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Dems Debate Adding SCHIP to Economic Stimulus Package

By Mary Agnes Carey, CQ HealthBeat Associate Editor

DECEMBER 10, 2008 -- Democrats are debating whether or not to include a reauthorization of the State Children's Health Insurance Program (SCHIP) as part of an economic stimulus package, according to House and Senate lawmakers and aides.

"Nothing has been decided, but our first focus will be with the stimulus package and part of that would be SCHIP," Sen. Tom Harkin, D-Iowa, said Wednesday. In a recent interview, Rep. Henry A. Waxman, D-Calif., said adding SCHIP to the stimulus measure was "under discussion."

With economic stimulus legislation a top legislative priority in the 111th Congress, folding SCHIP into that bill could help bring bipartisan support for the proposal, provide financial assistance to states and help ease the burden of finding ways to finance the measure. Few, if any, lawmakers and experts say the stimulus package should be offset.

Reauthorizing SCHIP through the stimulus also would assure Democrats a legislative health care victory if they are unable to pass any broader health care overhaul measures, said aides and health care lobbyists. SCHIP is currently authorized through March 31.

At a news conference Wednesday, Senate Finance Committee Chairman Max Baucus, D-Mont., said he favored including a short-term reauthorization of the program in the stimulus package and discussing a longer-term SCHIP expansion as part of health care overhaul legislation Baucus said he plans to introduce early next year.

Baucus also said that he expects to see a health information technology package of less than $50 billion in the economic stimulus bill. Additional Medicaid funding for states is also expected to be part of that package.

Rep. Diana DeGette, D-Colo., said Congress needs to reauthorize SCHIP quickly. "We've got 9 million kids without health insurance in this country. But we need to realize that's not a substitute for universal national health care." DeGette said her support for a short-term SCHIP extension would depend on the size of the package.

The addition of SCHIP to the stimulus could draw the ire of fiscal conservatives in both parties who do not want the legislation loaded up with items not critical to improving the nation's sagging economy, particularly if the provisions are being added to avoid offsetting their cost per the "pay-as-you-go" budget rule.

While some Democrats have expressed an interest in putting SCHIP in the stimulus a House Democratic aide said, "it would be a hard sell" because of its size and that it is not related directly to the current economic downturn. Obama administration officials have also cautioned that the stimulus measure, which is expected to cost between $500 billion and $700 billion, must be focused on the economy, the aide said.

House Democrats passed a bill in 2007 that would have expanded SCHIP by nearly $50 billion over five years, but the Senate did not consider the measure. Instead, the Senate passed a bipartisan bill (HR 976) that expanded SCHIP by $35 billion over five years, to about $60 billion. But Bush vetoed that measure, as well as a second, very similar bill (HR 3963) that Democrats had hoped would draw a veto-proof proof majority. It did not.

SCHIP could move again separately if legislative efforts to overhaul the health care system drag on, said a Senate Finance aide. "If it appears that health reform is going to take a very long time, it increases the chances that we do SCHIP separately," the aide said.

Adoja Adofo, Drew Armstrong, David Clarke, John Reichard and Alex Wayne contributed to this report.

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