House Approves Legislation To Expand SCHIP, Revise Medicare

Main Category: Medicare / Medicaid / SCHIP
Article Date: 06 Aug 2007 - 16:00 PDT

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The House on Wednesday voted 225-204 to approve legislation (HR 3162) that would reauthorize SCHIP and make changes to the Medicare program, Roll Call reports (Dennis, Roll Call, 8/2). Five Republicans voted with 220 Democrats to pass the measure, while 10 Democrats and 194 Republicans voted against it (Pear, New York Times, 8/2).

SCHIP is set to expire on Sept. 30. The House legislation, called the Children's Health and Medicare Protection Act, would increase SCHIP funding by $50 billion over five years (Kaiser Daily Health Policy Report, 7/25). The bill would reduce payments to Medicare Advantage plans and increase the federal cigarette tax by 45 cents per pack to boost funding. To meet pay/go guidelines, Democrats on Monday agreed to reduce the amount of funding allotted for bonuses to states for enrolling children in the program. Lawmakers also agreed to limit to two years plans to reverse scheduled cuts in Medicare payments to physicians (Kaiser Daily Health Policy Report, 8/1).

Under the bill, states would have the option to cover children of documented immigrants and establish their own methods of verifying citizenship. The bill also would tax health insurance by $2 per person to fund research into cost-effective medical treatments (Alonso-Zaldivar, Los Angeles Times, 8/2). The House legislation has the support of Republican and Democratic governors, AARP, the American Academy of Pediatrics, the American Medical Association, the Catholic Health Association and the March of Dimes (Weisman, Washington Post, 8/2).

Veto Threat, Democratic Response
In a veto threat issued on Wednesday for the House bill, the White House said the bill "clearly favors government-run health care over private health insurance" and costs too much (Hirschfeld Davis, AP/Las Vegas Sun, 8/1). The White House called the bill a "wholesale, unapologetic move to government-run health care for large classes of children and a return to one-size-fits-all choices for Medicare beneficiaries" (Pugh, Miami Herald, 8/2).

House Majority Leader Steny Hoyer (D-Md.) said, "Contrary to the claims of some -- including, sadly, President Bush -- this legislation does not expand the SCHIP program. This does not constitute a government takeover of health care" (Walsh, New Orleans Times-Picayune, 8/2).

House Speaker Nancy Pelosi (D-Calif.) said that with the SCHIP legislation, Congress is "not going to fail America's children -- we are championing them," adding, "This legislation has fiscal soundness, it has a values base and it should have the support of everyone."

House Energy and Commerce Committee Chair John Dingell (D-Mich.) said, "For this Congress, this (bill) is perhaps the greatest opportunity we will have." Dingell added, "It's not only a humanitarian and a compassionate concern of this nation, but rather it's the future of this country" (Lengell, Washington Times, 8/2).

Republican Comments
Rep. Joe Barton (R-Texas) said Republicans are "for reauthorization of SCHIP" and "for covering our low-income and near-low-income children." However, Barton said, "We disagree with our friends on the majority side on the amount of individuals we are talking about" (Dart, Fort Worth Star-Telegram, 8/2).

Rep. Jim McCrery (R-La.), who led Republican opposition in the House, said that the bill "will raise the cost of private health insurance," adding, "Maybe that's what the majority wants, to drive people out of private insurance and into government-run health care" (New Orleans Times-Picayune, 8/2).

Former House Speaker Dennis Hastert (R-Ill.) said that the bill is "government-paid health care," adding, "It's a bad bill for a bad time, and it's coming under the false pretenses of trying to do something for children" (Washington Post, 8/2).

Additional Comments
Drew Altman, president and CEO of the Kaiser Family Foundation, said that if lawmakers "fail to reach a compromise on covering kids, it would be pathetic," adding, "If they can't agree on kids, what will they be able to reach a deal on when it comes to health reform? Failure to reauthorize [SCHIP] would damage many of the most important state health reform efforts around the country" (Los Angeles Times, 8/2).

Genevieve Kenney, a researcher at the Urban Institute's Health Policy Center, said, "There's a lot of common ground between" the House and Senate legislation, but "that's not to underestimate the difficulties they will have reconciling scaling of support and how they will pay for it" (Marcus, Bloomberg/Boston Globe, 8/2).

Senate Progress
Meanwhile, the Senate on Wednesday "continued to beat back amendments" to its SCHIP legislation (S 1893) that would expand the program by $35 billion over five years through a 61-cent-per-pack tobacco tax increase, CQ Today reports. The Senate is debating its legislation as a substitute to a tax bill (HR 976) that passed in the House (Armstrong/Wayne, CQ Today, 8/1).

Senate Majority Leader Harry Reid (D-Nev.) said the Senate will complete work on the bill before the August recess (CongressDaily, 8/2).

Related Coverage

Editorial
"Lawmakers in both chambers must reconcile their differences and be prepared to iron out a workable compromise between the two proposals before the SCHIP program expires," according to a Baltimore Sun editorial. The House version "offers the best approach to financing" by reducing payments to MA plans and increasing the tobacco tax, while the larger tobacco tax used to fund SCHIP in the Senate version "tends to fall most heavily on those least able to pay," according to the editorial. The Sun concludes that the reauthorization of SCHIP "is critical, the need is urgent -- and despite the usual procedural bickering, the opportunity for progress is unusually ripe" (Baltimore Sun, 8/2).

Broadcast Coverage
Several broadcast programs recently reported on the bill. Summaries appear below.



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. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Article adapted by Medical News Today from original press release.
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