[Congressional Record (Bound Edition), Volume 150 (2004), Part 9]
[Senate]
[Page 11960]
[From the U.S. Government Publishing Office, www.gpo.gov]




                      SCHIP EXPANSION ACT SUPPORT

  Mr. GRAHAM of Florida. Mr. President, I ask unanimous consent that 
the following letters related to the May 13 introduction of the SCHIP 
Expansion Act, S. 2420, be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                           National Association of


                                         Children's Hospitals,

                                                     June 4, 2004.
     Hon. Bob Graham,
     U.S. Senate,
     Washington, DC.
       Dear Senator Graham: On behalf of the National Association 
     of Children's Hospitals and our more than 120 member 
     hospitals from across the country, I would like to express 
     our strong support for your bill, S. 2420, ``the SCHIP 
     Expansion Act of 2004.'' Your legislation takes important 
     steps to ensure broader access to health coverage for 
     children, which in turn will improve the overall state of our 
     nation's health.
       Since 1997, State have made remarkable progress in their 
     effort to insure low-income children under SCHIP. As of June 
     2003, SCHIP provided health coverage for 3.9 million 
     children. Over the year from June 2002 to June 2003, 
     enrollment of children in the State Children's Health 
     Insurance Program (SCHIP) increased by roughly 264,000, an 
     increase of 7.3 percent.
       But for all that the SCHIP program has accomplished, still 
     more needs to be done. More than 6 million children in the 
     United States remain uninsured. We could reduce the number of 
     uninsured children by more than two-thirds--thereby insuring 
     almost all children--if all children eligible for Medicaid 
     and SCHIP were simply enrolled. By eliminating the upper 
     income eligibility limit in SCHIP, your bill would pave the 
     way to removing children from the ranks of the uninsured.
       As providers of care to all children, regardless of their 
     economic status, children's hospitals have extensive 
     experience in assisting families to enroll eligible children 
     in Medicaid and SCHIP. They are keenly aware of the 
     importance of addressing the challenges that states face in 
     enrolling this often hard to reach population of eligible 
     children. We strongly support your efforts to reward States 
     that streamline the SCHIP enrollment and renewal process by 
     providing them with a five percentage point increase in the 
     SCHIP matching rate for specified outreach activities, 
     particularly presumptive and 12-month continuous eligibility.
       The Nation's children's hospitals are grateful for your 
     leadership in attempting to provide States with the needed 
     funding and flexibility to expand health coverage to our 
     country's uninsured children. We look forward to working with 
     you to advance this important legislation and once and for 
     all ensure that all children have access to the quality 
     health services they need and deserve.
           Sincerely,
                                            Lawrence A. McAndrews,
     President & Chief Executive Officer.
                                  ____



                               American Academy of Pediatrics,

                                     Washington, DC, June 8, 2004.
     Hon. Bob Graham,
     U.S. Senate,
     Washington, DC.
       Dear Senator Graham: I write today on behalf of the 57,000 
     members of the American Academy of Pediatrics to express our 
     support for the SCHIP Expansion Act of 2004 (S. 2420).
       As you know, the State Children's Health Insurance Program 
     (SCHIP) provides health insurance to over 6 million low-
     income children whose family income is not low enough to 
     qualify for Medicaid but are unable to afford health 
     insurance in the private market. SCHIP and the Medicaid 
     program are a critical child health safety net that currently 
     provides health insurance to over 17 million low-income 
     children. Furthermore, eligibility of these programs covers 
     almost two-thirds of the more than 9 million uninsured 
     children in this country; however, these 6.7 million children 
     remain uninsured because of insufficient enrollment and 
     outreach efforts to enroll these eligible children. Your 
     legislation is an important step towards strengthening and 
     sustaining SCHIP, an important part of the child health 
     safety net.
       In particular, this legislation would provide necessary 
     additional funds to fix the SCHIP funding ``dip'' and allow 
     states to maintain current coverage in the program. As you 
     know, when SCHIP was enacted it was funded at lower levels in 
     the later years of the program in order to meet budget 
     requirements. This ``dip'' in program funding is coming at a 
     time when states are in need of funds. Estimates suggest that 
     17 states will experience a federal funding shortfall by 
     FY07. S. 2420 provides necessary funds to allow states to 
     maintain current coverage in SCHIP. This legislation also 
     provides an incentive to the states to improve outreach and 
     enrollment efforts in both Medicaid and SCHIP in order to 
     enroll the nearly 7 million children who are eligible for 
     Medicaid or SCHIP but unenrolled. In addition, this 
     legislation addresses another important barrier to enrolling 
     SCHIP eligible children by prohibiting states from capping 
     their SCHIP programs without first exhausting all available 
     federal funding. Although this provision is a step in the 
     right direction, the American Academy of Pediatrics believes 
     that any cap on health care funding for public program 
     coverage is detrimental to ensuring that all uninsured, 
     eligible children and families are able to enroll.
       The American Academy of Pediatrics believes that all 
     children, regardless of income, should have access to 
     affordable health insurance such that their families can 
     afford health care services necessary for healthy 
     development. We therefore commend your efforts to strengthen 
     the SCHIP program and give states the option to expand this 
     program to reach more children in their state whose families 
     are unable to afford health insurance in the private market. 
     We encourage states to maintain efforts mandated in the SCHIP 
     statute to minimize crowd-out of the private market as they 
     consider such expansions of SCHIP coverage. Because in most 
     states Medicaid and SCHIP currently pay physicians who care 
     for children at inadequate rates, maintaining the private 
     market is necessary to allow physicians to subsidize care for 
     these children. The Academy urges Congress to consider the 
     impact of inadequate payment rates for services under 
     Medicaid and SCHIP on access to necessary services for 
     beneficiaries in these programs.
       The American Academy of Pediatrics is committed to 
     protecting Medicaid and SCHIP. We look forward to working 
     with you on this and other legislative efforts to protect, 
     sustain, and strengthen these critical child health safety 
     net programs.
           Sincerely,
                                                  Carden Johnston,
     President.

                          ____________________