Recent News About CHIP Reauthorization 1. House Dems Tweaking Immigration, Income Eligibility On New CHIP Bill House Democrats are crafting a children's healthcare bill that would tighten language on immigration, deny states the opportunity to cover children above 300 percent of poverty, and move childless adults out of the program within one year, lawmakers and aides said. Moderate Republicans who asked for the changes to woo more GOP members are asking for more time to allow them to review the bill. President Bush vetoed the bill on October 3. "I strongly encouraged them to give people a chance to look at it, to give people a chance to think about it," said Rep. Heather Wilson (R-NM), who met with Majority Leader Hoyer and House Democratic Caucus Chairman Rahm Emanuel of Illinois Tuesday to discuss the new bill. "When you're asking people, 'Is this good enough?' I think it's unfair to ask them to do that overnight." Other Republicans at the meeting included Reps. Ray LaHood (R-Il), Fred Upton (R-MI), Charles Dent (R-PA), and Michael Castle (R-DE). "We're trying to find a path to compromise. We don't have much time," LaHood said, adding that he is unsure if the new bill will win over another dozen Republicans needed to reach a veto-proof majority on the measure. "I'm not saying with certainty that we'll get to 15," LaHood said. "The purpose of trying to get a compromise is to run things by people." House Democrats also are vetting the proposal through the Senate before scheduling a floor vote. House Republican sources were skeptical the changes could do enough to ensure Democrats get a veto-proof vote, but they acknowledged the possibility. "It's got some of our guys really interested," said a senior GOP leadership aide. A Democratic aide predicted that the changes would not give CHIP proponents the necessary votes to override and could lose support from key players. Without a veto-proof majority, the next step for CHIP would be a continuing resolution that could last for up to one year, the aide said. GOP leadership sources said key issues that could swing Republican votes are immigration and how the bill forces states to focus on poorer children first. They are watching how the bill handles the administration's new requirements that states cover 95 percent of children under 200 percent of poverty before expanding eligibility. "If they fix that, they own it," said the aide. On immigration, it appears that Democrats are not giving in on several Republicans' requests that the current law's requirements for citizenship documents under Medicaid be added to CHIP. The citizenship document requirement has been cited by critics as barring large groups of eligible enrollees from obtaining assistance. Proponents say the requirement is the only way to ensure that illegal immigrants cannot apply for benefits. The vetoed CHIP bill would have required states to bounce the names and Social Security numbers of applicants against the national database. Wilson said such a change would be a huge improvement over current law, which does not have any proof-of-citizenship requirements for CHIP. If states choose, the bill would allow them to ask applicants for documents to prove their citizenship instead of checking Social Security numbers. Senate Majority Whip Durbin called Republicans' repeated complaints about the immigration problems in the bill a "bloody shirt" that they keep waving to "fire up the troops at home to explain why you voted against the bill." "What [House Ways and Means Chairman] Charlie Rangel suggests is that we put in big bold print on every page of the bill, 'Illegal Aliens Need Not Apply.' We'll just put it on every page, so that no matter what page you turn to, it's there in bold letters, and you know what? They'll still say, 'This program is for illegals,'" Durbin said. Democrats are working on "mechanisms" to encourage states to look for the poorer children first, Wilson said, but she would not specify those changes. The vetoed bill would have phased in a target rate for states to cover their children under 200 percent of poverty based on the average rate among the top 10 performing states. Other Republicans have suggested that a 90 percent benchmark for covering the children below 200 percent of poverty would be an acceptable target. It is unclear whether the new cap on eligibility at 300 percent of poverty would allow New Jersey to continue to cover children up to 350 percent. New Jersey is the only state that extends eligibility beyond 300 percent of poverty. LaHood said the discussions among moderates and Democratic leaders did not include any exceptions to the 300 percent rule, but other Democratic aides said New Jersey's waiver could be grandfathered in. [Fawn Johnson, Congress Daily, 10/24/07] 2. Kansas: CHIP Facts and Myths If you have been watching the debate surrounding the State Children's Health Insurance Program (CHIP), you have probably noticed that the Washington spin factor is out of control. Given all the commentary, it's a wonder that anyone understands what the bill actually does. There are rumors this bill provides free government health care to illegal immigrants, taxpayer funded abortions, subsidized health care to high-income families, or health care for “children” up to age 25. These rumors are simply not true – if they were, I would not have supported the bill. First, a little background: CHIP provides health