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http://www.100md.com 2001年7月10日 好医生
     WASHINGTON, Jul 06 (Reuters Health) - The Bush administration is seeking to craft a controversial policy that would enable states to define fetuses as persons eligible for coverage under a public health insurance program for children, according to a draft letter from the office that oversees the government's health programs for the poor.

    In an undated draft letter to state health officials obtained by Reuters Health, the Center for Medicaid and State Operations at the Centers for Medicare and Medicaid Services (CMS) said that the administration would propose a new rule "in the near future" to allow states to extend medical coverage to an "unborn child" under the State Children's Health Insurance Program (SCHIP).
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    Although the rule would allow states to expand health coverage for pregnant women not eligible currently for either SCHIP or Medicaid, some critics see the Bush plan as a way to establish the concept of a fetus as an individual.

    "Secretary Thompson will be proposing that for purposes of the SCHIP program, an unborn child may be considered a 'targeted low-income child' by the state and therefore eligible for SCHIP if other applicable state eligibility requirements are met," the letter said.
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    The letter is from Dennis G. Smith, who oversees the Medicaid and state operations center for CMS, formerly known as the Health Care Financing Administration.

    Bill Pierce, a Department of Health and Human Services spokesman, told Reuters Health that Thompson is considering such a proposal, and that "the key goal is to provide another opportunity for states to increase access to health care services to pregnant women."

    Pierce said the administration does not know how many more pregnant women would be eligible to receive health care services under such a policy change.
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    "It's a fairly transparent effort...to undermine birth control and abortion rights by trying to extend 'personhood' to unborn fetuses," Kim Gandy, executive vice president and president-elect of the National Organization for Women (NOW), told Reuters Health.

    SCHIP covers children, generally through age 18, and does not cover adults. It was established under 1997 legislation to provide health insurance to children in low-income families with incomes high enough to make them ineligible for Medicaid. More than 3 million children are enrolled in SCHIP.
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    "[I]t is well established that access to prenatal care can improve health outcomes over a child's life," the letter said. The letter was sent earlier this week to various groups, including the National Governors' Association and the American Public Health Services Association (APHSA), for comment to the administration by July 9, an APHSA source said.

    "Sounds like a good thing to us," Douglas Johnson, legislative director for the National Right to Life Committee, told Reuters Health about the administration's plan.
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    Johnson said the House last year passed a bill that would prevent the execution of a female prisoner who had been sentenced to death if she were pregnant. The Senate did not take up that bill. "Some people on the other side are trying to make too much of this," he added of the new Bush plan.

    However, NOW's Gandy told Reuters Health that the plan to extend SCHIP coverage to pregnant teenagers not eligible for Medicaid is yet another attempt by abortion opponents to try to recognize the fetus, even an embryo, as a person. Instead, the administration could "simply grant a waiver to every state" that wanted to extend SCHIP eligibility to pregnant women, she insisted.

    "They are saying one thing and doing something else," Gandy said., http://www.100md.com