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Senate Finance SCHIP Markup Possible Week of June 11

By Mary Agnes Carey, CQ HealthBeat Associate Editor

June 5, 2007 -- The Senate Finance Committee may mark up legislation the week of June 11 to reauthorize the State Children's Health Insurance Program (SCHIP), but full Senate action is not expected before the July Fourth recess, senators said Tuesday.

Finance Chairman Max Baucus, D-Mont., said he hoped his panel would mark up SCHIP legislation next week, and that a 90-minute bipartisan committee meeting Tuesday was a good start toward that goal. Other senators who were in the meeting also described it as "constructive" and "fluid," with members freely expressing their views about the program, which expires Sept. 30 and is up for reauthorization this year.

Policy issues discussed in the session included income levels at which children would qualify for coverage and which adults should be covered, such as pregnant women or childless adults. There was some discussion about how to finance the bill, with options including a possible increase in the federal tobacco tax or reductions in Medicare payments to Medicare Advantage plans, but no decisions were reached, participants said.

"There was very little talk about the payfors this morning," said Finance member Kent Conrad, D-N.D.

The amount of funding needed to pay for the SCHIP reauthorization "will be determined by the policy" in the legislation, Baucus said. He also said that he had been discussing possible offsets with House Ways and Means Committee Chairman Charles B. Rangel, D-N.Y., and House Energy and Commerce Committee Chairman John D. Dingell, D-Mich., but offered no specifics.

Senate Majority Leader Harry Reid, D-Nev., noting the Senate's crowded calendar, which includes immigration and energy legislation, indicated that SCHIP would wait until July.

Once the Senate returns from the July Fourth break, "we've got to do appropriation bills. We have SCHIP we have to do. We have to do a farm bill," Reid told reporters.

Baucus has made SCHIP reauthorization the Finance panel's top policy priority, and has said that he supports spending an additional $50 billion on the program. The fiscal 2008 budget resolution (S Con Res 21) includes a "deficit neutral" reserve fund that allows for up to $50 billion in new spending for SCHIP as long as the spending is fully offset.

Conrad said the panel should move cautiously when debating whether or not to expand the program to cover more adults. "If you want to cover adults, you've got to call [the program] something else," he said. "We can't be misleading people."

He also said that allowing children whose families have income of up to 300 percent of the federal poverty level or $60,000 in yearly income for a family of four—a provision in some of the pending SCHIP proposals—was overly generous. "That's not poverty in North Dakota," Conrad said. "Sixty thousand dollars a year in New York is very different."

Sen. Olympia J. Snowe, R-Maine, said it was important to build bipartisan support for the SCHIP reauthorization, since the program was created in 1997 with bipartisan support. She cautioned against looking to payment reductions to Medicare providers, such as hospitals or home health agencies, as a way to finance SCHIP. Reducing provider payments would "roll back some of the services provided to the elderly," she said. "I think that's much more difficult."

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