News & Policies >
For Immediate Release
Office of the Press Secretary
October 6, 2007
Just the Facts: The $83,000 Question
QUESTION: Does Congress' SCHIP bill really allow the program to cover children in some families earning up to $83,000 a year?
ANSWER: YES. The vetoed bill grandfathers in New York at a higher SCHIP match rate than the rest of the country allowing SCHIP to cover children in some households with incomes of up to $83,000 per year (400 percent of the Federal poverty level). It also overturns the standards that would allow the Health and Human Services Secretary to disapprove State plans to cover children in higher income families.
Section 114(a) of the vetoed bill would add a new section to the Social Security Act that states: "(B) - Exception - Subparagraph (A) [the limitation of the matching rate to the Medicaid rate for children whose effective income exceeds 300 percent of the Federal poverty level] shall not apply to any State that, on the date of enactment of the Children's Health Insurance Program Reauthorization Act of 2007, has an approved State Plan Amendment or waiver to provide, or has enacted a State law to submit a State plan amendment to provide, expenditures described in such subparagraph under the State child health plan."
New York enacted a state law to submit a "State plan amendment." While that amendment was disapproved, the language of the Senate bill would still allow New York to claim the enhanced match.
New York State is filing a lawsuit challenging the Administration's disapproval of its request to allow SCHIP to cover children in some families making as much as $83,000 per year. "Gov. Eliot Spitzer said yesterday that New York , joined by six other states, would file suit against the Bush administration, challenging stricter eligibility rules for the government health insurance program that covers poor children. In their legal challenges, the eight states contend that the new eligibility rules, which went into effect in August and limit coverage to children living at or below 250 percent of the poverty level, will either force out children in the program or leave tens of thousands without coverage who would be eligible. Three weeks ago the federal health officials denied a request by New York to insure more children by covering those in families with incomes up to 400 percent of the poverty rate, or $82,600 for a family of four." (Sarah Kershaw, "8 States Plan To Press Bush On Health Bill," The New York Times , 10/2/07 )
Section 116 (g) of the vetoed bill overturns the Administration's August 17 guidance to State Medicaid Directors. The result of that provision, if it became law, would be to require the Administration to approve a new state plan amendment filed by New York to go to 400 percent of the Federal poverty level.
The section states: "(g) EFFECTIVE DATE OF AMENDMENTS; CONSISTENCY OF POLICIES. The amendments made by this section shall take effect as if enacted on August 16, 2007 . The Secretary may not impose (or continue in effect) any requirement, prevent the implementation of any provision, or condition the approval of any provision under any State child health plan, State plan amendment, or waiver request on the basis of any policy or interpretation relating to CHIP crowd-out or medical support order other than under the amendments made by this section."
The vetoed SCHIP bill also grandfathers in New Jersey 's program at 350 percent of the Federal poverty level, which includes children in families with incomes of $72,000 a year. "Corzine added that the state, which covers about 122,000 kids in its program, known as FamilyCare, 'will continue to provide health care to children in families with income up to 350 percent' of the federal poverty level or $72,275 for a family of four. He also wrote that he is prepared to file a lawsuit challenging the new rules." (Christopher Lee, "N.J.'s Corzine To Defy New Health-Care Rules," The Washington Post , 9/14/07 )
The same section of the bill that allows New York to cover children in families with income of nearly $83,000 per year permits New Jersey to cover children in families with incomes of $72,000 per year. The bill protects States that have "an approved State Plan Amendment or waiver to provide" health insurance coverage up to 350 percent of the Federal poverty level.
Read the full text of the vetoed SCHIP legislation at: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_bills&docid=f:h976eah.txt.pdf
# # #