Bush Administration, Congress Set To ‘Clash’ Over SCHIP Expansion, New York Times Reports

The Bush administration plans to “strenuously resist” Democratic efforts to expand SCHIP, which will expire on Sept. 30, “ensuring a clash with Congress over the most important health care legislation being considered this year,” the New York Times reports. President Bush has proposed to increase funds for SCHIP by $4.8 billion over five years. In addition, Bush has proposed to reduce federal funds for states that have expanded SCHIP eligibility to children in families with annual incomes more than 200% of the federal poverty level to “refocus the program on low-income uninsured children.” At least 17 states would lose federal funds as a result of the proposal. Democrats are seeking to expand SCHIP “as a first step to universal coverage” and are proposing to $50 billion to the program “for a total of $75 billion over the next five years,” according to the Times. Dennis Smith, director of the Center for Medicaid and State Operations at CMS, said that SCHIP was established “to cover low-income children who were uninsured,” adding that the proposals by Democrats “would change the complexion of the program and take it away from its original intent.” Smith said, “At higher income levels, families are more likely to have private health insurance. If they become eligible for the Children’s Health Insurance Program, you are more likely to be substituting public for private coverage. You could add billions of dollars to the program without insuring many new kids.” HHS Secretary Mike Leavitt added that SCHIP “should not be the vehicle by which we insure every adult and every child in America.” Dingell said, “One of my problems with this administration is that there are people who know the cost of everything and the value of nothing,” adding that SCHIP is “a great investment” (Pear, New York Times, 4/1). Rockefeller, Snowe Announce Proposal
In related news, Sens. Jay Rockefeller (D-W.Va.) and Olympia Snowe (R-Maine) on Friday announced a proposal that would increase funds for SCHIP by about $25 billion over five years to maintain coverage for current beneficiaries and expand coverage to six million children who qualify for, but have not enrolled in, the program. According to a summary released on Friday, the proposal would allow states to use financial information from other programs to determine eligibility for SCHIP. The proposal also would establish a mechanism to ensure adequate funds for state outreach programs and for states with a high rate of growth in Medicaid enrollment. In addition, the proposal would allow states “to determine the best way to establish citizenship.” Under the proposal, states would have more flexibility to determine whether they cover pregnant women and children who are legal immigrants and whether they cover children of state employees. The proposal also would ensure mental health and dental coverage. Rockefeller and Snowe said that they would formally introduce the proposal as legislation after the April recess (CQ HealthBeat, 3/30).

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