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Both chambers of the U.S. Congress have sent an affirmative message to the American public that they are committed to strengthening the Medicaid and SCHIP programs with the goal of covering millions of uninsured children throughout the nation.
However the SCHIP bill approved by Congress was vetoed by President Bush.
Reauthorization of the State Children’s Health Insurance Program (SCHIP) is the most important health care issue addressed on Capitol Hill this year. The highly successful program, which started in 1997, provides health coverage to millions of low-income children with family incomes that are too high to qualify for Medicaid but not high enough to purchase other forms of health insurance. The program’s original 10-year authorization period expired on September 30, 2007.
Action is needed to ensure that our members of Congress vote to override the Presidential veto. Our most vulnerable children's health is at stake!
Just Off the Press
October 17, 2007
New Resources You Might Find Helpful:
- CCF's new fact sheet "$83,000 SCHIP Family Doesn't Exist"
- CBPP's new paper responding to the Administration's "poor children first" claims: POOR CHILDREN FIRST — OR LAST? Watch What the Administration is Doing, Not What It Is Saying
- Joint CBPP/Campaign for Tobacco Free Kids paper: "Expanding Children's Health Insurance and Raising Federal Tobacco Taxes Helps Low-Income Families"
- A series of fact sheets by Families USA to CHIP-ing away at the common CHIP myths:
October 15, 2007
Florida's Uninsured Children
Estimate of uninsured Florida children (under age 21) by District, using 2004 Florida Health Insurance Study (FHIS) expansion weights.
Top Myths About the Bipartisan Children's Health Insurance Bill
1. MYTH: Does not target poor kids and extends coverage to kids in families earning $83,000. BUT THE TRUTH IS… The bipartisan children’s health insurance bill puts poor kids first, just as the President claims it should. The bill specifically targets the lowest-income uninsured children for outreach and enrollment in the State Children’s Health Insurance (more...)
October 11, 2007
Can the President's Health Care Tax Proposal Serve as an Effective Substitute for SCHIP Expansion? (Policy Briefs/Health Policy Briefs)
The Bush Administration has proposed using a tax deduction approach to expand health insurance coverage instead of expanding SCHIP coverage for more children. On October 3, the president vetoed the SCHIP reauthorization bill passed by Congress. This brief compares the financial burden for families associated with purchasing coverage for their children under the President's proposal and under the SCHIP reauthorization bill and discusses the likely impacts on uninsurance among children. We find that the financial burdens for families between 150 and 300 percent of the federal poverty level would be much higher under the tax deduction approach than under SCHIP.
October 1, 2007
Concerns about Parents Dropping Employer Coverage to Enroll in SCHIP Overlook Issues of Affordability (Policy Briefs/Health Policy Briefs)
One of the more prominent concerns in the SCHIP reauthorization debate is that many children enrolling in the program could have been insured through their parents' employers. However, concern about parents dropping employer coverage to enroll their children in SCHIP typically ignores the affordability of that coverage. We show that families' spending burden is, on average, lower under public insurance than under employer-sponsored insurance (ESI), especially for the lowest-income families. For families in which children are covered by Medicaid or SCHIP, out-of-pocket spending is, on average, 4 to 5 percent of their income. However, for families in which children have ESI for a full year, the out-of-pocket spending burden is higher, ranging from 12.9 percent of income for families below 150 percent of the federal poverty level (FPL) to 6.1 percent for families between 250-400 percent of FPL.
September 24, 2007
Eligible but Not Enrolled: How SCHIP Reauthorization Can Help
(Policy Briefs/Health Policy Briefs)
More than 6 in 10 uninsured children qualify for Medicaid or the State Children’s Health Insurance Program (SCHIP) but are not enrolled. Reaching these children may not be easy. Medicaid and SCHIP already cover 79 percent of their target population—more than any other traditional, means-tested program. Moving significantly beyond current participation may require non-traditional strategies. For example, Medicare now uses government data to identify eligible, low-income seniors and provide them with subsidies for prescription drugs and other benefits. SCHIP reauthorization could give Medicaid and SCHIP the flexibility to use similar methods for enrolling eligible, low-income children. September 19, 2007
Versus: Is SCHIP Expansion a Step Toward Socialized Medicine? (Audio Files)
Two health policy experts face off on whether it is a reasonable concern that SCHIP expansion is "Congress's attempt to federalize medicine," or instead just empty rhetoric.
September 18, 2007
What Happened to Health Insurance Coverage of Children and Adults in 2006?
