Majority in USA Trust Democrats To Handle SCHIP

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State Children's Health Insurance Program

Fifty-two percent of U.S. residents trust Democrats to handle issueswith SCHIP, but the same percentage "agree with the president thatgovernment aid should be targeted to low-income families," according toa USA Today/Gallup Poll, USA Todayreports. The poll surveyed 1,009 adults from Friday to Sunday, abouthalf of whom were questioned about children's health care.

Thepoll found that 52% of people agree that SCHIP beneficiaries should bechildren in families with annual incomes up to 200% of the federalpoverty level, while 40% say SCHIP should be extended to children infamilies with annual incomes up to 300% of the poverty level. Inaddition, 55% of respondents said they are very or somewhat concernedthat SCHIP would create an incentive for families to drop privatecoverage.

According to USA Today, the poll shows that "while Bush may be losing the political battle with Democrats, he may be doing better on policy." HHSSecretary Mike Leavitt said that policy is most important, adding,"There's a lot of politics going on right now," but "the politics willlast a matter of weeks" and "policy here will go on for decades. Wehave to get this right."

However, Rep. Rahm Emanuel (D-Ill.)said that other polls have indicated much greater support for theDemocratic position. Robert Laszewski, an independent health policyconsultant, said the results of the USA Today/Gallup Pollare not surprising, adding that unless U.S. residents are made aware ofhealth coverage costs, "the notion that the government should be payinghealth insurance for the middle class is nuts."

Former CMSAdministrator Mark McClellan said, "For most Americans, there's arecognition that people at moderate income levels are struggling toafford health insurance. They're just not sure that having thegovernment pay almost all of the cost is the way to solve the problem"(Wolf, USA Today, 10/16).

Separately, Leavitt onMonday said, "There are two questions here. One is a question ofideology, who should be covered, and the second is what's the number ittakes to do that. One is policy. The other is arithmetic. We need tosolve the policy question, and then we can work the arithmetic out"(Johnson, CongressDaily, 10/16).

States' Dilemma

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As Bush and Congress continue the debate on SCHIP, states are preparingto cap enrollment or cut children from the program because of theuncertainty of future funding levels, the Washington Post reports (Lee, Washington Post,10/16). Bush earlier this month vetoed legislation that would haveprovided an additional $35 billion in funding for the program over thenext five years and increased total SCHIP spending to $60 billion. Theadditional funding would have been paid for by a 61-cent-per-packincrease in the tobacco tax. An override vote in the House is scheduledfor Thursday (Kaiser Daily Health Policy Report,10/15). SCHIP until mid-November operates under a continuing resolutionintended to maintain existing enrollment until a compromise can bereached. However, "many state program leaders say the short-term fixwill not be enough to maintain existing enrollment if gridlockcontinues," according to the Post (Washington Post, 10/16).

Joy Wilson, a health care specialist with the National Conference of State Legislatures,said that the "immediate issue out there is the uncertainty" thatstates are "confronted with, just not knowing how this is going to playout," adding, "If the money (finally settled on) is a lot less (thanCongress' bill), it'll put some states in the position of having todrop some covered children."

In addition, some worry that theSCHIP debate will continue and "eventually lead to a simple continuingresolution for this year that would surely engender a setback in thenumber of covered enrollees," according to CongressDaily."It's unclear whether that number (in a resolution) would providestates with enough to avoid having to cut people from the program,"Wilson said (Hess, CongressDaily, 10/16). Leavitt saidHHS has been working with governors of 49 states to ensure that nostate would have to cut children from the program (Washington Post, 10/16).

Future Prospects

Republicans are confident they will be able to sustain Bush's veto in Thursday's override vote, the AP/Houston Chronicle reports (Espo, AP/Houston Chronicle,10/15). The Bush administration on Monday said that after the overridevote, it wants to begin negotiations with House and Senate leaders toexpand SCHIP. Spokesperson Tony Fratto said, "Once the veto issustained and I think that becomes a reality for Congress," then "maybewe can sit down and try to find areas where we can agree and extend andreauthorize the program" (Hoskinson/Reichard, CQ HealthBeat,10/15). Fratto noted that Bush wants to "try to find ways toreauthorize the program in a way that puts the poorest children firstin line -- makes sure they're covered" (Hoeffel/Simon, Los Angeles Times, 10/16).

Ina speech in Arkansas on Monday, Bush defended his veto, saying, "Notonly is the eligibility requirement" in the SCHIP bill "being expandedway beyond the scope of the program," it "sounds like there's anationalization of medicine going on here." Bush said that if the vetois sustained, "I call upon the leadership in Congress to come to thetable" and "get money to those families that the program was intendedto help."

Bush has asked Ed Gillespie, his chief politicaladviser; Leavitt; and White House economic adviser Al Hubbard to helpnegotiate a new SCHIP bill (Runningen/Nichols, Bloomberg/Boston Globe,10/16). After the SCHIP reauthorization bill is completed, leadersshould begin to discuss how to insure more U.S. residents, Leavitt said(CQ HealthBeat, 10/15).

Lobbying Efforts

Large health care organizations over the past year "have exertedthemselves to help Democrats pass" the SCHIP bill, "even though theirfinancial interests in the program are negligible," in hopes of"generat[ing] good will among Democrats," The Hill reports. Endorsement from the groups -- which include America's Health Insurance Plans, the Pharmaceutical Research and Manufacturers of America and the American Medical Association-- "have already provided political cover to Democrats -- and denied itto the president and the Republican Party," according to The Hill.However, health care lobbyists "have got plenty else on their plates,so what they'll do after the vote is the subject of speculation amongstalwart backers of the SCHIP bill," The Hill reports (Young, The Hill, 10/16).

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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