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Senate May Follow House in Expanding Children's Health Care
Thursday August 02, 2007
By Aliza Marcus
Aug. 2 (Bloomberg) -- The Senate may follow the House as soon as today in voting to expand a U.S. health insurance program for low-income children, defying a veto threat by President George W. Bush.
The Democratic-controlled House voted 225-204 yesterday to add $50 billion over five years to the $25 billion program, allowing enrollment to almost double to about 11 million kids. The money would come from increasing tobacco taxes and cutting government payments to insurance companies that provide health coverage through the Medicare system for the elderly and disabled.
The 10-year-old State Children's Health Insurance Program, known as Schip, is aimed at children in families that earn too much for the Medicaid insurance system for the poor, and too little to buy private coverage. The program will expire unless it's reauthorized by the end of September, cutting off health care for children already enrolled.
``If you are against this bill, you are in favor of depriving 6 million children of their health care,' said Representative John Dingell, a Michigan Democrat and chairman of the Energy and Commerce Committee.
Ten Republicans crossed party lines to support the House measure, and five Democrats opposed it. The vote fell short of the two-thirds majority needed in the 435-seat House to override a veto.
The Senate is expected to take action today or tomorrow on its measure, which has more Republican support. The legislation approved by the Senate Finance Committee would add $35 billion, with money coming solely from increasing tobacco taxes. Bush has said he would veto either version, saying Democrats are trying to replace private insurance with government-run health care.
The Democratic-controlled House voted 225-204 yesterday to add $50 billion over five years to the $25 billion program, allowing enrollment to almost double to about 11 million kids. The money would come from increasing tobacco taxes and cutting government payments to insurance companies that provide health coverage through the Medicare system for the elderly and disabled.
The 10-year-old State Children's Health Insurance Program, known as Schip, is aimed at children in families that earn too much for the Medicaid insurance system for the poor, and too little to buy private coverage. The program will expire unless it's reauthorized by the end of September, cutting off health care for children already enrolled.
``If you are against this bill, you are in favor of depriving 6 million children of their health care,' said Representative John Dingell, a Michigan Democrat and chairman of the Energy and Commerce Committee.
Ten Republicans crossed party lines to support the House measure, and five Democrats opposed it. The vote fell short of the two-thirds majority needed in the 435-seat House to override a veto.
The Senate is expected to take action today or tomorrow on its measure, which has more Republican support. The legislation approved by the Senate Finance Committee would add $35 billion, with money coming solely from increasing tobacco taxes. Bush has said he would veto either version, saying Democrats are trying to replace private insurance with government-run health care.
`Veto-Proof'
Congress needs a ``veto-proof' measure, said Senator John Kerry, a Democrat from Massachusetts, in an e-mailed statement yesterday. If the Senate bill passes, a compromise would have to be negotiated by the House and Senate.
Bush has proposed an extra $5 billion for the program, saying that's enough to help uninsured low-income children. The funding proposed by Democrats would allow the benefit to be tapped by middle-income families earning $83,000 a year or more, the administration said in a statement yesterday by the Office of Management and Budget.
``This bill essentially extends a welfare benefit to middle-class households,' the administration's statement said.
Bush, who has proposed tax incentives to encourage private- sector health insurance, said in his budget that the children's program should ``re-focus' attention on its original target: Low-income kids whose families earn up to 200 percent of the federal poverty level, or $41,300 a year for a family of four.
17 States
Seventeen states allow children to enroll if their families earn more than that. New Jersey, the most generous, accepts children whose families earn up to 350 percent of the poverty level, on the rationale that the state has high living expenses. New York has applied for a waiver, not yet granted, to increase eligibility to $83,000, or 400 percent of the poverty level.
``People can always be generous with other people's money,' said Representative Mike Pence, a Republican from Indiana, before the House vote. ``This bill is a massive increase of the government's role in health care.'
