[Congressional Record Volume 152, Number 119 (Thursday, September 21, 2006)]
[Senate]
[Pages S9901-S9903]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. CANTWELL (for herself, Mrs. Murray, Mr. Bingaman, and Ms. 
        Mikulski):
  S. 3924. A bill to amend title XXI of the Social Security Act to 
allow qualifying States to use all or any portion of their allotments 
under the State Children's Health Insurance Program for certain 
Medicaid expenditures; to the Committee on Finance.
  Ms. CANTWELL. Mr. President, I rise today to introduce the Children's

[[Page S9902]]

Health Protection and Eligibility Act of 2006. I am delighted to have 
Senator Murray, Bingaman, and Mikulski introduce this bill with me 
today.
  As health insurance costs continue to rise and the number of 
employers that offer health coverage to their employees decline, our 
safety net programs are all the more critical, especially for the 
health of our children. It is more important than ever to sustain 
existing health care coverage for our children--and, in fact, to expand 
it. It's the best way to reduce costs and improve access. It's about 
keeping children healthy.
  New Census data released last month showed that the number of 
uninsured has grown from 41.2 million in 2001 to 46.6 million in 2005. 
These are largely working families--the number of fulltime workers 
without any insurance increased to 17.7 percent in 2005 from 16.8 
percent in 2002.
  In Washington, our Medicaid program is currently providing coverage 
for more than 500,000 children. Our State Children's Health Insurance 
Program is providing coverage to another 11,000 children. But 100,000 
of our kids in Washington State remain uninsured even though they are 
eligible for one of the public programs.
  One barrier to expanding kids' access to health care in Washington is 
the funding rules that were put into place when SCHIP was enacted in 
1997. In short, our state has been punished for its early innovation 
for doing the right thing.
  When SCHIP was enacted at the Federal level in 1997, Washington was 
one of only four States already providing health coverage for children 
at the level Federal lawmakers wanted SCHIP to reach. Under the 
original Federal rules, Washington was not allowed to use new funds to 
pay for children who were covered prior to SCHIP's implementation.
  As a result, we have been penalized and prevented from fully using 
our share of the funding. That is why in 2002 I worked to ensure a 
temporary fix to the funding inequity and I have been fighting to make 
this fix permanent ever since. And as a result of these temporary 
fixes, Washington has been able to extend coverage to an additional 
60,000 children and reinvest $47.3 million in children's health safety 
net programs.
  Despite this success, the State has still been forced to return over 
percent of its share of Federal funding. Over the first decade of the 
SCHIP program, Washington is expected to return $191 million in Federal 
funds.
  Let me say that again: we're returning millions of dollars to the 
Federal Government and we still have 100,000 uninsured children in our 
State--the majority of whom are eligible for these public programs.
  It's unacceptable and it runs contrary to the central goal of the 
SCHIP program. We need a permanent solution once and for all so that 
Washington and the other States that expanded eligibility in their 
Medicaid programs before the enactment of SCHIP in 1997 are no longer 
penalized for their early innovation and their commitment to the health 
of children.
  This is why we are introducing the Children's Health Protection and 
Eligibility Act of 2006.
  This legislation will give states the ability to use SCHIP funds more 
efficiently to prevent the loss of health care coverage for children. 
States that have made a commitment to insuring children could use their 
entire SCHIP funds allotment to maintain access to health care coverage 
for all low-income children in the state. The bill also ensures that 
all of the qualifying States that have demonstrated a commitment to 
providing health care coverage to children can access SCHIP funds in 
the same manner to support children's health care coverage. Finally, 
this bill allows States that have expanded coverage to the highest 
eligibility levels allowed under SCHIP, and meet certain requirements, 
to receive the enhanced SCHIP match rate for any kids that had 
previously been covered above the mandatory level.
  The requirements are best practices that have been tested and proven 
all across our Nation: a simplified application process, twelve-month 
continuous eligibility and easy access to enrollment staff are just a 
few of the examples of actions that we have taken in Washington that 
are proven to work. They result in more children having coverage and 
accessing appropriate care. Many of our States are working to make the 
program easier for children and families to navigate and now Congress 
needs to make it easier for all States to access their SCHIP allotment 
in order to expand and improve coverage to our youngest citizens.
  Children are the leaders of tomorrow; they are the very future of our 
great Nation. We owe them nothing less than the sum of our energies, 
our talents, and our efforts in providing them a foundation on which to 
build happy, healthy and productive lives. With the rising number of 
uninsured and the ever-increasing healthcare costs, it is more 
important than ever to maintain existing health care coverage for 
children in order to hold down health care costs and to keep children 
healthy. Removing barriers for innovative states and allowing them to 
fully access their SCHIP allocation is a major step in achieving this 
goal. I urge my colleagues to join us in support of this bill and ask 
unanimous consent that the text of the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3924

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. AUTHORITY FOR QUALIFYING STATES TO USE ALL OR ANY 
                   PORTION OF THEIR SCHIP ALLOTMENTS FOR CERTAIN 
                   MEDICAID EXPENDITURES.

