House adopts SCHIP expansion

The measure also would block new physician-owned hospitals.

By Doug Trapp, amednews staff. Posted Jan. 26, 2009.

Washington -- The House on Jan. 14 adopted a 4½-year reauthorization of the State Children's Health Insurance Program, a move largely supported by physicians. But the bill also would effectively ban new or expanded doctor-owned hospitals.

The measure, passed 289-139, would cover about 11 million children under SCHIP -- an expansion of 4 million -- and extend the program until Oct. 1, 2013. The bill would boost existing SCHIP spending by $32.3 billion and be funded with a 61-cent increase in the federal tobacco tax. It is similar to a $35 billion increase adopted by Congress in 2007 and 2008 but vetoed by President Bush.

SCHIP bill provisions
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The AMA supports the extension of SCHIP, which will expire on March 31 without congressional action. But the AMA strongly opposes language in the House bill that would prevent any physician-owned hospital that did not have a Medicare certificate on Jan. 1 from acquiring one. This would prevent about half of the 172 members of Physician Hospitals of America from participating in Medicare and Medicaid, said Molly Sandvig, the group's executive director. About 200 hospitals in the U.S. have physician ownership, she said.

A Senate version of the SCHIP bill does not contain the ban on physician-owned hospitals. Both bills would end a five-year waiting period for legal immigrant children and pregnant women to be eligible for Medicaid and SCHIP.

The Senate Finance Committee on Jan. 15 voted 12-7 to send its SCHIP expansion bill to the Senate floor.

The committee's ranking Republican, Sen. Charles Grassley (Iowa), sharply criticized Democrats for amending the bipartisan SCHIP bill from 2007 with language to end the five-year waiting period, among other adjustments. "Is that change that we need?" he asked.

The print version of this content appeared in the Feb. 2, 2009 issue of American Medical News.

ADDITIONAL INFORMATION:

SCHIP bill provisions

The 4½-year House extension of the State Children's Health Insurance Program would cover a projected 11 million children, a increase of 4 million over the number of current enrollees. The measure also would:

Prohibit nearly all physician-owned hospitals from expanding their facilities and increasing their level of physician ownership. Also, such facilities that did not have a Medicare certification number by Jan. 1 would not receive one, excluding them from participating in Medicare and Medicaid.
End the five-year waiting period for legal immigrant children and pregnant woman to be eligible for Medicaid and SCHIP.
Allow states to use Social Security numbers to help verify the identity of Medicaid and SCHIP applicants. Existing law requires original documents, such as birth certificates, to be used in the verification process.
Provide $4.4 billion between 2009 and 2019 for performance bonus payments to state Medicaid programs that enroll eligible children beyond the anticipated growth of their child populations. States must also incorporate certain outreach activities into their programs and allow children to re-enroll every year instead of every six months.

Sources: Congressional Budget Office, bill text