Bush Administration Issues Final Regulation Extending CHIP Coverage to Fetuses

Bush administration officials on Friday issued a final regulation that will allow states to define fetuses as "unborn children" eligible for health coverage under the CHIP program, the Washington Post reports. The regulation, which was first proposed earlier this year, marks the first time that "any federal policy has defined childhood as beginning at conception" (Goldstein, Washington Post, 9/28). The CHIP program currently provides government-funded health insurance to low-income children from birth to age 19 in families with annual incomes that exceed the requirements for Medicaid. States wishing to expand their CHIP coverage to include prenatal care for pregnant women are permitted to seek a federal waiver for such coverage. The new rule would eliminate the need for such waivers by clarifying the definition of "child" under the CHIP program to say that states can include coverage for children "from conception to age 19" (California Healthline, 2/1). Under the final version of the rule, which will be published in the Federal Register Oct. 2, states also can extend CHIP coverage to the fetuses of undocumented immigrants, a provision not included in the original version of the rule proposed in February (Fagan, Washington Times, 9/28). In the past, federal law has excluded undocumented immigrants from "any form of government health insurance." An HHS official said that the new rule could cost $350 million over the next five years (Washington Post, 9/28).

HHS Secretary Tommy Thompson said that the regulation would increase the number of low-income women who receive prenatal care. Some opponents called the new rule a "backdoor effort" by the Bush administration to promote an antiabortion agenda and establish a legal precedent that recognizes a fetus as a person, the New York Times reports (Pear, New York Times, 9/28). Thompson said, "This is a common-sense, compassionate measure to make sure that all children born in this country will come into the world as healthy as possible" (Kemper, Los Angeles Times, 9/28). He added, "This, to me, is not an abortion issue. It's strictly a health issue. Our goal is simply to promote the health of that unborn baby" (New York Times, 9/28). HHS officials have received more than 8,000 written comments on the rule, which will take effect 30 days after its publication Oct. 2, the Los Angeles Times reports (Los Angeles Times, 9/28).