       (a) In General.--Section 2105(g)(1)(A) of the Social 
     Security Act (42 U.S.C. 1397ee(g)(1)(A)) is amended by 
     striking ``not more than 20 percent of any allotment under 
     section 2104 for fiscal year 1998, 1999, 2000, 2001, 2004, or 
     2005'' and inserting ``all or any portion of any allotment 
     made to the State under section 2104 for a fiscal year''.
       (b) Additional Requirements.--Section 2105(g)(2) of such 
     Act (42 U.S.C. 1397ee(g)(2)) is amended--
       (1) by striking ``a State, that, on'' and inserting ``a 
     State that is described in subparagraph (A) and satisfies all 
     of the requirements of subparagraph (B).
       ``(A) State described.--A State described in this 
     subparagraph is a State that, on''; and
       (2) by adding at the end the following:
       ``(B) Requirements.--The requirements of this subparagraph 
     are the following:
       ``(i) No reduction in medicaid or schip income 
     eligibility.--Since January 1, 2001, the State has not 
     reduced the income, assets, or resource requirements for 
     eligibility for medical assistance under title XIX or for 
     child health assistance under this title.
       ``(ii) No waiting list imposed.--The State does not impose 
     any numerical limitation, waiting list, or similar limitation 
     on the eligibility of children for medical assistance under 
     title XIX or child health assistance under this title and 
     does not limit the acceptance of applications for such 
     assistance.
       ``(iii) Provides assistance to all children who apply and 
     qualify.--The State provides medical assistance under title 
     XIX or child health assistance under this title to all 
     children in the State who apply for and meet the eligibility 
     standards for such assistance.
       ``(iv) Protection against inability to pay premiums or 
     copayments.--The State ensures that no child loses coverage 
     under title XIX or this title, or is denied needed care, as a 
     result of the child's parents' inability to pay any premiums 
     or cost-sharing required under such title.
       ``(v) Additional requirements.--The State has implemented 
     at least 3 of the following policies and procedures (relating 
     to coverage of children under title XIX and this title):

       ``(I) Simplified application form.--With respect to 
     children who are eligible for medical assistance under title 
     XIX, the State uses the same simplified application form 
     (including, if applicable, permitting application other than 
     in person) for purposes of establishing eligibility for 
     assistance under title XIX and this title.
       ``(II) Elimination of asset test.--The State does not apply 
     any asset test for eligibility under title XIX or this title 
     with respect to children.
       ``(III) Adoption of 12-month continuous enrollment.--The 
     State provides that eligibility shall not be regularly 
     redetermined more often than once every year under this title 
     or for children eligible for medical assistance under title 
     XIX.
       ``(IV) Same verification and redetermination policies; 
     automatic reassessment of eligibility.--With respect to 
     children who are eligible for medical assistance under 
     section 1902(a)(10)(A), the State provides for initial 
     eligibility determinations and redeterminations of 
     eligibility using the same verification policies (including 
     with respect to face-to-face interviews), forms, and 
     frequency as the State uses for such purposes under this 
     title, and, as part of such redeterminations, provides for 
     the automatic reassessment of the eligibility of such 
     children for assistance under title XIX and this title.

[[Page S9903]]

       ``(V) Outstationing enrollment staff.--The State provides 
     for the receipt and initial processing of applications for 
     benefits under this title and for children under title XIX at 
     facilities defined as disproportionate share hospitals under 
     section 1923(a)(1)(A) and Federally-qualified health centers 
     described in section 1905(l)(2)(B) consistent with section 
     1902(a)(55).''.

       (c) Effective Date.--The amendments made by this section 
     shall take effect on October 1, 2006, and shall apply to 
     expenditures described in section 2105(g)(1)(B)(ii) of the 
     Social Security Act (42 U.S.C. 1397ee(g)(1)(B)(ii)) that are 
     made after that date.
                                 ______