Lawmakers Nearing Agreement On SCHIP Reauthorization

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State Children's Health Insurance Program

House and Senate negotiators on Sunday said they have reached atentative agreement on a framework for compromise SCHIP legislationthat would expand enrollment to an additional four million uninsuredchildren, the New York Times reports. The draft compromise bill closely resembles the Senate version of SCHIP legislation, according to the Times (Pear, New York Times, 9/17).

A measure approved by the Senate (S 1893)would reauthorize SCHIP and increase the federal cigarette tax by 61cents per pack to boost funding for the program by $35 billion overfive years. The House version (HR 3162)would reduce payments to Medicare Advantage plans and increase thefederal cigarette tax by 45 cents per pack to increase funding forSCHIP by about $50 billion over five years. The bill also would make anumber of revisions to Medicare (Kaiser Daily Health Policy Report, 9/13).

Underthe proposed compromise, SCHIP would receive an additional $35 billionin funding over the next five years, bringing total spending on theprogram to $60 billion. The additional funding would be paid for by anincrease in the tobacco tax, which would be "generally similar" to the61-cent-per-pack tax proposed in the Senate version of the legislation,according to the Times.

The compromise legislation "is likely to roll back some" of the new enrollment rules, but it "would probably not eliminate all of them," the Timesreports. The rules, announced by the Bush administration last month,would require states to enroll at least 95% of children with familyincomes below 200% of the poverty level who are eligible for Medicaidor SCHIP before expanding SCHIP eligible above 250% of the povertyline. In addition, the bill would affirm states' right to decide whoqualifies for enrollment in the program.

The bill does notinclude revisions to Medicare that were included in the House versionof the bill because the provisions are "vehemently opposed byRepublicans," according to the Times. Senior Democrats inthe House and Senate said that Medicare revisions will be addressed inseparate legislation later this year. According to the Times,while some details "have yet to be decided," aides "predicted thatCongress would approve the compromise before the" program expires onSept. 30 (New York Times, 9/17).

Bush, Republican Response

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President Bush has threatened to veto the measure, according to the Washington Post (Washington Post,9/15). White House spokesperson Tony Fratto said, "We have issued vetothreats against both the House and Senate bills. So the House movingtoward the Senate position is not sufficient." Fratto added, "The Houseand the Senate still appear to be far away from legislation that wewould find acceptable."

While the bill "is likely to pick upsome Republican votes in the House," it will "probably not" be enoughto override Bush's veto, according to the Times (New York Times,9/17). Brian Walton, spokesperson for the Republican NationalCommittee, said, "Democrats have decided to use SCHIP as yet anothervehicle to try to increase government control of health care and sliptens of millions of dollars of extra spending in the budget" (AP/Boston Herald, 9/15).

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A Senate aide said, "There are still details being worked out, butthere has been a realization in the House that the final bill needs tobe closer to our bill," adding, "There is a new spirit of 'We've got toget this done,' -- $35 billion is the number everybody is zeroing inon" (Los Angeles Times, 9/15).

Sen. John Rockefeller(D-W.Va.) said, "I'm increasingly optimistic that we're going to have adeal. The House and Senate are working day and night to put together aframework that both Democrats and Republicans can support." Rockefellersaid that while neither the Senate nor the House will be completelysatisfied, "we are very close to a compromise that will protect thehealth and future of millions of children."

Rep. Rahm Emanuel(D-Ill.) said, "If the president signs the bill we present to him, it'sa major accomplishment," adding, "If he vetoes the bill, it's apolitical victory for us. Public opinion polls show strong support forexpanding kids' health coverage" (New York Times, 9/17).

Sen.John Kerry (D-Mass.) called Bush's veto threat and possible programexpiration "unconscionable," adding that if the program expires,"children will die and some will end up with permanent disabilities" (AP/Boston Herald, 9/15).

Ron Pollack, executive director of Families USA,said Democrats "don't want to be in a situation where any delay (inrenewing the program) was occasioned by Congress," adding, "They wantto get this done and let the onus be on the president for vetoing it"(Alonso-Zaldivar, Los Angeles Times, 9/15).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation.

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