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Wilson disagrees with Bush, counters Dems on SCHIP

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Location: Washington, DC

Wilson disagrees with Bush, counters Dems on SCHIP

By James W. Brosnan

In contrast to President Bush and many of her Republican colleagues, Rep. Heather Wilson says she wants to expand a federally funded children's health insurance program that helps about 19,000 New Mexico kids.

But she doesn't want to do it the way House Democrats are proposing, either.

Wilson, an Albuquerque Republican, announced on July 26 she would not support the bill in the House Energy and Commerce Committee for a $50 billion expansion for the State Children's Health Insurance Program over the next five years.

Wilson said she opposes the bill because it finances the increase in part by cutting reimbursement rates for insurance companies that offer Medicare HMO plans.

"This is a devil's choice. We shouldn't have to choose between health coverage for seniors or children," she said.

Wilson said 39 percent of Medicare recipients in her district, about 35,000 people, are enrolled in the Medicare Advantage HMO-type plans - such as Presbyterian Senior Care, Lovelace Senior Plan, Blue Medicare PPO from BlueCross BlueShield, and the Humana Gold Choice plans - that would be affected by cuts in the Democrats' bill.

"These programs will be forced to drop seniors from coverage or will have to pull out of the Medicare market altogether," Wilson said. "They may have to reduce benefits or pay providers less, causing seniors to lose access to the doctors they have now."

Energy and Commerce Committee Chairman John Dingell, a Michigan Democrat, defended the cuts in reimbursement to the Medicare HMOs.

"This year, seniors in traditional Medicare will pay nearly three-quarters of a billion dollars in excess premiums to finance overpayments to HMOs. Those overpayments, if they are not stopped, will accelerate the insolvency of the Medicare trust fund by two years," Dingell said.

More than 6 million children nationwide are covered with health insurance because of State Children's Health Insurance Program, but an estimated 5 million to 6 million children remain uninsured, according to the Congressional Budget Office.

In February, Wilson co-authored a letter to the House Budget Committee urging them to allocate enough funds to continue and expand the program. The letter was signed by 29 Republicans and 47 Democrats.

She noted in the February letter that the program helps New Mexico serve 19,000 children through New MexiKids.

"It's an important program that keeps kids healthy, and we need to support it," she said at the time.

Wilson hinted on July 26 that she could have supported the Democrats' bill if it had followed the bipartisan approach of the Senate Finance Committee, which approved a bill to finance a $35 billion expansion of the program without cutting Medicare. That bill, which was supported by six out of 10 Republican senators on the committee, raises federal cigarette taxes from 39 cents a pack to $1 a pack. The House Democrats' bill provides for a smaller increase, to 84 cents a pack.

Bush opposes both the tobacco tax hike and expansion of the State Children's Health Insurance Program.

"If Congress continues to insist upon expanding health care through the SCHIP program - which, by the way, would entail a huge tax increase for the American people - I'll veto the bill," he told reporters earlier this month.

Sen. Jeff Bingaman, a Silver City Democrat who helped to craft the Senate bill, responded: "My answer is that any parents who are willing and able to pay for private insurance should be encouraged to do so, but we should not go to the extreme of denying their children their health care. Four million additional children will be covered if we approve this bill."

Bush's concerns were echoed by several Republicans on the House Energy and Commerce Committee as it began deliberations on the bill on July 26.

"It's part of the 'grand design for government-run health care,' " said Rep. Steve Buyer, an Indiana Republican.

Rep. Hilda Solas, a California Democrat, countered: "For those who accuse us of wanting the government to provide affordable health care, right here and now, I plead guilty."

Wilson said she could support many parts of the bill to expand the program, including requiring states to provide the same level of treatment and reimbursement for mental health treatment as with physical ailments.

"The bill in front of us today is a missed opportunity. Instead, we will have a bloody fight over a bill that overreaches," she said.

New Mexico Medicaid officials are closely watching the outcome.

The program's authorization will expire Sept. 30 without congressional action. New Mexico officials need to know how much funding they can expect under the program when the governor submits his budget to the Legislature in January. The funding would be an integral part of any plan to expand health care in the state. The worst outcome would be a stalemate in Washington, they say.

"That would be disappointing to New Mexico and to all the states," said Carolyn Ingram, director of the state Medical Assistance Division. "It kind of leaves in limbo what we would do next as a state."

The legislation also is expected to change the way SCHIP funds are used in New Mexico. When the federal program was created a decade ago, the state was already covering children up to 200 percent of the federal poverty level. So New Mexico was allowed to use the funds to cover parents and childless adults. Fourteen other states have similar waivers.

Now Congress wants to make sure the funds are being used only for families.

Bingaman included provisions in the Senate bill to ensure that New Mexico can continue covering adults through 2010. After that, the childless adults could be covered under Medicaid and the state could use SCHIP funds for parents who qualify and pregnant women.

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