Bonnie Frost still can't drive down the road where the accident occurred. It's upsetting to think back to that December morning nearly three years ago when her family's sport utility vehicle hit a patch of black ice, skidded off the road and slammed into a tree - sending two of her four children to the hospital with brain injuries.
Had it not been for a federal health insurance program tailored for working families such as hers - ones lacking the income to purchase private health insurance - Frost is certain that she and her husband would be buried under a mound of unpaid medical bills. Both children were hospitalized for many months and still require regular therapy and services.
For the bipartisan group of lawmakers in Congress backing the State Children's Health Insurance Plan, Frost and her family - who live in Baltimore's Butchers Hill neighborhood - are prime examples of why the program should be reauthorized and expanded with an additional $35 billion over the next five years. There is also talk of reaching out to more families who lack insurance.
"I am incredibly thankful," said Frost, who works full time for a medical publishing firm. Her husband, Halsey, is a full-time woodworker. "Without the [SCHIP] program, we would be in another place emotionally and financially. I can't imagine how we would have managed."
Said Halsey Frost: "The medical tabs from the accident would have fallen on us. We would have lost our house."
The reauthorization bill was approved by the House late Tuesday by a vote of 265 to 159, and the Senate is scheduled to vote on the issue today. Congressional approval is necessary to allow the 10-year-old program to continue for another five years; it would also provide new funds to provide health care to an additional 3.8 million low-income children nationwide.
President Bush, who has offered a significantly smaller increase in funds, has said he will veto the legislation. He has said he would support an increase of about $5 billion, an amount that analysts say is not enough to support the current client caseload, let alone cover additional children who still lack health coverage.
The program expires Sept. 30, and members of Congress are scrambling to enact legislation that would keep it going a few more months or until a compromise can be reached.
"The United States of America is the richest nation in the world, and we have the resources to ensure that all our children have access to quality health care," said Maryland Sen. Benjamin L. Cardin in a statement released yesterday. Cardin, a Democrat, backs reauthorization and expansion of the program. "Failure to provide our children with this benefit would be a travesty," he said.
More than 100,000 Maryland children are covered under the federal program, according to state health officials. They estimate that the program will require an infusion of roughly $160 million in federal funds over the next five years - with the state also contributing dollars of its own - to continue providing coverage to those families. Additional funds would also provide health coverage to an additional 42,000 children in Maryland.
"That is what the president's veto puts in danger," said John G. Folkemer, deputy secretary for health care financing for the Maryland Department of Health and Mental Hygiene. "We are obviously very interested in the fate of this bill, and we are doing everything we can to work with our representatives in the House and the Senate to make sure this bill is enacted."
Maryland provides health coverage under SCHIP to families of four with annual household income of up to 300 percent of the federal poverty level, or roughly $60,000 a year, Folkemer said. The reauthorization bill would not allow the state to provide coverage to families with a greater income, but the state could recruit more families with incomes below that level, he said.
Some Republicans and other opponents have argued that state programs are becoming crowded with children from middle-class families who could afford private health insurance. But Folkemer said that is not so in Maryland. He said most families who are part of the SCHIP program are from lower income brackets.
"The Bush administration seems to be worried that we are taking children out of the private [health insurance] marketplace," he said. "But we don't see that happening. We are mostly hitting the lower-income children."
The Frost family has a combined annual income of about $45,000, said Bonnie Frost. She and her husband have priced private health insurance, but they say it would cost them more per month than their mortgage - about $1,200 a month. Neither parent has health insurance through work.
"There should never be a moment when you have to ask, 'Do you have health insurance?'" said Halsey Frost, who along with his wife is an advocate for a national health care plan that would cover everyone, no matter the age or income bracket.
Bonnie Frost and daughter Gemma, 9, who was injured in the accident, went to Washington on Tuesday to discuss the SCHIP legislation with congressional leaders. Mother and daughter were introduced on the House floor by Speaker Nancy Pelosi of California and posed before a bank of news photographers.
"We might go back to Washington to advocate against Bush's veto," said Bonnie Frost.
Sen. Barbara A. Mikulski, another Maryland Democrat, has also vowed to vote in favor of the legislation today. Mikulski was in the Senate when the program was created in 1997, and she said she has been fighting for its expansion ever since.
This month, Mikulski joined Maryland Gov. Martin O'Malley in opposing new Bush administration regulations that they said could result in a cut in funds to Maryland and other states that provide health care coverage to families with higher incomes. Reauthorization of the SCHIP bill would negate the proposed rule change, officials said. Otherwise, about 4,000 Maryland families could be affected, according to state officials.
"This program fills the gap for children who might otherwise have to go without any health care at all," said Mikulski in a statement. "The funding is critical to ensure our children have access to the health care they need and deserve."
Rep. Roscoe G. Bartlett, a Republican whose district includes Western Maryland, was the only member of the state's congressional caucus to vote against the SCHIP bill Tuesday. A spokeswoman from his office said that he disagrees with aspects of the bill, including language that she said would provide health coverage to adults as well as immigrants who lack proof of citizenship.
Local advocates are also urging SCHIP's reauthorization. "One thing that is very important for everyone to understand is that if we don't provide health care through SCHIP, we will all pay more," said Vincent DeMarco, president of the Maryland Citizens' Health Initiative. "Children will still require medical services. This is the smart way to do it."