NASE News

Congress Working to Reauthorize SCHIP

Congressional Democrats have been working on enactment of a children’s health insurance bill that President Bush vetoed twice in the 110th Congress. The legislation would reauthorize and expand the State Children’s Health Insurance Program (SCHIP).

SCHIP began in 1997 to provide health care to low-income children whose parents’ income level does not qualify them for Medicaid yet who can’t afford private insurance. The program is financed by both the federal government and the states.

The House bill would provide an additional $35 billion for the program over four and a half years, a sum bill sponsors say would bring total enrollment up to 11 million children by allowing coverage of an additional 4 million.

As originally written, the Senate bill would have increased spending on SCHIP by $31.5 billion over the same period, however changes made in committee are expected to increase the cost by several billion.

The bills differ only slightly from the two versions vetoed by President Bush in 2007. The House passed its bill (HR 2) by a vote of 289-139 on Jan. 14, and the Senate Finance Committee approved a very similar measure, 12-7, the following day.

Both bills would rely on a cigarette tax increase of 61 cents per pack to fund most of the expansion. The Senate committee added language by Sen. John D. Rockefeller IV (D-W.Va.) to allow legal immigrants and new citizens into the program without the standard five-year waiting period. The panel adopted the amendment, 12-7, thus eliminating any real difference between the bills.

Congressional Republicans however, are in opposition to the bill’s elimination of the waiting period for immigrants and new citizens, looser citizenship and residency documentation requirements, and slightly looser provisions on income limits.

Senate Finance Committee Ranking Member Charles Grassley (R-Iowa) argued that doing a full SCHIP reauthorization would make a health care overhaul only more complicated in the future, saying “In a lot of ways it makes more sense to do a simple extension of SCHIP for two years so we can work through how to fold SCHIP into a program that covers everyone.”

Republicans said eliminating the waiting period would encourage illegal immigration, and offered several motions to require more stringent documentation of legal residency or citizenship. All failed, with the exception of an amendment by Grassley that would require states to also review the citizenship or legal residency status of SCHIP enrollees when reviewing income levels. The amendment was adopted by voice vote.

The committee also adopted an amendment to give states the option of offering dental insurance to children who are privately insured but do not have dental coverage.

The bill will now go to the Senate floor and then to a conference committee to resolve differences.