U.s. Senate Votes to Expand Childrens Health Fund
The vote was 66-32 late yesterday to add $32.8 billion over 4 1/2 years to the State Childrens Health Insurance Program, or Schip, expanding coverage to more than 11 million children from 7.4 million last year. The House passed a similar measure on Jan. 14, and the two versions must be reconciled before the legislation is sent to Obama.
Then-President George W. Bush in 2007 twice vetoed an expansion of the program, aimed at low-income children whose families earn too much for the Medicaid health plan for the poor, saying that Democrats were trying to undermine private health coverage. Lawmakers said job losses in the recession threaten to cut more children from insurance rolls, and Obama said he wants expanded coverage to be among the first measures he signs into law as president.
“As the worsening economy causes families to lose their jobs and health insurance, it is vital that we redouble our efforts to ensure that every child in America has access to affordable health care,” Obama said today in an e-mailed statement. The expanded program “will serve as a down payment on my commitment to ensure that every American has access to quality, affordable health care.”
Republicans who voted against the measure objected to a change that extends benefits to legal immigrant children, without requiring that they be residents in the U.S. for five years, as currently called for. The Senate rejected Republican amendments to limit such coverage.
Poorest Families
The proposal also doesnt ensure that states enroll children from the poorest families first before expanding coverage to children in other families, some Republicans said.
The legislation the Senate approved brings the U.S. governments contribution to the joint state-federal program to about $12 billion annually from the current $5 billion.
Schip originally was intended for households with incomes up to $42,400 for a family of four, or 200 percent of the poverty level. Medicaid, the jointly funded federal-state health program, generally is targeted at children in families with incomes no higher than the federal poverty level, which is $21,200 for a family of four.
Over the years, some states raised income eligibility for Schip, citing higher costs of living. Eight states, along with Washington, D.C., allow children to enroll if their parents have incomes of $63,600 a year, or 300 percent of the poverty level for a family of four. A ninth state, New Jersey, sets the income level at $74,200, the most generous. Companies such as UnitedHealth Group Inc. and Aetna Inc. contract with states to provide coverage.
Low-Income Kids
“When the government steps in and says lets have taxpayers pay for your coverage, it should be focused on low-income kids,” Senator Charles Grassley, an Iowa Republican and the ranking minority member of the Senate Finance Committee, said during debate two days ago.
Grassley, who supported a Senate measure to expand Schip in 2007, said previous proposals had stronger provisions to protect against families dropping private coverage in favor of the subsidized care. He voted against the legislation last night.
An estimated 2.4 million children with private insurance, in addition to the 4 million without any coverage, are expected to sign up for Schip under the Senate measure, according to an analysis by the nonpartisan Congressional Budget Office.
Critical First Step
“Inexplicably, we hear a chorus of why we shouldnt expand Schip,” said Senator Olympia Snowe, a Maine Republican, who backed the attempts to extend the program in 2007 and voted in favor of the current version. “This bill is a critical first step to greater health reform.”
Obama campaigned on a pledge to overhaul the U.S. health- care system, reducing the number of uninsured. About 15 percent of the population lacks coverage, according to the Census Bureau.
The Senate and House versions call for financing the changes by raising the federal tax on cigarettes to $1 a pack from 39 cents. The current tax on tobacco now helps finance the program, which was created in 1997 and will expire at the end of March unless new money is authorized.
Republicans, who say they dont want to raise taxes, offered a measure to add $19 billion over five years to enroll an additional 2 million uninsured children. Most of the funding would have come from reducing the amount of money states get from Medicaid for their administrative expenses. Their proposal also would end up insuring about 1 million children who have private coverage, according to the Congressional Budget Office.
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