SCHIP Round 2

The Senate passed the latest reauthorization package for the State Children’s Health Insurance Program (SCHIP) despite continued veto threats from the White House. The Senate voted 64-30 in favor of passing H.R. 3963, setting up yet another veto fight in what appears to be the season of vetoes. However, unlike the first time Congress sent SCHP to the President, Democrats are not planning to rush an override vote, opting to take a more subtle approach this time around.

The bill still increases SCHIP funding by $35 billion over five years, offset by a $.61 increase on cigarette taxes. However, the bill contains language that will phase childless adults out of the program in one year, as well as language to ensure children currently covered by private insurance companies stay with their current plans. Republicans, however, are still concerned with the cost, and the bill’s apparent attempts to shift children to “socialized” healthcare. President Bush is still promising to veto the package due to excessive spending. His Administration proposed only a $5 billion expansion earlier this year.

The new bill also includes language that would keep the Department of Health and Human Services (HHS) from implementing restrictions on Medicaid payments until January of 2010. This provision is in direct response to efforts by the Center for Medicare and Medicaid Services (CMS) to place restrictions on Medicaid payments to schools for administrative and transportation costs related to services provided to students under the Individuals with Disabilities Education Act (IDEA). Congress attached a 6 month moratorium on these restrictions in the conference report of the last SCHIP bill, but that proposal died when the House failed to override the President’s veto.

Thursday, November 1, the House Oversight and Government Reform Committee held a hearing on the proposed changes to Medicaid payments. Advocates from various education and health organizations presented their concerns regarding CMS’ efforts to members of Congress. Dennis Smith, Director of the Center for Medicaid and State Operations at CMS attempted to defend his agency’s regulatory efforts, but was met with much skepticism. Members of the Committee, including Chairman Henry Waxman (D-CA), viewed CMS’ actions as disrespectful to Congress’ role of oversight and their authority over governmental programs.

Democrats in the House are still 15 votes shy of a veto-proof majority for the SCHIP bill, but have laid plans to bring as much political pressure to their opposition as they can before bringing the bill to the floor for an override vote. Last time, Democrats rushed the House vote, against Republican protests, and suffered for it. This time the Democratic leadership plans to hold off on an override vote long enough to actively campaign for the additional votes necessary. As such, it is not clear when the final override vote will happen, so Congress may end up having more December votes than they anticipated.

Resources:
Drew Armstrong, “SCHIP Clears Again; Talks Continue With Would-Be Supporters in House,” CQ Today, November 1, 2007.
Stephen Langel, “Democrats Stepping Back After Latest SCHIP Defeat,” Congress Now, November 1, 2007.
Mark W. Sherman, “Lawmakers, CMS Official Spar Over School Medicaid Dollars,” Education Daily, November 2, 2007.
Author: SAS

Read More...

Summary only...

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

Read More...

Summary only...

SCHIP Veto Sustained

H.R. 976, the State Children’s Health insurance Program (SCHIP) reauthorization bill, officially died as the House was unable to override the President’s veto, voting 273-156, falling 13 votes short of the necessary two-thirds majority. While six of the eight Democrats who votes against the bill’s initial passage chose to support the override, no Republicans changed their vote, choosing instead to send the issue back to committee. Now, the House and Senate, will each go back to the beginning, and craft new proposals.

Wasting no time, House Minority leader John Boehner (R-OH), introduced H.R. 3888, the More Children More Choices Act. The bill would fund the program at $7 billion per year until 2012 and at $8 billion thereafter. The legislation also includes a $1,400 tax credit for insured and uninsured children between 200 percent and 300 percent of the federal poverty level. Democratic leaders, however, were quick to dismiss the bill, which falls far below their proposal of funding SCHIP at $60 billion a year over the next five years. While Democrats may be willing to compromise, such a drastic cut in their proposal is not likely to gain any substantial support.

Meanwhile, with H.R. 976 being put to rest, the amendment dealing with a moratorium on the Department of Health and Human Services restricting, “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” is now in limbo. The moratorium would have lasted through May 2008, giving Congress additional time to find a more permanent solution to efforts by the Center for Medicare and Medicaid Services (CMS) to discontinue payments for non-medical payments to schools.

