[Congressional Record Volume 153, Number 18 (Tuesday, January 30, 2007)]
[Senate]
[Pages S1344-S1345]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself, Mr. Domenici, Mr. Reed, Ms. 
        Cantwell, Mr. Lieberman, Mr. Leahy, Mr. Coleman, and Mr. 
        Inouye):
  S. 434. A bill to amend title XXI of the Social Security Act to 
permit qualifying States to use a portion of their allotments under the 
State children's health insurance program for any fiscal year for 
certain Medicaid expenditures; to the Committee on Finance.
   Mr. BINGAMAN. Mr. President, since the passage of the Children's 
Health Insurance Program, or CHIP, in 1997, a group of States that 
expanded coverage to children in Medicaid prior to the enactment of 
CHIP has been unfairly penalized for that expansion. States are not 
allowed to use the enhanced matching rate available to other States for 
children at similar levels of poverty under the act. As a result, a 
child in the States of New York, Florida, and Pennsylvania, because 
they were grandfathered in the original act or in Iowa, Montana, or a 
number of other States at 134 percent of poverty is eligible for an 
enhanced matching rate in CHIP but that has not been the case for 
States such as New Mexico, Vermont, Washington, Rhode Island, Hawaii, 
and a number of others, including Connecticut, Tennessee, Minnesota, 
New Hampshire, Wisconsin, and Maryland.
  As the health policy statement by the National Governors' Association 
reads, ``The Governors believe that it is critical that innovative 
states not be penalized for having expanded coverage to children before 
the enactment of S-CHIP, which provides enhanced funding to meet these 
goals. To this end, the Governors support providing additional funding 
flexibility to states that had already significantly expanded coverage 
of the majority of uninsured children in their states.''
  For 6 years, our group of States have sought to have this inequity 
addressed. Early in 2003, I introduced the ``Children's Health Equity 
of 2003'' with Senators Jeffords, Murray, Leahy, and Ms. Cantwell and 
we worked successfully to get a compromise worked out for inclusion in 
S. 312 by Senators Rockefeller, and Chafee. This compromise extended 
expiring CHIP allotments only for fiscal years 1998 through 2001 in 
order to meet budgetary caps.
  The compromise allowed States to be able to use up to 20 percent of 
our State's CHIP allotments to pay for Medicaid eligible children about 
150 percent of poverty that were part of our State's expansions 
prior,to the enactment of CHIP. That language was maintained in 
conference and included in H.R. 2854 that was signed by the President 
as Public Law 108-74. Unfortunately, a slight change was made in the 
conference language that excluded New Mexico and Hawaii, Maryland, and 
Rhode Island needed specific changes so an additional bill was passed, 
H.R. 3288, and signed into law as Public Law 108-107, on November 17, 
2003. This second bill included language from legislation that I 
introduced with Senator Domenici, S. 1547, to address the problem 
caused to New Mexico by the conference committee's change. 
Unfortunately, one major problem with the compromise was that it must 
be periodically reauthorized. Most recently, this authority was renewed 
through Fiscal Year 2007 in Section 201(b) of the National Institutes 
of Health Reform Act of 2006, Pub. L. No 109-482. Without future 
authority, the inequity would continue with CHIP allotments.
  This legislation would address that problem and ensure that all 
future allotments give these 11 States the flexibility to use up to 20 
percent of our CHIP allotments to pay for health care services of 
children. In order to bring these requirements in-line with those of 
other states, it also would lower the threshold at which New Mexico and 
other effected states could utilize the funds from 150 percent of the 
Federal poverty level to 125 percent.
  This rather technical issue has real and negative consequences in 
States such as New Mexico. In fact, due to the CHIP inequity, New 
Mexico has been allocated $266 million from CHIP between fiscal years 
1998 and 2002, and yet, has only been able to spend slightly over $26 
million as of the end of last fiscal year. In other words, New Mexico 
has been allowed to spend less than 10 percent of its federal CHIP 
allocations.
  This legislation would correct this problem.
  The bill does not take money from other States's CHIP allotments. It 
simply allows our States to spend our States' specific CHIP allotments 
from the Federal Government on our uninsured children--just as other 
States across the country are doing.
  I 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. 434

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Children's Health Equity 
     Technical Amendments Act of 2007''.

     SEC. 2. AUTHORITY FOR QUALIFYING STATES TO USE PORTION OF 
                   SCHIP ALLOTMENT FOR ANY FISCAL YEAR FOR CERTAIN 
                   MEDICAID EXPENDITURES.

       (a) In General.--Section 2105(g)(1)(A) of the Social 
     Security Act (42 U.S.C.

[[Page S1345]]

     1397ee(g)(1)(A)), as amended by section 201(b) of the 
     National Institutes of Health Reform Act of 2006 (Public Law 
     109-482) is amended by striking ``fiscal year 1998, 1999, 
     2000, 2001, 2004, 2005, 2006, or 2007'' and inserting ``a 
     fiscal year''.
       (b) Modification of Allowable Expenditures.--Section 
     2105(g)(1)(B)(ii) of such Act (42 U.S.C. 1397ee(g)(1)(B)(ii)) 
     is amended by striking ``150'' and inserting ``125''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on October 1, 2007, and shall apply to 
     expenditures made on or after that date.
                                 ______