Monday, January 12, 2009

US congress to vote on S-CHIP expansion

The US Congress is set to vote on the S-CHIP expansion later this week. Congress passed the expansion package only to get it vetoed by President Bush a couple of times. Now, with a President-Elect about to arrive who will sign the bill, Congress will get it passed again. This should give President-Elect Obama something that he can claim he accomplished early in his administration.

For details on the vote and an analysis on how the expansion of children's health care will be paid for, E Max Health provides a round up of news stories about S-CHIP.

Although House Majority Leader Steny Hoyer (D-Md.) last week said the package would be nearly the same as the bill vetoed by Bush in 2007, some Democratic aides have said the pending economic-stimulus package and previous $700 billion economic bailout have limited the amount of federal money available and could force Democrats to cut costs on the original proposed expansion, the Times reports (Lengell, Washington Times, 1/12).

The original proposal included an increase in the federal cigarette tax to fund the SCHIP expansion. The 2007 bill, which supporters believe would have increased SCHIP enrollment from six million to 10 million, would have raised the tax by 61 cents per pack and would have cost an estimated $35 million over five years (Kaiser Daily Health Policy Report, 1/8).

However, because the 61-cents-per-pack cigarette tax likely will not cover the full cost of a five-year expansion, aides to House Democrats said lawmakers would seek a shorter SCHIP reauthorization, CQ Today reports (Armstrong, CQ Today, 1/9). According to the Times, SCHIP's expenses have increased over the last two years and cigarette sales are declining, making it necessary to seek new revenue sources for an expansion (Washington Times, 1/12). Lawmakers are waiting for cost projections from the Congressional Budget Office before they determine the length of the reauthorization. According to lobbyists and congressional aides, the extension likely will be between two years and four-and-a-half years.

According to CQ Today, a shorter-term reauthorization could mean that Democrats will attempt a "fuller expansion" of the program as part of a comprehensive health reform package. Rep. Diana DeGette (D-Colo.) said, "If a shorter-term reauthorization is the only way to craft a stronger bill that would provide coverage for more eligible children, we should take that course."

House Minority Leader John Boehner (R-Ohio) and Minority Whip Eric Cantor (R-Va.) wrote in a letter to Obama and House Speaker Nancy Pelosi (D-Calif.) that Republicans want the program to require coverage of children below 200% of the federal poverty level before increasing to higher income levels. The letter said, "Republicans are committed to reauthorizing SCHIP in a manner that puts poor children first, which is the original intent of the program." They also want the legislation to require stricter citizenship documentation (CQ Today, 1/9).

Expanding SCHIP "is good politics and the right thing to do" and is "one of the clearest signals" that Obama has sent in "his determination to learn from the Clinton years, particularly from the former president's failures on health care," E.J. Dionne, Washington Post columnist, writes in a Post opinion piece. According to Dionne, in 1994 a group of senators suggested Clinton try to insure all children when his plan for universal coverage was encountering difficulties, in order to "make, at least, a down payment on reform."

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