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

   
   
Vol. 20, Issue 28: 7/23/2007   
Headlines

SCHIP Reauthorization Legislation Clears the Senate Finance Committee

House Committee Continues Child Welfare Focus with Health Hearing

House Mental Health Parity Bill Passes Out of Education and Labor Committee

HHS Appropriations Approved by House; President Threatens Veto

Advocates Hold Child Care Briefing

CWLA Legislative Alerts Available to Subscribers

Key Upcoming Dates for Congress



SCHIP Reauthorization Legislation Clears the Senate Finance Committee

The Senate Finance Committee marked up and cleared by a vote of 17-4 a draft bill that would reauthorize and expand the State Children's Health Insurance Program (SCHIP) on July 19. The Committee's convening and approval brought a sigh of relief to many who are concerned about the timeline of events, considering the program is set to expire this September 30. The committee delayed the markup twice due to the ongoing debate over the war and the defense authorization bill.

SCHIP was originally enacted as part of the Balanced Budget Act of 1997 and currently covers approximately 6 million low income children whose families earn too much to qualify for Medicaid and those who are either not offered or cannot afford private coverage, as well as some lower income adults. Each state has SCHIP, and having helped reduce the rate of uninsured low-income children by one-third, the program has been widely hailed as a success. With its reauthorization, many members of Congress and advocates have been recommending improvements and members of the Senate Finance Committee were able to come together and reach a package that is seen by most as a move in the right direction.

The measure that Senate Finance approved would provide $35 billion over five years in additional funding for SCHIP, a move the Congressional Budget Office estimates would cover 4.1 million children who otherwise would go uninsured (3.3 million of those are already eligible or will be made eligible through the reauthorization legislation; 800,000 of them would have lost coverage if SCHIP maintained its baseline level of funding). Senate Finance has recommended that SCHIP's expansion be paid for by a 61-cent per pack increase in the federal tobacco tax.

Key provisions of this committee's draft bill include: improvements to the formula that yields state allotments, to avoid future shortfalls; incentives to states that successfully enroll low-income children; establishment of a new child health quality initiative housed at HHS; mental health parity; a state option to implement express lane eligibility; and dental health grants. It does not, however, correct the current five-year bar from SCHIP and Medicaid coverage for legal immigrant children and pregnant women. Any states that decide in the future to cover families above 300% FPL would not receive SCHIP's enhanced match rate, but rather the regular Medicaid match rate. It also prohibits new waivers to cover parents and childless adults with SCHIP.

President Bush, tagging this package as "government-run health care" and disapproving of the federal tobacco tax increase as a pay-for, has threatened to veto the bill if placed on his desk in its current form. Both Republican and Democratic members have urged President Bush to rethink that potentially devastating action. Senators Charles E. Grassley (R-IA) and Orrin Hatch (R-UT), for example, issued a joint statement that it is "disappointing, even a little unbelievable, to hear Administration officials wanting a veto of a legislative proposal they haven't even seen yet." In a letter to HHS Secretary Michael Leavitt, Senate Finance Chairman Max Baucus (D-MT) similarly called on the Administration to "stop blocking the way and join with Congress in extending this important program."

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House Committee Continues Child Welfare Focus with Health Hearing

The House Subcommittee on Income Security and Family Support continued its examination of child welfare with a hearing on health care for children in foster care. Chair Jim McDermott (D-WA) stated, "the foster care system has a responsibility to provide health care to the children it has taken into custody. We know that we often fail to adequately meet that obligation." The July 19 hearing included a panel with Dr. David Rubin, Director of Research and Policy, Safe Place: Center for Child Protection and Health, Philadelphia; Dr. Michael Naylor, Director of the Division of Child and Adolescent Psychiatry, Program Institute for Juvenile Research, University of Chicago; and Dr. David Olds, Director of Prevention Research Center for Family and Child Health, University of Colorado.

The witnesses repeatedly emphasized the need for better coordination between the foster care and health systems. Rubin pointed out how the Deficit Reduction Act, passed last year, introduced ambiguity into the reimbursement and thus access to Medicaid targeted case management services, existing vital services that aim to defeat cross-system barriers by helping children in foster care locate much-needed educational, mental health, and social services. After stating that psychotropic medications can be effective when used in the correct manner and situation, Naylor highlighted the growing concern surrounding the recent dramatic increase of prescribing them to treat youth with severe and emotional disturbances and recommended standardizing the consent process for them. Other common themes woven into the panelists' discussions were the need for comprehensive coverage, including mental health benefits for children in out-of-home care, the need to mandate the extension of Medicaid to youth aging out of foster care until age 21, and the need for an electronic medical recordkeeping system.

CWLA provided testimony at the hearing, which is accessible online.

