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

   
   
Vol. 22, Issue 6: 2/9/2009   
Headlines

President Signs CHIP Expansion, Rescinds 2007 CHIP Directive

Debate Over Economic Recovery Legislation Continues Across Washington

Update on Health Provisions in Economic Recovery Package

Tax Benefits for Children and Families Posted by State

Rest of 2009 Budget, Future 2010 Budget Yet to Come

Direction of HHS Uncertain

McDermott, Other Key Leaders to Be Recognized on Advocacy Day

On the Line with CWLA, Speaking for America's Children

Join CWLA's Call for a White House Conference on Children and Youth

CWLA Legislative Alerts Available to Subscribers

Key Upcoming Dates for Congress



President Signs CHIP Expansion, Rescinds 2007 CHIP Directive

On February 4, the President signed into law the new and improved Children's Health Insurance Program (CHIP) not long after the House approved the final bill by a vote of 290-135. The Senate passed the same legislation a week before with a vote of 66-32, including nine Republicans supporting passage. The reauthorized CHIP law is expected to provide health coverage to millions more children and take a significant step forward toward the President's goal of insuring all children.

CHIP programs exist in every state and provide health coverage to millions of children whose families earn too much to qualify for Medicaid and those who are either not offered or cannot afford private coverage. Serving as Medicaid's essential companion, since its inception in 1997, state CHIPs have effectively reduced the uninsured rate of low-income children by one-third.

The 110th Congress passed two compromise bills in 2007 (H.R. 976 and H.R. 3963) that would have reauthorized and strengthened CHIP, but President Bush vetoed both measures. As a result of this gridlock, CHIP was extended through March 31, 2009, with sufficient funding to maintain current enrollment and avoid shortfalls (P.L. 110-173).

House Speaker Nancy Pelosi (D-CA) and other Congressional leaders took quick action on CHIP this year, fulfilling their commitment to providing health coverage to 11 million children. Very similar to the CHIP bills Congress passed in 2007, the new law maintains coverage for more than 7 million children and contains funding to expand coverage to another 4 million. The reauthorization also guarantees dental benefits and mental health parity, offers states the option to implement express-lane eligibility, has grants for outreach and enrollment, and establishes a child health quality initiative. Another accomplishment advocated for by CWLA and many other organizations is that the legislation will eliminate the five-year waiting period for legal immigrant children and pregnant women to enroll in Medicaid or CHIP.

A day after signing CHIP into law, President Obama sent a memo requesting that the August 17, 2007, HHS letter to state health officials, restricting flexibility, be withdrawn. Recognizing states are very differently situated--in terms of costs of living, for example--the federal government has long afforded states flexibility to uniquely tailor certain aspects of their CHIP programs, including the ability to set income eligibility limits. In a sharp departure from that sound policy, however, the Bush Administration's 2007 directive made it next to impossible for state CHIP programs that are already covering or desire to cover children in families who earn over 250% of the federal poverty level (FPL) to do so. President Obama's memo stressed this policy had denied tens of thousands of children health coverage.

This is a historic time for children. Making such a significant investment to improve the physical and mental health of our children, Congress and the President have shown that children are a priority. CWLA sincerely thanks and applauds those members of Congress who championed these efforts. Because of their commitment, we are closer to our goal of insuring all children.

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Debate Over Economic Recovery Legislation Continues Across Washington

Senators spent most of last week adding to and subtracting from the American Recovery and Reinvestment Act (ARRA, S. 1/H.R.1). While senators debated, the President continued his negotiations with members of both parties. The week before, the House of Representativees approved its version of the bill by a vote of 244-188. At one point ,the Senate bill had increased in cost to more than $900 billion as new tax and housing provisions were added.

Congressional intent had been to hold a formal conference committee between the House and the Senate once the Senate had acted on its bill, but such a lengthy process was looking unlikely last week if Congress were to meet its commitment to sending the President a bill by the start of the President's Day holiday on February 16. Although the bill's final content remains uncertain, the White House did release state-by-state figures on the number of jobs it believes will be created by its proposal. See www.whitehouse.gov/the_press_office/state_by_state_employment_impact and www.whitehouse.gov/assets/documents/White_House_Releases_Additional_State1.pdf.

The White House also announced the President would address a joint session of Congress on February 24. This will be the new President's first such address. Normally, the President addresses Congress at the end of January shortly before the new budget is sent to Capitol Hill. The transition to a new Administration and the challenging economic situation has changed much of the traditional scheduling.

