This week, the House and Senate approved a bill (H.R. 976) to reauthorize the State Children’s Health Insurance program (SCHIP). President Bush has said he intends to veto the bill.
House
On September 25, the House agreed, 265-159, to the Senate amendments to the Children’s Health Insurance Program Reauthorization Act of 2007 (H.R. 976). The House also passed, 215-199, the rule (H. Res. 675) governing debate on the bill. The rule amended the bill to include dental coverage for children and $100 million for states, localities, schools, and community organizations to conduct outreach activities.
H.R. 976 was initially passed by the House as a small business tax relief measure in February (see The Source, 2/16/07). However, in August, the Senate stripped the language in H.R. 976 and adopted a substitute amendment that incorporated the language contained in S. 1893. That bill was approved by the Senate Finance Committee on July 19 (see The Source, 7/20/07). The House passed its own version of SCHIP reauthorization on August 1 (see The Source, 8/3/07).
SCHIP was created by the Balanced Budget Act of 1997 (P.L. 105-33) and provides health insurance to low-income children who are ineligible for Medicaid, but unable to obtain private health insurance coverage. SCHIP’s current authorization expires on September 30, 2007; however, the continuing resolution approved by Congress this week will provide funding to continue the program through November 16 (see The Source, 9/28/07).
Speaker Nancy Pelosi (D-CA) said, “I am pleased as one who represents a [majority-minority] district from a majority-minority state, where our state is blessed with a beautiful diversity, that…nearly four million additional children [will be] covered, [and] 67 percent of those children are minority children. Two-thirds of those children are children from families who are working hard, playing by the rules, lifting themselves out of poverty. They are the working poor in America. They are those who have aspired to the middle class to change that status and want to stay there. They simply don’t make enough money to afford the private health insurance that this SCHIP initiative enables them to do. In fact, my colleagues might be interested to know that 72 percent of the children on this SCHIP program get their health coverage from private health insurance.” She continued, “I am reminded of the Bible tonight, and I speak with all of the sincerity and all of the hope to President Bush…that he will change his mind to dig deeply into his heart and think about the children in America who don’t have health care. Because, if not, I think that the president is giving new meaning to the words ‘suffer, little children.’ Suffer, little children, if your parents can’t afford health insurance, but they are working hard and they are not on Medicaid, but you will suffer because they are struggling to give you the best possible future. Suffer, little children, if your family has played by the rules and they have come to this country and you are here as a legal immigrant, because if you are sick, you will not get health care unless your parents can afford private insurance. Suffer, little children, if you are sick because you haven’t had the proper nutrition, the proper prevention, the proper early intervention to your affliction that you should go directly to the emergency room. But until you can get into that emergency room with enough of a serious illness, you will suffer. That is just not right.”
Rep. Dave Camp (R-MI) said, “Mr. Speaker, this bill clearly isn’t about helping low-income children. If it were, it would have support from both parties and the president would be eagerly waiting to sign it into law. This is a missed opportunity. Virtually everyone supports providing health insurance to low-income children. But when a federal health program for children starts covering not only families, but childless adults making three and four times the poverty level, it has clearly lost its focus. It is clear that Democrats want taxpayers to fund, and the federal government to directly provide, health care benefits to millions of Americans, even…families making over $80,000 a year. They are using SCHIP as a vehicle and the children it is intended to cover as a shield to get one step closer to total government control over our health care system. The current plan to expand SCHIP is in dire need of a second opinion. Instead of moving further and further away from the core mission, we should be reforming the program to ensure it is truly helping America’s uninsured children. The nonpartisan Congressional Budget Office stipulates that the proposed expansion would cover an additional 5.8 million Americans at a cost of $35 billion. Alarmingly, more than one out of every three individuals already has private insurance. The bill before us does little more than move children and upper-income families from private insurance plans to taxpayer-funded [health insurance]…This bill is designed poorly, funded poorly, and will do little to help lower-income Americans obtain health coverage. The president should veto this bill. Congress should work in a bipartisan fashion, as we did nearly 10 years ago when the program was created, to make certain that children in America have access to a health care system.”
Senate
On September 27, the Senate approved, 67-29, the House amendments to the bill, after agreeing, 60-39, to a cloture motion to end debate and proceed to a vote.
Sen. Hillary Rodham Clinton (D-NY) said, “I believe every child deserves health care. Yet far too many children in our nation more than nine million do not have access to quality, affordable health care. That is a moral crisis which should be impelling us to act, and this Congress has done so…The [S]CHIP program provides health insurance for 6 million children. In New York alone, almost 400,000 kids benefit from [S]CHIP every month…According to the Congressional Budget Office, 3.8 million children who are uninsured nationwide will gain coverage. That will reduce the number of uninsured children by one-third over the next five years.” She continued, “Now, I am disappointed that the [S]CHIP bill doesn’t include the Legal Immigrant Children’s Health Improvement Act, which I introduced with Senator [Olympia] Snowe [R-ME] and have been working on with her for a number of years. This bipartisan bill would give states the flexibility to provide Medicaid and [S]CHIP coverage to low-income legal immigrant children and pregnant women. I want to underscore that. We are talking about legal immigrant children and pregnant women. The current restrictions prevent thousands of legal immigrant children and pregnant women from receiving preventive health services and treatment for minor illnesses before they become serious. Families who are unable to access care for their children have little choice but to turn to emergency rooms. This hurts children, plain and simple, and I think it costs us money. A legal pregnant woman who cannot get prenatal care may have a premature baby, who ends up in a neonatal intensive care unit, which ends up costing us hundreds of thousands of dollars. So I hope we are going to be able to lift this ban and make it possible for states to access Medicaid and [S]CHIP for legal immigrant children and pregnant women. But I could not be more proud that the Senate is voting on expanding health care to 3.8 million children. There is no debating the importance of this and the way the Senate has come together in order to produce this result.”
Sen. John Cornyn (R-TX) said, “Along with virtually everyone else in Congress, I strongly believe the SCHIP program should be renewed, and it will be renewed. I voted for a renewal bill called Kids First [S. 95] that provided $10 billion in addition to the $35 billion over 5 years and which would enroll 1.3 million new children in SCHIP. But the majority has rejected that as too miserly.” He continued, “I think it is a bad idea to lose sight of the original target for SCHIP, which is children whose families make up to 200 percent of the poverty level, who have more money than they can make and still qualify for Medicaid. But we should do everything in our power to recommit to those children that we are going to make sure the money Congress appropriates, takes out of the pocket of the taxpayer, and provides in terms of health benefits to them, is true to the vision Congress originally intended and that that money which could go to expanding health care coverage to these kids who come from relatively modest incomes is not taken and provided for adult coverage or middle-income coverage in places such as New York for up to 400 percent of the poverty level. So there is a lot of misinformation and, indeed, downright demagoguery going on in the media and elsewhere with regard to what is happening here. I hope we will make one thing clear: that every member of the Congress certainly this senator supports a continuation and reauthorization of SCHIP. It is a canard to suggest that anyone is denying access to health care to the children who have benefited historically and should benefit from SCHIP. But it is simply a Trojan horse to suggest that we are merely reauthorizing this legislation because what is happening is we are seeing a dramatic expansion of federal spending, losing sight of the targeted population, and taking another incremental step toward a disastrous Washington-controlled and -run health care system which will be expensive to the American taxpayer, which will be incredibly bureaucratic, and which will result in rationing of health care, which is something that is not in the best interest of the American people.”
