Obama Approves Expansion of Children’s Health Insurance

On Wednesday, President Obama signed into law a bill (HR 2) that will reauthorize and expand the State Children's Health Insurance Program to an additional four million children, the AP/San Francisco Chronicle reports.

Obama said that expanding the program is "the first step" to achieving universal health coverage in the U.S. (Freking/Elliot, AP/San Francisco Chronicle, 2/5).

The House cleared the final version of the measure by a vote of 290-135 earlier in the day. Forty Republicans voted in favor of the bill, and 133 voted against it.

Two House Democrats voted against the measure (Lengell, Washington Times, 2/5).

The Senate approved the legislation last week.

SCHIP was set to expire on March 31 without congressional action.

Details

Under the bill, children in families with incomes of up to three times the federal poverty level will qualify for the program. New Jersey and New York state will be exempt from those income eligibility requirements and will be allowed to expand coverage to children in higher-income families (Kaiser Daily Health Policy Report, 2/4).

The bill allows states to offer dental care through SCHIP to children who have private coverage that does not include dental benefits (CongressDaily, 2/4).

In addition, the measure generally requires states to provide equal coverage of mental and physical illnesses under SCHIP.

The bill eliminates a five-year waiting period for documented immigrant children and pregnant women to become eligible for the program.

The measure requires states to verify that SCHIP beneficiaries are documented immigrants or citizens, but it allows states to try to verify eligibility by matching an applicant's name and Social Security number against federal records, rather than requiring documents proving citizenship (Pear, New York Times, 2/5).

The measure calls for increasing SCHIP spending by $32.8 billion over four-and-a-half years.  It will be funded by a 62-cent-per-pack increase in the federal cigarette tax.

The bill will provide coverage for the additional four million children by 2013, while continuing coverage for seven million children already in the program (AP/San Francisco Chronicle, 2/5).

The Congressional Budget Office projects that California could get as much as $30 billion in additional federal funding under the bill (Weiss, "KXJZ News," Capital Public Radio, 2/4).

President's Comments

At a White House signing ceremony, Obama said, "I refuse to accept that millions of our children fail to reach their full potential because we fail to meet their basic needs" (Pulizzi/Johnson, Wall Street Journal, 2/4). He added, "In a decent society, there are certain obligations that are not subject to tradeoffs or negotiation, and health care for our children is one of those obligations" (Mussenden, Media General News/Richmond Times-Dispatch, 2/5).

Obama said, "The way I see it, providing coverage to 11 million children [through SCHIP] is a down payment on my commitment to cover every single American" (Levey, Los Angeles Times, 2/5).

He continued, "It is just one component of a much broader effort to finally bring our health care system into the 21st century," adding, "I am confident that, if we work together, if we come together, we can finally achieve what generations of Americans have fought for and fulfill the promise of health care in our time" (Washington Times, 2/5).

Democratic Lawmakers' Comments

House Speaker Nancy Pelosi (D-Calif.) said, "This is the beginning of the change that the American people voted for in the last election and that we will achieve with President Obama" (Los Angeles Times, 2/5).

Rep. Charles Rangel (D-N.Y.) said, "I cannot think of a better investment than the health of our children" (Graham, "Triage," Chicago Tribune, 2/4).

Sen. John Kerry (D-Mass.) said, "We've waited far too long for this day. America's kids should be guaranteed comprehensive care whether they need dental care, mental health, medical or surgical treatment" (Rhee, "Political Intelligence," Boston Globe, 2/4).

House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) said, "While this bill is short of our ultimate goal of health reform, it is a down payment, and is an essential start" (New York Times, 2/5).

Republican Criticism

Republicans expressed concern that the expansion would cause children to leave private insurance plans to enroll in SCHIP.

Sen. Pete Sessions (R-Texas) asked, "Why would you take someone who has private health insurance and move them to a government-run program?" (Wall Street Journal, 2/4).

Rep. Steve King (R-Iowa) said that the bill is "a foundation stone for socialized medicine," and Rep. Tom McClintock (R-Calif.) said that SCHIP was "slowly replacing employer health plans with government-paid health plans, with spiraling costs to taxpayers" (New York Times, 2/5).

Schwarzenegger Comments

In a statement, Gov. Arnold Schwarzenegger (R) said, "Protecting this program has been a priority of mine, and I applaud President Obama for signing this bipartisan legislation and following through on our shared commitment to ensuring that children who need it most have a healthy start in life. This is the first of many steps that are urgently needed to fix our broken health care system so that it is more affordable and accessible for everyone" (Office of the Governor release, 2/4).

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