SCHIP Debate Stalled in the Senate
On Tuesday, according to the National Council for Community Behavioral Healthcare, Senate Republicans blocked a move to begin negotiating with the House on legislation to re-authorize and expand the State Children’s Health Insurance Program [SCHIP]. According to the GOP, there are concerns over the scope of the final bill. The move may mean that an extension is required to continue funding for SCHIP past its September 30 expiration date.
Before adjourning for the month long August recess, both the house and the Senate passed separate bills to re-authorize and expand SCHIP, which is set to expire on September 30, 2007. Diffrerences in the two bills must be resolved by a joint House-Senate conference committee before the legislation can be passed on to the President for final approval. If a conference report is not produced by September 30, Congress will need to pass an extension to continue funding for SCHIP, most likely at the program’s current level.
In the House, the Children’s Health and Medicare Protection [CHAMP] Act of 2007 [HR3162] would expand SCHIP by $50 billion over the next five years and includes a variety of Medicaid and Medicare provisions. In the Senate , the Children’s Health Insurance program Re-authorization Act of 2007 [S1893] would expand SCHIP by $35 billion over five years. While both bills include increases in the tobacco tax to fund SCHIP, the Senate bill includes a larger increase.
Senate Majority Leader Harry Reid [D-NV] sought to appoint members to the conference committee by unanimous consent on Tuesday and begin negotiations as soon as the House Legislation is received in the Senate. Senate Minority Leader Mitch McConnell [R-KY] objected on the grounds that the House has not yet formally requested a conference on the bills. Republicans in the Senate have expressed a desire for assurances on the size and scope of the final SCHIP package before the conference committee meets. An aide to Senator Max Baucus, chairman of the Senate Finance Committee, has said that discussions would begin regardless of whether a formal conference committee convenes, according to a Congress Daily report.
It looks like the battle lines have been drawn-this contributor to OpEdNews suggests that you contact your Senators at once and ask that they support Majority Leader Harry Reed’s [D-NV] efforts to appoint and convene the conference committee at once.
In related action, on August 17, Dennis Smith, Director of the Center for Medicaid and Medicare Services [CMS] Center for Medicaid and State Operations issued a letter to State health officials outlining new enrollment standards for the State Children’s Health Insurance Program [SCHIP] that would limit states’ ability to expand eligibility to children in families with income levels above 250 percent of the federal poverty level [FPL]. These new requirements come just weeks after both the House and Senate passed separate bills to re-authorize and expand SCHIP.
The letter clarifies how existing statutory and regulatory requirements will be applied in reviewing states’ requests to extend eligibility to children in families with income levels above 250 percent of the FPL and outlines new requirements that states must meet before they can expand SCHIP to other children. Under existing regulations, states must have "reasonable procedures" in place to prevent SCHIP coverage from substituting for private coverage, or "crowed out" procedures. In the past , states have adopted one or more of the following crowed-out strategies to meet this requirement:
Imposing waiting periods between dropping private coverage and enrollment;
Imposing cost sharing in approximation to the cost of private coverage;
Monitoring health insurance status at time of application;
Verifying family insurance status through insurance databases; and/or
Preventing employers from changing dependent coverage that would favor a shift to public coverage.
States will now be required to adopt all five crowed-out strategies as part of their SCHIP programs.
To read these and other requirements contained in the full letter, go to www.cms.hhs.gov/smdl/downloads/SH0081707.pdf.
Congressional leaders have already voiced their opposition to these new policies and will attempt to override them. Senator Max Baucus [D-MT], chairman of the Senate Finance Committee, called the new guidelines a "drastic change" in policy that "will jeopardize coverage for tens of thousands of children in low-income, working families. "