Senate To Begin Debate on Children’s Health Insurance Legislation
The Senate on Monday voted 80-0 to begin debate on 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, CongressDaily reports (Johnson, CongressDaily, 7/31). SCHIP expires on Sept. 30.
The Senate Finance Committee on July 13 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, 7/20).
The Senate bill would allow states to enroll pregnant women but would exclude undocumented immigrants (CongressDaily, 7/31).
President Bush on Monday issued a formal veto threat against the Senate legislation. Bush has proposed a $5 billion increase over five years for SCHIP, which would raise the program's total five-year funding to $30 billion (Donnelly, Boston Globe, 7/31).
A Statement of Administrative Policy issued by the White House said that the Senate bill "essentially extends a welfare benefit to middle-class households." In addition, the administration takes issue with the proposed exclusion of pregnant undocumented immigrants because the bill "wrongly weakens the current option available to states to cover unborn children and their mothers," according to the SAP.
Under current policy, states may allow pregnant undocumented immigrants to enroll in SCHIP to receive prenatal and delivery services because their children will be U.S. citizens (CongressDaily, 7/31).
A second cloture vote later this week might be necessary to end debate and move to vote on the legislation, according to CongressDaily (Johnson, CongressDaily, 7/30).
Meanwhile, House Democrats on Monday reached an agreement on revisions to SCHIP legislation (HR 3162) that would enable the bill to meet budgetary pay/go requirements, CQ Today reports (Wayne, CQ Today, 7/30).
A preliminary scoring by the Congressional Budget Office found that over the next 10 years, the bill marked up by the House Energy and Commerce Committee would have a deficit of $90 billion, most of which would occur in the second half of that time period.
The House Ways and Means Committee bill would have a $76 billion deficit in a decade, all of which would occur in the second half of that time period, according to CBO Director Peter Orszag (California Healthline, 7/27).
To meet the pay/go guidelines, Democrats agreed to reduce the amount of funding allotted for bonuses to states for enrolling children in SCHIP.
Lawmakers also agreed to limit to two years plans to reverse scheduled cuts in Medicare payments to physicians, according to a House aide. Funding for state bonuses would not be affected in the first five years, and subsequent reductions would be based on the notion that the "goal of improving enrollment in the program will have been achieved by the time the bonuses are scaled back," according to CQ Today (CQ Today, 7/30).
The House Rules Committee before the August recess this week is scheduled to combine the bills approved in the House Ways and Means Committee and the House Energy and Commerce Committee for floor consideration (Young, The Hill, 7/31).
The latest scoring documents from CBO estimate that the House SCHIP legislation would cost $47.8 billion over five years and $159.9 billion over 10 years, CQ HealthBeat reports. The scoring includes figures for the years 2008-2012 and 2008-2017. Reversal of a scheduled payment cut to physicians in 2008 and 2009 would cost $20.1 billion over five years, including the costs of a 0.5% increase for those two years. The 10-year cost of the reversal of cuts for those two years is $101 billion, according to CBO.
The scoring also determined that House cuts to Medicare Advantage plans would result in a decline in expenditures of $50.4 billion over five years and $157.1 billion over 10 years. All cuts to Medicare included by the bill would total $194.8 billion over 10 years. However, it is "unclear" how closely the scoring document reflects the provisions on which lawmakers will vote, according to CQ HealthBeat. It also is unknown whether House lawmakers will make deeper cuts or pay for the bill over five years, CQ HealthBeat notes (Reichard, CQ HealthBeat, 7/30).
Three broadcast programs recently reported on the debate over SCHIP. Summaries appear below.
- C-SPAN's "Washington Journal": The segment includes a discussion with HHS Secretary Mike Leavitt ("Washington Journal," C-SPAN, 7/30). Video of the segment is available online.
- NPR's "All Things Considered": The segment includes comments from Bush and Jon Gruber, a health economist at the Massachusetts Institute of Technology (Rovner, "All Things Considered," NPR, 7/30). Audio of the segment is available online.
- PBS' "The NewsHour with Jim Lehrer": The segment includes discussions with Leavitt and Minnesota Gov. Tim Pawlenty (R) (Ifill, "The NewsHour with Jim Lehrer," PBS, 7/30). Audio and a transcript of the segment are available online. Video will be available Tuesday afternoon.