With the bill’s demise, the moratorium language now needs a new legislative vehicle. The most likely candidate now is either an individual appropriations bill, such as the Labor-HHS-Education bill currently on the Senate floor, or as part of the large omnibus appropriations bill that Congress will likely pass in the next month or two. The CMS proposed rule is currently in its public comment period, through early November. After that, there is an indeterminate amount of time for the Office of Management and Budget to approve the final rule and its eventual implementation. As such, Congress may find itself racing the clock to place a moratorium on the rule before CMS puts it into effect.

Resources:
Drew Armstrong, “Failure to Override SCHIP Veto Sends Democrats Back to Drawing Board, “CQ Today, October 18, 2007.
Stephen Langel, “Lawmakers Begin Search for SCHIP Compromise,” Congress Now, October 18, 2007.
Author: SAS

Read More...

Summary only...

One Week Before SCHIP Vote (old)

Three weeks ago, the House’s scheduled vote on overriding the President’s veto of the State Children’s Health Insurance Program reauthorization bill (SCHIP). House leaders spent the last week working tirelessly trying to garner more support from the 159 Republicans that voted against the bill’s passage. Opponents of the bill, as it stands, only need 145 votes to sustain a veto, meaning Democrats need to convince at least fifteen Republicans to switch side if they want to override the President.

H.R. 976, the reauthorization bill, provides for a $35 billion expansion of SCHIP over five years, to a total of $60 billion. The President, who proposed a $5 billion expansion, vetoed the legislation last week, citing excessive spending and tax increases as his basis for attempting to kill the bill. To pay for the greater expansion, Congress increased taxes on cigarettes, a tax that the Congressional Research Service claims will be passed on to low-income Americans. Republicans, reluctant to agree to any tax increase, claim that they will remain steadfast and will vote to sustain the veto. Moderate Republicans that voted for the bill are trying to suggest minor changes that might reign in spending, but Democrats seem unwilling to negotiate after the President’s veto.

The Senate meanwhile, seems to have the 67 votes necessary to override the veto, but because the bill originated in the House, it must act first. Sen. Chuck Grassley (R-IA), the ranking Republican on the Senate Finance Committee, is the most outspoken Republican pushing for the override. Grassley has spent time during the last week attempting to convince his colleagues in the House to pass the bill, but House Majority Leader John Boehner (R-OH), claims that he still has the necessary votes to sustain the veto and put the bill to its final rest.

Resources:
Alex Wayne, “Democrats Say They Aren’t Interested in GOP-Touted SCHIP Compromise,” CQ Today, October 10, 2007.
Author: SAS

Read More...

Summary only...

President Vetoes SCHIP, CMS Rule Now Faces Uncertainty

Wednesday, October 3, the President vetoed H.R. 976, a bill to reauthorize the State Children’s Health Insurance Program (SCHIP). The President pointed to the increased spending and tax hikes that Congress passed in order to pay for what he claims would lead to socialized health care. The bill expands the SCHIP program by $35 billion over five years by raising taxes on tobacco products to an even $1. The President originally proposed a $5 billion expansion, but lawmakers say that, due to inflation, such a small expansion will not even cover the same number of children that are already covered under the program.

The biggest impact the veto has on the education community concerns an amendment to the bill that addresses the Center for Medicare and Medicaid Services’ (CMS) cut in funding for reimbursements for administrative and transportation costs for students with disabilities. The amendment places a moratorium on the authority of the Secretary of Health and Human Services to take any action that would limit Medicaid payments to school districts. According to Section 616 of the conference report:

The Secretary of Health and Human Services shall not, prior to May 28, 2008, take any action […] 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.

While the moratorium would only extend until May 28, 2008, it would represent a considerable victory for school districts and states that are resisting the recent regulatory actions by the Center for Medicare and Medicaid Services (CMS) to cut Medicaid funding by reducing school-based and rehabilitative services for children with disabilities. The threatened veto, however, places that victory in jeopardy. There is little likelihood that the Democratic majority can secure enough votes in the House and Senate at this point.

