A CHIP off the Clinton Block

Last week, Public Law 111-3, the Children's Health Insurance Program Reauthorization Act of 2009 (CHIP) took effect. Originally known as SCHIP (the State Children's Health Insurance Program), it was brought to life by President William J. Clinton, who identified children's health care as a national priority in his 1997 State of the Union address. He included the program in his fiscal year 1998 budget, and signed the resulting legislation into law on August 5, 1997.

SCHIP is actually an amendment to the Social Security Act, but became law as part of the Balanced Budget Act of 1997 (Public Law 105-33). The program gives states federal taxpayer money to provide health insurance to low-income children.

The 105^th Congress and Mr. Clinton appropriated the following amounts for SCHIP:

1998: $4.275 billion

1999: $4.275 billion

2000: $4.275 billion

2001: $4.275 billion

2002: $3.150 billion

2003: $3.150 billion

2004: $3.150 billion

2005: $4.050 billion

2006: $4.050 billion

2007: $5.000 billion

2008: $5.000 billion **This amount was appropriated by President George W. Bush in Public Law 110-173 “The Medicare, Medicaid and SCHIP Extension Act of 2007” on December 29, 2007. He also appropriated $5.000 billion for 2009, but the current bill amends the 2009 figure.

Total: $44.65 billion

The 111^th Congress and President Barack H. Obama appropriated the following amounts for SCHIP:

2009: $10.562 billion

2010: $12.520 billion

2011: $13.459 billion

2012: $14.982 billion

2013: $17.406 billion **2013 payments to states will be made in two equal installments of $2.850 plus a one-time payment of $11.706 billion.

Total: $68.929 billion

It's hard to know whether President Obama believes Clinton's SCHIP plan is terrific or terrible to justify this near-quadrupling of spending. It really could be either.

Here is what the original SCHIP legislation accomplished between 1998 and 2007, according to the US Census Bureau:

	1998	2007
Total US Population	270 Million	302 Million
Total number of uninsured children	15.4% (11.1 Million)	11.0% (8.1 Million)
Total number of citizens receiving government-provided health care	24.3% (66 Million)	27.8% (84 Million)

SCHIP succeeded at reducing the number of American children without health care coverage by 3 million, it also increased the total number of Americans that rely on taxpayer-provided health care coverage. Of the 32 million new citizens we acquired during this time, 18 million receive health care benefits from a government agency.

At a cost of $40 billion to American taxpayers, SCHIP provided health care insurance benefits to 3 million children, an average of $13,333 per child.

2009's Reauthorization Act, which officially changes the name of SCHIP to CHIP, aims to provide coverage to 4 million low-income children over five years. At a cost of $69 billion, that averages $17,250 per child. What remains to be seen, is how many additional taxpayer-supported citizens will result from this legislation.

CHIP attempts to correct a perceived flaw in SCHIP – namely, a provision allowing coverage for adults. After April 1, 2009, no new or renewal applications for adults will be approved without a special waiver from Health and Human Services Secretary (and Obama appointee) Kathleen Sibelius.

As CHIP closes one loophole, it opens another. To anyone who cannot provide ordinary proof of citizenship, and whose Social Security number when applying for benefits is inconsistent with records at the Social Security Administration, the State must allow 90 days for the individual to resolve the error, while providing medical assistance during said period. If there is no resolution within 90 days, the State must disenroll the individual from the program in 30 days. There is no provision requiring repayment for medical services received while without adequate proof of citizenship. This immigrant-friendly provision, unlike the rest of the bill, takes effect January 1, 2010. Months before the 2010 Census.

The CHIP Reauthorization Act of 2009, which began life as bill HR 2, was sponsored in the House of Representatives by Mr. Frank Pallone, Jr. Mr. Pallone is the Chairman of the Subcommittee of Health, under the Energy and Commerce Committee. He has been representing 650,000 citizens of New Jersey since 1993. Interestingly, in 1997, Mr. Pallone voted against passage of SCHIP when it was included in the Balanced Budget Act.

President Obama signed the final version of HR 2 into Public Law 111-3 on Wednesday, February 4, 2009, the same day he received it from the Senate. Obama's campaign pledge to allow five days for public comment between receiving and signing legislation, lasted only 16 days into his Presidency.

No doubt the public would have had plenty of comments about States required to provide medical assistance for 90 days while citizenship inconsistencies are resolved, with no repayment provision for improperly received services. We, the public, hire people to represent our views in the lawmaking process. Did your Representatives represent YOU?

Minnesota Delegates on Passage of the

CHIP Reauthorization Act of 2009

Yea Votes:

Senator Amy Klobuchar

1^st District Representative Tim Walz

3^rd District Representative Erik Paulsen

4^th District Representative Betty McCollum

5^th District Representative Keith Ellison

7^th District Representative Collin Peterson

8^th District Representative James Oberstar

No Votes:

2^nd District Representative John Kline

6^th District Representative Michelle Bachmann

Know what you vote for.

PS. If anyone out there has ideas on why the payment for fiscal year 2013 is so funky, I'd like to hear them. Is Obama planning a one-term Presidency? Is SCHIP a political power-tool to keep Democrats in power beyond 2012?