January 30, 2009

Senate Passes SCHIP Expansion Bill

This week the Senate voted 66-32 to expand the State Children's Health Insurance Program (SCHIP). SCHIP is a joint state and federal program that provides health insurance to children in families who cannot afford private health insurance but do not qualify for Medicaid. The Senate bill would expand the SCHIP program to cover an additional 4 million children at a cost of $32 billion.

The SCHIP expansion is funded by a $0.61 per pack increase on cigarettes and other tobacco products. During consideration of the SCHIP bill, Senator Jim Webb (D-VA) proposed an amendment to reduce the tobacco tax to $0.37 per pack. The American Thoracic Society and other tobacco control advocates were successful in beating back the Webb amendment.

In addition health insurance expansion, the bill also allows states to purchase dental coverage for children who have private health insurance but not dental coverage. The Senate bill also creates Medicare payment advisory commission, similar to the existing Medicare Payment Advisory Commission (MedPAC) that makes recommendations to Congress on Medicare payment policy. Physician hope that the proposed Medicaid commission might help address historically low Medicaid reimbursement rates.

The House has passed a similar SCHIP expansion bill, but funds the bill by prohibiting new physician specialty hospitals. The House is expected to vote on the Senate version of the SCHIP bill early next week. President Obama has expressed his support for SCHIP expansion legislation.

Budget: House Passes Stimulus Package

With no Republican supporters, the House of Representatives passed the economic stimulus legislation this week by a vote of 244-188.

As reported earlier, the bill provides increases in several key health programs including:

• $2 billion for NIH
• $1.5 billion for research infrastructure
• $81 billion to temporarily increase federal Medicaid payments to states
• $39 billion for COBRA payments for those who lose employer-based health insurance
• $3 billion for chronic disease prevention, including hospital infection prevention, preventative health services block grants for states and immunization programs
• $20 billion for health information technology expansion efforts
• $1.1 billion for healthcare effectiveness research in the Medicare, Medicaid and SCHIP programs
• $950 million for VA medical facilities

House to Consider FY09 Spending Bill

The House of Representatives may begin consideration this coming week of an omnibus appropriations package that includes the Labor-Health and Human Services and Education(Labor-HHS-ED) spending bill for Fiscal Year 2009. This bill, which provides all health research and services funding, includes a proposed 3.5% funding increase for the NIH, which would translate evenly across all institutes, including the National Heart, Lung and Blood Institute (NHLBI), the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute for Environmental Health Sciences (NIEHS) and the Fogarty International Center (FIC). The Senate Labor-HHS-ED bill includes the same 3.5% increase for the NIH asthe House bill.

The Centers for Disease Control and Prevention (CDC) is slated for a 2.4% increase under the House-proposed bill. This includes allocations for the following public health programs of interest to the ATS:

• A 5% increase over the FY08 funding level for domestic TB control
• Stagnant funding at the FY08 level of $30 million for the asthma program
• Stagnant funding at the FY08 level of $104 million for the tobacco control program
• A 5% increase for chronic disease prevention and health promotion

The House and Senate have until March 6, 2009, when the current continuing resolution funding all programs at FY08 levels expires, to pass the FY09 spending bills. The ATS Washington Office will keep members informed of the progress of the FY09 health research and services spending bill.

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