President Bush and Health and Human Services Secretary Michael Leavitt fielded questions this morning on reauthorization of the State Children's Health Insurance Program, which expires in 10 days. The administration kept to its hard line on SCHIP - a promise to veto Congress' current $35 billion expansion effort.
Members of the House and Senate are currently working on a reauthorization bill that draws from provisions in a Senate bill passed in August. The legislation would raise the federal cigarette tax by 39 cents per pack to fund a $35 billion five-year extension of SCHIP.
The proposal would also expand eligibility for the program - a provision Bush and Leavitt said could endanger access for the poorest children.
"Congress made a decision to expand eligibility up to $80,000. That's not the intent of the program," Bush said. "I believe this is a step towards federalization of healthcare... That's why I'm going to veto the bill."
Bush also said that he is concerned by Congress' proposal to raise the federal cigarette tax to fund SCHIP. "They don't need to raise taxes," he said. The administration has proposed a $5 billion reauthorization of SCHIP, which Leavitt said is adequate enough to ensure that all children in families with incomes up to 200 percent of the federal poverty line are enrolled.
"SCHIP was designed as a program to provide coverage for children under 200 percent," Leavitt said. "We know that 75 percent of children in 200 to 300 percent range already have coverage." He added that 90 percent of children in families with incomes up to 400 percent of the poverty line already have private insurance. "Many under 200 percent do not." Leavitt said the program needs to focus on the poorest children.
In recent weeks, the Bush administration has discouraged states from expanding their eligibility levels for SCHIP. However, such levels and other enrollment aspects remain at the discretion of state officials. Leavitt said the administration has offered guidance to states looking to increase eligibility levels to prioritize poorer children.
"It seems likely that Congress will not be able to achieve reauthorization by Sept. 30," Leavitt said. In such circumstances, the administration will work with Congress to temporarily extend the existing SCHIP to ensure continuity of coverage.
Despite the threat of a veto of proposed legislation, said Leavitt, "We'd like to see (SCHIP) reauthorized and we'd like to get onto the larger question of how we provide insurance to all Americans."