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

   
   
Vol. 20, Issue 41: 10/29/2007   
Headlines

Sign Up to Support a White House Conference on Children and Families

House Takes Swift Action on New CHIP Bill, Fails to Achieve Veto-Proof Majority

President Requests $46 Billion More for War, Senate Moves Labor-HHS

CWLA, NGA, Others Weigh In on Medicaid Rehabilitative Services Regulation

CWLA Legislative Alerts Available to Subscribers

Key Upcoming Dates for Congress



Sign Up to Support a White House Conference on Children and Families

The CWLA campaign for a White House Conference on Children and Youth continues to build. Groups can now sign up online to support this effort. To view the web site and sign on, visit www.cwla.org/advocacy/whitehouseconf10.htm.

This White House Conference on Children and Youth would be the first since 1970. Three decades have passed without the White House bringing the focus of the nation to examine the state of our children. CWLA is calling on Congress to authorize this conference so the next President will convene a conference in 2010. We must once again use the power of the White House to organize a national conference on the welfare of our children to establish national goals for improvement in the subsequent 10 years.

A White House Conference on Children and Youth is necessary to focus the nation's attention of the nation on the children who, after all, are our responsibility. The conference would examine the greatest needs and set the country on a path to reform. The commitment of the President and the power of the White House are needed to once again make vulnerable children a national priority and point the way to significant reform and improvements.

The CWLA website has been developed to provide information on the purpose and history of these conferences and other information, in addition to ways for groups and individuals to get involved.

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House Takes Swift Action on New CHIP Bill, Fails to Achieve Veto-Proof Majority

After failing a week earlier to override the President's veto of compromise, bipartisan legislation that would reauthorize the Children's Health Insurance Program (CHIP, H.R. 976) by 13 votes, House leadership quickly regrouped, produced a new bill (H.R. 3963) that sought to address opponents' concerns, and voted on the measure shortly thereafter. The new CHIP reauthorization passed the House by a vote of 265-142, but that tally is still unable to override another threatened veto.

As Medicaid's essential companion, CHIP programs exist in every state and provide much-needed coverage to low-income children whose families earn too much to qualify for Medicaid and those who are either not offered or cannot afford private coverage. CHIP expired September 30 but continues to operate funds included in Congress's continuing resolution (CR). This CR, however, expires November 16, necessitating speedy completion of a more permanent reauthorization.

The new compromise CHIP bill, like its predecessor, provides authorization and funding necessary to maintain current enrollment of 6.6 million children and encompass nearly 4 million additional children who otherwise would go without coverage. It also similarly provides mental health parity in CHIP programs, guarantees dental benefits, and begins a child health quality initiative.

Although backers of the original compromise bill largely denied opponents' accusations, leadership made certain substantive changes to clarify their intent and help garner more votes for the new reauthorization bill. Among the revisions, the new bill, for the first time in CHIP's history, largely sets the income eligibility limit at 300% of federal poverty level (or $61,950 for a family of four). The only state currently covering children in families above 300% FPL (New Jersey) could continue to do so.

In addition, although the original CHIP compromise bill granted performance bonuses to states that successfully enrolled low-income children in Medicaid or CHIP, to ensure the focus is on the lowest income children, H.R. 3963 provides performance bonuses only to states that successfully enroll Medicaid-eligible children.

H.R. 3963 phases childless adults entirely out of CHIP within one year (as opposed to the original bill's two year phase-out). Although the original bill only required states covering children in families above 300% FPL to have anti-crowd-out policies, H.R. 3963 would require all states to develop thoughtful plans that guard against crowd out. To ameliorate suspicions that noncitizens could enroll, H.R. 3963 includes specific language that federal dollars may not be used for undocumented immigrants, and accompanying enforcement measures.

The Administration revealed a greater willingness to compromise on October 24, inferring it may be willing to put 20 billion new dollars toward CHIP, a significantly higher amount than its original $5 billion proposal. But the Administration still adamantly opposes fundamentals that most of Congress is unwilling to budge on, such as the bill's pay-for of increasing the federal tobacco tax by 61 cents per pack.

