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Wilson Announces Support for Child Health Bill

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Location: Albuquerque, NM


Wilson Announces Support for Child Health Bill

Congresswoman Heather Wilson today says she will vote for a bicameral agreement to reauthorize the State Children's Health Insurance Program for an additional five years. Wilson says the bill is a huge victory because it extends health coverage to uninsured children while leaving intact an important health care program that covers thousands of New Mexico seniors.

Wilson, who introduced a nearly identical bill in July, says she hopes the President will sign the compromise.

"It's been my hope that we could have a bipartisan SCHIP reauthorization bill that could gain the support of Members of both parties and show the strong support that exists in Congress for this children's health insurance program," says Wilson. "The additions to this bill for mental parity and dental coverage make the bill even stronger and today we have a strong bipartisan bill to provide health care coverage to kids. I will vote for this bill when it comes to the House floor next week and I will urge my colleagues to also vote for this bill."

Wilson introduced the Senate bill in the House in July and led an effort with 16 other moderate Republicans this week to encourage House leaders to bring the Senate bill to the floor for a vote.

"This bill is also an incredible victory for seniors," said Wilson, who opposed cutting Medicare Advantage programs as the House Champ bill did. "I heard from more than a thousand seniors in New Mexico who are very happy with their coverage and can breathe a sigh of relief now. We have averted a huge cut for senior health care for now."

Below is an outline of the agreement, which is designed to target specifically the lowest-income uninsured American children for outreach and enrollment.

Investing $35 Billion in New Funding for SCHIP. The agreement reauthorizes the Children's Health Insurance Program, investing an additional $35 billion over five years to strengthen SCHIP's financing, increase health insurance coverage for low-income children, and improve the quality of health care children receive.

Lowering the rate of uninsured low-income children. The agreement will provide health coverage to millions of low-income children who are currently uninsured. The bill also ensures that the 6.6 million children who currently participate in SCHIP continue to receive health coverage. Pending final Congressional Budget Office estimates, the reduction in the number of uninsured children will approach four million children.

Improving Access to Benefits for Children (Dental Coverage/Mental Health Parity/EPSDT). Under the agreement, quality dental coverage will be provided to all children enrolled in SCHIP. The agreement also ensures states will offer mental health services on par with medical and surgical benefits covered under SCHIP, and protects medically necessary benefits (EPSDT) for low-income children.

Prioritizing children's coverage. The agreement makes several modifications as it relates to populations eligible for SCHIP.

· Pregnant Women: The agreement provides coverage to pregnant women as a new state option as well as preserving the options to cover them through a state waiver or through regulation.

· Parents: The agreement prohibits any new waivers to cover parents in the SCHIP program. States that have received waivers to cover low-income parents under SCHIP will be allowed to transition parents into a separate block grant. The federal match for services to parents covered through SCHIP will be reduced.

· Childless Adults: The agreement retains the current law prohibition of waivers to allow coverage of childless adults. Currently covered childless adults will transition off SCHIP. For states that have received SCHIP waivers to cover childless adults, the agreement terminates those waivers after a one-year period, provides temporary Medicaid funding for already-enrolled adults, and allows states to apply for a Medicaid waiver for coverage.

Providing states with incentives to lower the rate of uninsured low income children. Under the financing structure, states will receive state-based allotments that are responsive to state demographic and national spending trends and allow additional up-front funding for states planning improvements. States that face a funding shortfall and meet enrollment goals will receive an adjustment payment to ensure that no child who is eligible for Medicaid or SCHIP is denied coverage or placed on a waiting list. The formula also sets in place new overall caps on federal funding to ensure the program's expenditures do not exceed the amounts authorized. The agreement provides incentives for states to lower the rate uninsured children by enrolling eligible children in SCHIP or Medicaid.

Agreement Replaces CMS August 17th Letter to States. The Congress agrees with the President on the importance of covering low-income children have health coverage while taking steps to address crowd-out and prioritize coverage of lower income children. The agreement replaces the flawed CMS August 17th letter to states with a more thoughtful and appropriate approach. In place of the CMS letter, the agreement gives states time and assistance in developing and implementing best practices to address crowd out. The agreement also puts the lowest income children first in line by phasing in a new requirement for coverage of low-income children as a condition of receiving SCHIP funding for coverage of children above 300 percent of the poverty level.

Improving Outreach Tools to Simplify and Streamline Enrollment of Eligible Children. The agreement provides $100 million in grants for new outreach activities to states, local governments, schools, community-based organizations, safety-net providers and others.

Improving the Quality of Health Care for Low-Income Children. The agreement establishes a new quality child health initiative to develop and implement quality measures and improve state reporting of quality data.

Improving Access to Private Coverage Options. The agreement expands on current premium assistance options for states. The agreement allows states to offer a premium assistance subsidy for qualified, cost-effective employer-sponsored coverage to children eligible for SCHIP and who have access to such coverage. It also changes the federal rules governing employer-sponsored insurance to make it easier for states and employers to offer premium assistance programs.

Legislative language is currently being finalized, and will be available Monday. The House of Representatives will likely vote on legislation implementing this agreement on Tuesday of next week. The Senate will take up the measure shortly thereafter, to deliver a full renewal of the Children's Health Insurance Program to the President for signature into law before SCHIP's current authorization expires on September 30.


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