The number of uninsured children in the U.S. has dropped from 22.5 percent before Schip was enacted to 16.9 percent in 2005, according to a May report by the Congressional Budget Office, an independent government agency.
There still are about 9 million children without coverage, of whom 6 million currently would qualify for Schip.
Bush has proposed an extra $5 billion for the program, saying that's enough to help uninsured low-income children. The funding proposed by Democrats would allow the benefit to be tapped by middle-income families earning $83,000 a year or more, the administration said in a statement yesterday by the Office of Management and Budget.
``This bill essentially extends a welfare benefit to middle-class households,' the administration's statement said.
Bush, who has proposed tax incentives to encourage private- sector health insurance, said in his budget that the children's program should ``re-focus' attention on its original target: Low-income kids whose families earn up to 200 percent of the federal poverty level, or $41,300 a year for a family of four.
17 States
Seventeen states allow children to enroll if their families earn more than that. New Jersey, the most generous, accepts children whose families earn up to 350 percent of the poverty level, on the rationale that the state has high living expenses. New York has applied for a waiver, not yet granted, to increase eligibility to $83,000, or 400 percent of the poverty level.
``People can always be generous with other people's money,' said Representative Mike Pence, a Republican from Indiana, before the House vote. ``This bill is a massive increase of the government's role in health care.'
The number of uninsured children in the U.S. has dropped from 22.5 percent before Schip was enacted to 16.9 percent in 2005, according to a May report by the Congressional Budget Office, an independent government agency.
There still are about 9 million children without coverage, of whom 6 million currently would qualify for Schip.
`High-Quality' Care
``Despite our success with Schip, our work is not yet complete,' said Representative Diana DeGette, a Democrat from Colorado, in a statement before the House vote. ``There is a great deal that we may disagree about the legislation before us today. What is indisputable is the need for children to receive high-quality health care.'
The House measure would cost about $90 billion over five years altogether. That includes the added funds for children's health, plus money to block a scheduled cut in Medicare fees to doctors and provide subsidies to help low-income seniors pay for certain Medicare benefits.
Most of the money would come from reducing payments to insurers contracted by the government to provide benefits to Medicare beneficiaries.
The privately run plans, known as Medicare Advantage and sold by companies such as Humana Inc., of Louisville, Kentucky, and UnitedHealth Group Inc., of Minnetonka, Minnesota, are paid on average 12 percent more than the government spends to provide Medicare services directly.
The House measure would cost about $90 billion over five years altogether. That includes the added funds for children's health, plus money to block a scheduled cut in Medicare fees to doctors and provide subsidies to help low-income seniors pay for certain Medicare benefits.
Most of the money would come from reducing payments to insurers contracted by the government to provide benefits to Medicare beneficiaries.
The privately run plans, known as Medicare Advantage and sold by companies such as Humana Inc., of Louisville, Kentucky, and UnitedHealth Group Inc., of Minnetonka, Minnesota, are paid on average 12 percent more than the government spends to provide Medicare services directly.
Extra Benefits
The companies say they provide extra benefits for enrollees, such as eye care and exercise programs.
Democrats say private insurers shouldn't be paid extra. About 18 percent of Medicare enrollees get their benefits through private companies, and the added costs are borne by all Medicare beneficiaries, the House Ways and Means Committee said in a statement.
The House legislation also would increase the federal tax on cigarettes to 84 cents a pack from 39 cents, producing $26 billion in tax revenue over five years, according to the U.S. Joint Committee on Taxation. The measure before the Senate would increase the tobacco tax to $1 a pack.
Democrats say private insurers shouldn't be paid extra. About 18 percent of Medicare enrollees get their benefits through private companies, and the added costs are borne by all Medicare beneficiaries, the House Ways and Means Committee said in a statement.
The House legislation also would increase the federal tax on cigarettes to 84 cents a pack from 39 cents, producing $26 billion in tax revenue over five years, according to the U.S. Joint Committee on Taxation. The measure before the Senate would increase the tobacco tax to $1 a pack.