SCHIP Debate May Not Move Forward This Month

One of the few areas in which Congress seemed to be making progress has lost momentum since the August recess. Both chambers passed their own versions of an expansion on the State Children’s Health Insurance Program (SCHIP) prior to the recess, but have failed to move forward with a conference report since returning to session this month. The major hold up is coming from the Senate, were Republicans are concerned about the House bill’s tax increase as well as proposed cuts to Medicare payments to doctors. While negotiations continue, Senate leaders are calling on the Department of Health and Human Services (HHS) to release studies on the program. Between the delays on Capitol Hill, and continued criticism of both chamber’s expansion proposals from the White House, circumstances are aligning against final passage before the program expires at the end of the month (Sept. 30).

Currently, lawmakers are seeking to iron out differences between the House and Senate versions of the bill. The House bill would provide $50 billion over the next five years, while the Senate's bill would provide $35 billion. Both bills pay for the increase by raising tobacco taxes, while the House also cuts some Medicare payments to private doctors. Senate Republicans are vowing to oppose any version of a conference report that contains such a provision, stalling pre-conference negotiations. Republicans have also expressed concerns that the expansion goes far beyond the program's original intent and could be the first step down the road of universal health coverage through the federal government.

Meanwhile, Senate Finance Committee chairman Max Baucus (D-MT) and ranking Republican Chuck Grassley (R-IA) are asking HHS to release studies on the program. Both Senators are hoping the studies will provide more information to the effects, both positive and negative, that the program has had and what the proposed expansion will mean for the number of children the program covers. In their letter, sent earlier this week, Sens. Baucus and Grassley ask the department to “identify all contracts and other agreements or arrangements your department or any of its agencies has entered into with any outside entity to evaluate, study or analyze in any way how the [SCHIP] program works.” Although the effort seems to be in good faith, the studies can only add to the delay Congress is dealing with regarding final passage.

Meanwhile, the White House continues its own negotiations with Congressional leaders over the program’s expansion. President Bush originally proposed a mild $5 billion expansion, and has been very critical of the higher level proposed in both the House and the Senate. His opposition to such a large expansion gives Senate conferees more weight when negotiating with the House, since the Senate’s proposed expansion is $15 billion less than the House’s, and it does not include the Medicare cuts. However, whatever deal Congressional leaders are able to come out with will have to have veto-proof majorities in both chambers if they hope to have any bargaining power with the White House. This leaves a lot of debating and horse trading to complete in only two weeks.

Resources:
Kelly Shaw, “Pallone: Lawmakers and Bush Will Reach SCHIP Deal by Sept. 30,” Congress Now, September 12, 2007.
Geoff Koss and Kelly Shaw, “Baucus, Grassley Ask HHS for 'Unpoliticized Information' About SCHIP,” Congress Now, September 13, 2007.
Author: SAS