Volume 6, Number 7
In this Issue:
House and Senate Leaders Reach Agreement on SCHIP; Legislation Still Faces Veto Threat
FY 2008 Labor-HHS-Education Appropriations Update
2006 Census Data Shows That Low-Income Families Are Not Sharing Nation’s Prosperity
House and Senate Leaders Reach Agreement on SCHIP; Legislation Still Faces Veto Threat
With the September 30th deadline to reauthorize the State Children’s Health Insurance Program (SCHIP) rapidly approaching, House and Senate negotiators have settled on the contents of a bill that will go to the floor of both chambers this week. This move comes after several weeks of informal negotiations between U.S. House and Senate leaders to reach a compromise, a process that was initiated after Republican leadership in the Senate blocked the appointment of official conferees on the original House and Senate bills. Negotiations were also slowed by House Democrats, who wanted the final bill to include certain policies not contained in the Senate bill as well as the $47 billion increase in funding over the next five years authorized by the House bill (as opposed to the $35 billion increase provided in the Senate bill). A summary of the agreed-upon provisions prepared by the Senate Finance Committee can be viewed here:
http://www.senate.gov/~finance/press/Bpress/2007press/prb092107d.pdf
Funding
In the end, it appears that the final bill will very closely resemble the bill passed by the Senate in August, including the $35 billion increase. While many House Democrats are reportedly unhappy that the compromise developed heavily favors the demands of Senate negotiators, they have also acknowledged that the more expansive House-passed bill would have very little chance of passing the Senate. Senate Republicans have stated very clearly that they would not support a bill that exceeds the $35 billion increase in the Senate bill. Like the original Senate bill, the version agreed upon will pay for the program’s expansion through a 61-cent increase in the federal tobacco tax on cigarettes. It does not include any provisions that would reduce payments to private Medicare Advantage plans, which had been included in the bill passed by the House.
Program Eligibility
While the agreement allows for coverage of pregnant women with SCHIP funding, noticeably absent are the provisions from the House-passed bill that would have extended coverage to legal immigrant children and pregnant women, who currently must have lived in the country for five years before becoming eligible for the program. While the House bill did not include any income eligibility limits, the new agreement closely resembles what was proposed by the Senate: phasing in a new requirement that states cover low-income children before using funding to cover children whose family income is above 300 percent of the federal poverty level (FPL), combined with a reduced federal matching rate for future coverage of children above this threshold.
Addressing New Administration Guidelines
The agreement reached also addresses the new guidelines issued by the Administration in August. During the August Congressional recess, the Administration issued new guidelines through the Center for Medicare and Medicaid Services (CMS) that direct state health officials to establish a firm income eligibility limit of 250 percent of the federal poverty level (FPL) for their SCHIP programs, unless states can meet a series of strict requirements. From its inception, the program has allowed individual states to determine their own income eligibility requirements for SCHIP programs, providing flexibility to adjust for differences in cost of living and other factors that might make states’ needs different. The new CMS regulations directly affect nearly half of all states, as many states already provide SCHIP coverage to families above 250 percent of the FPL and many others have adopted but not yet implemented income eligibility thresholds above this level. From the time the new guidelines were issued, they were met by strong bipartisan opposition in Congress. Prior Congressional actions taken in response included a bipartisan letter written by Senators Menendez (D-NJ) and Smith (R-OR) and signed by 44 colleagues in the Senate, as well the introduction of a stand-alone bill that would have blocked the new regulations, sponsored by Senators Snowe (R-ME), Kennedy (D-MA), Rockefeller (D-WV), and Smith (R-OR).
The Senate Finance Committee summary of the new House-Senate agreement states that the provisions in the final bill sent to the President will replace the CMS guidelines.
Next Steps:
Once a final bill is passed by both chambers, Congress still faces an uphill battle with the Administration, which is pushing for a significantly smaller increase of $5 billion over 5 years. The Administration has repeatedly voiced concern over expanding SCHIP. In a press conference late last week President Bush reaffirmed his intent to veto the bill and stated that he is in favor of a “clean extension” of the program.
It remains to be seen whether this new agreement will be able to garner enough support across both chambers to override a Presidential veto. While the Senate passed its bill by a 68-31 vote, reaching the two-thirds majority needed, the numbers in the House were short of a two-thirds majority by 65 votes. If they are unable to pass a bill before the September 30th expiration date, members of Congress have indicated that they will likely turn to a short-term extension of the program at its current funding level until a full reauthorization can be passed.
FY 2008 Labor-HHS-Education Appropriations Update
While the House has passed all 12 of its appropriations bills for FY 2008, the Senate has only been able to bring 4 of 12 spending bills to a full floor vote. Among the Senate bills still awaiting passage is the FY 2008 Labor-HHS-Education bill (S.1710). With the new federal fiscal year beginning October 1st and no House-Senate conferences scheduled for any of the appropriations bills yet, it is nearly certain that Congress will need to pass a continuing resolution (CR) this week that provides short-term funding for all government programs until appropriations work is completed. The number of weeks that will need to be covered by the continuing resolution has been a point of contention between the House and Senate, with House leadership intent on Congress finishing all appropriations work by November 9th, while leaders in the Senate have indicated that they see November 23rd as a more realistic deadline.
Democrats have stated that they intend to hold off on challenging the Administration on spending levels for now, and will offer a continuing resolution that funds the government at the current FY 2007 spending levels.
Next Steps:
Once a continuing resolution is passed, which must happen this week, the Senate Labor-HHS-Education appropriations bill, which has been approved by the Senate Appropriations Committee, will need to be passed by the full Senate. Following passage in the Senate, a House-Senate conference committee will reconcile the differences between the House and Senate bills in order to draft a single bill that will be sent to the President’s desk.
The President has indicated that he will veto a Labor-HHS-Education bill that exceeds the spending level set forth in the Administration’s FY 2008 budget. The House bill exceeds the Administration’s request by approximately $11 billion, while the Senate bill comes in at approximately $9 billion over the Administration’s proposed spending level. However, it is possible that Congress will have enough bipartisan support to override a Presidential veto. In the House, the bill passed by a vote that was just one vote shy of the two-thirds majority needed to overcome a veto, and the Senate bill is reportedly expected to pass by a large margin. It is also possible that FY 2008 Labor-HHS-Education appropriations will be bundled with other spending bills in a large omnibus spending bill sent to the President. This would occur if Congress is unable to send a stand-alone bill to the President before the continuing resolution expires, or if the bill they pass does not have enough support to override a Presidential veto.
2006 Census Data Shows That Low-Income Families Are Not Sharing Nation’s Prosperity
The most recent census data, released at the end of last month, indicates that poverty rates have remained at virtually the same level as the previous year, despite a fifth straight year of economic recovery for the country. Earnings for both men and women declined in 2006, for the third year in a row. Additionally, the number of uninsured Americans has risen by over 2 million since 2005, including approximately 700,000 more uninsured children. This data highlights the need for a strong reauthorization of the State Children’s Health Insurance Program (SCHIP), discussed above. This increase in the number of uninsured children reflects the funding shortages faced by many states in 2005 and 2006 as their SCHIP funding began to run out. The SCHIP bill headed to the floor of the House and Senate this week would provide coverage for approximately 4 million children who would otherwise be uninsured. In contrast, the Congressional Budget Office estimates that the Administration’s proposed total funding level of $30 billion over the next five years would result in an additional 840,000 children losing health insurance coverage.
The Coalition on Human Needs has developed numerous tools and resources that can help you to use the census data, including data for individual states, to make a case for increased funding for programs that serve low-income families in your state. 
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