This way we could insure some parents, maybe.

Forgive the snark - after all, it's wonderful that we're doing so much to fund children's health care. But good as SCHIP is, there are plenty of adults who need health care, too. Over the past couple of years, North Carolina has taken some steps to provide more adults with health insurance: in 2006, the state passed a tax credit which allowed employers to take a deduction of $250 for every employee enrolled in a company health plan. Of course there were conditions - the employee couldn't make more than $40,000, the company had to be paying 50 percent of the employee's insurance costs, and the law only covered employers with 25 or fewer employees. But hey - a step forward is a step forward.

Then last year, North Carolina became the 35th (35th? Why does that sound familiar?) state to find the money to pay for a high risk insurance pool - subsidizing insurance premiums for North Carolinians whose medical conditions made it difficult to find affordable plans. There was a catch here, too: even with the subsidy, people who got this coverage were expected to pay 2/3 of a premium that could be 50% or 100% more than what a healthy person might pay. But it was another step forward.

So when I received my most recent Statside Dispatch from the folks at the Progressive States Network, I found what they had to say very interesting. Apparently some states are using Medicaid and SCHIP funds to pay some or all of the premiums of employed workers on Medicaid. In other words, some state governments are paying private premiums for the working poor.

This has a number of benefits: It provides the kind of positive employment incentive our welfare system has had less and less of since welfare "reform." It can increase the number of employees that a company insures, possibly allowing the employer to purchase insurance less expensively. It subsidizes private insurance, which can lower everyone's insurance costs. And it's another opportunity to work toward the main goal - insuring everyone, including adults - without a frontal assault on private insurors (though that's going to have to happen sometime).

It's not a foolproof system - there's always a chance that these kinds of policy initiatives will get twisted away from their original lofty goals, and some states are seeing low levels of participation. And of course it means that taxpayers are continuing to subsidize the inefficient private health insurance companies when they'd be better off just paying directly for medical care. But when you're in a state like North Carolina, where only incremental change seems possible, and social policies apparently have to allow the wealthy to feel good about themselves, it's good to have another piece of the puzzle handy in case there's an opportunity to put it in.