DETROIT — It may shock parents to know what happens to state and federal taxes that should subsidize children’s basic health insurance. They are in part going to agencies that provide teens with confidential abortion and contraception without parental knowledge.

In essence, some tax dollars meant to give life-saving help to the working poor are being funneled away from them and supporting programs that attack human life.

Now is a perfect time to remedy this, according to those seeking to reform the State Children’s Health Insurance Program (SCHIP). That’s because the 10-year-old program will expire Sept. 30 and Congress is poised to re-authorize it for another five years.

The direction its future will take forms part of the debate over a national health care policy, which has been called the “defining domestic issue” in the 2008 presidential race.

“No Catholic organization should expand its use of SCHIP until all states remove confidential coverage for sterilization, contraception, and abortion for rape, incest and life of the mother. The federal government currently does not require this coverage,” said Mike O’Dea, executive director of Detroit-based Christus Medicus Foundation, which is devoted to restoring Christ-centered values to health care.

“In my opinion, this is direct cooperation in evil,” said O’Dea, who also runs ValuSure Corp., a faith-based health insurance company.

Since 1997, the $40 billion State Children’s Health Insurance Program has expanded health coverage for nearly six million children under 19 years old whose families are at or below 200% of the federal poverty level.

Within broad guidelines, the federal government funds two-thirds of the insurance program through the Centers for Medicare and Medicaid Services. States contribute one-third, set up their own guidelines for eligibility and services, and administer the program.

This is where the problem has arisen, according to O’Dea, who actively supports two crisis pregnancy centers.

Powerful political interest groups like Planned Parenthood and NARAL have pressured private employers and policymakers. Although federal law doesn’t require insurance plans to offer “family planning services,” many states have added these requirements to various degrees, he said.

“This forces millions of people to violate their ‘right of conscience’ by forced cooperation in this funding through tax money,” O’Dea said.

Centers for Medicare and Medicaid Services spokesman Steven Hahn said that because all states have different policies, no total figure is readily available on how much State Children’s Health Insurance Program money goes to family planning services.

Texas is one state that won’t use these funds for that purpose, according to Dr. Angelo Giardino, medical director of the Texas Children’s Health Plan and a member of the National Review Board for the U.S. Conference of Catholic Bishops.

“SCHIP is a godsend for the working poor,” he said. “Some people are working two jobs at minimum wage and they need this for dental care and immunizations for their kids.”

Michigan still covers contraception but removed funding for sterilization and abortion, O’Dea said.

From the start, Pennsylvania avoided problems. The state Catholic Health Association and the Pennsylvania Catholic Conference got assurances that Catholic-sponsored health providers and plans could participate in the State Children’s Health Insurance Program without having to offer morally objectionable services.

Sister Clare Christi Schiefer, president of Pennsylvania Catholic Health Association, led that effort. “Some states are having a problem funding it as it is now,” she said in an interview, “so whatever money is there should be going toward what it was intended for: basic health care services for children.”

At least 14 states will have spent their State Children’s Health Insurance Program allotment before the program expires.

President Bush’s 2008 budget proposes reauthorizing the insurance program for five years with funding at existing levels, or about $30 billion for the period. In heated partisan debate, lawmakers led by House Speaker Nancy Pelosi, D-Calif., want to double enrollment to 12 million, adding up to $60 billion in authorization.

“It’s appalling to me that people should call for more money without asking that the money go to the right cause,” O’Dea said.

And now is the time to ask about issues, as Congressional committees could start policy debate by late April, said Nina Owcharenko, a Heritage Foundation senior policy analyst.

“This is what reauthorization is all about. It’s not just about the money; it’s about evaluating what the policies are that drive the program. Contraception and related issues could easily come into the debate,” she said.

Thirty American bishops have personally endorsed a Christus Medicus proposal, Declaration 2007, which calls for reform of the State Children’s Health Insurance Program by specifically refusing to provide federal money to states that fund the confidential promotion and provision of the non-health care services of abortion, sterilization and contraception.

While that’s unlikely, O’Dea said, “People can demand that state policymakers allow HMO, PPO (preferred provider organization) and Non-PPO traditional plans as value-centered options in SCHIP.”

Among the bishops who have endorsed the reform proposal are Cardinal Sean O’Malley of Boston, Bishop Fabian Bruskewitz of Lincoln, Neb., Bishop Robert Vasa of Baker, Ore., and Archbishop Alfred Hughes of New Orleans.

O’Dea aims to get the proposal endorsed by the bishops’ conference and both the Catholic Health Association and Catholic Medical Association. Christus Medicus will host a May 19 conference for the Catholic Medical Association and the Society for the Education of Physicians and Patients at Duquesne University in Pittsburgh on this and other health care issues.

In a related testimonial posted on the Christus Medicus website, Bishop Vasa wrote, “Our actions need to be as consistent as possible with our words.”

And O’Dea noted that Pope John Paul II warned about the danger of a totalitarian government whose power keeps encroaching on personal freedom. In his 1991 encyclical letter Centesimus Annus (The 10th Anniversary of Rerum Novarum), the Pope predicted it could “absorb within itself the nation, society, the family, religious groups and individuals themselves.”

Gail Besse is based in Boston.