Wednesday, January 17, 2007

Back to "Regular Order"--The House Medicare Part D Drug Bill and SCHIP Reauthorization

The debate over the House Medicare drug negotiation bill is now moving over to the Senate.

My post from last Friday (next post below) still reflects what I am seeing on this issue. The Senate will move a drug bill on "regular order" which means we will see the standard committee hearings and process that could lead to floor action later in the spring or summer. The House Medicare Part D drug negotiation bill––all three pages of it--will go nowhere. It is possible a bill focused on the most expensive drugs with no competitor in its class has a chance. See Friday's post for those details.

The other health care issue that will be getting both House and Senate time (lots of it) will be the reauthorization of SCHIP (State Children's Health Insurance Program). This is the existing Medicaid plan that covers uninsured children who are part of families not otherwise eligible for Medicaid benefits.

SCHIP was a 1997 bipartisan product of the Clinton Administration that both Democrats and Republicans will tell you has been a success. As the number of working uninsured has grown, the only thing that has kept the overall number of the uninsured from going up even further is SCHIP.

It is estimated that if the program were to end as many as 6 million kids would become uninsured.

The problem is that the program needs to be reauthorized--and soon or it will die. Even at current funding levels the program will face big deficits perhaps leading to 1.5 million kids losing coverage.

To keep the program going and fix the funding gap over the next five years would cost between $13 billion and $15 billion.

The Democrats have boxed themselves into a bit of a corner because the new House has put the Congress on a pay-as-you-go basis with their new budget rules--they say no more big deficits like the Republicans piled up. You don't spend money unless you find a spending offset or you raise taxes to pay for it.

So, Republicans and Democrats think SCHIP is a great plan--a bipartisan success. Both sides want to reauthorize it and nobody wants to see more kids uninsured.

But there isn't any money obviously available.

Right now, every one in Congress is waiting for the President to make the first move in his budget message and the upcoming State of the Union Address.

So, no "100 hours" quick fixes for SCHIP. It's also "regular order" for this challenge.

SCHIP isn't a sexy political issue but it is an important one.

And, SCHIP is the first real test of the Democrats ability to lead and keep their promise to be fiscally responsible.

When it comes to health care, SCHIP and a Part D Senate bill are the two big issues everyone in Washington will be focused on for the next few weeks.


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