On August 1, the U.S. House of Representatives passed its State Children’s Health Insurance Program (SCHIP) legislation, the “Children’s Health and Medicare Protection Act of 2007” (HR 3162) by a vote of 225 to 204.  On August 2, the Senate passed its measure (S.1607) to reauthorize SCHIP by a vote of 68 to 31 after many hours of debate and attempts to amend the fragile bi-partisan agreement.  There are significant differences between the two bills and both chambers will need to negotiate those differences when they return on September 4th from their August recess. 

The Senate bill makes changes to SCHIP, including $35 billion in new resources over five years; improvements to dental and mental health coverage; state incentives to enroll eligible children; and demonstration projects for expedited enrollment. 
 
The House legislation provides $50 billion in new resources over five years, paid for with a new tobacco tax and changes to Medicare Advantage payments; allows states to extend health insurance to legal immigrant children and pregnant women who have been in the U.S. for less than five years; provides a state option to expand SCHIP coverage to age 21; gives incentives to states that effectively reach and enroll eligible children; improves benefits for dental health and mental health parity; and extends Medicaid Transitional Medical Assistance for two years. 

The Congressional Budget Office (CBO) says the Senate bill would cover 3.2 million uninsured children, including 2.7 million who are currently eligible but not enrolled.  The House bill, according to the CBO, would cover 4.2 million children, including 3.8 million already eligible for benefits. In addition, both bills would provide money to prevent 800,000 children now on the program from losing coverage. 

Catholic Charities USA and the Washington State Catholic Conference are pleased with many of the important changes in both proposals and prefer the funding level of the House bill as well as some provisions of the Senate bill.  There are still major challenges ahead before SCHIP is reauthorized.  In addition to reconciling the House and Senate differences, President Bush has threatened to veto any comprehensive legislation to strengthen SCHIP that lacks sufficient funding and exceeds his $25 billion proposal.