shows that these frames continued to be used by proponents of SCHIP expansion, while opponents, notably President George W. Bush, framed eligibility expansion as a Trojan horse for “government-run health care for every American.” This framing echoed that used for decades by opponents of universal health insurance, but unlike earlier framing, did not represent the views of health services providers. I argue that the continuity of both sets of frames over time constitutes a set of “policy legacies.”
Source: SSRN Electronic Journal
Author: Alice Sardell
Institution: Queens College, CUNY
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2260182570