The Senate has the 67 votes necessary to override the veto, but the House has to act first, and presently it is shy of the 250 votes needed. House Majority Leader Steny Hoyer (D-MD) scheduled the override vote for October 18, giving Democrats two weeks to try and sway more Republicans to vote their way. Meanwhile, Republican leaders claim they will still sustain the veto and that Congress should move on to trying to pass a new SCHIP bill that the President will sign. In the meantime, assuming the override fails, the CMS amendment will need to find a new vehicle for passage.

Resources:
Stephen Langel, “Republicans Confident Bush Veto of SCHIP Will Be Upheld,” Congress Now, October 3, 2007.
Author: SAS

Read More...

Summary only...

SCHIP Heading Towards Veto

The House and Senate have both passed the State Children’s Health Insurance Program, H.R. 976 (SCHIP) conference report and the attention now turns to the promised Presidential veto and the Democratic leadership’s ability to override it. An override requires two-thirds vote in each chamber.

Last Thursday evening, the Senate passed the SCHIP conference report by a vote of 67-29, enough to override the threatened Presidential veto in the Senate. The House approval of the conference report, however, lacked the needed 2/3 majority with a vote of 265-159.

The conference report would expand the children’s health insurance program by $35 billion over the next five years, to $60 billion. The expansion would be financed by tobacco tax increases, including a 61-cent increase in the cigarette tax to $1 per pack.

It also contains a critical moratorium on the ability of the Secretary of Health and Human Services from taking any action that would limit Medicaid payments to school districts. According to Section 616 of the conference report:

The Secretary of Health and Human Services shall not, prior to May 28, 2008, take any action […] 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.

While the moratorium would only extend until May 28, 2008, it represents a considerable victory for school districts and states that are resisting the recent regulatory actions by the Center for Medicare and Medicaid Services (CMS) to cut Medicaid funding by reducing school-based and rehabilitative services for children with disabilities. The threatened veto, however, places that victory in jeopardy. Whether the Democratic majority can secure enough votes in the House and Senate is not clear but unlikely.

The President argues that the expansion is a step toward federalization of health care. “Their proposal is beyond the scope of the program, and that's why I'm going to veto the bill.” If the President does, in fact, veto the conference bill then negotiations will begin anew, making one thing certain: The political theatre over the SCHIP bill will continue beyond its expiration on September 30. To keep funding flowing for the program, the Senate cleared a continuing resolution on Thursday that extends until November 16.

Resources:
Alex Wayne, “As SCHIP heads Toward Veto, Backers Say Bush Abandoning Promise to Kids,” Congressional Quarterly, Sept. 27, 2007.
Mark Silva, “Line in sand: Health-care veto,” Chicago Tribune, Sept. 21, 2007, http://www.chicagotribune.com/services/newspaper/printedition/friday/chi-bush_frisep21,0,5782557.story/
Stephen Langel, “Lawmakers: Even After Veto, Chances for SCHIP Deal Appear Dim,” Congress Now, Sept. 27, 2007.
Author: DAD

Read More...

Summary only...

Congress Reaches Deal on SCHIP

Lawmakers on Capitol Hill finally reached a deal on expanding the State Children’s Health Insurance Program (SCHIP), which expires at the end of September. The deal mirrors the Senate version of the expansion, though it does contain certain House provisions. Congress is expected to move quickly on the compromise, but veto threats from the White House will still act as a barrier to final passage.

According to Congressional aides, the agreement includes the Senate’s $.61 tax increase on tobacco products and the Senate’s provisions for adult coverage. The bill will also include the Senate’s $35 billion funding level for the program over five years, but will use the House’s formula for coverage. The final language will also include the House’s additional provisions for dental, mental health and vision coverage. Adding those coverage provisions allow the House to claim some credit for shaping the deal. A controversial House proposal that would cut Medicare payments to private doctors was left out of the final compromise. If that provision were included in a final bill, many conservative Republicans in the Senate would have stood in opposition to final passage.

