House Democrats Plan To Vote On Revised SCHIP Legislation

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State Children's Health Insurance Program

The House this week will consider a modified bill to reauthorize andexpand SCHIP, "seeking to keep political pressure on Republicans whosupported President Bush's veto of an earlier bill," CongressDaily reports (Bourge, CongressDaily,10/23). The vetoed legislation would have provided an additional $35billion in funding for the program over the next five years andincreased total SCHIP spending to $60 billion. The additional fundingwould have been paid for by a 61-cent-per-pack increase in the tobaccotax Kaiser Daily Health Policy Report, 10/24).

Thevote on the bill could occur as early as Thursday, although Democraticleadership aides said the timing is not definite (Johnson, CongressDaily,10/24). Democrats stressed that the legislation still must expand SCHIPfunding by $35 billion over five years and cover 10 million children,according to CQ Today (Wayne, CQ Today,10/23). The modifications to the bill will "address some of the moreeffective talking points raised by Bush and House Republicans," The Hill reports (Soraghan, The Hill, 10/24).

Rep.Heather Wilson (R-N.M.) said she believed Democratic lawmakers would bewilling to cap eligibility at three times the federal poverty level.She also said the modified bill would give states greater authority toconfirm the validity of applicants' Social Security numbers in aneffort to confirm U.S. residency status (Babington/Freking, AP/Philadelphia Inquirer,10/24). Democrats have not responded to Republicans' request to applythe same proof-of-citizenship rules for Medicaid to SCHIP, whichcritics have said make it too difficult to apply (CongressDaily, 10/24). Under the revised bill, childless adults would be phased out of SCHIP within one year, Wilson said (AP/Philadelphia Inquirer, 10/24).

Wilsonand other moderate Republicans -- Reps. Ray LaHood (Ill.), Fred Upton(Mich.), Charles Dent (Pa.) and Michael Castle (Del.) -- on Tuesday metwith House Majority Leader Steny Hoyer (D-Md.) and House Democratic Caucus Chair Rahm Emanuel (D-Ill.) to discuss changes to the bill that could garner GOP support (CongressDaily, 10/24).

Republican Requests

House Republican ConferenceChair Adam Putnam (R-Fla.) said that the new bill would need three"substantive" changes to garner additional GOP support. According toPutnam, the modified bill would need a greater focus on covering"children of the working poor first," which Republicans have most oftendefined as children in families with annual incomes less than 200% ofthe poverty level. "Greater protections" against fraud and abuse inSCHIP and stronger mechanisms for denying undocumented immigrantsenrollment in SCHIP also would be needed, Putnam said. In addition, themodified bill must include "[n]o incentive" for families to dropprivate insurance coverage to enroll in SCHIP.

"Take care ofthose three things, and we're on our way to the White House with bellson," Putnam said. He said that narrowing eligibility to 200% of thepoverty level likely would result in fewer than 10 million childrenreceiving coverage under the program. For that reason, Democrats'policy changes under the modified bill likely will be much lessfar-reaching than those outlined by Putnam (CQ Today, 10/23).

Timing

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House Democratic leaders decided to speed consideration of the bill onTuesday "after dozens of colleagues told them the issue is extremelypopular in their districts and should not be allowed to cool down," theAP/Inquirer reports (AP/Philadelphia Inquirer, 10/24).

ModerateRepublicans have asked for more time to review the bill. Wilson said,"I strongly encouraged them to give people a chance to look at it, togive people a chance to think about it," adding, "When you're askingpeople, 'Is this good enough?' I think it's unfair to ask them to dothat overnight." LaHood said, "We're trying to find a path tocompromise. We don't have much time" (CongressDaily, 10/24). The Senate is "seen as likely" to approve a modified bill with a veto-proof majority, according to the AP/Inquirer.

White House Concessions

HHSSecretary Mike Leavitt on Tuesday announced that the administrationunder certain conditions would support covering children in familiesearning up to 300% of the poverty level. While Leavitt would not givethe specific funding level that the administration would recommend forthe program, he said that an additional $15 billion is "a rationalnumber." Leavitt said that Bush would continue to oppose the cigarettetax increase used to offset the increase in spending on the program (AP/Philadelphia Inquirer, 10/24).

Dingell Letter

In related news, House Energy and Commerce CommitteeChair John Dingell (D-Mich.) in a letter to Leavitt on Tuesday tookissue with the administration's claim that the original bill would haveexpanded SCHIP eligibility to families earning up to 400% of thepoverty level, or about $83,000. That eligibility limit was requestedby New York state and was rejected by the administration. Democrats"seethed" when Bush then cited that figure as an example, according to The Hill.

Inhis letter, Dingell asked Leavitt to highlight the passage of thevetoed bill that the administration claims would extend eligibility to400% of the poverty level. Dingell also disputed the claim that thecigarette tax would unfairly impact lower-income residents, citinggovernment data finding that 60% of adult smokers have incomes above200% of the poverty level (The Hill, 10/24).

Earmarks vs. Children's Health Care

The Washington Poston Wednesday examined the efforts of Sen. Tom Coburn (R-Okla.) -- a"foe" of "congressional pork" -- to add an amendment to a spending billthat would have forced lawmakers to choose between earmark spending andproviding health care to children. Coburn proposed an amendment thatsaid no lawmakers would be able to earmark spending for home districtprojects until "all children in the U.S. under the age of 18 years areinsured by a private or public health insurance plan." The amendmentfailed on a 68-26 vote, according to the Post.

Coburnsaid, "What this amendment is about is asking the Senate to choose,"adding, "Choose your directed earmarks for back home, or make astatement that says we really believe kids' health care is important."However, a number of lawmakers "complained that if Coburn were trulyconcerned about children's health care, he would have supported anexpansion of" SCHIP, according to the Post (Milbank, Washington Post, 10/24).

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 HealthPolicy Report is published for kaisernetwork.org, a free service of The HenryJ. Kaiser Family Foundation.

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