After months of debate and two presidential vetoes, Congress has successfully voted to extend the State Children's Health Insurance Program to April 2009.
President Bush signed the legislation on December 29th. The law containing the SCHIP extension also addressed Medicare physician reimbursement, payments for Part B drugs, lab tests used by diabetics, and long-term care hospitals.
Authorization for SCHIP expired Sept. 30. The program continued to operate through two resolutions that kept the entire federal government funded until December while lawmakers and President Bush wrangled over a 5-year reauthorization. The showdown ended in December when the Senate and House both agreed to a stripped-down version of the Democrats' wish list. Congress allocated enough federal funds to keep SCHIP enrollment at 2007 levels—or about 6 million children and adults—through March 31, 2009. Democrats sought to cover 10 million children.
“Today we passed a package that puts a band-aid on Medicare and buys just a little more time for families currently relying on SCHIP,” Rep. Charles B. Rangel (D-N.Y.) said in a statement.
Also in a statement, House Speaker Nancy Pelosi said the bill “does not make headway in reducing the number of uninsured.” Sen. Charles Grassley (R-Iowa) said although the original bill was passed unanimously in the Senate, he knew it fell short of what many in Congress were hoping for.
The SCHIP package that was passed did not—as Democrats had preferred—reverse a directive issued by the Centers for Medicare and Medicaid Services last August. States were notified that if they were raising eligibility for children whose family incomes were equal to or above 250% of the federal poverty level, they would have to meet stringent new requirements proving that 95% of eligible children—those at 250% of poverty—were enrolled. The goal: to ensure these families are not opting for SCHIP instead of private insurance.
States must meet that target by August 2008. In a briefing with reporters, Acting CMS Administrator Kerry Weems said at least two states, Vermont and Massachusetts, will soon meet the goal.
In a conference call, Robert Greenstein, executive director of the Center on Budget and Policy Priorities, a liberal-leaning think tank in Washington, said the directive could have a huge impact on enrollment. Fourteen states already cover children above 250% of poverty, and 10 more had plans to expand eligibility above that level.
Thus, the SCHIP bill “was not a maintenance of the current situation but backwards progress,” he said.