California Kids Remain Insured as Congress Passes Health Bill
The House on Wednesday approved legislation (S 2499) to extend funding for the State Children's Health Insurance Program through March 2009, a move that secures current enrollment levels in California but could impair statewide health care reform efforts, the Sacramento Bee reports.
President Bush has indicated he will sign the bill, which won approval from the Senate on Tuesday (Whitney, Sacramento Bee, 12/20). The bill would also delay for six months a 10% cut to Medicare physician fees that is scheduled to take effect Jan. 1, 2008 (Armstrong, CQ Today, 12/19).
California's Managed Risk Medical Insurance Board, which oversees Healthy Families, the state's SCHIP program, was prepared to create a waiting list and begin removing some of the 1.1 million children enrolled in the program if Bush and Congress could not agree on legislation (California Healthline, 11/19).
Bush has previously vetoed two measures that would have expanded SCHIP enrollment.
Rep. Doris Matsui (D-Calif.) said, "Without the action we took today, over 600,000 children in California ... would lose their health coverage before the end of 2008."
Jean Ross, executive director of the California Budget Project, said that while the state can maintain its current enrollment, the bill could impede legislation (ABX1 1) that would expand Healthy Families as part of a larger effort to overhaul California's health care system (Sacramento Bee, 12/20).
The bill also would increase Medicare physician fees by 0.5% for six months and would extend several programs that provide higher Medicare reimbursement rates to rural health care providers and hospital laboratories.
In addition, the bill would extend for six months rural and low-income subsidies, as well as payments for rehabilitative therapy under Medicare.
The Congressional Budget Office on Tuesday estimated that the measure would cost $5.3 billion over five years. The costs would be offset by:
- $1.5 billion in cuts from a "stabilization fund" created under the Medicare prescription drug benefit to attract preferred provider organization plans to underserved areas;
- $1.4 billion in reduced payments to hospitals for inpatient rehabilitation services; and
- $1 billion in reduced payments for drugs administered by physicians rather than taken at home by beneficiaries.
The legislation does not address future physician fee cuts, which means the 10% reduction will take effect when the delay expires in June 2008 unless additional legislative action is taken (CQ Today, 12/19).
House Energy and Commerce Health Subcommittee Chair Frank Pallone (D-N.J.) said that he expects Congress in June 2009 to pass another short-term delay of the fee cut because the White House is opposed to offsets that would stop the cut for a longer period of time (Johnson, CongressDaily, 12/20).
White House spokesperson Dana Perino in a statement said, "With this (SCHIP) bill, we can be assured that children will continue to have coverage, and Democrats won't be able to play election-year politics with children's health" (Neikirk, Chicago Tribune, 12/20).
The measure does not address an SCHIP policy directive announced in August by CMS that states must enroll 95% of children in families with incomes up to 250% of the federal poverty level before expanding eligibility, The Hill reports. Acting CMS Administrator Kerry Weems said that the Bush administration would not require states to disenroll children from the program despite the requirement.
C-SPAN's "Washington Journal" on Wednesday included a discussion with Rep. Tom Price (R-Ga.), a member of the House Education and Labor Subcommittee on Health, Employment, Labor and Pensions, about the SCHIP provisions in the bill ("Washington Journal," C-SPAN, 12/19). Video of the segment is available online.
NPR's "All Things Considered" on Wednesday also reported on the bill. The segment includes comments from Reps. Roy Blunt (R-Mo.), Rahm Emanuel (D-Ill.) and Pete Stark (D-Calif.) (Rovner, "All Things Considered," NPR, 12/19). Audio and a partial transcript of the segment are available online.