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Update on Health Provisions in Economic Recovery Package

With the economic recovery package debate heating up, and provisions possibly being dropped to reduce the overall cost, it is important to review and support several important health care provisions in the House and Senate versions of ARRA. Both would provide $87 billion over two years for a temporary increase to the Federal Medical Assistance Percentage (FMAP), the federal match for state-run Medicaid programs. All states would receive a base increase retroactive to October 1, 2008, and going through December 31, 2010.

The House version (H.R. 1) would increase all states' FMAP by 4.9%, with 50% of the overall funds allocated directly and 50% targeted to states in the greatest economic turmoil. The Senate bill (S. 1) would increase all states' FMAP by 7.6%, with 80% of funds allocated directly but only 20% targeted for states in the greatest economic turmoil. For states to receive the FMAP increase, their Medicaid eligibility rules and procedures must be as they existed on July 1, 2008. States could, however, still increase cost-sharing or cut benefits or provider rates.

The House recovery package would extend the moratorium on six Medicaid regulations, including rehabilitative services and targeted case management, to June 30, 2009. The Medicaid regulation pertaining to outpatient hospital services would also be put under moratorium until that date. The Senate's package, at press time, did not address the regulations.

The House package provides a new option for states to cover temporarily any of the following populations, with 100% federal government financing of the new Medicaid category through December 31, 2010: individuals receiving, but who have exhausted, their unemployment benefits; individuals receiving food stamps but who are not otherwise eligible for Medicaid; and individuals in families below 200% of the federal poverty level. They must have exhausted their unemployment benefits or lost their jobs between September 1, 2008, and December 31, 2010. The Senate does not include this state option.

Both the House and Senate versions would allow individuals who have lost their jobs between September 1, 2008, and December 31, 2009, for reasons other than gross misconduct, and who worked at businesses of 20 or more employees, to continue their health coverage. This would be a modification of COBRA, with individuals responsible for only 35% of the premium and the government subsidizing the remaining 65%. This continuance could last up to 12 months past the involuntary termination, but would also terminate upon an offer of new employer-sponsored coverage.

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Tax Benefits for Children and Families Posted by State

Last week, the Washington-based group Citizens for Tax Justice (CTJ) posted individual state breakouts of the tax benefits that would flow to states if one the two versions of the economic recovery package were to pass. The tables examine the benefits flowing from an increase in the earned-income tax credit (EITC), the Child Tax Credit (CTC), and the temporary "making work pay credit." The state breakouts indicate how the tax refunds would flow to families based on income.

The making work pay credit would reduce weekly tax withholding by $10 a week. Many consider this an alternative to last year's tax rebate checks, which some economists felt took too long to get into consumers hands. They argue a reduction in weekly withholding could get to people within weeks instead of months and would be spent almost as quickly.

EITC and CTC are already law, but the economic recovery bills would increase the amounts provided or increase the credits' refundability. Making a tax credit refundable means the taxpayer receives the federal refund even if his or her income is low enough not to have to pay federal income tax. Some critics in Congress have argued that providing tax refunds or rebates to workers whose tax liability is so low they do not owe federal income tax is not fair or is just another form of welfare.

EITC was enacted in 1975 as a way to help low-income workers who did not pay federal income tax but were paying the payroll tax for Medicare and Social Security. Throughout its history, EITC has garnered bipartisan support, originally passed by a Democratic Congress and signed by Republican President Gerald R. Ford. Every President since has signed into law increases in the EITC. In fact, President Ronald Reagan labeled the EITC, which is based on income earned from jobs, as "the best antipoverty, best pro-family, and best job creation measure to come out of Congress." The EITC increases for family size.

The CTC is newer, signed into law by President Bill Clinton and made partially refundable under President George W. Bush. It too is based on the number of children in the family. Advocates see increases in both tax provisions as a way to get more money to lower-income families who, they argue, will be more likely to spend it.

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Rest of 2009 Budget, Future 2010 Budget Yet to Come

Shortly after Congress completes work on the economic recovery package, it is expected to turn attention to completing the 2009 fiscal year budget. Last year, Congress passed a continuing resolution (CR) that generally provided level funding (2008 level) for most programs. That CR runs out March 6. Appropriators have been working on completing the remaining bills (the Defense and Homeland Security departments have full budgets approved) and are likely to pass them as an omnibus budget bill. Major changes between what the Senate and House Appropriators have approved are unlikely. For a comparison between the Senate and House bills on key children's programs, go to www.cwla.org/advocacy/budgetdetails09.htm.

