Health Reform Marches On: Implications for Kids of Latest Developments

This week there was a lot of back-and-forth on health reform as both the House and Senate attempted to get a bill to the floor before the now infamous August recess (which for those of you not up on the Congressional calendar is August 1st to September 8th in the House and August 10th to September 7th in the Senate). While that self-imposed deadline was not met (due to issues generally not related to kids), there was significant advancement of health reform legislation this week.  

In the House, the Energy and Commerce Committee is finalizing mark-up of its health reform bill after reaching agreements with "Blue Dog" Democrats and others on, among other things, reimbursement rates in the public plan and Medicare payments to rural hospitals. Once the bill passes out of Energy and Commerce it will be merged with the versions passed by the other House Committees and should be brought to the floor for a vote in September.

The amendments have been flying and continue to do so even as I write this blog. But here are some highlights of amendments so far affecting children and families:

• An amendment by Reps. McNerney (D-CA) and Murphy (R-PA) was approved prohibiting states from establishing enrollment waiting periods for children in CHIP who: are under age 2, have lost employer health insurance, or have only unaffordable coverage options (defined as costs exceeding 10% of family income). A number of states currently allow such exceptions, but the amendment requires (while CHIP is still in effect) this important improvement for kids.  

• Rep. Rush (D-IL) submitted two amendments to make it easier for children to enroll in public benefits programs and to ensure that children in CHIP shifted to the Exchange receive comparable benefits and cost sharing protections. The amendments were withdrawn because they would have pushed the cost of the bill above an agreed-upon target and after Chairman Waxman made a commitment to work with Rep. Rush on these critical issues for children.

• An amendment by Rep. Capps (D-CA) that extends CHIPRA's development of Medicaid and CHIP quality measures for children to maternity and adult health services.

• An amendment by Rep. DeGette (D-CO) that would preclude the movement of children from CHIP to Exchange plans until it is certified that they will receive comparable coverage has not yet been acted upon, but still is widely expected to be adopted before mark up concludes. In addition, amendments were defeated that would have affected Medicaid rules on the circumstances under which immigrants can secure coverage and that required states to offer premium assistance.

In the Senate, things progressed more slowly as the Finance Committee continued its negotiations for a bipartisan bill, which is now expected in September. Once the bill passes out of Committee, it must still be merged with the Senate Health, Education, Labor, and Pensions Committee bill, which was approved on July 15, 2009, before being taken to the floor for a vote.

What's Next? We are busily going through the fast breaking changes being made in Energy and Commerce and will provide an update as soon as possible. To help you navigate the bills, we will also release a side-by-side of the key provisions affecting children and families in the House Tri-Committee and Senate HELP Committee proposals next week.