Children's Monitor Online
A Public Policy Update from the Child Welfare League of America

   
   
Vol. 20, Issue 14: 4/2/2007   
Headlines

April Promises to Be Challenging Time for Budget and Appropriations

SCHIP in Budget

House Subcommittee Examines Cost and Utility of Mental Health and Substance Abuse Parity

CWLA Submits Testimony to House Appropriations Subcommittee

Cardoza Introduces Bill Requiring Medicaid Coverage to 21 for Foster Youth

CWLA Legislative Alerts Available to Subscribers

Key Upcoming Dates for Congress



April Promises to Be Challenging Time for Budget and Appropriations

Both Houses have now adopted their own budget resolutions. The House bill (H. Con. Res. 99) was passed last week along party lines. The resolution provides nearly $5 billion more in discretionary funding then the Senate counterpart, S. Con. Res. 21. Both resolutions set aside an additional $50 billion in a reserve fund, a technical vehicle that will allow the key authorizing committees to extend SCHIP with substantially more funds then the President has offered (see SCHIP in Budget, below). The Senate resolution also includes a reserve fund to increase child care funding through an increase in mandatory funds.

The next step is for the two Budget Committees to work out their relatively narrow differences and to agree to one final resolution. On Monday, the House is starting a two-week spring break, while the Senate leaves for one week. The budget resolution is not signed by the President, but it is binding on Congress in regard to how much each of the Appropriations Committees can spend and how much mandatory and entitlement spending can be increased.

Also last week, the Senate completed action on its version of the supplemental war appropriations (Senate substitute for H.R. 1591). The supplemental bills have been the focus of intense debate and media attention due to their limitations on the Iraq war. The President has promised to veto a bill that has troop withdrawal requirements. Although differences exist between the House and Senate funding levels, both supplemental bills do include critical funds to cover a short-term shortfall in SCHIP funding, separate from and in addition to the $50 billion referenced above, which is long-term funding.

When Congress returns, it will also have to deal with the outcome of any final supplemental agreement and or presidential veto.

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SCHIP in Budget

As stated above, the Senate budget resolution provides up to $50 billion over five years for reauthorization and hopeful expansion of the State Children's Health Insurance Program (SCHIP), with at least $15 billion of that most likely coming from an accompanying and gradual reduction of Medicare spending. The budget summary assured that savings "will improve efficiency, quality, and value in the Medicare program, without harming seniors' access to care." The additional $35 billion going toward SCHIP would have to follow pay-as-you-go rules, in the form of cuts or revenue increases elsewhere in the federal budget.

An amendment was adopted granting Congress the option to raise the federal tobacco tax as a source of revenue for SCHIP reauthorization. The amendment was sponsored by Senators Gordon Smith (R-OR) and Edward M. Kennedy (D-MA).

The House budget resolution would also contribute a reserve fund of up to $50 billion over five years for reauthorization and expansion of SCHIP, but it is less specific on possible sources of funds. The House reserve fund allows for one House committee to find savings in its jurisdiction while allowing the committee that has jurisdiction over SCHIP (Energy and Commerce) to use that savings.

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House Subcommittee Examines Cost and Utility of Mental Health and Substance Abuse Parity

At a hearing before the House Ways and Means Subcommittee on Health on March 27, Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) shared their personal battles with substance abuse and stressed the need to end years of discrimination against individuals who need mental illness and addiction treatment. The Paul Wellstone Mental Health and Addiction Equity Act of 2007 (H.R. 1424) does not mandate that group health plans provide mental health treatment, but states that if they do, their deductibles, copayments, and other financial limits for mental health conditions must be the same as medical and surgical benefits.

The insurance industry has raised concerns over potential accompanying costs, but witnesses before the subcommittee pointed to several studies that prove otherwise. The largest such study--one that analyzed four years of data from the mental health and substance abuse parity implemented under the Federal Employees Health Benefits Program (FEHB)--concluded that with effective care management, parity does not cause any statistically significant increase in health care costs.

The Congressional Budget Office has estimated the Senate's parity bill (S. 558) would increase health insurance premiums initially by 0.4%, and supporters of the House bill anticipate only a tenth or two higher hike than that.

Of children entering the child welfare system, approximately 50% have mental health problems, so with both versions of the bill bettering access to vital services, either would be a major step forward for the child welfare community.

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CWLA Submits Testimony to House Appropriations Subcommittee

On March 8, the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a hearing on the Administration for Children and Families. CWLA submitted testimony for the record, which highlights the need for full funding of child welfare services under the Appropriation Committee's jurisdiction.

Read CWLA's testimony.


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Cardoza Introduces Bill Requiring Medicaid Coverage to 21 for Foster Youth

On March 7, Representative Dennis Cardoza (D-CA) introduced H.R. 1376, a bill that would extend Medicaid coverage for foster children who have aged out of the system by requiring state health coverage through age 21.

"Foster children face unique and difficult challenges," said Cardoza, who has two adopted foster children. "The incidence of psychological and developmental problems in foster kids is shockingly high. Too many of these vulnerable young people see their coverage abruptly cut off during a critical transition period in their lives. This bill is a wise investment--not only for foster kids, but for all of us."

States have an option under the 1999 Foster Care Independence Act to extend Medicaid health coverage as young people leave the foster care system at age 18. According to a recent survey by the American Public Human Services Association, 17 states currently extend Medicaid to age 21, and an additional 5 states indicated they will be extending their coverage in the next state legislative session. The report, Medicaid Access for Youth Aging Out of Foster Care, surveyed states and is available online.

In 2004, 23,121 young people left foster care because they aged-out or left because they became ineligible for support through the foster care system. Other studies have indicated great challenges for this population, who frequently are on their own without needed supports, including education, housing, and health care. CWLA has endorsed the call for all states to extend Medicaid coverage to all foster youth aging out of care.

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CWLA Legislative Alerts Available to Subscribers

CWLA's Legislative Alerts provide breaking news, advocacy information, and critically important timely details of legislative battles. In an effort to broaden CWLA's advocacy network on behalf of children, anyone can now subscribe and receive the same information. This effort compliments CWLA's weekly electronic legislative newsletter, the Children's Monitor, which is also available free to any subscriber. We encourage you to register to receive these items directly and to pass on the information to other colleagues, family, and friends.

Subscribe to Legislative Alerts.

Subscribe to Children's Monitor.

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Key Upcoming Dates for Congress

April 1-30: Child Abuse Prevention Month
April 2-9: Senate Spring Recess
April 2-13: House Spring Recess
May 1-31: Foster Care Awareness Month
May 13: Mothers Day and Sponsor Kinship Care Legislation Week: Support S. 661


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