House, Senate moving on SCHIP renewal and extension

Last Wednesday, the House voted (H.R. 2) to renew the State Children's Health Insurance Program (SCHIP) and extend it to about four million additional children and their parents, including legal immigrant children and pregnant women, bringing the total number of individuals covered under SCHIP to about 11 million (see article from Washington Post and article from Wall Street Journal). A similar measure also passed through the Senate Finance Committee and is headed to the full Senate this week. If passed by the Senate as well, these two bills will be reconciled in conference, resent to both Houses, and if passed, they will move to President Obama.

It is interesting to note that a bipartisan SCHIP bill was vetoed by President Bush in 2007 because the Administration did not like the inclusion of tax increases on tobacco and felt the bill signified an expansion of government-run health care. Instead of dusting off the bipartisan bill, democratic leaders included new provisions in H.R. 2 that expanded the program to include immigrant pregnant women and children and lost the support of Republicans. Senator Charles Grassley (R-Iowa), the ranking member of the Senate Finance Committee, stated that the new provisions would violate a 100-year-old law that requires new immigrants' sponsors to pledge that for the first five years, the persons they sponsor would not be a burden to taxpayers (see report from AP/ContraCosta Times).

This departure from an already agreed-upon bipartisan bill does not bode well for health care reform, says health care leader Bob Laszewski in a post at the Healthcare Policy and Marketplace Review blog.

One important point has been missing from the discussion...cash-strapped states are going to have a difficult time paying their share to expand the program (in Florida, it is 32%). A report by Florida Health News notes that states are hoping the new Administration will waive some matching requirements for states with strained budgets.

Personally, I feel that expansion of SCHIP is good policy because we pay for the coverage of legal immigrants one way or the other (either though SCHIP or uncompensated care). The expansion allows care to come out in the open as opposed to being provided through uncompensated care, disproportionate share (DSH), and other pools that obfuscate health care financing. But regardless of the merits of the policy, this departure from bipartisanship does not bode well for the larger and more necessary health reform discussions to come. ~BAA