House Passes SCHIP Bill...Again

Thursday, October 25, the House passed H.R. 3963, the latest State Children’s Health Insurance Program (SCHIP) reauthorization bill, by a vote of 265-142. Once again, the House fell short of the 289 votes necessary to override a Presidential veto, casting doubt over this new proposal’s chances of becoming law. The override vote tally, however, is not clear due to the number of California Congressmen who were in their home districts monitoring local fire relief efforts, as well as the absence of a few other members of Congress.

Like the previous reauthorization bill, H.R. 3963 proposes a $35 billion expansion over five years, and still tries to offset the costs with a $.61 increase in cigarette taxes. This time, Democratic leaders attempted to assuage some Republican concerns over the coverage provided under the bill. Childless parents, which were slated for a more gradual phase out, would be phased out in one year under the new bill. The bill also directs private insurance companies to work towards ensuring that children would not be forced to alter their plans under the new SCHIP expansion, another White House concern.

A critical change to the new bill includes a longer moratorium on the ability of the Center for Medicaid and Medicare Services (CMS), in the Department of Health and Human Services, to restrict Medicaid reimbursement payments to schools. The new language reads as follows:

Notwithstanding any other provision of law, the Secretary of Health and Human Services (HHS) shall not, prior to January 1, 2010, take any action (through promulgation of regulation, issuance of regulatory guidance, use of federal payment audit procedures, or other administrative action, policy, or practice, including a Medical Assistance Manual transmittal or letter to State Medicaid directors) to restrict coverage or payment under title XIX of the Social Security Act for rehabilitation services, or school-based administration, transportation, or medical services if such restrictions are more restrictive in any aspect than those applied to such coverage or payment as of July 1, 2007.

The conference report for the previous SCHIP bill, H.R. 976, provided a similar moratorium, but only through May 2008. This provision would provide more long-term security for schools in danger of losing funds for school related rehabilitative, administration and transportation costs for students currently eligible under the Individual with Disabilities Education Act (IDEA). Earlier this year, the CMS issues proposed rules that would eliminate CMS’ obligations for these payments. Education advocates have been and continue to call for a legislative block to the proposed payment restrictions.

As stated above, the House fell 24 votes short of the required number for overriding a veto, but 26 members of Congress missed the vote, a fact that Republicans tried to use to delay debate on the issue. There were a number of Republicans included in that number, so it is unlikely that all 26 votes would have gone in favor of the bill. However, the bill is now headed to the Senate, giving Democratic leaders in the House more time to lobby their Republican colleagues. In the end, if the House is not able to gain a veto-proof majority, the moratorium langue will need to find another vehicle for passage.

Resources:
Stephen Langel, “House SCHIP Bill Again Fails to Secure Veto-Proof Majority,” Congress Now, October 25, 2007.
Author: SAS