(Research Report)
On August 28, 2007, the Census Bureau reported that the number of nonelderly uninsured had increased by 2.1 million in 2006. Of the 2.1 million non-elderly uninsured, 1.4 million were adults and 710,000 were children (age 18 and under). In this paper we show that children experienced declines in employer-sponsored coverage at all income levels. The largest growth in uninsured children (48%) occurred among those in middle-income families (between 200 and 399% of poverty) because there was no increase in Medicaid and SCHIP to offset the decline in employer sponsored coverage. September 17, 2007
SCHIP Reauthorization: How Will Low-Income Kids Benefit under House and Senate Bills? (Policy Briefs/Health Policy Briefs)
In July 2007, bills to reauthorize the State Children's Health Insurance Program were passed in both the House and the Senate. One question that has been raised is how well the bills target low-income children. In this brief, Genevieve Kenney and colleagues estimate that the proportion of children below 200 percent of the Federal Poverty Level (FPL) covered by the bills is 70% or higher. The share of uninsured children below 200 percent of the FPL who would gain coverage is estimated to be even higher (78 to 85 percent).
September 12, 2007
Medicaid and SCHIP Participation Rates : Implications for New CMS Directive
(Policy Briefs/Health Policy Online)
In August 2007, the Centers for Medicare and Medicaid Services (CMS) issued a directive requiring that states reach participation rates of 95 percent among children in families with income below 200 percent of the federal poverty line in Medicaid and the State Children’s Health Insurance Program (SCHIP) before using SCHIP funds to cover higher-income children. In this brief, Genevieve Kenney shows that there are serious methodological challenges involved with obtaining valid and policy-relevant state-level participation rate estimates. Kenney also reviews recent trends in Medicaid and SCHIP participation rates and comments on participation estimates just released by CMS. September 11, 2007
Low-Wage Workers with Children Face Difficulties Gaining Ground (Press Release)
About one in 20 workers age 18 to 61, some 7 million men and women, earn low wages and live in low-income families with children. New analyses by Urban Institute researchers address ways the private and public sectors can support working families and, at the same time, encourage productivity and organizational competitiveness; what supports to provide low-income workers; and public policy's role in encouraging or mandating stronger private-sector involvement. Access to Employer-Sponsored Health Insurance among Low-Income Families : Who Has Access and Who Doesn't? (Research Report)
Lack of health insurance can affect the health and productivity of workers as well as the health of workers’ families, especially for low-income families, who are more likely to have members in poor health. We show that about half of children in low-income families do not have access to employer-sponsored insurance (ESI). Among the families without access to ESI, public insurance fills some gaps among children, but parents remain uninsured at high rates. For these families, children are twice as likely—and parents are nearly three times as likely—to be uninsured compared to families with an ESI offer. Employer-Sponsored Health Insurance and the Low-Income Workforce: Limitations of the System and Strategies for Increasing Coverage (Research Report)
As the number of uninsured grows, and the share with employer-sponsored insurance (ESI) falls, questions arise about the future viability of our largely employer-based insurance system. Significant weaknesses exist in the system, and these are heightened for the low-income working population and their employers. A menu of policy options are available for expanding coverage, and expansions will require a combination: income and health status related subsidies; a guaranteed source for all individuals to obtain coverage; requiring at least a minimum level of insurance; requiring employers contributions; increasing enrollment and retention in existing insurance options; and cost containment strategies.
August 31, 2007
White House Strategy on SCHIP Could Backfire, May Galvanize Support for Expansion
The Bush administration’s decision to issue a policy restricting state efforts to expand children’s health care eligibility may backfire and increase bipartisan support for expanding a federal children’s health insurance program, various lobbyists and former Congressional aides said.
Download PDF
Census Bureau Report
Real median household income in the United States climbed between 2005 and 2006, reaching $48,200, according to a report released today by the U.S. Census Bureau. This is the second consecutive year that income has risen.
Meanwhile, the nation’s official poverty rate declined for the first time this decade, from 12.6 percent in 2005 to 12.3 percent in 2006. There were 36.5 million people in poverty in 2006, not statistically different from 2005. The number of people without health insurance coverage rose from 44.8 million (15.3 percent) in 2005 to 47 million (15.8 percent) in 2006.
These findings are contained in the Income, Poverty, and Health Insurance Coverage in the United States: 2006 report [PDF]. The data were compiled from information collected in the 2007 Current Population Survey (CPS) Annual Social and Economic Supplement (ASEC).
Read full details of the press release
New SCHIP Standards
The Bush Administration has adopted new standards that would make it more difficult for states to extend coverage under SCHIP to middle-income families. The administration’s new policy is explained in a letter that was sent to state health officials from Dennis G. Smith, the director of the federal Center for Medicaid and State Operations.
The letter is linked for your review. The policy would continue indefinitely. Act now urge Congress to override policies that would limit expansion and full funding of SCHIP.
