Senate, House To Continue SCHIP Negotiations

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State Children's Health Insurance Program

Senate and House negotiators this week will continue discussions tocraft an SCHIP bill that would receive enough support in the House tooverride a presidential veto, CQ Today reports. However,language proposed by House Republican leadership "reveals just howdaunting" reaching compromise might be, according to CQ Today (Armstrong, CQ Today, 11/2).

The Senate last week voted 64-30 to approve revised SCHIP legislation (HR 3963)that would expand the program to cover 10 million children and increasespending on the program to $35 billion over five years, funded with a61-cent-per-pack increase in the federal cigarette tax. The measure issimilar to the bill vetoedby President Bush last month, but it would limit coverage to childrenin families with annual incomes below 300% of the federal povertylevel. The House last month approved the bill but failed to pass itwith a veto-proof majority (Kaiser Daily Health Policy Report, 11/2).

Thelanguage proposed by House Republican leadership would require that allstates enroll 90% of children in families with annual incomes less than200% of the poverty level before enrolling higher-income children. Inaddition, the Republican language would require stricter guidelines forproving citizenship by requiring the adoption of current Medicaidregulations. According to a GOP aide, the language was a starting pointfor negotiations and lawmakers have moved forward since it wasdelivered. Both Senate negotiators and House Republicans "seem eager toreach a deal and avoid the likely alternative"" passing a temporaryextension of the program that will expire directly prior to the 2008elections, CQ Today reports (CQ Today, 11/2).

National Agenda

The SCHIP debate "symbolizes the inability of Mr. Bush and the newDemocratic leaders of Congress to work together, but it also highlightsthe rift between Mr. Bush and members of his own party," the New York Times reports. According to the Times, "misconceptions and frustrations on both sides" led to the veto of the bill (Pear, New York Times,11/5). However, Democrats are "expressing increasing confidence" thattheir emphasis on SCHIP "has succeeded in putting health care on thenational agenda," the Boston Globe reports.

Democratic pollster Geoffrey Garin, president of Peter D. Hart Research Associates,said, "Everything I'm seeing in terms of public opinion is that votersfeel good that Democrats are taking on this fight. It's the presidentwho is perceived as being mule-headed and stubborn." Robert Blendon, aprofessor of health policy and political analysis at Harvard School of Public Health,said that "what has happened with the Democrats fighting for [SCHIP],and the president attacking it, is that it's become a poster child forthe broader debate on whether government should guarantee coverage forpeople" (Donnelly, Boston Globe, 11/5).

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Tax Increase Implications

Bush's refusal to sign any legislation that calls for a tax increase"could lead to the awkward scene of a large number of congressionalRepublicans voting to override his veto of a high-profile bid toexpand" SCHIP, the AP/San Jose Mercury Newsreports. Many House Republicans "have agreed to swallow" the taxincrease, and the issue "is so settled that it isn't even discussed byHouse-Senate negotiators" trying to craft a new bipartisan bill, the AP/Mercury News reports. According to the AP/Mercury News,Bush's stand on SCHIP puts House Republican leaders "in a tough spot"because changes to the bill could attract enough support from Housemembers to override a veto. If lawmakers can negotiate a veto-proofbill, "it would mark a rare legislative defeat for Bush on a majorissue," the AP/Mercury News reports (Babington, AP/Mercury News, 11/5).

Proof-of-Citizenship Requirements

Proof-of-citizenship requirements for SCHIP have "become a major hang-up delaying renewal" of the program, the Omaha World-Heraldreports. Republicans claim that the bill as written would allowundocumented immigrants to receive SCHIP benefits, but bill supporterssay that is untrue and accuse Republicans "of using the immigrationissue as political cover," according to the World-Herald.Under the bill, states could verify citizenship of applicants bychecking the applicant's Social Security number against Social SecurityAdministration records.

Sen. Chuck Grassley (R-Iowa) said,"There's absolutely nothing in this bill that would make coverage moreeasily available for illegal immigrants," adding, "Those who sayotherwise believe what they want to believe, not the facts." Rep. LeeTerry (R-Neb.) said, "Social Security numbers are a dime a dozen on thestreets, fraudulent Social Security ID's," adding, "So, the fact thatthere's no verification allows illegals to obtain the benefit"(Thompson, Omaha World-Herald, 11/5).

Editorials, Opinion Pieces, Letter

Summaries of recent opinion pieces, editorials and a letter to the editor that address the SCHIP debate appear below.

  • Sen. James DeMint (R-S.C.), Charleston Post and Courier:A "better way to fix" the U.S. health care system, proposed by Sen. MelMartinez (R-Fla.), would reauthorize "SCHIP to ensure poor childrencontinue to receive health care" and provide a "tax credit tomiddle-class families for their children's health insurance," DeMintwrites in a Post and Courier opinion piece. The U.S. "cancontinue down the path of government-controlled health care that hasproven disastrous in European nations -- leading to rationing, waitinglines, high taxes and low-quality care," DeMint writes, adding, "Or, wecan reform our current health care system and empower individuals, notWashington politicians, to make choices about their own health care"(DeMint, Charleston Post and Courier, 11/2).
  • Rep. John Mica (R-Fla.), Daytona Beach News-Journal: Mica, in response to a recent News-Journaleditorial, writes in an opinion piece that he voted against the SCHIPbill because the legislation included a "flawed method of financing"and several other "controversial provisions," such as language thatinvolved coverage for undocumented immigrants and income eligibilitylevels. However, Mica writes that he will "continue to support areasonable increase in the SCHIP program and will vote to increase bothfunding and eligibility" (Mica, Daytona Beach News-Journal, 11/2).
  • New York Times:"For weeks now, the president and his Congressional allies have chargedthat the Democrats are unwilling to negotiate a compromise onexpanding" SCHIP "because they want to use Republican opposition as acampaign issue," but "it is the Senate's Republican leaders who aredoing their best to block any compromise," a Timeseditorial states. According to the editorial, Senate Republican leaders"clearly would prefer to have no bill enacted -- and provide ammunitionfor the president's campaign to depict Congress as a failure -- than doanything meaningful to help children." The editorial states, "Theefforts to find a compromise are expected to continue, and we can onlyhope they ultimately bear fruit" (New York Times, 11/4).
  • Virginian Pilot:Lawmakers should "end the standoff" over SCHIP, with reauthorization ofthe program "already a month overdue and some states on the brink ofdropping currently enrolled children," according to a Piloteditorial. An SCHIP bill approved by Congress and vetoed by Bush"raised substantial concerns" about increased spending on the programand the "inevitable incentive for employers to ditch their healthinsurance plans," but "those concerns do not trump the desperate needto provide health care to millions of children who will lose it ifSCHIP disappears or even continues at currently approved levels," theeditorial states (Virginian Pilot, 11/4).
  • Robert Beall, Washington Post:"As our political leaders grapple with the important issue of providinghealth coverage for all children, there is an equally challenging andoften overlooked piece of the puzzle: the burden faced by many people-- often with rare or chronic diseases -- who are underinsured," Beall,president and CEO of the Cystic Fibrosis Foundation, writes in a Post letter to the editor. According to Beall, "This is a key part of the debate and too important to ignore" (Beall, Washington Post, 11/5).

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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 FamilyFoundation.

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