Friday, January 16, 2009

SCHIP Bill Not a Good Sign for Major Health Care Reform

The extension and expansion of the State Children's Health Insurance Program (SCHIP) has now passed the full House and the Senate Finance Committee and is on its way to the full Senate.

After minor differences between the House and Senate are reconciled it will become law.

However, the way it is being done does not give me a good feeling.

In the Senate Finance Committee the Democrats were only able to get the support of one Republican--Maine's Olympia Snowe--on the way to a 12-7 approval.

They did not have the support of the ranking Republican, Chuck Grassley of Iowa.

Senate Finance Democrats lost the support of the Republicans when they insisted on departing from last year's bipartisan agreement to leave existing policy on covering the children of legal immigrants as is. As it now stands, a legal immigrant agrees not to apply for Medicaid and SCHIP benefits for the first five years they are in the country. Under the new rules states would have the option of covering legal immigrants. The new bill also left out provisions from the earlier bipartisan comprise to limit benefits for higher income families.

Without judging on the merits whether these two new provisions should have been in the bill, what the Democrats have done is moved away from earlier bipartisan agreements and in doing so lost moderate Republicans like Grassley who showed good faith in reaching an earlier bipartisan compromise.

As I have repeatedly said on this blog, major health care reform is not possible unless it is bipartisan.

My simple definition of bipartisan reform is getting Chuck Grassley onside.

Ditching Grassley over SCHIP was a mistake and it does not bode well for bipartisan health care reform. This is the kind of dumb stuff the Clintons did in their failed 1993 unilateral health care reform effort.

To put it as simply as I can, no major reform of America's health care system will pass without Chuck Grassley voting for it.


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