Read Letter
Washington
Rules May Limit Health Program Aiding Children
By ROBERT PEAR
The Bush administration has adopted new standards that would make it much harder for states to extend coverage to children in middle-income families
Read New York Times Article
August 20, 2007
Side-by-side Summary from Families USA of Senate and House CHIP Reauthorization & Medicare Improvement Plans
Download PDF
The Week's Top Five Myths Regarding Congressional Efforts to Strengthen Children's Health Coverage
Compiled by the Center on Budget and Policy Priorities
Download PDF
August 13, 2007
Utilization in the Los Angeles Healthy Kids Program: A Preliminary Study of Health Plan Administrative Data (Research Report)
As part of a multi-year evaluation of the Healthy Kids program in Los Angeles, we analyzed service utilization of Healthy Kids enrollees ages 0 to 18 using health plan encounter and claims data and assessed these data for completeness. Results suggest that actual service rates are higher than administrative data indicate. Other evidence from the evaluation suggests that some services are likely reimbursed by Restricted/Emergency Medi-Cal, and other services are provided just prior to enrolling in Healthy Kids. As a result, some encounters are not captured in health plan data for Healthy Kids, and will present challenges for ongoing program monitoring.
July 26, 2007
Governor Charlie Crist today signed Executive Order 07-148, creating the Governor's Commission on Disabilities. The commission will advance public policy and work with state agencies & organizations on behalf of Floridians with disabilities.
July 25, 2007
House - Things are happening quickly in the House. House Energy and Commerce Committee Chairman John Dingell (MI) unveiled his Chairman's Mark, called the “Children’s Health and Medicare Protection Act” (CHAMP Act). Currently, it is scheduled to be marked up by the House Energy and Commerce Committee tomorrow, with opening statements in the committee today. This will be followed by a mark up by the House Ways & Means Committee this Thursday, July 26th. As we learned last week though, things can change daily. Overall we are very pleased with the proposal.
The highlights are: Includes the entire $50 billion set aside for SCHIP reauthorization in the Budget Resolution Reaching Eligible but Unenrolled Children - Major new performance bonuses for states that are successfully enrolling uninsured children already eligible for coverage, including “express lane” eligibility and other enrollment simplifications Citizenship Documentation - Includes a provision to make citizenship documentation in Medicaid an option, but only for children. The CHAMP bill does not apply the citizenship documentation requirement to SCHIP. ICHIA - Gives states the option to cover legal immigrant children - Pregnant Women- Gives states the option to cover pregnant women under SCHIP, as long as Medicaid covers pregnant women up to certain income levels. Offsets – This proposal is funded by a combination of a 45 cent tobacco tax, phasing out of Medicare overpayments over the next four years, and some other small items.
Senate We now expect the floor debate to begin in the Senate this Friday, July 27th. We ask that you continue your work to get the message across to your Senators to hold the line on the Chairman's Mark and defeat any amendments that would weaken the bill.
July 24, 2007
The House Energy and Commerce Committee is planning to mark up a bill Wednesday on the State Children's Health Insurance Program and Medicare, with the Ways and Means Committee following suit Thursday, leadership aides said today. Although no final decisions have been made, the bill could be on the House floor next week, making its passage one of the final acts before members leave for the August recess. The House version is more ambitious than the Senate bill, which authorizes $35 billion in new money for SCHIP and does not include Medicare provisions. SCHIP expires Sept. 30. The House bill is expected to cost an additional $100 billion over five years, with $50 billion going to SCHIP. The Senate also is likely to complete action on its bill before the August break. July 20, 2007
The Impact of the Los Angeles Healthy Kids Program on Access to Care, Use of Services, and Health Status
A longitudinal survey of parents of enrollees in the Los Angeles Healthy Kids Program has found that the program had significant positive impacts on children’s health and access to care. Children experienced improvements in access to and use of ambulatory, specialty and dental care; reduced unmet need; increased parent confidence in getting care and satisfaction with quality; and reduced financial worries. Most important, children’s health status improved, as perceived by parents and according to several measures. Healthy Kids covers uninsured children below 300 percent of poverty who are ineligible for Medicaid or SCHIP, and primarily serves poor, undocumented Latino children. July 19, 2007
• Families USA Summary of SFC Final MarkUp
• Modifications to the Children's Mark
• Preliminary CBO Estimates of Chairman Mark
• Preliminary CBO Estimates of Changes is SCHIP
• Children's Health Insurance (Transcript of The Diane Rehm Show) July 18, 2007
• Sen. Ken Salazar Response to Bush Veto Threat July 17, 2007
• SCHIP House Congressional Record July 16, 2007
• SCHIP Senate Proposal Update July 13, 2007
• ICHIA Letter to Chairman Dingell
• SCHIP Kerry Statement and Senate Negotiations July 11, 2007
• SCHIP House Congressional Record
• Sen. Grassley Letter to the President and HHS Please download the following documents for useful background information: For More Info, visit FamiliesUSA.org 
Please Note: The documents listed in this section are available in PDF (Portable Document Format), downloadable by clicking the titles. Some of these files are large and make take a few minutes to download. In order to open PDFs you'll need Adobe's free Acrobat Reader application. Use the provided link to get the latest version.
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