On to the President’s desk…

Thursday, September 27, 2007

* Senate passes SCHIP/Healthy Families expansion with veto-proof 69-30 vote
* Follows House passage of SCHIP, 265-159, a majority but not enough to override veto
* ACTION ITEM: Write your Representative about their SCHIP vote

New on the Health Access WeBlog: Much More on SCHIP; Health Premium Increases; Special Session Gossip.

The U.S. Senate on Thursday sent to President Bush a bipartisan $60 billion package that would extend the State Children’s Health Insurance Program (SCHIP) for another five years. Healthy Families, California’s version of SCHIP, currently covers 850,000 children. Both California Sens. Barbara Boxer and Dianne Feinstein voted in favor of the measure.

Even though SCHIP is set to expire on Sunday, September 30th, President Bush has already vowed to veto the measure, which achieved a veto-proof majority in the Senate, but not in the House.

Thirty-four of 53 California Representatives supported the measure in the House of Representatives vote on Tuesday, including Representative Mary Bono, who was the only one of the 19 California Republicans to cross party lines to vote in favor of children’s coverage. HR976 ultimately passed with a 265-159 vote majority on Tuesday evening, but not the 290 votes needed to withstand a veto. See the full list of how California ’s delegation voted here.

The State Children’s Health Insurance Program expires on Sunday after 10 years. It covers 6.6 million children nationally, including about 850,000 children in California through our Healthy Families Program. HR976 (the SCHIP reauthorization bill) would extend coverage to an additional 4 million children – halving the number of uninsured children in the nation.


HR976 would provide an increase to SCHIP of $35 billion over five years. State would receive a 2:1 federal match that dollars states spend in covering eligible children.

The bill would provide federal funds for children in families up to 300 percent of poverty — $61,950 for a family of four. While many states only allow children under 200 percent of poverty, some states with high costs-of-living have higher eligibility levels: California ’s Healthy Families program goes up to 250 percent, and has pending proposals to extend that coverage to 300 percent. New Jersey has had 350 percent, and New York has proposed 400 percent, although their request has recently been rejected by the Bush Administration.

Allowing more middle-income families to join the program has been a point of contention with the President and other Republican members of Congress who view expanding SCHIP into middle-income territory as leverage toward “socialized medicine.’’ But supporters of the expansion argue that private health coverage has become too expensive for families to buy on their own – especially as employers scale back benefits offerings or decline to offer coverage altogether.

In California, some estimate the increase would help the state achieve near-universal coverage for children: about 650,000 children. Gov. Arnold Schwarzenegger and Democratic leaders have all advocated for increasing eligibility for children under the SCHIP/Healthy Families program, and such expansions are part of their overall health expansion proposals.

The expansion of eligibility at the federal level would be covered by a 61-cent increase in the tobacco tax, which was decried by Republican opponents, even though a new poll shows that 67 percent of Republicans favor an even larger tobacco tax to fund children’s health care. The same poll even shows that smokers don’t mind (by a 51-47 margin) paying more to keep children healthy.


Many senators, both Democrat and Republican pointed to the hypocrisy of those who planned to oppose the extension and expansion of children’s health insurance.

Sen. Edward Kennedy, D-Mass., for instance, pointed out that senators who planned to vote against expanding SCHIP earned $160,000 annually, “well above 300 and 400 percent of poverty’’ yet still receive a generous health package paid for by taxpayers. “You’d think if they (the opposing senators) are so offended by federal government spending, they wouldn’t use it themselves. But no, they’ll take it. …This is extraordinary hypocrisy. How can they be complaining all afternoon about a federal government program, and then have the federal government paying for their own,” he said.

Sen. Chuck Grassley, R-Iowa, also spoke in favor of the measure, accusing some of his Republican colleagues of distorting information and correcting the inaccurate assertions his friends made. Grassley also reminded lawmakers that President Bush declared at the 2004 Republican Convention that low-income children should receive the health care they need when they need it.

Republican senators who opposed the bill denounced the expansion as leading to “government health insurance,’’ an argument that President Bush has been rolling out the previous weeks in laying out reasons he will veto the bill.

Others, like Sen. Jim Bunning, R-KY, opined that his state, which does not allow anyone earning more than 200 percent of poverty ($41,300 for a family of four), was subsidizing other states, like California and New York, which had higher thresholds for eligibility. But there’s a reason some states have higher thresholds – it’s far more expensive to live in California than it is to live in Kentucky.

While the Senate voted with over two-thirds of the chamber voting for the SCHIP reauthorization. the House also had a broad bipartisan vote, with 45 Republican votes in favor.

Republicans Congressmen in those states with higher eligibility thresholds (and thus more to gain for their states) generally voted for the program, including 4 of the 6 New York Republican Representatives, and 3 of the 6 New Jersey Republican Representatives. This was not the case for California’s delegation. Despite the support from Republican Governor Arnold Schwarzenegger, only 1 of 19 California Republican Representatives–Mary Bono–voted in favor of SCHIP. Another, Wally Herger, did not vote.


If Bush keeps his promise to veto the SCHIP re-authorization bill, a California HealthCare Foundation analysis by Peter Harbage, found here, shows that California could run out of money to run Healthy Families by mid-November. That means our Healthy Families program may have to disenroll 850,000 children, who would suddenly be unable to go to the doctor, the dentist, fill prescriptions and other medical needs.

Bush has urged Congress to extend the program at current funding levels, but that would also be a detriment to California . Our Healthy Families program has been partially running on money that was saved up from previous years when fewer children were enrolled. With more children enrolled now, California would not have enough money to keep the currently enrolled children covered, let alone accept new children into the program. According to the CHCF analyses, that would mean California would run out of money by summer 2008, leaving all children without coverage, or dis-enrolling about 250,000 immediately in October to keep the program going for slightly longer period.


The children’s coverage reauthorization debate has unfolded this year in tandem with the larger debate about expanded health coverage. In California , and many other states, the expansion of children’s coverage is a first step and an important building block toward a larger coverage expansion for the uninsured.

Seeing this, advocates this year have worked hard and remained unified in advocating for coverage expansions for both children and adults. The work was enough to convince a majority of California ’s congressional delegation to vote in favor of the SCHIP re-authorization. Advocates are encouraged to write THANK YOU notes, to members of Congress, particularly Rep. Mary Bono, who was the only California Republican who crossed party lines to support the measure.

Advocates should also write and follow up with other delegation members, such as and others who voted against the measure, to express their disappointment. Their “no’’ votes have put hundreds of thousands of California children at risk.

Again, to see how the delegation voted, click here. To find your Representative, click here. To find their addresses, click here.

For more information, you can contact Health Access, including Hanh Kim Quach, policy coordinator, at hquach@health-access.org, or Elizabeth Abbott, project director, at eabbott@health-access.org.

Health Access California promotes quality, affordable health care for all Californians.
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