Although the bill is expected to move through Congress quickly, the President commented yesterday that he intends to veto the expansion. The President proposed a mild expansion for SCHIP, totaling $5 billion over five years. President Bush opposes the $35 billion expansion, which he claims is simply a way for Democrats to earn points in Washington, because the proposal would, "raise taxes on working people.” Although Republican Senators Susan Collins (ME) and Charles Grassley (IA) have publically chastised the White House for threatening to veto the deal, it is unclear if either the House or the Senate has the necessary votes to override a veto. Meanwhile, Rep. Joe Barton (R-TX), the ranking member of the House Energy and Commerce Committee is drafting a one year extension of the program, including inflation-based funding increases, to act as a replacement if the current proposal is vetoed.

Resources:
Stephen Langel, “Lawmakers Reach Deal to Expand SCHIP Coverage,” Congress Now, September 19, 2007.
David Jackson, “Bush Vows to Veto Expansion of Children's Insurance Plan,” USA Today, September 21, 2001.
Author: SAS

Read More...

Summary only...

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

Read More...

Summary only...

SCHIP Debate on Hold

Negotiations on the State Children's Health Insurance Program (SCHIP) are on hold regarding Republican objections to a provision in the House version that cuts Medicare payments to private doctors. Both chambers have passed their own versions of the bill, but still need to go to conference. Meanwhile, Congressional Democrats and various advocacy groups rallied to encourage conferees to move forward on the bill. As has been the case on nearly every major bill this session, after conferees agree on a bill, they will still have to contend with criticisms and veto threats from the White House.

Republicans are upset with a provision the House's SCHIP bill, which expands the program by $50 billion, through both a cigarette tax increase and proposed cuts in Medicare payments to private doctors. Senate Republicans have stated their strong opposition to the cuts, freezing negotiations until a compromise is reached. Even after the conferees move past that particular issue, there is still a matter of reconciling the difference between the House expansion, and the Senate's $35 billion expansion. Both proposals include tax increases on cigarettes, but the amount of the increase is a matter of contention. The conferees will have to strike a delicate balance that will keep a majority of support in both chambers. While the program itself enjoys bipartisan support, liberal Democrats in the House are adamant about the Medicare cuts, while conservative Republicans are equally opposed. Both groups are important to Congressional leaders to ensure final passage.

Meanwhile, House Speaker Nancy Pelosi (D-CA), several Democratic lawmakers and labor leaders rallied in support of the legislation, urging President Bush not to veto the final bill that emerges from Congress. The President opposes the bill because of the excessive spending involved, the large tax increase, as well as the Medicare cuts. The President proposed a mild $5 billion expansion, and has threatened the large increase proposed in both chambers. If negotiators are unable to appease Republicans in both the House and the Senate, neither chamber will have the necessary votes to override a veto. Between this debate, and the battle over other appropriations measures, there is likely to be a lot of horse trading occurring on the Hill.

Resources:
Stephen Langel, "SCHIP Conference on Hold Over GOP Objections to Medicare Provisions," Congress Now, September 5, 2007.
Kelly Shaw, "Top House Democrats, Labor Allies Push for Passing Final SCHIP Bill," Congress Now, September 6, 2007.
Author: SAS

Read More...

Summary only...

SCHIP Set for Contentious Conference

Both the House and Senate passed their own versions of an expansion of the State Children’s Health Insurance Program (SCHIP). Listed as a top Democratic priority, Congress spent much of the summer working out the details of the expansion, including methods of paying for it. While both chambers have answered that question, there is disagreement over which method is better. When Congress comes back next week, leaders have less than a month for reconciliation, final passage, and a showdown with the White House over a threatened veto. Considering all the other items on the legislative calendar for next month, the chances of passing a bill the President will sign before the deadline are not good.

