Thursday, August 02, 2007

SCHIP expansion bill gets through House, heads to Bush

CHIP expansion bill gets through House, heads to Bush

Valley lawmakers split on measure that would provide $75 billion to states over five years.

By Josh Drobnyk


Call Washington Bureau

August 2, 2007


The House on Wednesday approved a broad expansion of the State Children's Health Insurance Program, a move that would open the door to health coverage for an additional 5 million children whose families can't afford insurance while cutting subsidies to some Medicare providers.

The bill, which passed 225-204, would provide

$75 billion to states over the next five years for the program, a $10 billion-per-year increase over what is now provided. The program now covers 6 million children and is geared toward families who earn too much to qualify for Medicaid but not enough to afford private insurance.

The Lehigh Valley area lawmakers split along party lines. Democratic Reps. Allyson Schwartz, 13th District; Tim Holden, 17th District; Paul Kanjorski, 11th District; and Patrick Murphy, 8th District, supported the measure. Republican Reps. Charlie Dent, 15th District, and Jim Gerlach, 6th District, opposed the bill.

The measure, though, is expected to be scaled back significantly before it goes to President Bush for his signature, and even then it faces an uncertain path, considering the president has vowed to veto the bill.

The Senate, which has called for a more modest increase in the program for a total of $60 billion over five years, is expected to approve its version of the legislation before lawmakers leave for the August recess at the end of the week. Lawmakers from both chambers would then hash out a compromise measure for the program, which is set to expire Sept. 30.

Renewal of the popular program isn't in doubt. Much of the debate in the House, though, hinged on how Congress would pay for the expansion, which supporters say would provide coverage to most of the 133,000 children still uninsured in Pennsylvania. The funding would come from a 45-cent-per-pack increase in the federal excise tax on cigarettes and cuts in subsidies to private health insurance companies participating in the Medicare Advantage program.

Democrats argued that a significant expansion of the program, which already covers 159,000 children in Pennsylvania, was necessary to not only cover those children currently in the program but also those eligible and not enrolled. They said the benefits to children outweighed the costs.

''There are great things about this bill,'' Murphy said. ''It's not perfect.''

Murphy said his support also hinged on a provision in the bill that would eliminate a 10 percent cut in the reimbursement rates to doctors who treat Medicare patients that is slated to take effect in January. ''This bill helps out the kids and helps out the doctors,'' he said.

Opponents, though, said the expansion would go too far, and the cuts in subsidies to Medicare Advantage providers would hurt tens of thousands of seniors in Pennsylvania. The state recently expanded its children's health insurance program to provide coverage on a sliding scale to children from families earning up to 300 percent of the federal poverty level ($61,950 for a family of four).

''We're confronted with the devil's choice here,'' Dent said.

Gerlach was more blunt in his opposition. ''It's an awful bill, pitting our seniors against young kids,'' he said. He said 29,000 seniors who participate in the Medicare Advantage program in his district, which includes parts of Berks, Chester, Lehigh and Montgomery counties, would suffer from the cuts to that program.

Medicare Advantage, used by about a fifth of Medicare recipients, provides a series of benefits, all through one medical provider. Subsidies are about 12 percent higher than traditional Medicare, and critics argue that a cut in those subsidies is well-placed.

''We are leveling the playing field,'' Holden said. ''Insurance companies have made an exorbitant amount of profits [off Medicare].''

Opponents, though, fear seniors would be forced to pay more or lose benefits as a result of the cuts.

With passage in the House, the focus now turns to the Senate. And with that chamber offering a more modest measure, which would be paid for through a 61-cent-per-pack increase in the tobacco tax, the key question is whether the bill can get the two-thirds support from lawmakers needed to override a veto by Bush. The president has proposed funding the program at a level --

$30 billion over five years -- that the Congressional Budget Office said won't cover all of the children already enrolled. Bush argues the proposals in both chambers amount to a ''massive expansion of the federal role'' in health care care at the expense of private insurance.

Dent said he would consider supporting a measure similar to the Senate bill. Gerlach said he would vote for it.

''I think the Senate bill is a very good bill,'' he said. The entire Democratic caucus and nearly 70 of Gerlach's GOP House colleagues would ultimately need to agree with him to override a presidential veto.


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