Healthcare measures top Congressional agenda

April 1, 2007

The State Children's Health Insurance Program (SCHIP) will expire September 30, 2007, unless Congress approves legislation reauthorizing this popular program offering healthcare services for children and some adults. The deadline puts this issue at the top of the Congressional agenda as an opportunity for Democratic leaders to increase public access to care. Efforts to expand coverage for children and secure the Medicare program are important to the managed care community because the legislators are eyeing "overpayments" to Medicare Advantage plans as a possible source for some $50 billion to fund SCHIP and other healthcare programs.

Democrats want to boost SCHIP's budget by at least $10 billion a year ($50 billion over five years), which they claim is needed to maintain current coverage; program expansion to more children and adults will require added funding. The Bush administration has proposed only $5 billion in annual spending and limiting the program to children in families with annual incomes less than 200% of the federal poverty level (about $38,000). State governors are pressing hard for an expanded program and for immediate relief from funding shortfalls this year.

About 6 million children are enrolled in SCHIP, which varies from state to state; several states cover children up to 300% of poverty, and New Jersey has a 350% coverage level. Health experts estimate that some 2 million additional children are eligible for the program but have not enrolled, usually because of lack of information on the program.

TOP PRIORITIES

Several other healthcare measures top the legislative priority list for Congressional leaders:

Jill Wechsler, a veteran reporter, has been covering Capitol Hill since 1994.