Senate, House To Continue SCHIP Negotiations

Main Category: Medicare / Medicaid / SCHIP
Article Date: 06 Nov 2007 - 5:00 PDT

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Senate and House negotiators this week will continue discussions to craft an SCHIP bill that would receive enough support in the House to override a presidential veto, CQ Today reports. However, language proposed by House Republican leadership "reveals just how daunting" reaching compromise might be, according to CQ Today (Armstrong, CQ Today, 11/2).

The Senate last week voted 64-30 to approve revised SCHIP legislation (HR 3963) that would expand the program to cover 10 million children and increase spending on the program to $35 billion over five years, funded with a 61-cent-per-pack increase in the federal cigarette tax. The measure is similar to the bill vetoed by President Bush last month, but it would limit coverage to children in families with annual incomes below 300% of the federal poverty level. The House last month approved the bill but failed to pass it with a veto-proof majority (Kaiser Daily Health Policy Report, 11/2).

The language proposed by House Republican leadership would require that all states enroll 90% of children in families with annual incomes less than 200% of the poverty level before enrolling higher-income children. In addition, the Republican language would require stricter guidelines for proving citizenship by requiring the adoption of current Medicaid regulations. According to a GOP aide, the language was a starting point for negotiations and lawmakers have moved forward since it was delivered. Both Senate negotiators and House Republicans "seem eager to reach a deal and avoid the likely alternative"" passing a temporary extension of the program that will expire directly prior to the 2008 elections, CQ Today reports (CQ Today, 11/2).

National Agenda
The SCHIP debate "symbolizes the inability of Mr. Bush and the new Democratic leaders of Congress to work together, but it also highlights the rift between Mr. Bush and members of his own party," the New York Times reports. According to the Times, "misconceptions and frustrations on both sides" led to the veto of the bill (Pear, New York Times, 11/5). However, Democrats are "expressing increasing confidence" that their emphasis on SCHIP "has succeeded in putting health care on the national agenda," the Boston Globe reports.

Democratic pollster Geoffrey Garin, president of Peter D. Hart Research Associates, said, "Everything I'm seeing in terms of public opinion is that voters feel good that Democrats are taking on this fight. It's the president who is perceived as being mule-headed and stubborn." Robert Blendon, a professor of health policy and political analysis at Harvard School of Public Health, said that "what has happened with the Democrats fighting for [SCHIP], and the president attacking it, is that it's become a poster child for the broader debate on whether government should guarantee coverage for people" (Donnelly, Boston Globe, 11/5).

Tax Increase Implications
Bush's refusal to sign any legislation that calls for a tax increase "could lead to the awkward scene of a large number of congressional Republicans voting to override his veto of a high-profile bid to expand" SCHIP, the AP/San Jose Mercury News reports. Many House Republicans "have agreed to swallow" the tax increase, and the issue "is so settled that it isn't even discussed by House-Senate negotiators" trying to craft a new bipartisan bill, the AP/Mercury News reports. According to the AP/Mercury News, Bush's stand on SCHIP puts House Republican leaders "in a tough spot" because changes to the bill could attract enough support from House members to override a veto. If lawmakers can negotiate a veto-proof bill, "it would mark a rare legislative defeat for Bush on a major issue," the AP/Mercury News reports (Babington, AP/Mercury News, 11/5).

Proof-of-Citizenship Requirements
Proof-of-citizenship requirements for SCHIP have "become a major hang-up delaying renewal" of the program, the Omaha World-Herald reports. Republicans claim that the bill as written would allow undocumented immigrants to receive SCHIP benefits, but bill supporters say that is untrue and accuse Republicans "of using the immigration issue as political cover," according to the World-Herald. Under the bill, states could verify citizenship of applicants by checking the applicant's Social Security number against Social Security Administration records.

Sen. Chuck Grassley (R-Iowa) said, "There's absolutely nothing in this bill that would make coverage more easily available for illegal immigrants," adding, "Those who say otherwise believe what they want to believe, not the facts." Rep. Lee Terry (R-Neb.) said, "Social Security numbers are a dime a dozen on the streets, fraudulent Social Security ID's," adding, "So, the fact that there's no verification allows illegals to obtain the benefit" (Thompson, Omaha World-Herald, 11/5).

Editorials, Opinion Pieces, Letter
Summaries of recent opinion pieces, editorials and a letter to the editor that address the SCHIP debate appear below.

• Sen. James DeMint (R-S.C.), Charleston Post and Courier: A "better way to fix" the U.S. health care system, proposed by Sen. Mel Martinez (R-Fla.), would reauthorize "SCHIP to ensure poor children continue to receive health care" and provide a "tax credit to middle-class families for their children's health insurance," DeMint writes in a Post and Courier opinion piece. The U.S. "can continue down the path of government-controlled health care that has proven disastrous in European nations -- leading to rationing, waiting lines, high taxes and low-quality care," DeMint writes, adding, "Or, we can reform our current health care system and empower individuals, not Washington politicians, to make choices about their own health care" (DeMint, Charleston Post and Courier, 11/2).
  
  
• Rep. John Mica (R-Fla.), Daytona Beach News-Journal: Mica, in response to a recent News-Journal editorial, writes in an opinion piece that he voted against the SCHIP bill because the legislation included a "flawed method of financing" and several other "controversial provisions," such as language that involved coverage for undocumented immigrants and income eligibility levels. However, Mica writes that he will "continue to support a reasonable increase in the SCHIP program and will vote to increase both funding and eligibility" (Mica, Daytona Beach News-Journal, 11/2).
  
  
• New York Times: "For weeks now, the president and his Congressional allies have charged that the Democrats are unwilling to negotiate a compromise on expanding" SCHIP "because they want to use Republican opposition as a campaign issue," but "it is the Senate's Republican leaders who are doing their best to block any compromise," a Times editorial states. According to the editorial, Senate Republican leaders "clearly would prefer to have no bill enacted -- and provide ammunition for the president's campaign to depict Congress as a failure -- than do anything meaningful to help children." The editorial states, "The efforts to find a compromise are expected to continue, and we can only hope they ultimately bear fruit" (New York Times, 11/4).
  
  
• Virginian Pilot: Lawmakers should "end the standoff" over SCHIP, with reauthorization of the program "already a month overdue and some states on the brink of dropping currently enrolled children," according to a Pilot editorial. An SCHIP bill approved by Congress and vetoed by Bush "raised substantial concerns" about increased spending on the program and the "inevitable incentive for employers to ditch their health insurance plans," but "those concerns do not trump the desperate need to provide health care to millions of children who will lose it if SCHIP disappears or even continues at currently approved levels," the editorial states (Virginian Pilot, 11/4).
  
  
• Robert Beall, Washington Post: "As our political leaders grapple with the important issue of providing health coverage for all children, there is an equally challenging and often overlooked piece of the puzzle: the burden faced by many people -- often with rare or chronic diseases -- who are underinsured," Beall, president and CEO of the Cystic Fibrosis Foundation, writes in a Post letter to the editor. According to Beall, "This is a key part of the debate and too important to ignore" (Beall, Washington Post, 11/5).

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.

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