Democrats Consider Next Moves With SCHIP Legislation

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State Children's Health Insurance Program

Sen. Orrin Hatch (R-Utah) on Tuesday said if lawmakers on Thursdayare unable to override President Bush's veto of legislation that wouldreauthorize and expand SCHIP, he will push to quickly beginnegotiations with the administration, the Los Angeles Timesreports. "Assuming we don't override the veto, then I am certainlygoing to try to bring us all together to see what we can do to resolvethis," Hatch said after a Capitol Hill rally urging Republicans tooverride the veto (Alonso-Zaldivar, Los Angeles Times, 10/17).

Bushearlier this month vetoed legislation that would have provided anadditional $35 billion in funding for the program over the next fiveyears and increased total SCHIP spending to $60 billion. The additionalfunding would have been paid for by a 61-cent-per-pack increase in thetobacco tax. An override vote in the House is scheduled for Thursday (Kaiser Daily Health Policy Report, 10/16).

HouseDemocratic leaders say that they will not consider any SCHIP proposalthat covers fewer than 10 million children. House Speaker Nancy Pelosi(D-Calif.) said that "no matter what happens" with the veto overridevote, "we will continue to fight to insure 10 million children"(Lengell, Washington Times,10/17). Many "Democrats say they have already given away too much tocome up with a bill acceptable to Hatch and other Republicans" and nowwould like to "keep sending the congressional bill back to the WhiteHouse again and again" to "wear down the opposition ... by forcingRepublican lawmakers to make politically unpopular votes as the 2008election approaches," according to the Los Angeles Times.

Rep.Henry Waxman (D-Calif.) said, "I would prefer another attempt in Marchor April of next year to see if we can get the votes for a programcloser to what Congress approved." However, the Los Angeles Timesreports, that strategy "carries substantial risks ... in terms ofpolitics and policy" because "[r]efusing to compromise could hurt thepopular program and boomerang politically," and "[p]rolonged fightingcould damage the program because it would almost certainly shatter thebipartisan coalition that has supported it" (Los Angeles Times, 10/17).

Theresult of the "standoff" between the White House and congressionalDemocrats is "another chapter in the long-running dispute over thefederal government's role in providing health care and an issue for the2008 campaign," according to USA Today (Jackson, USA Today, 10/17).

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Income Limits

When House members on Thursday vote on the bill, Republicans "willinsist" that children in families with annual incomes up to $83,000could qualify for SCHIP under the compromise bill, while Democrats willsay that "it is a total distortion for Mr. Bush and his Republicanallies to say that the bill allows coverage" up to that level, the New York Timesreports. But the bill "does not encourage or prohibit coverage ofchildren with family incomes at that level" and "would give statesfinancial incentives to sign up low-income children who are eligiblebut not enrolled," according to the New York Times.

According to the New York Times,"Some of the current confusion can be traced back" to legislationintroduced in March that would have explicitly allowed coverage ofchildren in families with incomes up to 400% of the federal povertylevel, but that provision was not included in Democrats' compromisebill.

Under the compromise measure, after Oct. 1, 2010, stateswould not be eligible to receive funds to cover children in familieswith annual incomes greater than 300% of the poverty level unless thestate enrolled a sizable majority of children in families with annualincomes less than 200% of the poverty level. To meet this requirement,a state would need to show that its proportion of low-income childrenwith insurance was at least equal to the average of the 10 states withthe highest percentage of low-income children enrolled. In addition, ifa state is granted a waiver to cover children in families with annualincomes greater than 300% of the poverty level, the federal match inmost cases would be reduced, except for New Jersey and New York if theymeet other requirements.

Jocelyn Guyer, a researcher at the Health Policy Instituteof Georgetown University, said that the SCHIP income limit level is "awildly contentious political issue, but it's largely a theoreticalquestion," adding, "More than 99% of children in the program are belowthree times the poverty level, and New York is the only state that hasexpressed any interest in going to four times the poverty level" (Pear,New York Times, 10/17).

Advertising Backlash

In related news, lawmakers targeted by an advertising campaign topressure them to vote to override Bush's veto have responded to theattacks, the Miami Herald reports.

Reps.Ileana Ros-Lehtinen (R-Fla.), Lincoln D

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