House Likely To Vote on Revised Kids’ Health Insurance Bill This Week
The House this week will consider a modified bill to reauthorize and expand the State Children's Health Insurance Program, "seeking to keep political pressure on Republicans who supported President Bush's veto of an earlier bill," CongressDaily reports (Bourge, CongressDaily, 10/23).
The vetoed legislation would have provided an additional $35 billion in funding for the program over the next five years and increased total SCHIP spending to $60 billion. The additional funding would have been paid for by a 61-cent-per-pack increase in the tobacco tax (California Healthline, 10/24).
The vote on the bill could occur as early as Thursday, although Democratic leadership aides said the timing is not definite (Johnson, CongressDaily, 10/24). Democrats stressed that the legislation still must expand SCHIP funding by $35 billion over five years and cover 10 million children, according to CQ Today (Wayne, CQ Today, 10/23).
The modifications to the bill will "address some of the more effective talking points raised by Bush and House Republicans," The Hill reports (Soraghan, The Hill, 10/24).
Rep. Heather Wilson (R-N.M.) said she believed Democratic lawmakers would be willing to cap eligibility at three times the federal poverty level. She also said the modified bill would give states greater authority to confirm the validity of applicants' Social Security numbers in an effort to confirm U.S. residency status (Babington/Freking, AP/Philadelphia Inquirer, 10/24). Democrats have not responded to Republicans' request to apply the same proof-of-citizenship rules for Medicaid to SCHIP, which critics have said make it too difficult to apply (CongressDaily, 10/24). Under the revised bill, childless adults would be phased out of SCHIP within one year, Wilson said (AP/Philadelphia Inquirer, 10/24).
Wilson and other moderate Republicans -- Reps. Ray LaHood (Ill.), Fred Upton (Mich.), Charles Dent (Pa.) and Michael Castle (Del.) -- on Tuesday met with House Majority Leader Steny Hoyer (D-Md.) and House Democratic Caucus Chair Rahm Emanuel (D-Ill.) to discuss changes to the bill that could garner GOP support (CongressDaily, 10/24).
House Republican Conference Chair Adam Putnam (R-Fla.) said that the new bill would need three "substantive" changes to garner additional GOP support. According to Putnam, the modified bill would need a greater focus on covering "children of the working poor first," which Republicans have most often defined as children in families with annual incomes less than 200% of the poverty level. "Greater protections" against fraud and abuse in SCHIP and stronger mechanisms for denying undocumented immigrants enrollment in SCHIP also would be needed, Putnam said. In addition, the modified bill must include "[n]o incentive" for families to drop private insurance coverage to enroll in SCHIP.
"Take care of those three things, and we're on our way to the White House with bells on," Putnam said. He said that narrowing eligibility to 200% of the poverty level likely would result in fewer than 10 million children receiving coverage under the program. For that reason, Democrats' policy changes under the modified bill likely will be much less far-reaching than those outlined by Putnam (CQ Today, 10/23).
House Democratic leaders decided to speed consideration of the bill on Tuesday "after dozens of colleagues told them the issue is extremely popular in their districts and should not be allowed to cool down," the AP/Inquirer reports (AP/Philadelphia Inquirer, 10/24).
Moderate Republicans have asked for more time to review the bill. Wilson said, "I strongly encouraged them to give people a chance to look at it, to give people a chance to think about it," adding, "When you're asking people, 'Is this good enough?' I think it's unfair to ask them to do that overnight." LaHood said, "We're trying to find a path to compromise. We don't have much time" (CongressDaily, 10/24). The Senate is "seen as likely" to approve a modified bill with a veto-proof majority, according to the AP/Inquirer.
HHS Secretary Mike Leavitt on Tuesday announced that the administration under certain conditions would support covering children in families earning up to 300% of the poverty level. While Leavitt would not give the specific funding level that the administration would recommend for the program, he said that an additional $15 billion is "a rational number." Leavitt said that Bush would continue to oppose the cigarette tax increase used to offset the increase in spending on the program (AP/Philadelphia Inquirer, 10/24).
In related news, House Energy and Commerce Committee Chair John Dingell (D-Mich.) in a letter to Leavitt on Tuesday took issue with the administration's claim that the original bill would have expanded SCHIP eligibility to families earning up to 400% of the poverty level, or about $83,000. That eligibility limit was requested by New York state and was rejected by the administration. Democrats "seethed" when Bush then cited that figure as an example, according to The Hill.
In his letter, Dingell asked Leavitt to highlight the passage of the vetoed bill that the administration claims would extend eligibility to 400% of the poverty level. Dingell also disputed the claim that the cigarette tax would unfairly impact lower-income residents, citing government data finding that 60% of adult smokers have incomes above 200% of the poverty level (The Hill, 10/24).
The Washington Post on Wednesday examined the efforts of Sen. Tom Coburn (R-Okla.) -- a "foe" of "congressional pork" -- to add an amendment to a spending bill that would have forced lawmakers to choose between earmark spending and providing health care to children. Coburn proposed an amendment that said no lawmakers would be able to earmark spending for home district projects until "all children in the U.S. under the age of 18 years are insured by a private or public health insurance plan." The amendment failed on a 68-26 vote, according to the Post.
Coburn said, "What this amendment is about is asking the Senate to choose," adding, "Choose your directed earmarks for back home, or make a statement that says we really believe kids' health care is important." However, a number of lawmakers "complained that if Coburn were truly concerned about children's health care, he would have supported an expansion of" SCHIP, according to the Post (Milbank, Washington Post, 10/24).
PBS' "Tavis Smiley" on Monday included a discussion with House Speaker Nancy Pelosi (D-Calif.) about SCHIP and other issues (Smiley, "Tavis Smiley," PBS, 10/22). Audio and a transcript of the segment are available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.