The first obstacle is to reconcile the various differences between the House and Senate version of the SCHIP reauthorization. The Senate bill contains a $.61 increase to the cigarette tax, bringing it to exactly $1.00. The House proposes a smaller increase of only $.45, but also includes spending cuts for Medicare Advantage, a program in which private managed-care plans provide benefits to seniors in place of the government. The cuts in the House bill would raise $157 billion over 10 years that, along with the tobacco tax increase, would pay for the increased expansion. Many Senate Republicans who voted in favor of SCHIP reauthorization say that they will not vote for a bill that includes cuts to Medicare Advantage. Southern Democrats in the House are reluctant to approve a larger tax increase.
While staffers are working on a compromise over the August break, the delicate situation is going to require full participation by the Members themselves. Therefore, no progress is likely until legislators return from the recess. Once they return, conferees need to find a compromise that can pass through both chambers.

If conferees reach a compromise and a conference report passes through both chambers, Congressional leaders still have to deal with a threatened Presidential veto. The White House called for a $5 billion expansion and has voiced opposition to the large increases proposed on Capitol Hill. While the Senate vote indicates it will have the 60 votes necessary to override a veto, the House fell far short of the 290 votes required to fight off a veto. If the conference report is able to pull in the additional votes in the House, conferees run the risk of alienating too many Republicans in the Senate, thereby taking away their ability to fend off the veto. At this same time, legislators have all twelve fiscal year 2008 appropriations bills to worry about, leaving a rough road ahead for SCHIP reauthorization.

Resources:
Stephen Langel, “Agreement on Expanding SCHIP Unlikely Before Sept. 30 Sunset, Sources Say,” Congress Now, August 13, 2007.
Author: SAS

Read More...

Summary only...

SCHIP Deal Unlikely Before Deadline

As Congress remains in recess this August, advocates for the State Children’s Health Insurance Program (SCHIP) are beginning to realize that lawmakers are not likely to reconcile the House and Senate versions of a reauthorization bill before the program expires on September 30. Both chambers of Congress will return to session on Tuesday, September 4, leaving less than a month for reconciliation, final passage, and a showdown with the White House over a threatened veto. Considering all the other items on the legislative calendar for next month, the chances of passing a bill the President will sign before the deadline are not good.

The first obstacle is to reconcile the various differences between the House and Senate version of the SCHIP reauthorization. The Senate bill contains a $.61 increase on cigarette taxes, bringing them to an even $1.00. The House proposes a smaller increase of only $.45, but also includes spending cuts for Medicare Advantage, a program in which private managed-care plans provide benefits to seniors in place of the government. The cuts in the House bill would raise $157 billion over 10 years that, along with the tobacco tax increase, will pay for the increased expansion. Many Senate Republicans who voted in favor of SCHIP reauthorization say that they will not vote for a bill that includes cuts to Medicare Advantage. Southern Democrats in the House are reluctant to approve a larger tax increase. While staffers are working on a compromise over the August break, the delicate situation is going to require full participation by the Members themselves. Therefore, no progress is likely until legislators return from the recess. Once they return, conferees need to find a compromise that can pass through both chambers.
If conferees reach a compromise and a conference report passes through both chambers, Congressional leaders still have to deal with a threatened Presidential veto. The White House called for a $5 billion expansion and has voiced opposition to the large increases proposed on Capitol Hill. While the Senate vote indicates it will have the 60 votes necessary to override a veto, the House fell far short of the 290 votes required to fight off a veto. If the conference report is able to pull in the additional votes in the House, conferees run the risk of alienating too many Republicans in the Senate, thereby taking away their ability to fend off the veto. At this same time, legislators have all twelve fiscal year 2008 appropriations bills to worry about, leaving a rough road ahead for SCHIP reauthorization.
Resources:
Stephen Langel, “Agreement on Expanding SCHIP Unlikely Before Sept. 30 Sunset, Sources Say,” Congress Now, August 13, 2007.
Author: SAS

Read More...

Summary only...

Congress Passes SCHIP Expansion

Last Thursday, the Senate passed an expansion of the State Children’s Health Insurance program (SCHIP), by a vote of 68-31. S. 976 expands SCHIP by $35 billion over five years to cover an additional 3 million low-income children, paid for by an increase in federal taxes on cigarettes. The House passed a $47 billion five-year SCHIP expansion on Wednesday, by a vote of 225-204. Both proposals are facing a veto threat from the White House but, unlike the House, the Senate seems to have the necessary votes to override the President. Yet, before the President plays a role, the two bills must go to conference where Congressional negotiators need to iron out the large differences between the two measures.

