Congress Weighs Options for Boosting Kids’ Insurance Funds
House Appropriations Committee Chair David Obey (D-Wis.) on Tuesday confirmed that the committee will include funds for the State Children's Health Insurance Program in a supplemental appropriations bill for military operations in Iraq and Afghanistan, CQ Today reports. Fourteen states this year face a combined $745 million deficit in federal funds for SCHIP, according to an estimate from the Congressional Research Service.
Obey said, "As far as I'm concerned, the supplemental we report out will contain at least $750 million in additional funds, to see that states don't rip kids off those rolls."
Some Republican lawmakers have said that the military appropriations bill should not include funds for SCHIP, "but there is likely to be little real opposition" to the proposal, CQ Today reports (Wayne, CQ Today, 2/27).
Enactment of the military appropriations bill "is expected as early as May, but some states may already have run out of SCHIP funding by then," CongressDaily reports (Johnson, CongressDaily, 2/28).
In related news, Sen. Gordon Smith (R-Ore.) on Tuesday proposed an increase to the federal cigarette tax from 39 cents per pack to as much as 99 cents per pack to cover the cost of an expansion of SCHIP. Smith said the cigarette tax increase would raise $46.5 billion in additional revenue over five years (CongressDaily, 2/27).
Smith, a member of the Senate Finance Committee, said the proposal "would get a lot of kids covered, pregnant women included."
Committee Chair Max Baucus (D-Mont.) said that he does not oppose the proposal.
Committee member Orrin Hatch (R-Utah) said that he would consider the proposal. However, he said, "There's no way he's going to get that kind of money, in my book" (CQ Today, 2/27).
Meanwhile, Baucus and Senate Budget Committee Chair Kent Conrad (D-N.D.) on Tuesday said the Congressional Budget Office plans to release a cost estimate for the reauthorization of SCHIP that is less than previously expected by lawmakers, CongressDaily reports. According to a congressional source cited by CongressDaily, although CBO estimates the cost of reauthorization of SCHIP for all current beneficiaries at $13 billion over five years, the estimated cost decreases to $8 million to account for the fact that additional funds for SCHIP would allow the program to enroll some children who would otherwise shift to Medicaid.
Lawmakers "have been operating on the assumption that simply extending the program without dropping beneficiaries would cost between $12 billion and $15 billion in new funding over five years," CongressDaily reports.
According to CongressDaily, Baucus "considers any downscaling of cost estimates for reauthorizing SCHIP to be a positive development, giving him more options for raising money to cover the costs of reauthorization."
However, Sen. Jay Rockefeller (D-W.Va.) said that he "can't accept" the revised cost estimate. "I don't think you can get 15 to eight," he said, adding, "I don't know how that works" (CongressDaily, 2/28).
Governors "are resisting administration pressure to consider something other than swift congressional action" to address deficits in federal funds for SCHIP, The Hill reports. At the recent National Governors Association winter meeting in Washington, D.C., governors asked Congress to provide $745 million in supplemental funds for SCHIP.
However, HHS Secretary Mike Leavitt said that states could avoid deficits in SCHIP through more effective management of their programs.
An HHS spokesperson said, "We have offered to work with states, beyond the congressional action ... on trying to come up with solutions" that would require administrative revisions to their SCHIP and Medicaid programs. For example, states could shift beneficiaries from SCHIP to Medicaid.
SCHIP is not an entitlement program, "so if federal funds dry up, states would be left to foot the entire cost," but under entitlement programs such as Medicaid, the "federal government's financial responsibilities are open-ended," The Hill reports.
New Jersey Gov. Jon Corzine (D-N.J.) said, "That's a possibility," but added, "I think the most important thing is to focus on getting the supplemental done in an expeditious and timely manner ... so we don't have to go through these stretch maneuvers."
Cindy Mann, executive director of the Center for Children and Families at the Georgetown University Health Policy Institute, said the transfer of beneficiaries from SCHIP to Medicaid might prove more difficult in states that did not establish SCHIP as an expansion of Medicaid.
Joy Johnson Wilson, director of health policy at the National Conference of State Legislatures, said, because Medicaid often offers more benefits than SCHIP, states might experience political difficulties in the event that they seek to return beneficiaries from Medicaid to SCHIP (Young, The Hill, 2/28).
C-SPAN's "Washington Journal" on Tuesday included an interview with Vermont Gov. Jim Douglas (R), chair of the health and human services committee of NGA. In the interview, Douglas discussed SCHIP, universal health insurance and other health care policy issues ("Washington Journal," C-SPAN, 2/27).
Video of the segment is available online.