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SCHIP Reauthorization
Recently, the House considered H.R. 3162, the "Children's Health and Medicare Protection (CHAMP) Act." This legislation would reauthorize the State Children's Health Insurance Program (SCHIP). Congress created SCHIP in 1997 to provide health coverage to children from families who make too much money to qualify for Medicaid, but not enough to afford private insurance. Currently, about seven million children are covered under SCHIP, including more than one million in California. I voted for the bill creating SCHIP in 1997, and I support its reauthorization today.
Unfortunately, H.R. 3162 restructures SCHIP in a way that I believe moves away from the original purpose of the program. Currently, each state receives a specified annual funding allotment to run its SCHIP program. Under H.R. 3162, states can expand eligibility for SCHIP as broadly as they desire, and the federal government will continue to pay at least 75% of the cost. Some states have already expanded SCHIP to families making over $80,000 a year, and this legislation would allow them to go even higher. I believe this represents a major step toward complete government control over health care.
Also, H.R. 3162 eliminates the need for future sessions of Congress to reauthorize SCHIP, effectively creating a new entitlement without continued oversight. The bill adds $50 billion to SCHIP over the next five years, tripling the program's annual funding, but the Congressional Budget Office has estimated that its provision will add another $100 billion over the following five years (2013-2017). With Medicare and Medicaid already headed toward massive funding shortfalls in the future, H.R. 3162 appears to create another program whose future costs will exceed the federal government's ability to pay for it.
I believe Congress should reauthorize SCHIP in a way that retains the program's focus on insuring children from families between 100 and 200 percent of the federal poverty line. These are the children who are most in need. Certainly, higher-income families are also facing increasing challenges with obtaining health coverage, and we need to address this problem as well. However, I believe the best way to do this is by enacting tax reform and other policies that make health insurance more affordable, rather than by expanding government-provided health care to families who can already afford coverage.
H.R. 3162 also includes a provision to avert the 10 percent cut in Medicare reimbursement to physicians that is scheduled to go into effect on January 1, 2008. I support this section of the bill, although I am concerned that it does not fully address the underlying structural problems that lead to these annual cuts. In particular, while I am pleased that H.R. 3162 attempts to address long-standing inequities in the formula for calculating Medicare payments to California physicians, I am concerned that it could allow payments to physicians in Northern California to be cut by 5 to 7 percent beginning in 2011. This would have a devastating effect on access to physicians for seniors in our part of the state.
Additionally, H.R. 3162 contains a number of unrelated provisions that cause me great concern. It imposes severe payment cuts and extensive new regulations on Medicare Advantage, a program under which senior citizens can sign up for health plans that offer lower premiums and additional benefits not covered under traditional Medicare. This would likely result in a repeat of what happened after similar cuts in 1997, when every private Medicare plan pulled out of Northern California and other rural areas across the country. Furthermore, the bill cuts Medicare payments for home health, nursing facilities, dialysis, and power wheelchairs.
H.R. 3162 also repeals documentation requirements for Medicaid applicants, making it easier for illegal immigrants to qualify for Medicaid benefits. It does away with a law that forces Congress to consider the long-term solvency of Medicare and how the program can be preserved for future generations. Finally, it creates a new tax on health insurance policies, the impact of which for consumers is still unclear.
On August 1, the House passed H.R. 3162 by a vote of 225-204. Unfortunately, even though the bill addressed many different issues, House leadership did not permit the House to vote on any amendments to the bill. President Bush has threatened to veto it, and I understand there is substantial opposition to several of its provisions in the Senate, which passed its own SCHIP reauthorization bill on August 2. As a member of the House Committee on Ways and Means, which has jurisdiction over Medicare and taxes, I will be involved in future discussions on these issues and hope that Congress can come together to pass bipartisan legislation reauthorizing SCHIP.