While finishing work on 2009 appropriations, Congress will be waiting for the President's new budget for FY 2010. Normally, that budget is released the first week of February, but that process has been delayed both because of the transition to a new administration and because of the focus on the recovery bill. Indications are that an Obama budget will be released in April, with a preliminary budget released before then. In presidential transition years, the outgoing administration prepares a budget that is then altered by the new President. A clearer listing of the Obama budget priorities really won't occur until next year, when departments are more fully staffed.


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Direction of HHS Uncertain

With former Senator Thomas Daschle's withdrawal from consideration to become the next Secretary of Health and Human Services (HHS), who the next Secretary would be, and when that announcement would take place, remained unclear at the end of last week. Many names were put forward, but the White House has given no indication who is being considered and how long that would take.

In the interim, the HHS website indicates that senior leaders will become acting heads of their respective agencies and offices until the Administration appoints individuals to various leadership positions. Between January 20 at noon and the time when the Secretary-designate is sworn in, Assistant Secretary Charles E. Johnson will serve as Acting Secretary.

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McDermott, Other Key Leaders to Be Recognized on Advocacy Day

February 24 is Advocacy Day at CWLA's National Conference, Children 2009: Children Today...America's Future. The day will start with a plenary session honoring key congressional leaders who were vital to passing last year's Fostering Connections Act (P.L. 110-351). Representative Jim McDermott (D-WA) will be one of these featured congressional leaders. Later that day, CWLA members will go to Capitol Hill to support the call for the White House Conference on Children and Youth.

The National Conference February 23-25. Advocacy Day features round trip bus rides to Capitol Hill and provides attendees one of the first opportunities to come to Washington under President Obama and the new 111th Congress. This will be the first Advocacy Day since the opening of the new Capitol Hill Visitors Center.

CWLA members and other conference participants are strongly encouraged to go to Capitol Hill to talk to their members of Congress and ask them to support the call for the White House Conference on Children and Youth. Advocacy Day is also a wonderful opportunity for CWLA members to talk to their elected officials about the challenges in their state budgets and their effects on children and families.

For more information about Advocacy Day, contact Cristina Fahrenthold at cfahrenthold@cwla.org.

This will be an energizing conference and one of the most important advocacy events for child welfare in 2009. The conference hotel, the Marriott Wardman Park, is already full, and CWLA has secured rooms at the same rate at an overflow hotel, the Omni Shoreham. For more information, visit www.cwla.org/conferences/2009nationalhotel.htm.

Registration is now closed, but you can register on site at the conference. In addition, CWLA is running a last-minute special: Register five attendees, and receive a sixth registration free. This special is available only by contacting Nicky Dixon at 703-412-2414 or ndixon@cwla.org for details.

If you qualify, consider using Title IV-E child welfare funds to attend the conference. The program is a major source of funding for training child welfare workers. Check with your state, and let federal dollars help transform your work!

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On the Line with CWLA, Speaking for America's Children

On the Line with CWLA is a thought-provoking, interactive, live Internet radio program focusing on subjects, stories, and strategies of special interest to child welfare policymakers, providers, and practitioners. The program, devoted solely to discussions about the welfare of America's vulnerable children, features a forum where numerous points of view and voices of experience within the child welfare universe can be heard.

The weekly program broadcasts Wednesdays, 2:00-2:30 pm ET. To listen to On the Line with CWLA, go to www.blogtalkradio.com/CWLA-Radio. The call-in number is 347/326-9411. Programming schedule subject to change.

The schedule of coming shows is posted at http://www.cwla.org/newsevents/cwlaradio.htm.

On the Line with CWLA is a production of the Child Welfare League of America, Arlington, Virginia. Programming schedule subject to change.

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Join CWLA's Call for a White House Conference on Children and Youth

A White House Conference on Children will bring together a cross-section of policymakers, advocates, professionals (including the courts), and families and children directly affected by the child welfare system to create recommendations for policy and change. CWLA is calling on Congress and the next President to reestablish this important policymaking tradition. The time to act is now. Your support and involvement are crucial.

You can support this effort by going to www.cwla.org/advocacy/whitehouseconf10.htm. There, you can sign on to support CWLA's call for a White House Conference in 2010, let your members of Congress know of your support, complete a survey about what areas you would like to see such a White House Conference focus on, see which members of Congress are cosponsoring the authorizing legislation for a White House Conference, learn how to get your board to pass a resolution supporting this effort, and more!

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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

February 16: Deadline for completion of recovery legislation
February 16-20: Presidents Day break
February 23-25: CWLA National Conference
February 24: President addresses joint session of Congress
March 6: FY 2009 continuing resolution expires
April 6-17: Congressional Spring recess

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