Congress wants to enlarge SCHIP; Bush seeks limits

House and Senate 2008 budget resolutions include enough to cover all eligible children and expand enrollment. Meanwhile, 14 states still need additional funds for 2007.

By Doug Trapp, AMNews staff. April 23/30, 2007.

Washington -- Strong support exists in Congress for reauthorization of the State Children's Health Insurance Program, but divisions remain on funding and eligibility.

Last month, the House and Senate both narrowly passed budget resolutions -- roadmaps for federal spending -- creating a pathway for a five-year, $75 billion reauthorization of SCHIP. Both resolutions add $50 billion over five years to the existing $25 billion in SCHIP funding. But during the actual appropriations process, both chambers must offset the new spending with new revenues or cuts to meet budget rules, said staff members for the Senate Finance Committee and the chair of the House Budget Committee.

When it comes to specific plans, some Democrats are supporting five-year reauthorizations with eligibility as high as 400% of the poverty level and as much as $85 million in funding.

But President Bush -- in an attempt to refocus SCHIP on low-income children -- proposed a $30 billion, five-year reauthorization. This would fund coverage for children in families with incomes up to 200% of the federal poverty level.

SCHIP, a decade-old state-federal program expiring Sept. 30, provides health coverage to about 6 million children and about 600,000 adults who don't qualify for other public health programs. But between 7.5 million and 10 million children remain uninsured. Of those, approximately 2 million are eligible for SCHIP, according to various estimates.

There's a significant difference between the president's proposal and the others, said Jeremy A. Lazarus, MD, vice speaker of the American Medical Association House of Delegates and a psychiatrist from Denver.