Born without a right pulmonary artery, 17-year-old Megan Riley has endured eight surgeries, the removal of her right lung and myriad related health problems.

But thanks to daily medications, Children's Medical Health Center of Dayton and the State Children's Health Insurance Program, the Urbana High School senior is healthy, working part-time and looking forward to college and a career in nursing.

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Megan Riley, 17, (left) was born without a right pulmonary artery. She has had eight surgeries and the removal of a lung. In part, because of the State Children's Health Insurance Program, the Urbana High School senior is healthy. Peggy Boos (right), her mother, says if it were not for the state funding Megan would not be here today.Click to enlarge

"If it wasn't for Megan receiving state funding, Megan wouldn't be here," Megan's mother, Peggy Boos, said from her Urbana home.

That state funding — actually state and federal government funding — no longer is a certainty as a Democratic Congress and Republican President Bush spar over renewing the State Children's Health Insurance Program, known as SCHIP.

Established in 1997, the program was set up to serve children from families who earn too much to qualify for Medicaid — the state and federal government health care program for the poor and handicapped — but don't earn enough to be able to afford health insurance. Until recently, the program has been hailed as a successful bipartisan effort to reduce the number of kids without health care.

However, SCHIP is set to expire on Sept. 30. The House and Senate have passed separate bills to expand it to cover an additional 4 million to 5 million children, but Bush has supported a lower funding level and threatened to veto legislation that calls for spending more.

If the president and Congress don't agree by Sept. 30, it would be possible to extend SCHIP for a short time while negotiations continue although that is not a certainty.

In Ohio, the program serves nearly 140,000 children, including nearly 16,000 in the Miami Valley, according to the state Department of Job and Family Services.

The Ohio program covers children in families with incomes up to 200 percent of the federal poverty level — $41,300 for a family of four.

The state budget includes a provision to expand eligibility to children in families with incomes up to 300 percent of the federal poverty level — $61,950 for a family of four — starting Jan. 1. However, under the current rules Ohio would need a waiver from the federal government for the new guidelines to take effect, and the state has yet to submit one. Just Friday the Bush administration rejected New York's bid to expand eligibility to 400 percent of the federal poverty limit. Under guidelines announced last month, states must show they have enrolled at least 95 percent of poor children in public health programs before expanding eligibility to higher-income children.

The guidelines are aimed at reinforcing regulations that make sure people don't substitute SCHIP for private insurance, according to a letter announcing the changes from Dennis G. Smith, director of the Centers for Medicare and Medicaid Services.

One new guideline requires that children be uninsured for a full year before they have access to SCHIP.

Gov. Ted Strickland and U.S. Sen. Sherrod Brown, D-Ohio, have written a joint letter to Michael Leavitt, U.S. Secretary of Health and Human Services, protesting the guideines. They called the one-year waiting period requirement "wholly irresponsible."

"No child should be forced to go without health coverage for such an extended period," their letter said.

As the uncertainty continues, SCHIP supporters are speaking up.

"I think people realize children don't get to choose the economic situation they're born into and that children are a good investment," said Vicki Giambrone, spokeswoman for Children's Medical Center of Dayton.