The Senate bill contains a $.61 increase on cigarette taxes, bringing them to an even $1. The House proposes a smaller increase of only $.45, but also includes spending cuts for Medicare Advantage, a program in which private managed-care plans provide benefits to seniors in place of the government. The cuts in the House bill would raise $157 billion over 10 years that, along with the tobacco tax increase, will pay for the increased expansion. Many Senate Republicans who voted in favor of S. 976 say that they will not vote for a bill that includes cuts to Medicare Advantage. At the same time, Southern Democrats in the House are reluctant to approve a larger tax increase. Both sides need to find a compromise that can pass through both chambers.

Once the bill clears conference, the President will remain the final hurdle before the expansion can go into effect. The White House called for a $5 billion expansion and has voiced opposition to the large increases proposed on Capitol Hill. While the Senate vote indicates it will have the 60 votes necessary to override a veto, the House fell far short of the 290 votes required to fight off a veto. If the conference report is able to pull in the additional votes in the House, conferees run the risk of alienating too many Republicans in the Senate, thereby taking away their ability to fend off a Presidential veto. Lawmakers will likely do some pre-conference work during the August recess, so that the conference report can go to both chambers for final approval sometime in September.

Resources:
Alex Wayne, “Tough Negotiations Ahead on Children’s Health Care Expansion, Medicare,” CQ Today, August 2, 2007.
George Cahlink, “Senate Approves SCHIP With Veto-Proof Majority,” Congress Now, August 2, 2007.
Jennifer Bendery, “House Passes SCHIP, but Without Veto-Proof Margin,” Congress Now, August 1, 2007.
Author: SAS

Read More...

Summary only...

House Committees Work on SCHIP Expansion

Following action in the Senate last week, the House Ways and Means Committee approved a tax increase on tobacco yesterday to pay for the expansion of a State Children’s Health Insurance Program (SCHIP). The Committee voted 24-17 to approve H.R. 3162, which would reauthorize and expand SCHIP, due to expire on Sept. 30. The House Energy and Commerce Committee held a separate markup on other elements of the legislation the same day, though no votes were recorded. Republicans attempted to bog down both markups with procedural maneuvers as a way to protest the majority’s legislation.


The bill proposes a $50 billion increase for SCHIP, levying a 39-cent-per-pack tax on "small cigarettes," in order to pay for the expansion. Republicans offered an amendment that would cut out the tax increase, but it was defeated 16-23. Democrats later acknowledged that the bill would have to be altered before it is sent to the floor in order to adhere to budget-neutral "pay-as-you-go" rules. The preliminary Congressional Budget Office analysis found the Ways and Means bill to be short about $76 billion in offsets.
The Senate Finance Committee passed a SCHIP expansion last week, and Senate Majority Leader Harry Reid (D-NV) has stated that the bill will be on the Senate floor on Monday, giving the Senate time to pass the measure before the month-long August recess. The Senate bill expands the program by $35 billion over five years, far short of the $50 billion proposed in the House. The Finance Committee’s proposal faces contentious debate on the Senate floor. More liberal members of the majority feel the expansion is too mild. Sen. John Kerry (D-MA) has pledged to bring an amendment to the floor that will increase the expansion to the $50 billion agreed to in the budget resolution. On the other side of the spectrum, fiscal conservatives feel the expansion is too extreme.
Even if the House were to bring H.R. 3162 to the floor next week, a conference between the two versions would not take place until Congress returns in September. President Bush, who proposed only a $5 billion increase, has already promised to veto the bill, unless Congress draws back the funding increase. Democratic leaders may have to spend the August recess negotiating the expansion, working to make sure they have the votes, not only to pass the bill, but to override the threatened veto. Between SCHIP and appropriations, this recess could prove to be a very busy vacation for members of Congress.
Resources:
Autumn Campbell, “House GOP Lawmakers Stall Work on Children’s Health Insurance Plan,” Congress Now, July 26, 2007.
Author: SAS

Read More...

Summary only...

