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Second Children's Health Bill Makes Significant Changes to Focus More Heavily on Poor Children |
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From Center on Budget and Policy Priorities: On November 30, Congress sent the President a revised version of bipartisan legislation to strengthen children's health coverage (H.R. 3963). 1. The second bill focuses even more on covering the lowest-income uninsured children. It would prohibit any state from extending SCHIP coverage to children in families above 300 percent of the poverty line. The second bill would provide incentives to states only for enrolling uninsured children who are eligible for Medicaid and would increase the size of those incentives. Only 500,000 of the 3.9 million otherwise-uninsured children who would gain coverage under the bill would do so as a result of state actions to broaden their SCHIP eligibility criteria. 2. The second bill tightens the citizenship documentation option; it would ensure that ineligible undocumented immigrants are not enrolled in Medicaid and SCHIP, without reducing enrollment among eligible citizen children. Moreover, as CBO director Peter Orszag and leading health experts have explained, virtually any effort to cover more of the uninsured --- including tax deductions or credits for the purchase of insurance in the private market --- would result in some "crowd-out." In discussing the first SCHIP bill passed by the House, which also had a crowd-out rate of about one-third, Orszag noted that he "has not seen another plan that adds 5 million kids to SCHIP with a 33 percent crowd-out rate. Because such children are highly unlikely to have other access to health insurance, there is less risk of crowd-out at those income levels.
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