Children's Health Insurance Program Reauthorization Act of 2009

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Summary

Signed into law on February 4, 2009, the Children's Health Insurance Reauthorization Act of 2009 both extends and expands the State Children's Health Insurance Program (SCHIP), which was due to expire on March 31st, 2009. The act provides $32.8 billion over the next four and a half years to both maintain existing coverage for around 7 million children and to expand coverage to an estimated 4.1 million additional children. The program will be financed through increases in federal tobacco taxes, including a 62-cent-per-pack increase in the cigarette excise tax.

Main article: State Children's Health Insurance Program (SCHIP) (U.S.)


Details

  • Provides $32.8 billion in funding through September 30, 2013.[1]
  • Estimated to expand coverage to 4.1 million additional children.[2]
  • Allows states to cover legal immigrant children and pregnant women who have been in the United States for less than five years. Previously, legal immigrants were required to wait five years after arrival before enrolling in the program. [3]
  • Modifies the eligibility verification process to allow states to use Social Security numbers in order to verify that applicants are citizens or legal residents.[4]
  • Requires states to provide dental coverage under the program and allows states to offer dental coverage to children who have private health insurance that does not cover dental care.[5]
  • Limits the federal government's share of funding for children in families with incomes exceeding 300 percent of the poverty line.[6]
  • Increases federal tobacco excise taxes, including a 62-cent-per-pack increase in the cigarette tax, bringing the total tax up to $1.01 per pack.[7]

<USbillinfo congress="111" bill="H.R.2" />

Bill Passage

House

The measure, sponsored by Rep. Frank Pallone (D-N.J.) and 43 Co-Sponsors, passed the House without amendment by a vote of 289-139 on January 14, 2009.

<USvoteinfo year="2009" chamber="house" rollcall="16" />


Senate

The Senate passed an amended version of the bill by a vote of 66-32 on January 29, 2009.

<USvoteinfo year="2009" chamber="senate" rollcall="31" />

Amendments

Before passing the bill, the Senate adopted an amendment from Jeff Bingaman (D-N.M.) making it easier for states to enroll eligible children in SCHIP who are already enrolled in other federal programs such as food stamps or the National School Lunch Program. [8] This amendment was agreed to by a vote of 55-43.

<USvoteinfo year="2009" chamber="senate" rollcall="29" />


The Senate also considered and rejected a number of amendments that would have limited the expansion of the program outlined in the original bill. These included:

  • An amendment by Jim DeMint (R-S.C.] which would have required states to charge families with incomes over two hundred percent of the poverty line a fee in order to participate in the program.[9] This amendment was defeated by a vote of 60-37.

<USvoteinfo year="2009" chamber="senate" rollcall="16" />


  • An amendment in the form of a substitute by Mitch McConnell (R-Ky.) which would have increased the amount of aid states are allowed to provide to families for the purpose of purchasing private insurance, limited federal funding for states that cover more than just women and children under the program,[10] and which would have excluded legal immigrants from receiving coverage. McConnell's plan would have covered an estimated 2 million children in addition to those already covered and would have been funded primarily through reductions in federal government spending on Medicaid rather than through tax increases.[11] This amendment was defeated by a vote of 65-32.

<USvoteinfo year="2009" chamber="senate" rollcall="18" />


  • An amendment by Orrin Hatch (R-Utah) that would have allowed states to cover legal immigrants only after covering 95 percent of children currently eligible for the program. This amendment was defeated by a voice vote. [12]


  • An amendment by Pat Roberts (R-Kan) that would prohibit states from receiving federal SCHIP funds to cover families making more than either $65,000 in income or the median state income, whichever amount is lower. [13] This amendment was defeated by a vote of 60-36.

<USvoteinfo year="2009" chamber="senate" rollcall="21" />

Second House vote

On February 4, 2009, the House agreed to the bill as passed by the Senate by a vote of 290-135 and President Obama signed it into law that same day.[14]

<USvoteinfo year="2009" chamber="house" rollcall="50" />

Support and opposition

Supporters argued that the expansion of SCHIP was necessary because increasing numbers of Americans have lost employer-sponsored health insurance in recent years. They also saw it as part of a larger effort to reform the health care system. At the signing ceremony, President Obama referred to the expansion as "a down payment on my commitment to cover every single American."[15]

Opponents argued that the expansion was too broad and should have placed lower income limits on eligibility for the program. Republicans expressed concern that those with private health insurance would leave their current plans for government-sponsored ones.[16] They also worried that the new identity verification rules would make it more difficult to prevent illegal immigrants from entering the program.[17]

Particular controversy surrounded the provision allowing states to offer coverage to recently arrived legal immigrants. Opponents sought to maintain the existing rule requiring immigrants to wait for five years before enrolling in the program. Arguing in favor of the new rule, Sen. Richard Durbin (D-Ill.) stated that "it is likely many of these children are already U.S. citizens and many will become U.S citizens."[18]

Sources

  1. "Obama views children's health bill as step one", The Associated Press, February 5, 2009.
  2. Drew Armstrong, "Obama Signs Expansion of Children’s Health Program", CQ Politics, February 4 2009.
  3. Robert Pear, "Obama Signs Children’s Health Insurance Bill", New York Times, February 4, 2009.
  4. Robert Pear, "Obama Signs Children’s Health Insurance Bill", New York Times, February 4, 2009.
  5. "Obama views children's health bill as step one", The Associated Press, February 5, 2009.
  6. Ceci Conolly, Highlights of the Bill, Washington Post, January 30, 2009
  7. "Obama views children's health bill as step one", The Associated Press, February 5, 2009.
  8. Remarks of Senator Bingaman on the floor of the U.S. Senate, Congressional Record, January 29, 2009.
  9. Kevin Freking, "GOP amendment falls short on health bill", The Associated Press, January 27, 2009
  10. "Senate Rejects GOP Alternative for Children’s Health Insurance Expansion" CQ Politics, January 28, 2009
  11. "GOP Fails to Limit Health Program's Growth" The Associated Press, January 27, 2009
  12. Kevin Freking, "GOP amendment falls short on health bill", The Associated Press, January 27, 2009
  13. Senator Roberts Press Release, January 28, 2009.
  14. Robert Pear, "Obama Signs Children’s Health Insurance Bill", New York Times, February 4, 2009.
  15. "Obama views children's health bill as step one", The Associated Press, February 5, 2009.
  16. Robert Pear, "Obama Signs Children’s Health Insurance Bill", New York Times, February 4, 2009.
  17. Drew Armstrong, "Obama Signs Expansion of Children’s Health Program", CQ Politics, February 4 2009.
  18. Obama hails passage of children's health bill, Associated Press, January 30, 2009