Senate OKs Bill To Reauthorize, Expand Kids’ Health Insurance

The Senate on Thursday voted 68-31 to approve legislation (S 1893) that would reauthorize the State Children's Health Insurance Program and expand funding for the program by $35 billion over five years, the Wall Street Journal reports (Lueck, Wall Street Journal, 8/3).

Two independents, 18 Republicans and all 48 Democrats voted to pass the measure, with the 31 opposition votes coming from Republicans (Pear, New York Times, 8/3). The Senate would need 67 votes to override a potential presidential veto (Alonso-Zaldivar, Los Angeles Times, 8/3).

SCHIP expires on Sept. 30. The Senate Finance Committee in July finalized an agreement on SCHIP reauthorization that would increase five-year funding for the program from $25 billion to $60 billion by raising the federal cigarette tax from 39 cents to $1 per pack. Under the plan, the 6.6 million children currently enrolled in SCHIP would continue to receive benefits, and an additional 3.3 million children could be enrolled in the program (California Healthline, 7/31).

A White House spokesperson said President Bush's previous veto threat would stand, despite the large margin of support in the Senate, according to the Journal (Wall Street Journal, 8/3). The White House said the bill "goes too far in federalizing health care" (New York Times, 8/3).

The House on Wednesday voted 225-204 to approve its reauthorization legislation (HR 3162), which would increase SCHIP funding by $50 billion over five years and make changes to Medicare (California Healthline, 8/2).

HHS Secretary Mike Leavitt said that Congress was jeopardizing health care for children by passing bills that "the president will have no choice but to veto" (New York Times, 8/3). However, if conference committee members can reach a bipartisan agreement, the White House might "have to back down on its veto threat," according to some senior Republicans, the Los Angeles Times reports.

Senate Finance Committee ranking member Chuck Grassley (R-Iowa) said, "I hope to be able to talk to the president and just show how common sense dictates not vetoing this" (Los Angeles Times, 8/3).

The bill now goes to conference committee, and negotiators presenting will have "a formidable challenge in trying to work out differences" between the two bills, according to the New York Times. Still, Democratic leaders' "strong commitment to the issue ... virtually guarantees" that the committee will reach a compromise before Sept. 30, when the program is set to expire, the New York Times reports. However, it is unlikely that a compromise bill would be acceptable to Bush(New York Times, 8/3).

The House version of the bill includes a larger expansion of the program, along with revisions to Medicare that include cuts to private Medicare Advantage plans and a reversal of a scheduled cut to physicians' Medicare reimbursements. The House and Senate versions also differ in the size of the tobacco tax increase, with the Senate supporting a 61-cent increase and the House supporting a 45-cent increase.

House and Senate lawmakers acknowledge that the Medicare provisions in the House bill, "intended to piggyback their way into law on the popularity" of SCHIP, will "complicate negotiations," according to CQ Today (Wayne, CQ Today, 8/2). The Journal reports that the House-proposed level of cuts to MA plans "is unlikely to survive the Senate" (Wall Street Journal, 8/3).

Senate Majority Leader Harry Reid (D-Nev.) said that it would be difficult for the Senate to approve a bill expanding SCHIP above $35 billion. Noting that the Senate legislation was drafted with bipartisan support, Reid said, "It is the compromise, and I think that is our figure," adding, "We're encouraged to move to conference with the House, and we're happy to work with them to try to get something we can sell over here" (Johnson, CongressDaily, 8/3).

Senate Finance Committee Chair Max Baucus (D-Mont.) said, "What's going to happen in conference? I have no idea." He added that the bills "are really two different animals, and when that happens, generally some other solution presents itself. ... There are all kinds of ways to do things around here" (Lengell, Washington Times, 8/3).

Baucus said, "For the life of me, I can't understand why the president would want to veto this legislation. It's moderate, it's bipartisan, it helps low-income kids. ... It's just the right thing to do for the country" (Hirschfeld Davis, AP/Contra Costa Times, 8/3). He added, "This is not a huge expansion of the program. This has nothing to do with national health insurance" (Neikirk, Chicago Tribune, 8/3).

Sen. Debbie Stabenow (D-Mich.) said, "As lawmakers, we have a moral obligation to provide health care coverage for the millions of uninsured children. Health care should be a right, not a privilege, and covering every child is an important step toward this goal."

However, Senate Minority Whip Trent Lott (R-Miss.) said, "If you want to go to government-run, socialistic medicine, this is it, this is the way it's going to happen" (New York Times, 8/3).

• Rep. John Lewis (D-Ga.) and Robert Greenstein, Atlanta Journal-Constitution: The House SCHIP bill "improves health coverage for millions of America's children and seniors, and does so in a fiscally responsible way," Lewis and Greenstein, executive director of the Center on Budget and Policy Priorities, write in a Journal-Constitution opinion piece. Lewis and Greenstein conclude, "Maybe that's why its opponents have had to resort to distortions to attack it: The facts themselves clearly show that the bill is good for this country" (Lewis/Greenstein, Atlanta Journal-Constitution, 8/3).
• Washington Post: "The administration appears to be attempting to solve the problem of uninsured children by defining the numbers downward" when it focuses on studies that measure the number of children who are uninsured for a full year, rather than those measuring the number uninsured at any given point in time, according to a Post editorial. The editorial continues that "given a choice between dramatically underestimating the needs of low-income children and somewhat overstating them, we'd go with the latter" (Washington Post, 8/3).

NPR's "Morning Edition" on Friday reported on the Senate and House bills. The segment includes comments from Leavitt, Baucus and a parent who testified at the Senate hearing (Rovner, "Morning Edition," NPR, 8/3). Audio of the segment is available online.