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Some December Cheer From Capitol Hill for Kids' Care

By John Reichard, CQ HealthBeat Editor

December 11, 2006 -- In their final burst of lawmaking to wrap up the 109th Congress, lawmakers fended off looming shortfalls in funding for coverage of children and passed a separate measure praised by Wyoming Republican Sen. Michael B. Enzi as a "small but important step" toward preventing premature births.

Under provisions addressing funding of the State Children's Health Insurance Program (SCHIP), none of the 14 states facing a fiscal 2007 shortfall in funding for that program would run out of money before May 4, Sen. Edward M. Kennedy, D-Mass., said in a Dec. 9 statement.
"While not a complete solution, this proposal makes a down payment on the problem and gives the Congress time to consider more comprehensive solutions either through the [SCHIP] reauthorization process next year or through some other vehicle," Kennedy added.

The language does not appropriate new money for SCHIP funding, a step urged by Sen. John D. Rockefeller IV, D-W.Va. But it does allow the redistribution of certain SCHIP allotments given to states in fiscal 2004 that were not spent in all cases. And it also allows redistribution of unspent fiscal 2005 allocations.

States have three years to spend their yearly SCHIP allotments. Not all states spend them, while a number of other states that are covering a large number of uninsured children run out early.
The language appears to direct a total of $271 million toward states with shortfalls. Of that total, $146 million comes from unspent 2004 money that reverted to the U.S. Treasury. The money will be distributed on a monthly basis in the order that states begin to experience shortfalls.

The remaining $125 million comes from redistribution of unspent fiscal 2005 allotments. States that appear to have more funding than they need to meet projected demand would give up money to a new redistribution pool, but no state would have to give up more than $20 million.

Another provision would allow states that expanded their Medicaid programs to cover uninsured children before SCHIP was enacted to spend up to 20 percent of their fiscal 2006–07 SCHIP allotments to provide Medicaid coverage for eligible children. Eleven states including Rhode Island and Tennessee would benefit from that change.
Congress also passed a measure (S 707) championed by Sens. Lamar Alexander, R-Tenn., and Christopher J. Dodd, D-Conn., to expand research into the causes and prevention of premature births.

"By expanding, intensifying, and coordinating research into premature births, this bill will aim to reduce rates of premature delivery, promote evidence-based care and treatment for women and infants, and reduce infant mortality and disabilities caused by prematurity," said Enzi, whose Senate Health, Education, Labor and Pensions Committee had jurisdiction over the bill.

In addition to authorizing grants, the measure establishes an Interagency Coordinating Council on Prematurity and Low Birth Weight. And it requires the U.S. Surgeon General to hold a conference to develop a national agenda for preventing premature births.

March of Dimes President Jennifer L. Howse praised lawmakers for passing the measure, saying preterm birth is the leading cause of infant mortality, accounting for more than two-thirds of infant deaths. She noted that according to 2003 data, inpatient charges alone for premature birth totaled $18 billion, half of which was charged to the Medicaid program. Howse said she looks forward "to working with the administration and the 110th Congress on funding the provisions in the bill."

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