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March 2007

SCHIP Reauthorization Update

Congress spent the past several weeks focusing on short-term and long-term State Children’s Health Insurance Program (SCHIP) federal funding issues. Congressional action on SCHIP will have a major impact on many states’ existing SCHIP programs as well as some states’ prospects for coverage expansion.

Congress explored ways to avert FY 2007 federal funding shortfalls in 14 states (six of the 14 states are anticipating shortfalls by early May) and discussed future SCHIP funding options. Last week the House Appropriations Committee approved a supplemental war appropriations bill that would increase federal SCHIP funding for the 14 shortfall states by $750 million, but its final passage is uncertain. To address long-term funding issues, the Senate Budget Committee narrowly approved a FY 2008 budget resolution that includes $15 billion of the $50 billion over five years that the Democrats seek in order to eliminate shortfalls and expand SCHIP. Committee Chair Kent Conrad (D-ND) said the additional $35 billion could become available through spending reductions in other areas or new revenue sources.

Several new publications focusing on children’s health coverage have recently been released to inform the SCHIP reauthorization dialogue:

  • The March-April issue of Health Affairs includes articles on children’s health by a number of health policy experts. The articles explore the 10-year history of SCHIP, the role of Medicaid and SCHIP in providing coverage to children, health care disparities among children, the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit, school health, innovative private sector coverage enrollment strategies, crowd-out, and transforming the child health system. Archives from the press briefing on this children’s health theme issue are available online.
  • The Government Accountability Office released a March report highlighting states’ SCHIP enrollment and spending experiences, and considerations for reauthorization. The report suggests Congress consider three main issues during SCHIP reauthorization: (1) state flexibility, including coverage of adults and expanded financial eligibility for children, (2) federal financing strategy and the extent to which the federal government has the responsibility to address state funding shortfalls, and (3) equity issues, including the current federal funding formula and federal financial participation, and the degree to which funds should be targeted to states not meeting minimum coverage levels.
  • A March 12 briefing on children’s health care coverage and quality sponsored by The Commonwealth Fund and the Alliance for Health Reform (Alliance) discussed SCHIP reauthorization and other potential improvements in children’s access to quality care. In addition, a February 26 briefing, sponsored by the Robert Wood Johnson Foundation and the Alliance, focused on children’s coverage and outreach, enrollment, and retention experiences in SCHIP and Medicaid. Presentations, transcripts, and Webcasts are available on the Alliance’s website.
  • The Kaiser Commission on Medicaid and Uninsured recently released several new resources and tools related to children’s coverage and SCHIP reauthorization, including an interactive children’s health coverage timeline and customized state fact sheets on children’s health.