Summary of Senate Finance Committee SCHIP Mark-Up
Summary of Senate Finance Committee SCHIP Mark-Up
July 19, 2007The Senate Finance Committee marked-up legislation on July 19 to reauthorize the SCHIP program in a 17- 4 vote. While 68 amendments had been filed, only 6 amendments were offered during the mark-up session. Only one, an amendment to address a disparity in reimbursements for Federal Qualified Health Centers, was adopted in a voice vote.
As expected the proposal provides $35 billion for SCHIP, $15 billion short of the $50 billion that was designated for reauthorization in the FY 2008 congressional budget resolution.
Despite the limited spending parameters, the bill that was passed out of committee includes several important provisions that will improve coverage for our nation’s uninsured children. First Focus is pleased that the bill included several of its policy priorities, including:
- An Express Lane demonstration project – To test the application of Express Lane Enrollment (ELE) simplifications in 10 states. While this provision does not provide funding sufficient to implement ELE nationwide, it provides an opportunity to demonstrate ELE’s ability to improve the enrollment of a significant portion of the uninsured children who live in families already receiving benefits through programs such as Food Stamps, free or reduced price school lunch, and/or nutrition programs for women, infants and children.
- $200 million in grants for states to improve the availability of dental services and to strengthen dental coverage for children covered under CHIP. While this is not the “wrap-around” policy for dental services that would counter the inadequate private sector coverage for children in low-income families, it is clearly a step in the right direction to ensure that there are no more stories such as that of Deamonte Driver, whose uncared for toothache led to his death
- $100 million for grants to community-based entities to improve outreach and enrollment of eligible but enrolled children in SCHIP and Medicaid.
- Citizenship documentation improvements – This provision addresses onerous citizenship documentation requirements that have caused the disenrollment of thousands of low-income citizen children by allowing Social Security numbers to be used to verify citizenship. This provision is short of the fix First Focus sought through S. 909, which would gives states the option to determine how best to establish citizenship.
- Mental health parity – To ensure equitable coverage of mental health services for standalone SCHIP plans.
- Childhood Obesity Demonstration Project – To provide $25 million in demonstration funding for grants to develop a comprehensive and systematic model for reducing childhood obesity.
- Child Health Quality Improvements, including provisions to create an HHS quality initiative which would develop and implement quality measures and improve state reporting of quality data in an effort to strengthen the quality of care and health outcomes of children
In addition, First Focus is pleased that the Senate bill provides coverage at state option for pregnant women and retains some coverage for parents. At the same time, we are disappointed that the bill failed to include a provision to allow states to provide coverage for legal immigrant children. We also regret that the bill did not include a provision to allow states to offer nurse home visitation services as part of Medicaid and SCHIP.
Despite the limited funding level, the Senate bill make steps in the right direction to improve coverage for children. Most notably we are pleased that the bill would continue coverage for the 6.6 million children now enrolled in the program and provides coverage for 3.2 million new kids. While some of the policy proposals are not as comprehensive as we would have liked them to be, we are grateful that their inclusion in the mark provides a strong foundation on which the House can build as they finalize their version of SCHIP legislation.
The amendments offered during the mark-up session are listed below:
Amendment #49, Kyl Amendment #1, To require CBO estimates of SCHIP crowd out to be less than 20 percent.
Failed by roll call vote, 5 ayes, 16 nays
Ayes: Lott, Kyl, Bunning (proxy), Crapo (proxy), Ensign
Nays: Baucus, Rockefeller, Conrad, Bingaman, Kerry (proxy), Lincoln, Wyden, Schumer (proxy), Stabenow, Cantwell, Salazar, Grassley, Hatch (proxy), Snowe, Smith, Roberts
Kyl Amdt #1:
FAILS 5-16Amendment #36, Salazar Amendment #2, To ensure adequate reimbursement for community health centers.
Approved by voice vote, as modified.Amendment #68, Ensign #7, To allow high-deductible health plans as part of SCHIP premium support.
Failed by roll call vote, 5 ayes 16 nays
Ayes: Lott, Kyl, Bunning (proxy), Crapo (proxy), Ensign
Nays: Baucus, Rockefeller, Conrad, Bingaman, Kerry (proxy), Lincoln, Wyden, Schumer (proxy), Stabenow, Cantwell, Salazar, Grassley, Hatch (proxy), Snowe, Smith, RobertsAmendment #50, Kyl #2, To require CBO certification that the bill would not result in reduced enrollment after 2013 through 2017.
Failed by roll call vote, 5 ayes, 16 nays
Ayes: Lott, Kyl, Bunning, Crapo, Ensign
Nays: Baucus, Rockefeller, Conrad (proxy), Bingaman (proxy), Kerry (proxy), Lincoln, Wyden, Schumer (proxy), Stabenow, Cantwell, Salazar, Grassley, Hatch (proxy), Snowe, Smith, Roberts
Kyl #2: FAILS 5-16Amendment #62, Bunning #1, To eliminate exemption of SCHIP matching rate for covering children above 300% Federal Povety Level.
Failed by roll call vote, 6 ayes, 15 nays
Ayes: Lott (proxy), Kyl, Bunning, Crapo, Roberts, Ensign
Nays: Baucus, Rockefeller, Conrad (proxy), Bingaman (proxy), Kerry (proxy), Lincoln, Wyden, Schumer, Stabenow, Cantwell, Salazar, Grassley, Hatch, Snowe, Smith
Bunning #1: of poverty for NY and NJ FAILS 6-15Final passage of the Chairman’s Mark, as modified: approved by roll call vote, 17 ayes, 4 nays
Ayes: Baucus, Rockefeller, Conrad, Bingaman (proxy), Kerry, Lincoln, Wyden, Schumer (proxy), Stabenow, Cantwell, Salazar, Grassley, Hatch, Snowe, Smith, Crapo, Roberts,
Nays: Lott (proxy), Kyl, Bunning, Ensign
