CQ’s Carey Discusses CHIP, Economic Stimulus, Effects of Daschle Withdrawal
CQ HealthBeat Associate Editor Mary Agnes Carey discusses the signing of a bill to renew and expand CHIP to four million additional children, the Senate's ongoing efforts to pass an economic stimulus bill and former Senate Majority Leader Tom Daschle's (D-S.D.) withdrawal of his nomination for HHS secretary in this week's "Health on the Hill from Kaisernetwork.org and CQ."President Obama signed legislation (HR 2) that reauthorizes and expands CHIP and called the bill a down-payment on expanding health coverage to all U.S. residents, Carey says. The bill allows states to choose to cover children in families with incomes greater than 300% of the federal poverty level, but those states would receive the SCHIP matching rate up to 300% and the Medicaid matching rate above that level. The bill also allows states to eliminate the five-year waiting period for documented immigrant children and pregnant women to become eligible for the program. In addition, the bill changes
the name of the program from the State Children's Health Insurance Program to the Children's Health Insurance Program. Obama last week also reversed a Bush administration policy directive that would have required states to guarantee that they had provided health coverage to 95% of children in families with incomes up to 200% of the poverty level before they could enroll children in families with incomes up to 250% of the poverty level in CHIP, according to Carey.
Carey also says that moderate Republicans and Democrats in the Senate have been working to reduce the size of the economic stimulus bill. The Senate this week is scheduled to vote on a compromise package that would eliminate $5.8 billion for preventive health care services, including screenings, immunizations and nutritional counseling, and $870 million for pandemic flu prevention and preparedness, as well as reducing funding for health information technology, according to Carey. The Senate Finance Committee also removed about $7 billion in health spending provisions from the House bill, according to Carey. However, the revised Senate version would include $10 billion for biomedical research and $1.1 billion for comparative effectiveness research, according to Carey. The House bill, which totaled $820 billion, included $3 billion for prevention and wellness and $900 million for flu preparedness.
Once the Senate approves the bill, lawmakers will have to reconcile this version with the House bill. Carey says one "key difference" between the two packages is how they would extend COBRA benefits to allow laid-off workers to purchase insurance through their former employers. She says that the Senate version would provide a 50% subsidy for 12 months to people buying coverage through COBRA, while the House version would provide a subsidy of 65% for 12 months. In addition, the House would allow states to expand Medicaid to cover all unemployed individuals through 2010, while the Senate version includes no such provision, according to Carey.
Daschle's decision to withdraw his nomination for HHS secretary last week -- in response to reports that he was forced to pay more than $140,000 in back taxes and interest for a car and driver services and that he had accepted about $200,000 in speaking fees from health care groups that "he would have to regulate as HHS secretary" -- "certainly doesn't help" Democrats' chances for passing health care overhaul legislation this year, Carey says. She adds, "But that does not necessarily mean that health care overhaul legislation will get any less attention on Capitol Hill," noting that Senate Finance Committee Chair Max Baucus (D-Mont.) and Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) wrote to Obama last week stating their intentions to move an overhaul bill in the Senate this year. The letter also urged Obama to quickly select his HHS secretary (Carey, "Health on the Hill from Kaisernetwork.org and CQ," 2/9).
The complete audio version of "Health on the Hill," transcript and resources for further research are available online at kaisernetwork.org. This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
