Legislation Would Reauthorize, Expand SCHIP, Make Changes To Medicare

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The Senate on Monday will begin debate on legislation (S 1893) to reauthorize and expand SCHIP, while the House is scheduled to begin debate later in the week on a separate bill (HR 3162) that would reauthorize the program and also make revisions to Medicare, the Los Angeles Times reports (Alonso-Zaldivar, Los Angeles Times,7/30). The Senate legislation would reauthorize SCHIP and increase thecigarette tax by 61 cents per pack to boost funding for the program by$35 billion over five years (Godfrey, Wall Street Journal, 7/27).

TheHouse version would reduce payments to Medicare Advantage plans andincrease the federal cigarette tax by 45 cents per pack to increasefunding for SCHIP by $50 billion over five years (Kaiser Daily Health Policy Report, 7/27).

"Democratsare confident the overwhelming popularity of insuring millions of poorchildren will redound to their political favor -- and give them aneasily explained accomplishment to tout over the August recess -- whileRepublicans, particularly in the Senate, have struggled to coalescearound an alternative," according to Roll Call (Dennis/Pierce, Roll Call, 7/30).

Republicanlawmakers are questioning whether to support President Bush's"ideological line in the sand against growing calls for universalhealth care" because they do not "want to be tagged as opposing healthcare for children on the eve of an election year," McClatchy/Lexington Herald-Leader reports (Pugh, McClatchy/Lexington Herald-Leader,7/30). "House Democrats say moderate Republicans face a stark choice:stand with tobacco companies and insurance companies making obsceneprofits, or stand with kids, doctors and seniors," Roll Call reports.

Althoughboth bills are expected to pass with significant majorities,Republicans "remain confident they will be able to sustain a threatenedpresidential veto," according to Roll Call (Roll Call, 7/30).

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Analyst Comments

Robert Blendon, professor of health policy and political analysis at the Harvard School of Public Health,said, "If Congress fails to agree on a common bill, the Democraticleadership will get blamed, and the story will be, 'Democrats can't getthings done.'" Blendon added, "If it fails because of a presidentialveto, then the Democrats can run, saying, 'The president stopped theexpansion of coverage for children.' Almost every poll shows the publicstrongly supports the principle of covering more children."

John Rother, group executive officer of policy and strategy for AARP,said the House SCHIP legislation is a "package that helps kids, helpsseniors and helps doctors and is opposed by the tobacco and insuranceindustries," adding, "Which side do you think the public is going toline up with?" (Los Angeles Times, 7/30).

Editorials, Opinion Pieces

Summaries of editorials and an opinion piece related to SCHIP appear below.

  • Chicago Tribune:The "argument" over SCHIP "is not just about money -- although that's abig part of it -- but about overarching questions surrounding how fargovernment should go to provide such coverage," according to a Tribuneeditorial. The editorial continues, "We like SCHIP as an incrementalapproach to provide health care for the most vulnerable population:poor children," adding, "We can support an expansion, but it shouldn'tbe part of a leap toward government-sponsored universal healthcoverage." It concludes that the "Senate has the right approach tocover poor kids responsibly" (Chicago Tribune, 7/29).
  • Los Angeles Times:"With the nation apparently fighting a war on nicotine, it seems an oddtime to look to cigarette taxes as a solution to our health carecrisis, yet that's precisely what federal lawmakers are doing" byproposing a tobacco tax to fund SCHIP, according to a Timeseditorial. "Cigarette taxes are a smart way to cut down on smoking,"but "one does have to wonder whom we're going to tax once all theseanti-tobacco initiatives prompt the last smoker to kick the habit," theeditorial continues, suggesting that a "Twinkie tax" for obese peoplemight "be on the horizon." The Times concludes that"rather than sticking the bill to social outcasts for our short-termfixes, we could resign ourselves to the fact that our health caresystem isn't going to improve until everybody contributes" (Los Angeles Times, 7/28).
  • New York Times:An SCHIP expansion is "hardly" a "foot in the door for some darkgovernment design for socialized medicine," but rather a "needed boostfor a proven joint federal-state effort that epitomizes voters' growingconcern about the national neglect of health care coverage," accordingto a Times editorial. House Minority Leader John Boehner(R-Ohio) and Senate Minority Leader Mitch McConnell (R-Ky.), who opposean expansion of SCHIP, "may be on message at the White House, wherePresident Bush is foolishly threatening a veto," but the lawmakers"seem way off message for the American public and even their own partycaucuses," which are "rightly asking why they should oppose such asuccessful family values program," the editorial says (New York Times, 7/30).
  • Wall Street Journal: SCHIP "sounds like the epitome of good government" because "[w]ho could be against health care for children?" according to a Journaleditorial. It continues, "The answer is anyone who worries about onemore middle-class taxpayer entitlement and a further slide to agovernment takeover of health care." The editorial concludes,"Republicans would be wise to support" SCHIP legislation by McConnelland Sen. Jon Kyl (R-Ariz.) that would "reach the remaining 689,000uninsured children that SCHIP was intended to help," or they will "takeone more step to returning to their historic minority party status astax collectors for the welfare state" (Wall Street Journal, 7/30).
  • David Broder, Washington Post:"Had Bush joined" the debate over the U.S. health care system "beforehis time in office had dwindled to 18 months and his approval scoresslumped to Nixonian levels, the chances of something positive emergingwould have been much greater," columnist Broder writes in a Postopinion piece. "What will probably happen is that Congress will pass"an SCHIP reauthorization bill "that will draw a veto -- and then theserious bargaining will begin" because "no one wants to see the programend," Broder writes. He continues that "if and when a compromise isreached, the larger issues of health care will remain," adding, "Andthat is why it is important that the presidential candidates in bothparties take advantage of the opportunity being offered by a series ofhealth care forums this fall." Broder notes that the Federation ofAmerican Hospitals and Families USA along with several foundations aresponsoring hour-long sessions at which a presidential candidate willpresent his or her health care ideas and then take questions from apanel of health policy journalists (Broder, Washington Post, 7/29).

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Reprinted with permission from kaisernetwork\t\t\t\t\t\t\t

Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily Health Policy Report, search the archives, andsign up for email delivery at kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published forkaisernetwork.org,a free service of The Henry J. Kaiser Family Foundation.

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