Lawmakers Set To Vote On SCHIP Expansion This Week

Main Category: Medicare / Medicaid / SCHIP
Article Date: 13 Jan 2009 - 3:00 PDT

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House lawmakers say they will vote on Wednesday or Thursday on a stand-alone SCHIP expansion that will provide Democrats on Capitol Hill "an early session victory" and give President-elect Barack Obama "a high profile bill" to sign into law when taking office, the Washington Times reports. Although two measures to expand SCHIP were vetoed by President Bush in 2007, support from Obama, congressional Democrats and many Republicans make the measure "destined to finally pass," according to the Times. A quick victory on SCHIP legislation "would give Democrats confidence and momentum to tackle big-ticket items such as the economic-stimulus package and a comprehensive health care reform package," the Times reports.

Scaled-Back Package
Although House Majority Leader Steny Hoyer (D-Md.) last week said the package would be nearly the same as the bill vetoed by Bush in 2007, some Democratic aides have said the pending economic-stimulus package and previous $700 billion economic bailout have limited the amount of federal money available and could force Democrats to cut costs on the original proposed expansion, the Times reports (Lengell, Washington Times, 1/12).

The original proposal included an increase in the federal cigarette tax to fund the SCHIP expansion. The 2007 bill, which supporters believe would have increased SCHIP enrollment from six million to 10 million, would have raised the tax by 61 cents per pack and would have cost an estimated $35 million over five years (Kaiser Daily Health Policy Report, 1/8).

However, because the 61-cents-per-pack cigarette tax likely will not cover the full cost of a five-year expansion, aides to House Democrats said lawmakers would seek a shorter SCHIP reauthorization, CQ Today reports (Armstrong, CQ Today, 1/9). According to the Times, SCHIP's expenses have increased over the last two years and cigarette sales are declining, making it necessary to seek new revenue sources for an expansion (Washington Times, 1/12). Lawmakers are waiting for cost projections from the Congressional Budget Office before they determine the length of the reauthorization. According to lobbyists and congressional aides, the extension likely will be between two years and four-and-a-half years.

According to CQ Today, a shorter-term reauthorization could mean that Democrats will attempt a "fuller expansion" of the program as part of a comprehensive health reform package. Rep. Diana DeGette (D-Colo.) said, "If a shorter-term reauthorization is the only way to craft a stronger bill that would provide coverage for more eligible children, we should take that course."

Republican Requests
House Minority Leader John Boehner (R-Ohio) and Minority Whip Eric Cantor (R-Va.) wrote in a letter to Obama and House Speaker Nancy Pelosi (D-Calif.) that Republicans want the program to require coverage of children below 200% of the federal poverty level before increasing to higher income levels. The letter said, "Republicans are committed to reauthorizing SCHIP in a manner that puts poor children first, which is the original intent of the program." They also want the legislation to require stricter citizenship documentation (CQ Today, 1/9).

Opinion
Expanding SCHIP "is good politics and the right thing to do" and is "one of the clearest signals" that Obama has sent in "his determination to learn from the Clinton years, particularly from the former president's failures on health care," E.J. Dionne, Washington Post columnist, writes in a Post opinion piece. According to Dionne, in 1994 a group of senators suggested Clinton try to insure all children when his plan for universal coverage was encountering difficulties, in order to "make, at least, a down payment on reform." However, the Clinton administration did not accept the idea and a larger reform effort ultimately failed, Dionne writes. Dionne writes that the recession has made the expansion of SCHIP urgent because more people are becoming uninsured and many state budgets are suffering from losses, and as a result are cutting health care programs. Dionne says "good-faith concerns" that expanding coverage to children now "would make it easier to delay the broader effort" to reform health care should be ignored by Congress (Dionne, Washington Post, 1/12).

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