States Prepare for SCHIP Reductions As Congress Moves to Fill Shortfalls
By James Arvantes
• Washington, D.C.
3/21/2007
Georgia became the first state to make SCHIP reductions, freezing enrollment in the PeachCare for Kids program, the state's version of SCHIP, on March 11. The state now is shifting money from its Medicaid program to cover the SCHIP shortfall.
SCHIP: A Primer
"The program is not an open-ended entitlement," said Sara Rosenbaum, chair of the Department of Health Policy at George Washington University Medical Center's School of Public Health and Health Services. "As need rises and costs go up, medical inflation is going to eat away the allotment, even if states are not adding any more children."
Congressional Action
"I am sure that whatever compromise is developed, there will be money for SCHIP, but we may go for awhile without any money," said Rosenbaum.
Nevertheless, there is general agreement in the House that the SCHIP shortfall should be addressed without further delay. In the Senate, fixing the shortfall could become more contentious, slowing down the approval of additional funds. Some senators may want to look at why certain states are running out of SCHIP funds. They also may propose a partial funding solution for the shortfall, approving enough money to cover only families at 200 percent of the federal poverty level, for example.
SCHIP Reauthorization
"There is some support for an expenditure amount that would actually expand the current definition of who is eligible under SCHIP," said Rosenbaum.
An SCHIP expansion could provide health insurance to many uninsured individuals, said Daniel Hawkins Jr., vice president for federal, state and public affairs for the National Association of Community Health Centers. Community health centers provide health care services to about 6.5 million uninsured people in the United States; about 2 million of those are under the age of 20, said Hawkins. "An expansion of SCHIP would undoubtedly bring many of them into coverage," he said.
Rep. John Dingell, D-Mich., and Sen. Hillary Rodham Clinton, D-N.Y., have introduced companion bills in the House and Senate that would provide significant funding increases for SCHIP, encouraging states to cover all children with incomes up to 400 percent of the federal poverty level. The legislation, known as the "Children's Health First Act," also would allow families ineligible for SCHIP to buy into the program, providing subsidies to employers in states that expand eligibility to the levels outlined in the bill. The bill's intent is to extend health insurance to the estimated 9 million children without it. As chairman of the House Energy and Commerce Committee, Dingell is responsible for writing the SCHIP reauthorization bill in the House.
President Bush wants to rein in funding for SCHIP by toughening eligibility requirements for children and eliminating coverage for adults through the program. The president has proposed about $30 billion for SCHIP during the next five years, about $45 billion less than amounts proposed by congressional Democrats.
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