Dems may offer competing SCHIP bills

Senate Finance Committee Chairman Max Baucus (D-Mont.) is hoping to complete legislation to expand children’s health-insurance coverage by late spring — but a field of competing bills is already starting to bloom.

Democrats in the Senate and the House, sometimes in conjunction with Republicans, are advancing legislation separately from Baucus’s efforts, complicating the already difficult task of drafting a bill that adds tens of billions of dollars in new spending.

{mosads}The congressional Democratic leadership has identified the reauthorization and expansion of the State Children’s Health Insurance Program (SCHIP), which sunsets on Sept. 30 without congressional action, as one of its highest priorities this year.

Baucus will need to win the solid support of his Democratic colleagues, as well as that of key Republicans. But Senate Democrats are also mindful that a more ambitious, and more costly, bill may emerge from the House.

Baucus has yet to introduce any SCHIP legislation, but some high-profile colleagues are moving ahead on their own, including Sens. Edward Kennedy (D-Mass.), Hillary Rodham Clinton (D-N.Y.), Jay Rockefeller (D-W.Va.) and Orrin Hatch (R-Utah).

SCHIP has proven a politically popular program in its first 10 years. Moreover, Democrats are seeking to demonstrate their commitment to reducing the number of uninsured people in advance of a presidential election expected to feature healthcare issues.

But Democratic plans to expand the program through legislation, expected to carry a $50 billion price tag, face obstacles in the form of a recalcitrant President Bush and his Republican allies in Congress.

The Senate Budget Committee approved a budget resolution last week that instructs the Finance Committee to offset the $50 billion cost of SCHIP legislation, with $15 billion coming from “reducing certain overpayments to health care providers.” These industries can be expected to push back hard against any cuts. The House Budget Committee is expected to allocate a similar amount.

Meanwhile, Kennedy, who has identified himself closely with healthcare issues during his decades in Congress, is working on SCHIP reauthorization with Hatch, a Finance Committee member and one of the key Republican authors of the program. And Rockefeller, chairman of the Finance Committee’s Health Subcommittee, plans to introduce in the next two weeks SCHIP legislation that he expects to be the starting point for the committee’s work and the vehicle that advances SCHIP reauthorization this year, a spokesman said.

Clinton is leading yet another effort. Last week she sponsored the Senate companion bill to sweeping children’s health-coverage legislation introduced by House Energy and Commerce Committee Chairman John Dingell (D-Mich.). Clinton has made healthcare, particularly for children, a prominent theme of her presidential campaign.

Kennedy has “been in close contact with Rockefeller and is open to working with Baucus, Clinton and others in getting a strong [S]CHIP authorization,” a Kennedy spokeswoman wrote in an e-mail.

While Rockefeller views his bill as the main vehicle, Baucus has yet to give the green light.”  A Finance Committee Democratic aide maintained that Baucus might not cosponsor the Rockefeller bill when it drops. “We are absolutely working together,” the aide insisted, but said that Baucus has not signed off on Rockefeller’s legislation.

“Chairman Baucus is talking about [S]CHIP with just about everybody,” the aide said, adding that that included House Democrats.

Rockefeller’s spokesman insisted that the senator and his colleagues are not working at cross-purposes. “Everybody is supportive, I think, of everybody’s efforts,” he said. The Rockefeller bill also is expected to have at least one GOP cosponsor.
An Energy and Commerce Committee aide said that Dingell has deferred to Clinton on reaching out to senators. Although the Congressional Budget Office has not scored the Dingell-Clinton bill, its cost likely would exceed the $50 billion threshold that the Democratic leadership has established for SCHIP reauthorization.

Consequently, Dingell plans to move a smaller bill through committee markup, the Energy and Commerce Committee aide said. Rep. Frank Pallone Jr. (D-N.J.), the Health Subcommittee chairman, plans to hold hearings after the April recess, his spokeswoman said.

Before the work to reauthorize the program gets underway in earnest, the Democratic leadership in both chambers is trying to close SCHIP funding shortfalls in 14 states. The House Appropriations Committee approved $750 million for this purpose by attaching it to the supplemental spending bill for the wars in Iraq and Afghanistan, which is slated for a floor vote this Thursday.

The Senate Appropriations Committee is expected to employ a similar approach during its markup on Thursday.