Children's Health Insurance Program Reauthorization Act of 2009



Details

 * Provides $32.8 billion in funding through September 30, 2013.
 * Estimated to expand coverage to 4.1 million additional children.
 * Allows states to cover legal immigrant children and pregnant women who have been in the United States for less than five years. Previously, legal immigrants were required to wait five years after arrival before enrolling in the program.
 * Modifies the eligibility verification process to allow states to use Social Security numbers in order to verify that applicants are citizens or legal residents.
 * Requires states to provide dental coverage under the program and allows states to offer dental coverage to children who have private health insurance that does not cover dental care.
 * Limits the federal government's share of funding for children in families with incomes exceeding 300 percent of the poverty line.
 * Increases federal tobacco excise taxes, including a 62-cent-per-pack increase in the cigarette tax, bringing the total tax up to $1.01 per pack.

House
The measure, sponsored by Rep. Frank Pallone (D-N.J.) and 43 Co-Sponsors, passed the House without amendment by a vote of 289-139 on January 14, 2009.



Senate
The Senate passed an amended version of the bill by a vote of 66-32 on January 29, 2009.



Amendments
Before passing the bill, the Senate adopted an amendment from Jeff Bingaman (D-N.M.) making it easier for states to enroll eligible children in SCHIP who are already enrolled in other federal programs such as food stamps or the National School Lunch Program. This amendment was agreed to by a vote of 55-43.



The Senate also considered and rejected a number of amendments that would have limited the expansion of the program outlined in the original bill. These included:


 * An amendment by Jim DeMint (R-S.C.] which would have required states to charge families with incomes over two hundred percent of the poverty line a fee in order to participate in the program. This amendment was defeated by a vote of 60-37.




 * An amendment in the form of a substitute by Mitch McConnell (R-Ky.) which would have increased the amount of aid states are allowed to provide to families for the purpose of purchasing private insurance, limited federal funding for states that cover more than just women and children under the program, and which would have excluded legal immigrants from receiving coverage. McConnell's plan would have covered an estimated 2 million children in addition to those already covered and would have been funded primarily through reductions in federal government spending on Medicaid rather than through tax increases. This amendment was defeated by a vote of 65-32.




 * An amendment by Orrin Hatch (R-Utah) that would have allowed states to cover legal immigrants only after covering 95 percent of children currently eligible for the program. This amendment was defeated by a voice vote.


 * An amendment by Pat Roberts (R-Kan) that would prohibit states from receiving federal SCHIP funds to cover families making more than either $65,000 in income or the median state income, whichever amount is lower. This amendment was defeated by a vote of 60-36.



Second House vote
On February 4, 2009, the House agreed to the bill as passed by the Senate by a vote of 290-135 and President Obama signed it into law that same day.



Support and opposition
Supporters argued that the expansion of SCHIP was necessary because increasing numbers of Americans have lost employer-sponsored health insurance in recent years. They also saw it as part of a larger effort to reform the health care system. At the signing ceremony, President Obama referred to the expansion as "a down payment on my commitment to cover every single American."

Opponents argued that the expansion was too broad and should have placed lower income limits on eligibility for the program. Republicans expressed concern that those with private health insurance would leave their current plans for government-sponsored ones. They also worried that the new identity verification rules would make it more difficult to prevent illegal immigrants from entering the program.

Particular controversy surrounded the provision allowing states to offer coverage to recently arrived legal immigrants. Opponents sought to maintain the existing rule requiring immigrants to wait for five years before enrolling in the program. Arguing in favor of the new rule, Sen. Richard Durbin (D-Ill.) stated that "it is likely many of these children are already U.S. citizens and many will become U.S citizens."