Op-ed
Kay Hagan
http://www.reflector.com/

Less than a month into my service in the U.S. Senate, I was faced with a difficult choice, in which the health of our state's children was at odds with a key industry in North Carolina.

North Carolina employs 65,000 people in the tobacco industry - from the large tobacco companies to the distributors and, particularly in eastern North Carolina, the tobacco farmers.

These people, and this industry, were tapped to shoulder more than their share of the burden for the expansion of the Children's Health Insurance Program, which provides health care for our nation's neediest and most disadvantaged children.

The CHIP program is enormously important. Since 1997, it has been helping low-income and disadvantaged children access medical services. With our economy in dire straits, the staggering thought of 10 million young children without the health care coverage they need is unacceptable. According to a report issued by Families USA, the number of uninsured children in North Carolina rose by 21,200, or 7.7 percent, between three year periods of 2003-05 and 2005-07, and "is likely to continue to grow due to the financial crisis."

And as of late last year, more than one out of every eight children in North Carolina - or 12.8 percent of the state's children - were without health insurance.

Ninety-one percent of all CHIP-covered children live in families with incomes at or below 200 percent of the federal poverty level ($42,400 for a family of four).

Last year, the annual premium for an employer health plan covering a family of four was more than $1,000 a month. For a family with the median household income of $43,867, that is a nearly crippling amount. Not passing this bill was simply not an option.

But my vigorous support for the program itself does not mean that I approve of the way this expansion has been funded.

On Wednesday, I made my way to the Senate floor to voice my displeasure and encourage my colleagues to support a compromise that I had co-sponsored with U.S. Sen. Jim Webb from Virginia.

This is a matter of fairness, I said. While I applauded the fiscally responsible decision to pay for the increased spending under this bill, I believe that singling out cigarettes concentrates the impact in a few states, like North Carolina, in a way that is fundamentally unfair.

I was the co-sponsor of an amendment which would have reduced the proposed tax on cigarettes by 24 cents. I am disappointed that my colleagues did not agree that it represented a much more palatable compromise to all sides in this debate.

Ultimately, between a rock and a hard place, I found myself having to vote on behalf of the 10 million low-income and disadvantaged children the CHIP program helps. In this economy, when families are being forced to choose between paying their bills and putting food on their table, I could not make it harder for them to keep their children healthy, safe and cared-for.

I cast my vote in the affirmative as a mother of three children, who knows what it is like when one of your kids wakes up in the middle of the night with an earache, a stomachache or worse; as a former budget chairman for the state of North Carolina, who knows how difficult it is for the state to close the gap in funding for this critical program when the federal government drops the ball; and as a U.S. senator, who sees in this bill a chance for our neediest families, our most disadvantaged kids, to get ahead in the face of the daunting odds they will no doubt face in their future.