State Children’s Health Insurance Program -- SCHIP

November 5, 2007

On Thursday, Nov. 1, the Senate passed the SCHIP bill, H.R. 3963, by a vote of 64-30. Senate and House negotiators are working this week to craft a veto-proof version, but accomplishing that goal is proving to be difficult. The Senate already has the two-thirds margin needed to overturn a veto, but the House margin is not sufficient. On October 25, the House passed H.R. 3963 by a vote of 265-142, about 15 votes short of what is needed for an override.

President Bush vetoed an earlier version (H.R. 976) on October 3 and it is highly likely that he will veto this bill as well.

Republican negotiators want 90% of children under 200% of the poverty level to be enrolled in the program before it can be expanded upward to the 300% cap Democrats have put in place. Many state officials, however, feel that it would be nearly impossible to enroll such a high percentage of children, partly because some parents choose not to participate in the program. Current bill supporters say following that rule could make it more difficult to reach one of their non-negotiable goals: covering 10 million children.

The program has been extended until November 16, and negotiators are reported to be eager to avoid another extension of the program that could last until October 2008, just prior to the presidential election.

NETWORK will continue to advocate strongly for SCHIP. While the current bill is not perfect—and we deeply lament its provisions regarding immigrant children—we see it as an important step toward securing healthcare coverage for all low-income children.

For more information about the bill from the Center on Budget and Policy Priorities, to to: http://www.cbpp.org/10-25-07health.htm

Background

On October 3, President Bush vetoed the SCHIP bill that passed both the House and Senate by wide margins. As noted by ABC News, the “White House sought as little attention as possible, with the president wielding his veto behind closed doors without any fanfare or news coverage.” On October 18, the House failed to override the president’s veto. The vote was 273 to 156, which was 13 votes short of the necessary two-thirds majority of the representatives voting.

The Senate passed the SCHIP compromise bill on Thursday, September 27, by a vote of 67 to 29. Although this was a large enought margin to override a presidential veto, the Senate might not get the bill back since vetoed bills are returned first to the chamber where they originated, in this case the House.

The House passed the SCHIP compromise bill by a margin of 265-159 on September 25. That vote was 19 short of what is needed to override President Bush’s expected veto.

On September 25, President Bush issued a written statement saying the bill “goes too far toward federalizing health care and turns a program meant to help low-income children into one that covers children in some households with incomes of up to $83,000 a year.” This figure is greatly inflated. According to CongressDaily, Senator Grassley, a member of the president’s own party, has stated that the president’s “understanding of our bill is wrong, and I would urge the president to reconsider his veto message based upon the bill we might pass, not something that some staffer has told him wrongly about our bill.”

The $35 billion compromise agreement will provide health insurance coverage for the 6.6 million children currently enrolled in the program, plus an additional 4 million. It includes dental coverage and mental health parity, and it gives states the option to cover pregnant women, protecting the health and preserving the life of unborn children.

Unfortunately, it also fails :

• To provide adequate funding to cover the all children who remain uninsured.
• To extend coverage to legal immigrant children who have been in the country for less than 5 years.

Despite these failures, SCHIP represents a step in the right direction. Failure to enact this bill would mean millions more children without access to health care.

The cost of the bill would be offset by an increase in tobacco taxes.

In recent days, NETWORK's Simone Campbell, SSS, and Catherine Pinkerton, CSJ, have spoken out strongly for the SCHIP bill (press release) at Capitol Hill press conferences. They strongly endorsed the legislation as an imporant step in providing healthcare for vulnerable children. Catherine Pinkerton stated, “From our perspective, today is one of those defining moments in our nation’s evolution, this moment when Congress and the president either accept or reject the obligation of government to provide for the common good, in this case the common good of our nation’s most vulnerable children.”

What Is SCHIP?

The State Children’s Health Insurance Program (SCHIP) is up for re-authorization. The program is designed to subsidize the cost of health insurance for children whose families earn too much to be covered by Medicaid, but not enough to afford private health insurance. Since its inception in 1997, the number of uninsured children has dropped significantly.

There is disagreement about how many children lack insurance. The White House, for political reasons, uses numbers provided by the Urban Institute, which says that 5 million lack insurance and, of those, just over 1 million are eligible for government programs but not enrolled. Other groups, including the Agency for Healthcare Research and Quality (part of the U.S. Department of Health and Human Services) come up with far higher numbers – 9 million without insurance, with 5 to 6 million eligible but not enrolled. The difference in numbers comes, in part, because the Urban Institute study only includes children who lack insurance for the whole year rather than children uninsured at any given time. NETWORK believes that all low-income children deserve healthcare.

SCHIP is a joint program of federal and state governments, with the federal government paying an average of 70% of program costs, although it was designed as a 50/50 split.  In 1998, the program was amended by the federal government allotting an additional $40 billion over ten years to support states with large numbers of low-income children.  Even with this, an estimated 17 states will have used up their funding by this year, 2007. 

States have leeway in determining eligibility for children in their state.  Children whose family income is too high for Medicaid are eligible.  However, the upper limit ranges widely.  About 70% ensure children up to twice the poverty level.  This income level is not sufficient for private insurance, and most workers in this salary range do not have employer-provided health insurance.

NETWORK believes...

NETWORK calls on Congress to fully fund SCHIP so that all of the eligible children are covered by health insurance. We believe that healthcare is a basic human right.

The dignity of the human person is the underlying principle of Catholic Social Teaching.  It implies that each person deserves a life in which basic needs are met. Children who do not receive medical attention become ill more frequently, and more seriously. This affects all aspects of their growth and development.