Feeling confident they had suitably addressed opponents' concerns, and hoping to complete CHIP reauthorization sooner rather than later, leadership charged ahead and brought the new bill for a vote. This swift action frustrated many Republicans, who complained they did not have enough time to thoroughly understand and analyze the new bill's provisions and changes; and they protested the rule for debate, which barred amendments. All Republican efforts to delay the vote failed.

On the same day the House voted, the President issued a formal veto threat, stating that "the President will veto [H.R. 3963] if it is presented to him without significant changes." The long-term fate of CHIP remains undetermined--with enrollees and the eligible children the bill attemptins to encompass waiting on the sidelines.


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President Requests $46 Billion More for War, Senate Moves Labor-HHS

The same week the President delivered his official request for additional war funding, the Senate adopted its version of the Labor-HHS-Education funding bill (S. 1710). The President's request of $45.9 billion in funding for the war is in addition to the original budget request of $150 billion for FY 2008. The two requests together total $196 billion for 2008. If enacted, it would mean the wars in Iraq and Afghanistan will have cost approximately $800 billion by the end of FY 2008.

The initial response from Congressional leaders is that they would wait until early next year to address the supplemental war funding request, arguing that when the Defense budget is enacted with approximately $450 billion, it would provide enough money to fill in any gaps in funding, certainly in the short term.

The President announced his request on Monday; on Tuesday, the Senate passed the Labor-HHS-Education bill. The bill must now go to a conference with the House of Representatives. The President has threatened to veto either the Senate or House versions if they reach his desk, arguing they spend too much money. The Senate bill provides a 3% increase over current FY 2007, at $149 billion in overall discretionary funding, which is 6% more than the President's budget request. The House bill spends $1.9 billion more than the Senate version. What the Congressional strategy is as far as which appropriations bills leaders will send to the President first remains unclear. One strategy might be to send the President the Labor-HHS bill, and if he does veto it, send it back with a more popular bill, such as the Defense bill. The temporary funding provided for FY 2008 runs out November 16.


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CWLA, NGA, Others Weigh In on Medicaid Rehabilitative Services Regulation

Along with CWLA and other influential national, state, and local organizations and individuals, the National Governors' Association (NGA)--on behalf of the nation's governors—has now weighed in on the recent proposed regulation that would impact Medicaid rehabilitative services (CMS 2261-P/72 FR 45201). In an October 10 letter to the Centers for Medicare and Medicaid Services (CMS), NGA Executive Director Raymond Scheppach asked CMS to wholly rescind the proposed rule. In expressing NGA's opposition to the proposed regulation, Scheppach explained it "represents a significant departure from states' authority to provide necessary health-related services for Medicaid enrollees, and would unnecessarily shift costs to states."

CWLA is similarly concerned that in defiance of the President's New Freedom Commission on Mental Health, and the U.S. Surgeon General's recommendations, the regulation would greatly restrict access to vital community-based services for children with physical or mental disabilities. Among its most egregious actions, the proposed regulation would remove federal Medicaid dollars for services deemed "intrinsic to" other programs, including child welfare and foster care. For example, federal Medicaid dollars would not be available for rehab services provided in a therapeutic foster care setting unless they are medically necessary, clearly distinct from packaged therapeutic foster care services, and given by a qualified provider. The proposed rule would also exclude federal dollars from services provided to residents of an institution for mental disease (IMD) who are younger than 65, including residents of community residential treatment facilities more than 16 beds.

CWLA's final, comprehensive comments submitted to CMS are online.

CWLA continues to work with members of Congress and other potentially affected organizations to ensure that as the rulemaking process continues, our voices are heard and meaningful access to rehab services is preserved. A six-month moratorium on the rehab regulation was included in Section 616 of Congress's compromise CHIP reauthorization bill (H.R. 976). The intent behind the moratorium was, at a bare minimum, to permit more time for thoughtful conversations and decisions. Due to the President's veto of that legislation, however, the moratorium's fate is in limbo.


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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.

To subscribe to Legislative Alerts, visit www.cwla.org/advocacy/alerts.htm.

To subscribe to Children's Monitor, visit www.cwla.org/advocacy/monitoronline.htm.


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Key Upcoming Dates for Congress

October 26: House target adjournment date

November 16: Senate target adjournment date; Continuing resolution to fund the government runs out; Temporary extension of SCHIP expires


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