The State Children’s Health Insurance Program (SCHIP) was originated in the 1990’s to help states provide health insurance to lower income families with children. The program was designed to cover uninsured children in families with incomes that are modest, but too high to qualify for Medicaid.  Studies had shown that the number of uninsured children had risen even after SCHIP was enacted. This legislation was designed to expand the program to cover far more children and pregnant women, including legal immigrants without a waiting period. Previous legislative attempts to expand funding for the program had passed, but they did not become law because former President Bush vetoed them. President Obama had promised to sign the legislation if it passed.

The House leadership had made the expansion of SCHIP a major priority. The House passed a bill in January of 2009 that modified the rules of the program to allow an estimated 4.1 million additional children to be covered. It also would allow legal aliens to participate without a waiting period. Rep. Waxman (D-CA), who chairs the House Energy and Commerce Committee which drafted the previously-passed House bill, described it as being “. . . short of our ultimate goal of health reform”, but he called it “an essential start”. He also noted that the $33 billion in additional federal spending to cover the program expansion would be paid for over five years by a 62 cent increase in the federal cigarette tax imposed by the bill.

The bill passed in January was sent on to the Senate, which made some changes in it and returned it to the House. Rep. Waxman described the Senate bill as “very similar” to the one the House had passed. This vote was to decide whether the House should accept the Senate version of the previously passed bill. If accepted, the measure would then be sent to President Obama for his signature.

While there was some opposition from House Republicans to this bill to increase coverage, it was not universal. Rep. Sessions (R-TX), represented the Republican opposition when he argued that the program changes in the measure will greatly increase federal spending in a way that will generate “terrible financial circumstance for the future”.  Sessions also claimed that the majority of the additional 4.1 million children that would  be covered  as a result of the bill were already being covered by private health insurance plans, and that the bill would enable illegal aliens to enroll fraudulently in SCHIP and in Medicaid.

The vote on the legislation was 290 ayes to135 nays. Two hundred and fifty Democrats and forty Republicans voted “aye”. One hundred and thirty-three Republicans and two Democrats voted “nay”. As a result, the bill passed and was sent to the President. With his signature, the changes in SCHIP became law.