Medicaid Eligibility Issue In SCHIP Negotiations

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StateChildren's Health Insurance Program

A dispute over upper-incomelimits on Medicaid eligibility has become the "primary obstacle" tocompleting negotiations on revised legislation that would reauthorize andexpand SCHIP, according to lawmakers, CQ Today reports. HouseRepublicans, who initially discussed the issue last week, want the SCHIP bill (HR3963) to limit eligibility for Medicaid to 300% of the federal poverty level inan effort to prohibit states from using the program to expandgovernment-sponsored health care coverage to middle-income families. Democratssay that the SCHIP bill is not the proper vehicle for debating Medicaid policychange, according to CQ Today.

Although no states have expanded Medicaid eligibility above 300% of the povertylevel, Democrats say they do not want to make it impossible to do so. A SenateDemocratic aide said, "We would never agree to cap Medicaid," adding,"That has never been on the table."

However, House Republicans "appear to have won two important allies"in Sens. Orrin Hatch (R-Utah) and Chuck Grassley (R-Iowa), both of whom helpedwrite the legislation and "now say that House Republicans' concerns aboutMedicaid should be resolved," according to CQ Today. Hatchsaid, "If not, that will blow up the bill."

Grassley noted that Democrats have said they do not want Medicaid to expandabove 300% of the poverty level but "they're not willing to put languageinto the bill that the House Republicans want that would guarantee that." Headded, "It seems to me we all agree on the policy; why can't we writeit?" The dispute over an upper eligibility cap for Medicaid has"inflamed both sides," according to CQ Today.

Although Senate Finance Committee Chair Max Baucus (D-Mont.) has saidthat talks will continue after the Thanksgiving recess, a Senate Republicanaide said that lawmakers are preparing to focus on Medicare upon their return. "Ithink SCHIP might be left to simmer on the back burner for a while," theaide said. SCHIP funding will continue at current levels through a continuingresolution that expires Dec. 14 (Wayne, CQ Today, 11/16).

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In related news, House Speaker Nancy Pelosi (D-Calif.) at a rally on Saturdayin Texascalled for the expansion of SCHIP, the AP/Fort Worth Star-Telegram reports. Pelosi said, "If wecan afford a war, we can afford to insure our children," adding, "Wewill not rest until 10 million children are covered" (AP/Fort WorthStar-Telegram, 11/17).

School Districts Help Uninsured

McClatchy/Miami Herald on Sunday reported that whileCongress and President Bush "squabble" over the reauthorization ofSCHIP, school officials nationwide "are scrambling each day to findaffordable medical care so that sick and needy students can continue tolearn." According to McClatchy/Herald, growing numbers ofuninsured students have "made it harder for educators to focus onclassroom achievement without first addressing the medical needs of theirstudents who lack health insurance or dental coverage."

School officials "increasingly must help find health care, arrangetransportation for sick children and often advise beleaguered parents about thehealth consequences of their inaction," McClatchy/Heraldreports. Chandrai Jackson-Saunders, a school psychologist in Washington, D.C.,said that the lawmakers' inability to reauthorize SCHIP "looks like education neglect on the part of thegovernment," adding, "It's a very disheartening situation"(Pugh, McClatchy/Miami Herald, 11/18).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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