Senate Panel Passes SCHIP Proposal

On Thursday, July 19, the Senate Finance Committee passed the Children's Health Insurance Reauthorization Act, finally bearing results from the ongoing debate on the State Children’s Health Insurance Program (SCHIP). While leaders in both chambers failed to add SCHIP reauthorization as an amendment to the fiscal year 2007 (FY07) continuing resolution and the FY07 supplemental appropriations bill, Finance Committee chairman Max Baucus (D-MT) and ranking member Chuck Grassley (R-IA) have finally brokered a deal along more moderate terms. However, the story is far from over, as the bill must survive a floor vote before facing down a threatened Presidential veto.

SCHIP, which provides health insurance for about 6 million children from low-income families that are not poor enough to qualify for the larger Medicaid program, is considered by many to be the most important health legislation that Congress will take up this year. The bill expands the program by $35 billion over five years, far short of the $50 billion authorized under the FY08 joint budget resolution. The committee bill will use a tax increase on cigarettes, from $.39 to an even $1, to offset the increase. Chairman Baucus claims that the increase will expand the program to cover an additional 10 million uninsured children. Despite opposition from the extreme right and left of each party, the Committee passed the bipartisan deal.

The proposal faces contentious debate on the Senate floor. Some liberals in the majority feel the expansion is too mild. Sen. John Kerry (D-MA) has pledged to bring an amendment to the floor that will increase the expansion to the $50 billion agreed to in the budget resolution. House leaders have also announced their intentions to pass a $50 billion increase. On the other side of the spectrum, fiscal conservatives feel the expansion is too extreme. President Bush, who proposed only a $5 billion increase, has already promised to veto the bill, unless Congress draws back the funding increase. Congress and the White House find themselves at odds over funding levels on nearly every spending bill for FY08, putting the SCHIP proposal on very thin ice.

Resources:
Deb Riechmann, “Bush Threatens to Veto Insurance Measure,” Associated Press, July 18, 2007.
Stephen Langel, “SCHIP Clears Major Hurdle, but Compromise With White House Considered Unlikely,” Congress Now, July 19, 2007.
Timothy R. Homan, “Senate Panel Approves Renewal of Health Insurance Program for Children,” CQ Today, July 19, 2007.
Author: SAS

Read More...

Summary only...

Senate Panel Reaches First Agreement on SCHIP

Debate on the State Children’s Health Insurance Program (SCHIP) continued this week as members of the Senate Finance Committee announced an agreement on Tuesday, July 10, for expansion of the program. House and Senate leaders have carried on negotiations for most of this session regarding the program, but have consistently failed to reach a consensus. While the Finance Committee announcement marks the first significant agreement on SCHIP expansion, it falls significantly short of the $50 billion increase Democrats agreed to in the fiscal year 2008 joint budget resolution.

SCHIP is a state-federal insurance program covering about 6 million children and about 600,000 adults. It is intended to cover children of low-income families not poor enough to qualify for the larger Medicaid program. Under the bipartisan agreement, the expansion would cost $35 billion over five years, funded with a $.61 increase to the $.39 federal cigarette tax, to an even $1 per pack. Although committee leaders reached an agreement, the proposal may be too small an expansion to suit some Democrats and too expensive for many Republicans. Finance Committee Chairman Max Baucus (D-MT) has scheduled a markup on the legislation for Tuesday, July 17.

President Bush proposed a far smaller increase for SCHIP combined with tax deductions or credits for middle-income families to help them buy health insurance. If the White House feels the increase is too extreme, any bill that comes out of the Finance Committee may find itself on a long list of bills with veto threats levied against it. The President already stated his intention to resist the proposal, though he has not publically threatened a veto at this point. Sen. Gordon H. Smith (R-OR), an architect of the agreement, is attempting to defend the proposal against criticism from the White House.

Resources:
Alex Wayne, “Senators’ Deal on SCHIP Could Be Tough Sell,” CQ Today, July 10, 2007.
Alex Wayne, “Senate Republicans Challenge Bush on SCHIP,” CQ Today, July 12, 2007.
Author: SAS

Read More...

Summary only...