care to low-income children whose families would otherwise be unable to afford coverage. The bill overwhelmingly approved by Congress focuses on getting health coverage to children who currently qualify for CHIP, but are not enrolled because of the lack of resources in the program. As a member of the Senate Finance Committee which actually wrote this bill, let me try to set the record straight. Myth: This bill provides government health care to families with incomes as high as $83,000. Fact: This bill does not grant CHIP coverage to children whose families have incomes over $40,000. In fact, the only way a state can cover children in families at higher income levels is if the administration grants approval for the state to do so. This is already current law, and this bill does not change that. This means that those states who are currently covering families with incomes as high as $70,000 are doing so not through congressional approval, but through waivers by the administration. However, this bill for the first time puts tough standards into place to ensure states are truly focusing their programs on low-income children. Unfortunately, if current law remains in place, states actually have greater incentives to cover higher income populations and will continue to get a higher federal payments to do so. This means there would be no checks in place to stop future administrations from easily granting waivers to states to cover higher income families. This truly could mean a step towards national health care. Myth: This bill provides CHIP coverage to “children” up to age 25. Fact: This bill only covers children aged 18 or younger. This is current law and this bill does not change that. More importantly, this bill actually fixes the problem created by this administration which granted waivers to states to cover adults under this program meant for low-income children. Unfortunately, under this administration's watch, we now have 14 states that cover adults under their CHIP. And, many of these adults do not have any children. More disturbing is that several of these states actually spend more of their CHIP money on adults than they do children. This bill puts an end to this problem. Myth: This bill will encourage families to drop their private health insurance in favor of CHIP. Fact: This bill takes the necessary steps to encourage further private market participation in CHIP. It builds on the current private structure, better allowing states to provide health insurance to children through the private market. Most importantly, the Congressional Budget Office estimates that two-thirds of the children who will gain access to health coverage under this bill are currently uninsured--not children who will be dropping their private health care to enroll in CHIP. As a result of these important provisions, America's Health Insurance Plans--which represents over 1,300 private health insurance plans nationwide--endorsed this bill. This is in addition to every major medical association, state governors, and child advocacy groups. I truly hope all sides can take a step back and realize what is at stake for our children. This is a good bill and it will provide health insurance to children who would otherwise have no access to health care. [U.S. Senator Pat Roberts (R-KS), Hays Daily News, 10/17/07] 3. Public Views on CHIP Reauthorization: Survey Highlights Expansion Widely Popular This survey finds strong majority support for the reauthorization and expansion of CHIP (State Children's Health Insurance Program). Given the basic parameters of the expansion--its cost, the number of new children who would be covered, and how it would be paid for--seven in ten Americans say they back the plan. This asking was followed by a version of the question that provided proponents’ and opponents’ strongest arguments. Even when presented with these pros and cons, support stays at 65 percent. Though the partisan divide on CHIP is certainly large, there is a good deal more bipartisanship here than on issues such as Iraq. Democrats overwhelmingly favor the reauthorization: 82 percent before hearing the pro and con arguments, and 80 percent even after hearing them. Tilting the issue toward the bill's proponents, Independents also weigh in with majority support: 69 percent would back it (dropping only 3 points after hearing the arguments). Instead of being the usual mirror image of Democrats, Republicans are very divided on the CHIP issue: a narrow majority (54 percent) say they support the expansion when asked a straight up or down question, while 41 percent are opposed. This narrow divide deepens a bit--to 47 percent support, 45 percent oppose--after hearing the arguments on both sides. It's worth noting that the CHIP debate takes place in a general climate where two in three Americans (67 percent) think that the government is doing "too little" in providing health insurance to children who don't have it. This includes a majority among men and women, among every age group, and among every income group. Note that only half of Americans say they have heard at least some of the news about the ongoing CHIP debates, with half the country not paying attention. Those who have heard little or nothing about the program are as likely to back its expansion as those who say they have heard at least some news about the issue. [NPR/Kaiser Family Foundation/Harvard School of Public Health, 10/17/07]