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Senate SCHIP Bill Is Headed to Floor

By Drew Armstrong, CQ Staff

JANUARY 15, 2009 -- Legislation to reauthorize and expand the State Children's Health Insurance Program is headed to the Senate floor, after a Senate panel on Thursday approved a draft bill that includes a provision to relax eligibility standards for legal immigrants and new citizens.

The Senate's draft legislation, written by Finance Committee Chairman Max Baucus, hewed closely to SCHIP bills passed in the 110th Congress. It was approved by the panel 12-7, after several amendments.

As originally written, Baucus's draft bill would expand the SCHIP program by $31.5 billion, reauthorizing it for four and a half years. It would give health insurance coverage to about 4 million previously uninsured children and adults.

The House passed its own very similar SCHIP bill (HR 2) on Wednesday.

An amendment by Sen. John D. Rockefeller IV, D-W.Va., to allow legal immigrants and new citizens into the program without the standard five-year waiting program will likely boost the cost of the bill by several billion dollars. A similar provision exists in the House bill, and its absence in the Senate draft was the only major point of disagreement between the two.<?p>

The nearly five-hour markup turned contentious at points, with Republicans, including ranking member Charles E. Grassley of Iowa, claiming that Democrats had shut them out of the process and betrayed compromises worked out on similar bills in the 110th Congress.

"It makes me damned disgusted," Grassley told the panel. "We had all sorts of cooperation.... Now it's kind of feeling like you're thrown overboard."

Grassley and other Republicans were upset about the immigrant and new citizen waiting period provision, looser citizenship and residency documentation requirements, changes to how the bill deals with people transferring from private insurance to SCHIP—a phenomenon known as "crowd out"—and also the bill's slightly loosened provisions on income limits.

Doing a full SCHIP reauthorization would make health care overhaul only more complicated later in the year, Grassley argued. "In a lot of ways it makes more sense to do a simple extension of SCHIP for two years so we can work through how to fold SCHIP into a program that covers everyone," he said.

That lack of comity was a preview of the debate triggered by Rockefeller's amendment. His proposal's adoption, 12-7, set off a lengthy immigration discussion and a slew of Republican amendments.

Republicans argued that the eliminated waiting period would encourage illegal immigration.

Sen. John Ensign, R-Nev., also argued that if Congress eventually tackled immigration reform, it would suddenly add millions to the SCHIP program as once-illegal immigrant children suddenly became legal and eligible. "If we cross the line here... we will be taking on a huge number of additional kids," Ensign predicted.

Republicans offered several motions to require more stringent documentation of legal residency or citizenship. All failed, with the exception of an amendment by Grassley. Grassley's amendment would require states, when they re-check the income levels of SCHIP enrollees, to also review their citizenship or legal residency status. In that way, SCHIP enrollees who lost their legal residency while still in the program would be disenrolled. The amendment was adopted by voice vote.

The committee also adopted an amendment by Sen. Olympia J. Snowe, R-Maine, to allow states the option to offer dental insurance to children who are privately insured but do not have dental coverage.

The bill now goes to the Senate floor. Senate leaders are planning to amend Baucus's draft language into the House bill, then send it to conference to resolve the differences.

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