Thursday, September 20, 2007 Capitol
Hill Watch
House, Senate Leaders Soon Could Announce SCHIP
Compromise Legislation
House Democrats on Thursday could
announce a compromise with the Senate on legislation that would
reauthorize and expand SCHIP, according to aides, CQ Today
reports (Wayne, CQ Today, 9/19). A draft compromise bill,
announced on Sunday, reportedly closely resembles the Senate version of
SCHIP legislation, which would provide an additional $35 billion in
funding over the next five years and bring total spending on the program
to $60 billion. The additional funding would be paid for by an increase in
the tobacco tax, which would be similar to the 61-cent-per-pack tax
proposed in the Senate version. The compromise bill does not include
revisions to Medicare (Kaiser Daily Health Policy Report, 9/19).
House Energy and Commerce Subcommittee on Health Chair Frank Pallone (D-N.J.), Senate Finance
Committee ranking member Chuck Grassley (R-Iowa) and Sen. Orrin Hatch
(R-Utah) on Wednesday said that negotiators were close to reaching a deal.
"We're just about there," Grassley said, adding, "There still are a couple
things outstanding" (CQ Today, 9/19).
Grassley on
Wednesday said that the final compromise bill will include $300 million
for dental coverage and will adopt the formulas for state funding included
in the House SCHIP bill. Grassley said that Senate Finance Committee Chair
Max Baucus (D-Mont.) found a way to add the dental coverage provision
while ensuring the bill follows pay/go rules. Senate negotiators adopted
the House formulas for state funding in return for a guarantee that the
final bill will provide only an additional $35 billion over five years.
According to CongressDaily, House Democrats "consider
inclusion of dental benefits a victory, and they hope the addition will
help them collect votes" (Johnson, CongressDaily, 9/19).
Republican Response
Meanwhile, House Republicans on
Wednesday "began to splinter on the issue" of SCHIP, according to CQ
Today. Seventeen House Republicans told Democratic leaders that
they support the compromise bill. If the 17 lawmakers vote for the
compromise bill, along with the five Republicans who voted for the House
SCHIP measure, the legislation would receive about 250 votes -- "still far
short of the number Democrats would need to override a veto," CQ
Today reports (CQ Today, 9/19).
Rep. Ray
LaHood (R-Ill.), who is working with Democratic Caucus Chair Rahm Emanuel (D-Ill.) to whip up
Republican support, estimated that as many as 30 Republicans would vote
for the compromise bill. However, House Energy and
Commerce Committee ranking member Joe Barton (R-Texas) said he is sure
House Republicans will be able to sustain a presidential veto (Johnson,
CongressDaily, 9/19). Republican leaders urged Democratic
leaders to pass an extension of the program rather than try to pass
reauthorization legislation (CQ Today, 9/19).
Lobbying Efforts
The absence of revisions to Medicare in the
compromise SCHIP bill "changes the stakes for many" interest groups, who
were "ready to put some muscle behind passing" SCHIP legislation, The Hill reports. Lobbying groups "with a
stake in the Medicare provisions will be looking past SCHIP to restaging
those fights," according to The Hill.
Supporters of
the compromise SCHIP bill will have the "enthusiastic and active support
of a number of groups," including Families USA, which next week will launch a lobbying
campaign; the American Cancer Society and other members of the
anti-tobacco lobby; and America's Health Insurance Plans, which strongly opposed
the cuts to Medicare Advantage plans present in the House bill. Other
groups are undecided on whether to lobby in support of the bill, according
to The Hill.
AARP spokesperson Drew Nannis said, "I don't know where
we're going to focus our money and our efforts. We still need to see what
(the) final legislation is going to look like" (Young, The
Hill, 9/20).
Crowd-Out Report
In related news, Baucus on Wednesday
criticized HHS for making
revisions to a government-contracted report by Mathematica Policy
Research that examined whether an expansion of SCHIP would cause
crowd-out, the phenomenon of public coverage substituting for private
insurance. CQ Today reports that in the draft executive summary,
the research firm wrote, "The evidence suggests that substitution of
private coverage for SCHIP was not an issue." HHS, which released the
report on Wednesday, deleted that sentence while adding that "the evidence
suggests that substitution of SCHIP for private coverage does occur,"
according to CQ Today.
The report found that between 10%
and 56% of families enrolled in SCHIP dropped or declined private health
insurance coverage, depending on how crowd-out was calculated. The higher
figure assumes that any reduction in private coverage found among children
in lower-income families eligible for SCHIP is caused by crowd-out -- a
methodology the firm said has "limitations."
Timothy Love,
director of the Office of Research, Development and Information at CMS, in a letter said that
HHS asked Mathematica to reword the sentence because "some peer reviewers
felt (the sentence) was not completely supported by MPR's own discussion
-- in short, it appeared to be overly speculative." Baucus said, "I'm
troubled by the fact that this is not the first time we've seen skewed
information coming from" HHS regarding SCHIP (CQ Today,
9/19).
NPR's
"Morning Edition" on Thursday reported on the SCHIP
legislation. The segment includes comments from Emanuel, HHS Secretary
Mike Leavitt, Rep. Nathan Deal (R-Ga.) and Rep. Ray LaHood (R-Ill.)
(Rovner, "Morning Edition," NPR, 9/20). Audio of the segment is available
online.