Senate Rejects Republican SCHIP Amendment Requiring Coverage Of Most Eligible Children Before States Cover Children Of Documented Immigrants

Main Category: Medicare / Medicaid / SCHIP
Article Date: 29 Jan 2009 - 4:00 PDT

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The Senate on Tuesday rejected two Republican amendments to SCHIP reauthorization and expansion legislation, including an amendment that would have limited states' abilities to expand coverage to documented immigrants, CongressDaily reports (CongressDaily, 1/28). SCHIP is set to expire on March 1. Under the expansion bill (HR 2), children in families with incomes of up to three times the federal poverty level would qualify for the program. Supporters of the bill say it would raise the number of children covered by SCHIP from about seven million to about 11 million. The $31.5 billion measure would extend the program for four-and-one-half years and would be funded mainly by a 61-cent-per-pack increase in the federal cigarette tax (Kaiser Daily Health Policy Report, 1/27).

An amendment offered by Sen. Orrin Hatch (R-Utah) would have prohibited states from enrolling documented immigrant children and pregnant women in SCHIP within five years of their entering the country unless the state could show that it had enrolled 95% of eligible citizen children. Documented immigrants are prohibited by federal law from signing up for public programs during their first five years in the U.S., but a provision in the reauthorization bill would allow states to waive the waiting period for pregnant women and children. Hatch said, "Once those kids are covered, I'm happy to work with my colleagues to cover legal immigrant children, but our U.S. citizen children should be covered first" (Armstrong [1], CQ Today, 1/27). The amendment was defeated by voice vote. Senate Finance Committee Chair Max Baucus (D-Mont.) said no state could meet the 95% requirement. He added, "These ... [documented immigrant children] are sick through no fault of their own, and their parents are paying taxes" (Freking, AP/Miami Herald, 1/27).

Sen. Jim DeMint (R-S.C.) proposed an amendment that would have required families with annual incomes greater than 200% of the federal poverty level to contribute a portion of the cost of their SCHIP coverage through an agreement with their state. The amendment stated that beneficiaries could not be required to contribute more than 5% of their income. DeMint said, "The main goal of this is to stop the people moving from private plans ... to a government-sponsored plan," a phenomenon known as "crowd out." The measure was voted down by a margin of 60-37 (Armstrong [1], CQ Today, 1/27).

Additional Republican amendments are expected to address issues such as documentation requirements for immigrants enrolling in SCHIP and efforts to prevent children with private insurance from dropping coverage to sign up for SCHIP, according to a Republican aide (CongressDaily, 1/28).

Prospects
Senate Majority Leader Harry Reid (D-Nev.) said he had no plans to file cloture on the bill, which would end debate and bring about a vote. Stephen Krupin, a spokesperson for Reid, said, "We're not at that point in the process yet, but we hope to be able to move to a final vote by the end of the week." Reid said that the Senate would spend most of its time this week discussing the measure. He added, "I want to make sure that everyone has an opportunity to offer any amendment that they want." Democrats hope to pass the bill by the end of the week, triggering a conference with the House and President Obama to join the two chambers' bills into a single piece of legislation.

Reaction
Hatch said later, "I'm bitterly disappointed," adding that the legislation vetoed in 2007 "represented a compromise and laid the foundation for bipartisanship and trust. ... The bill being considered this week is not that bill." Senate Majority Whip Richard Durbin (D-Ill.) said the changes to the bill have been made necessary by the continuing economic recession. He said, "The issue that was before us many years ago when we created this children's health insurance program has become gravely worse" (Armstrong [1], CQ Today, 1/27).

Senate Minority Leader Mitch McConnell (R-Ky.) said of the Democrats' bill, "Our Democratic colleagues have gone back on many of the prior agreements that were reached in creating that bill last year, making this issue more contentious than it ought to be and setting a troubling precedent for future discussions on health care reform."

McConnell on Tuesday proposed his own version of the SCHIP bill (S 326), which would expand the program by $42.9 billion over four-and-one-half-years. McConnell's bill would increase the amount states can provide in premium assistance for the purchase of private insurance, to help prevent "crowd out," as well as limit federal funding to states that enroll anyone other than children and pregnant women in SCHIP. The bill would be funded by eliminating certain Medicaid payments and other changes to federal health care spending (Armstrong [2], CQ Today, 1/27).

The Philadelphia Inquirer on Wednesday looked at the debate over the SCHIP bill, as well as the program's history (Lubrano, Philadelphia Inquirer, 1/28).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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