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228 IRET Congressional Advisory 1 (2007)

handle is hein.taxfoundation/iretcgadv0225 and id is 1 raw text is: INSTITUTE FOR RESEARCH ON THE ECONOMICS OF TAXATION
IRET is a non-profit 501 (c)(3) economic policy research and educational organization devoted to informing
the public about policies that will promote growth and efficient operation of the market economy.

September 28, 2007

Advisory No. 228

SCRIP PASSES CONGRESS, FACES VETO

The Senate has joined the House in passing a
significant expansion of the State Children's Health
Insurance Program (SCHIP). It would more than
double the size of the program, expanding it by $35
billion over five years (from $25 billion to $60
billion), and would extend eligibility to children of
middle income families (up to 300% of poverty, or
nearly $62,000 for a family of four), most of whom
already have insurance. (The limits could be higher
in some states.) To hold the five-year estimate to
$35 billion, it ridiculously assumes that spending on
the program will drop by about 75% in 2012, forcing
all the new entrants and most of those covered by the
original program off the rolls.
President Bush is expected to veto the bill. He
had proposed a 20% increase in SCHIP, from $20
billion to $25 billion, over five years. His request
for extra funding did not rely on budget gimmicks.
The Bush request was enough to fully fund a renewal
of the SCHIP program at a level that would fully
cover health cost inflation and the rising number of
children  in the  originally  qualifying  income
categories (families with income up to 200% of
poverty).
The House-Senate conference agreement scaled
back some controversial features in the House's
earlier version. It had wanted a $50 billion increase
in funding (higher than the Senate's $35 billion
raise), and had proposed to pay for the additional $15
billion mainly by cutting Medicare Advantage
funding for private policies favored by many retirees.
These provisions were dropped.

The main funding mechanism in the final bill is
a nasty, regressive tobacco tax hike that would hurt
low income families, including families currently
receiving SCHIP assistance.  It would raise the
federal cigarette tax by $0.61 per pack hike (from
$0.39 to $1), and impose similar or higher tax hikes
on other tobacco products. Low income individuals
are far more likely to be smokers than middle and
high income individuals, and for those who do
smoke, people with lower incomes spend a higher
percentage of their incomes on cigarettes and the
associated tax than do people with higher incomes.
Who would lose and who would win? Low
income families already covered by SCHIP would
either gain nothing or lose. They would have the
same real health benefits as now, but would face a
stiff hike in their tobacco taxes (if they are smokers)
to pay for covering the new higher income enrollees.
The tax would offset about a third of what the
poorest families now receive from having a child in
the program. Middle income families who do not
smoke would get the full benefit of the expansion.
The bill is still too focused on extending a
federal subsidy to families that can pay for insurance
and who mostly have insurance already, dragging
millions of participants into the federal subsidy
program for no good reason. The bill deserves a
veto.
For further discussion of the original bills, see
IRET Congressional Advisories 221 and 226.
Stephen J. Entin
President and Executive Director

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