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House Panels Gear Up For SCHIP Action

By Mary Agnes Carey, CQ HealthBeat Associate Editor

July 20, 2007 – As two key House committees aim to mark up children's health legislation the week of July 23, the American Medical Association and AARP have teamed up to sponsor a national advertising campaign supporting the measure.

The groups will spend at least $1.3 million on national television advertising from July 23 through August 3, a period when the House and Senate are expected to be considering legislation to reauthorize the State Children's Health Insurance Program (SCHIP). Both the House Energy and Commerce and Ways and Means committees may mark up their version of the measure next week. Meanwhile, Senate floor action is expected on the SCHIP bill the Finance panel approved yesterday.

At a Friday news conference, AARP and AMA officials also said they are planning to conduct direct mail and e-mail campaigns, as well as coordinate visits to lawmakers' offices and other grass roots activities, in support of the House measure, which is expected to include provisions that benefit both groups' members.

In addition to reauthorizing SCHIP, the House package is expected to include language to provide more generous subsidies to low-income beneficiaries in the Medicare drug benefit and lessen or eliminate a scheduled 10 percent cut in 2008 Medicare physician payments.

A voice-over in the television ad warns that "powerful special interests are making misleading claims about critical health care reform facing America." Those special interests are tobacco companies that are trying to prevent an increase in the tobacco tax to finance an SCHIP expansion, as well as health insurers who oppose cutting Medicare reimbursements to Medicare Advantage (MA) plans, said AARP CEO Bill Novelli and AMA President-elect Nancy H. Nielsen. The ad then touches on key points of the House SCHIP plan and urges viewers to call their representatives to tell them to back the bill.

While the Senate bill includes provisions for higher tobacco taxes to finance the $35 billion SCHIP expansion—a 61-cent per pack hike—some conservative members of the House Democratic caucus are opposing a similar tobacco tax increase in their measure. In addition, some House Democrats from rural states and urban areas have expressed concern that cuts to Medicare Advantage plans could hurt members in their districts. The Senate SCHIP package would not cut Medicare Advantage plans.

Karen M. Ignagni, president and CEO of America's Health Insurance Plans (AHIP), said on Friday her group has heard that the cuts to Medicare Advantage plans could be as high as $50 billion over the next five years. "That would mean the end of the program," Ignagni said. "Members of Congress are going to have a strategic choice beginning next week. Are they going to go home and tell beneficiaries they have ended the program they have depended on? ... That would be one of the largest Medicare cuts ever."

Ignagni said AHIP, "was one of the first groups out there talking about the need to have SCHIP reauthorization. It's a major part of our universal access proposal." The group also is planning to launch its own advertising campaign next week about the value of Medicare Advantage and the need for SCHIP reauthorization.

Any payment cuts to providers in the traditional Medicare fee-for-service program, such as hospitals and nursing homes, would also generate revenue to pay for an SCHIP expansion larger than in the Senate bill, but the cuts are also likely to face opposition from House members in both parties, who fear they would reduce beneficiary services in their districts.

The Senate bill would expand SCHIP by $35 billion over the next five years. Many House Democrats favor an SCHIP expansion of $50 billion, saying the Senate bill does not go far enough. President Bush has said he will veto the Senate SCHIP package. The program expires Sept. 30.

In addition to providing health coverage to an additional 3.2 million children, the Senate package also includes $200 million in new grants for states to provide dental coverage for children, and would require states that provide mental health services to do so on an equal basis with medical and surgical benefits offered under SCHIP. The bill also would authorize $100 million in new grants to fund outreach and enrollment efforts aimed at increasing participation of eligible children in both Medicaid and SCHIP.

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