Groups split on children’s health insurance strategy

As time runs out on the negotiations to reauthorize and expand the State Children’s Health Insurance Program (SCHIP) this year, a division has emerged among children’s advocacy groups on whether lawmakers should scrap the talks and start fresh next year.

Several groups are openly urging lawmakers to set aside their goal of passing a major SCHIP bill this year and instead focus their energies on enacting a short-term extension with $1.6 billion in new funding to ensure that no children lose coverage while Congress and the White House remain in a standoff. Other organizations decry this strategy, contending that outside groups need to keep lawmakers’ feet to the fire over SCHIP.

{mosads}Lawmakers who have worked to pass a $35 billion, five-year expansion of SCHIP have failed to win over the dozen or so House Republicans they need to override President Bush’s veto.

Short of a reauthorization or the infusion of additional federal funding as part of a short-term extension of the program, as many as 21 states could run short of federal SCHIP dollars next year, according to the Congressional Research Service (CRS), which in turn could force them to remove children from the rolls. The money could dry up as early as March.

The authorization for SCHIP actually expired on Sept. 30. The continuing resolutions (CRs) passed by Congress to keep the federal government in operation also temporarily extended SCHIP at the current funding levels. The congressional leadership reportedly is considering another SCHIP extension that would keep funding at the current level, possibly through October 2008.

First Focus, a children’s advocacy group, bluntly declared the SCHIP negotiations as a failure in a statement issued last week. “The president and Congress have made three attempts to fix the SCHIP program. Unfortunately, all attempts have failed and time has run out,” First Focus President Bruce Lesley said.

“Folks really think that we’re not going to get a deal on a five-year [reauthorization] this year,” Lisa Shapiro, vice president for health policy at First Focus, said in an interview. First Focus sharpened its focus on the short-term issues based on growing anxiety among its state-based partners, she said. “In some states, the situation is really dire.”

Congress needs to shift gears because it could take them the next few weeks just to put together a short-term extension with the $1.6 billion that CRS estimates are needed to keep states’ SCHIP programs in the black, Shapiro said.

“Another CR is not enough,” she said. “Congress has made promises all year long that they won’t let kids get kicked off the program.”

Shapiro acknowledged that First Focus was staking out a different position than other allied groups but predicted more would come around. “We’re just coming out probably a little sooner,” she said.

Advocacy and lobbying groups are at “different stages in their willingness to talk publicly” about giving up on the negotiations over the full SCHIP bill, said Pete Wilson, vice president of public policy at the National Association of Children’s Hospitals.

Although it is “premature” to talk about a short-term bill, Wilson said, “This is a town in which you have to be realistic.”

The Children’s Defense Fund (CDF) has adopted a similar attitude to First Focus’s, spokesman Ed Shelleby said. Echoing the case made by many liberal Democrats and by the Congressional Black Caucus and the Congressional Hispanic Caucus, the CDF feels strongly that the Democrats have already compromised with Republicans as far as they ought to, he said. Continuing talks with Republicans in an effort to get a new SCHIP bill could lead to compromises and a weakened bill that would lose support from liberals.

“This bill has been already watered down,” Shelleby said. The group also argues that the short-term measure should eliminate or postpone an August directive by the Bush administration establishing new limitations on state plans to expand SCHIP.

Other advocates are unconvinced. “For us to start capitulating now — that would not help children,” said Bill Bentley, president and chief executive of Voices for America’s Children. “I don’t think we should roll over,” he said.

“It takes the pressure off those members of Congress who have not been supporting these very good bills,” Bentley said. “I don’t think we should let them off the hook that easily.”

Likewise, Families USA Executive Director Ron Pollack said it’s too soon to ease up. “I think they’re in the distinct minority on that position,” Pollack said of the groups changing tack on SCHIP.

Families USA and its allies “still are eager to pursue opportunities to secure a five-year reauthorization of $35 billion in new funds for the SCHIP program,” he said.

Pollack also suggested that concerns about the bill being “weakened” during end-stage talks are overblown. “If a compromise significantly eliminates key elements of a reauthorization … I think it’s going to be tough to get such a compromise through Congress” because it would lose the support of Democratic lawmakers, he said. “If we have concerns, there are likely to be similar concerns about certain key members of Congress,” he said.

Several advocates who say pressure should be maintained on getting the full SCHIP bill passed noted that lawmakers have a tendency to cut deals when the clock is almost run out — and that hearing about issues at home during recesses can change their perspective.

“I have continued to be impressed at how different the winds blow when members come back from a recess,” Wilson said.

The prospect of opposing an SCHIP bill on the last day of the session also could prompt fence-sitting lawmakers to back the measure. “There are many members who don’t want to go home and go into next year’s elections without having voted for a children’s healthcare bill,” said Gordon Whitman, spokesman for the PICO National Network, an interfaith organization.

The Rev. Heyward Wiggins, pastor of the Camden Bible Tabernacle Church in New Jersey, said the ingredients for a deal are already in place. Like other clergy members involved in PICO, Wiggins said he will encourage his congregation to emphasize to their lawmakers that Christmas is a “time of giving,” he said.

Although the congregations that make up PICO’s membership will stay on message that the full SCHIP bill can be enacted before Christmas, “We want to see as much progress as possible, even if it means not getting the full five years,” said the Rev. Ryan Bell, senior pastor of the Hollywood Seventh-day Adventist Church in Los Angeles.

Wiggins said that his grandson, an SCHIP beneficiary, could lose his coverage next year. To bring home the human side of the debate, PICO plans to deliver empty Christmas stockings to up to 100 congressional district offices next week.