[Jul 24, 2007]

      The House Energy and Commerce Committee on Wednesday plans to mark up legislation that would reauthorize and expand SCHIP and make revisions to Medicare, and the House Ways and Means Committee is expected to mark up the legislation on Thursday, CongressDaily reports (CongressDaily, 7/23). The legislation, called the Children's Health and Medicare Protection Act, would increase SCHIP funding by $50 billion over five years. The bill also would reverse a scheduled cut in Medicare payments to physicians and provide a modest increase in fees for each of the next two years. In addition, the legislation would:

• Simplify the Medicare application process and relax the current asset limits;
  
  
• Allow the HHS secretary to expand Medicare coverage of preventive screenings;
  
  
• Pay primary care physicians to coordinate the care of some traditional Medicare beneficiaries;
  
  
• Abolish a provision of the 2003 Medicare law that mandates the president propose changes in Medicare to limit the program's reliance on general revenue;
  
  
• Give state insurance commissioners more power to regulate the marketing of private MA plans by agents and brokers;
  
  
• Reduce payments to private MA plans, which are estimated to be 12% higher than payments to the traditional program for equivalent benefits (Kaiser Daily Health Policy Report, 7/23);
  
  
• Increase reimbursement rates for rural health providers in 2008; and
  
  
• Provide larger subsidies to lower-income beneficiaries.
  

The bill is expected to cost about $90 billion and would be funded by a tobacco tax increase and cuts to private MA plan payments (Wayne, CQ Today, 7/23). The rate of the tobacco tax increase has not been decided, according to House Ways and Means Committee Chair Charles Rangel (D-N.Y.). It is expected to range from 30 cents to 50 cents per pack (Reichard/Ferrechio, CQ HealthBeat, 7/23).

While some House Democrats do not support a tobacco tax increase, most "appear to be grudgingly accepting it because there are few other funding resources available to pay for SCHIP and Medicare," CongressDaily reports.

Republican Opposition
According to CongressDaily, "it is fairly certain" that House Republicans "will stay unified against the proposal" during a floor vote. Republican opposition is "bolstered by a veto threat from the administration," which says both the House and Senate SCHIP expansion proposals are too broad, CongressDaily reports (Johnson, CongressDaily, 7/24).

Kevin Smith, spokesperson for House Minority Leader John Boehner (R-Ohio), said, "Republicans support renewing SCHIP for children in low-income families, but we oppose Democratic leaders' plan to increase taxes on working families and cut popular Medicare programs in order to pay for a massive expansion of government-run health care." Smith added, "House Republicans will sustain the president's veto of this misguided proposal." Republicans have not decided whether to offer alternative legislation, according to Smith (CQ Today, 7/23).

Related Coverage
Two newspapers on Monday examined congressional efforts to reauthorize SCHIP. Summaries appear below.

• Gannett/Asbury Park Press: Sen. Robert Menendez (D-N.J.) and Rep. Frank Pallone (D-N.J.) "are on the frontlines of a political fight between Congress and the White House over the future" of SCHIP, Gannett/Park Press reports. Pallone, chair of the House Energy and Commerce Health Subcommittee, is helping to draft the House SCHIP legislation, and Menendez is "working to create a large-enough coalition to block [President] Bush's proposals and possibly override a veto," according to Gannett/Park Press (Chebium, Gannett/Asbury Park Press, 7/23).
  
  
• Kansas City Star: "Cutting off health care for six million kids is something no politician would seriously consider," and as a result, a "ticklish bidding effort is under way to find enough votes to increase SCHIP without triggering a Bush veto or Senate filibuster," the City Star reports (Helling, Kansas City Star, 7/23).
  

Editorials
Newspapers recently featured several editorials about legislation to reauthorize and expand SCHIP. Summaries appear below.

• Mike King, Atlanta Journal-Constitution: President Bush has threatened to veto legislation that would reauthorize and expand SCHIP, an action that "says a lot about the dismal record his administration will leave on domestic policy issues," King, a member of the Journal-Constitution editorial board, writes in an opinion piece. According to King, Bush "offers no viable alternative for expanding health insurance coverage for the millions of American children without it -- short of his questionable scheme to encourage families to create tax-free, health care savings accounts to pay their medical bills" -- an indication that he "doesn't have a clue about what's happening to middle-income families." King concludes, "It is long past time for the country to make health insurance available to every child, just as we have to every elderly citizen" (King, Atlanta Journal-Constitution, 7/22).
  
  
• Dallas Morning News: House and Senate versions of bills to reauthorize and expand SCHIP "do signal excess, more than doubling ... spending" for the program, but Bush should "come off his veto threat and realize that a more gradual expansion" would help families and reduce the number of uninsured U.S. residents, according to a Morning News editorial. The editorial concludes, "The answer is for Congress to come down on its price tag, governors to step in and President Bush to back off his veto threat. Washington could then avoid a meltdown, control spending and help families" (Dallas Morning News, 7/23).
  
  
• Houston Chronicle: "Expanding SCHIP is a stopgap measure that would expand the number of Americans with access to health care," according to a Chronicle editorial. Bush has threatened to veto legislation that would reauthorize and expand SCHIP because of concerns that "expanding the program would undermine the insurance industry," but "having more children insured would lower costs passed on to private insurers and employers," the editorial states (Houston Chronicle, 7/22).
  
  
• Las Vegas Review-Journal: House and Senate versions of bills to reauthorize and expand SCHIP amount "to not only a major tax hike, but another baby step toward the Democratic dream of a government takeover of our health care system," according to a Review-Journal editorial. SCHIP "isn't about 'the children,' at all," the editorial states, adding, "If it were, the focus would be on making sure that eligibility for SCHIP was confined to uninsured kids whose parents were barely scraping by yet weren't eligible for other federal assistance" (Las Vegas Review-Journal, 7/20).
  
  
• Milwaukee Journal Sentinel: A Bush veto of legislation that would reauthorize and expand SCHIP "would be a huge mistake, one that would have financial ramifications for Wisconsin and health implications for its children," according to a Journal Sentinel editorial. The editorial states, "The president said the legislation would lead to a massive expansion of the federal role in health care, which he says will lead to 'less quality care and rationing over time.'" The editorial concludes, "We don't buy that tired, anti-government rhetoric, and neither should the public, especially when it comes to health care for children" (Milwaukee Journal Sentinel, 7/20).
  

Broadcast Coverage
NPR's "Tell Me More" on Monday included a discussion with NPR health policy correspondent Julie Rovner about SCHIP legislation (Martin [1], "Tell Me More," NPR, 7/23). Audio of the segment is available online. The program also included a discussion with William Galston, a health policy adviser under former President Clinton, about efforts to expand health insurance for children (Martin [2], "Tell Me More," NPR, 7/23). Audio of the segment is available online.