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House Mental Health Parity Bill Passes Out of Education and Labor Committee

On July 18, the House Education and Labor Committee approved by a 33-9 vote the Paul Wellstone Mental Health and Addiction Equity Act of 2007 (HR 1424). Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN) introduced HR 1424 earlier this year and have been working tirelessly for its passage. The bill has been hailed by a wide array of advocates because it would finally recognize the equal rights of those with mental health and substance abuse issues and increase access to care for countless families.

HR 1424 would require group health plans of 50 individuals or more that choose to offer benefits for mental health and addiction to do so on the same terms of care as other diseases. The Government Accountability Office has estimated that currently close to 90% of plans impose lower financial limitations on mental health treatment than on medical or surgical benefits.

During the committee consideration, Representative John Kline (R-MN) offered an amendment that was ultimately rejected by a vote of 27-16 that would have substituted in the latest version of the Senate's mental health and addiction parity bill (S 558). Senators Ted Kennedy (D-MA) and Pete Domenici (R-NM) introduced this bill. The Senate's version is preferred by some members of Congress and by business groups for various reasons--most namely because it would continue to permit the employer and the insurer to negotiate what benefits are covered and it would preempt provisions of more aggressive state laws in a few circumstances. HR 1424 does not include these provisions.

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HHS Appropriations Approved by House; President Threatens Veto

On July 19, the full House approved legislation for the fiscal year 2008 appropriations for the Departments of Labor, Health and Human Services, and Education (Labor-HHS/HR 3043) after more than two days of debate. The bill was adopted by a vote of 276 to 140.

The bill allocates $151 billion in discretionary spending, an increase of 4.6% from the FY 2007 total of $144 billion. The biggest increases of more than 7% were in education funding and some health funding. Both Head Start and child care funding received increases of $75 million. That puts child care at $2.13 billion in discretionary funding compared to $2.06 billion in 2007 and Head Start at $6.96 billion compared to $6.88 billion in 2007. Discretionary funding for Promoting Safe and Stable Families remains at $89 million--the same level as 2007--and funding for CAPTA state grants stayed at $27 million, and at $42 million for the community-based prevention grants, also the same as 2007. Discretionary grants did increase by $10 million to $35 million. The bill remained intact from the version approved by both the House subcommittee and full committee. The President has indicated he will veto the bill due to its funding levels. If Congress followed the President's budget request, it would result in actual cuts from the 2007 spending levels in addition to any impact inflation would have.

With the debate over the war taking up so much floor debate time, the Senate is not expected to debate its bill (S 1710) until September, after Congress returns from an August break. That would leave less than a month before the start of the new fiscal year. With the threat of a veto, the likelihood of several appropriations bills being rolled into one omnibus bill has increased significantly.

S 1710 provides a 3% increase over current FY 2007, at $149 billion in overall discretionary funding, which also equates to 6% more than the President's budget request. The Senate numbers, however, are slightly lower than the House bill, which spends $1.9 billion more than the Senate version. The Senate bill puts less into some education programs than the House bill but increases funding beyond the President's request. The Senate bill also does not fund some Administration programs at the same level as the House. The Senate bill provides less for abstinence education and the Compassion Capitol Fund than what the President had asked for or what the House committee has approved. The Senate bill provides a $200 million increase for Head Start, more than the House version, but provided no increase in child care funding. The Senate also allocates an additional $12 million in discretionary grants under CAPTA but it more narrowly targets the use of $10 million for Nurse Family Practitioner home visiting programs.

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Advocates Hold Child Care Briefing

On July 18, a number of child care advocates held a Capitol Hill briefing on "Making Affordable, Quality Child Care an Economic Development Priority." The briefing highlighted the need for greater support and funding for child care. Sponsored by Representative Lynn Woolsey (D-CA) and Senator Chris Dodd (D-CT), the briefing was moderated by Danielle Ewen, Center for Law and Social Policy, and panelists included Helen Blank, National Women's Law Center, Bonnie Caldwell, Child Care Providers United, Ruth Mayden, Annie E. Casey Foundation, and Donya Paul, a parent from Maryland.

Blank focused her remarks on improvements needed in three programs: child care, Head Start, and Pre-K. She urged Congress to extend funding for the Child Care Development Block Grant and pointed out that recent child care funding decisions are projected to result in more than 450,000 children losing child care assistance by 2010. Caldwell highlighted the benefits of home-based child care and Mayden discussed Family, Friend, and Neighborhood Care, a program in which local caregivers are paid to care for children in their homes. Paul reinforced the need for all working parents to be provided access to support services. She urged Congress to make affordable child care a top priority.

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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.

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Key Upcoming Dates for Congress

  • August 6 to September 4--August Summer Break
  • September 30--SCHIP Reauthorization Expires
  • October 1--2008 Federal Fiscal Year Begins



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