UPDATE: Medicare, SCHIP and Kids

Last night the Senate voted 68 to 31 to renew and expand the State Children’s Health Insurance Program SCHIP). A day earlier the House voted 225-204, largely along party lines, to approve a larger expansion of the SCHIP program. As Matthew notes below, the Senate, unlike the House, would not try to help fund SCHIP by eliminating Medicare’s overpayments to Medicare Advantage for-profit insurers. (See my post below)

Meanwhile, President Bush has said that he would veto either version of the legislation. But the Senate bill garnered enough votes for its version of the bill to overcome a veto. (18 Republicans joined 48 Democrats and 2 Independents in the vote.)

According to PBS, the House and Senate plan to meet after their August recess to reconcile the differences between the two bills before sending a final measure to President Bush.

Below, Matthew offers his best guess as to what will happen next. He suggests if the Senate/House compromise avoids taking a whack at the Medicare Advantage private sector insurers, the President might well sign it. Nevertheless, Matthew believes that Democrats won’t be able to resist the temptation to include the provision cutting over payments to insurers in order to provoke the veto and then campaign on the fact that Republicans hate children.

I’m cynical but frankly, Matthew is so cynical. I take this as an ethnic (i.e. British) trait. On the other hand, I’m Irish, so I probably shouldn’t open a discussion about ethnic Achilles heels . . .

But I am idealistic enough to think that there are enough Democrats and Republicans who care about healthcare for uninsured children that they will eliminate the cuts to insurers in hopes of avoiding a veto.

It’s worth noting that on Tuesday, Sen. Orrin Hatch (R. Utah) and Sen. Edward Kennedy, (D-Mass), told the Washington Post that House-Senate negotiations will aim to keep the final bill within the scope of the Senate’s measure in order to try to avoid that Presidential Nix.In the end, if Congress doesn’t touch insurers’ profits, would President Bush say “no” to expanding SCHIP for kids? I don’t know.

What do you think?

Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron’s and Institutional Investor. She is the author of  “Money-Driven Medicine: The Real Reason Why Healthcare Costs So Much,” an examination of the economic forces driving the health care system. A fellow at the Century Foundation, Maggie is also the author the increasingly influential HealthBeat blog, one of our favorite health care reads, where this piece first appeared.

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2 replies »

  1. You may want to add the newest ruling at SSA that they probably don’t want you or anyone else to know about.
    I am Elizabeth Collier Shepherd and I live in Columbia SC.I wanted to share a Social Security Disability precedent decision with you. Something is terribly wrong with this decision and it affects many arguments out there today. Bear with me a minute.
    I was court awarded disability in 1987 for the diagnosis of Lupus, which doesn’t go away. Fortunately I went back to work in 1990 but got sick again in 2001. My court award has no expiration date and I had proudly informed my employers that I was a ” working disabled American citizen”. When I reapplied due to sickness at SSA in 2001, I was turned down twice at the Determinations stage. No one bothered to obtain my medical information. Someeone there removed the court award from the file. When I got to my hearing, the court award was missing but I gave the Judge a copy. There was no expiration date on this order and it had not been rescinded or revoked. That Judge made no note of a previous lifetime illness and disability.
    The Judge required me to forfeit two years off my disability claim in order for him to approve this claim! and he continued the hearing. I forced SSA into an Appeal, but got unsigned fake remand orders from the Appeals Council. Next another local ALJ affirmed that the time I initially claimed was indeed approvable but he refused to see me.. However, the SSA is ignoring paying the claim, holding over seven thousand dollars currently. They also allowed a monthly reduction in my benefit since I complained about my civil rights being violated. They also allowed me to be enrolled in two or three Medicare Part D plans paying three or four premiums every single month per draft.
    There are two huge problems with these actions. First , the initial Judge negated all employer paid disability income policies for working disabled Americans. Secondly , he also ruled it is satisfactory and acceptable for people with catastrophic health conditions to be without insurance.
    I was forced on SCHIP. You see, previously disabled people are rated by insurance companies and are unable to secure insurance.Cobra does end. SCHIP must be expanded to include people like me if SSA pushes us to the curb. You also do realize that Mr. Romney’s plan to fine people without insurance in the near future is aimed at taxing disabled people in America as we will be ones left out of this insurance argument, on purpose because we are expensive to maintain.
    A simple Administrative Law Judge in Columbi SC made these foul decisions. He has public relationships with the President of Blue Cross Blue Shield in SC, Ed Sellers, and also public relationships with Gayle Averyt, founder of Colonial Insurance company, part of Unum. Judge contributes heavily to the Republican party. SSA is ignoring my complaints. OIG is also ignoring. In fact, I received a threat for discontinuation of services from my former representative.
    Disabled Americans lost many rights in that Judge’s court room. And to top it all off, my file has not been seen or accounted for since that Judge handled it.SSA is ignoring my FOIA Privacy Act request to see my own file.
    Please share this story. I have no privacy so why should the new policy be a secret? Disabled Americans need to be warned there is no such thing as a ” working disabled American citizen” and trust me, this argument affects almost everyone at some time in their life. And now disabled Americans may go without healthcare insurance if they choose to work and succeed over an imaginary five year line of protection. Did you know all disabilities go away at the five year mark???? Someone should have told me!
    I have a 500 page document footnoted to letters and other documents to prove this story.
    Elizabeth Collier Shepherd Columbia SC 29204

  2. I’m inclined to think that Bush will back down from his veto threat if Medicare Advantage goes untouched. I’m also inclined to think that it would make a lot of House Republicans defect, although it’s hard to know whether or not they could override a veto. You have to figure that at some point it will sink in that voting against health insurance for poor children is going to haunt them during campaign season.