This vote was on an amendment by Tom Coburn, R-Okla., that would have required states to pay subsidies to private health insurers if they want to expand State Children’s Health Insurance Program (SCHIP) coverage above certain income levels.  Health plans purchased in the private market would have to have similar benefits to those under SCHIP.  The amendment also would institute a six-month waiting period between the time a child has private insurance and when the child enrolls in a premium assistance subsidy.  The amendment was offered to a bill that expands and reauthorizes SCHIP, which offers health insurance for children of families who are too poor to purchase private health insurance, but not poor enough to qualify for Medicaid.

Coburn said if states want to cover children from families earning more than 200 percent of the poverty level, they should simply provide them a subsidy to help defray the costs of a private health insurance plan, rather than enrolling them in SCHIP, which was designed to benefit the very poorest families.

“To say this is privatization is a total mischaracterization of it.  Not only do we increase access and quality, we save tremendous amounts of money, and it will still be a government-run program because it will be administered by the Secretary in a way that guarantees these kids are auto-enrolled. They will have premium health insurance coverage and we still save money, even after that,” Coburn said.  “To characterize this as getting rid of coverage is wrong. What it does is greatly create and increase access for children in this country to have the same access that our children have. It saves money and markedly improves quality for those children. Every American child ought to have access, and what we do is take the money we are spending now and spend it more wisely, and create a system where they all have coverage.”

Baucus said Coburn’s amendment goes far beyond simply providing a subsidy.

“It says, in addition to that, when you have to buy private health insurance, with premium assistance, you have to wait 6 months. You cannot get it right away. You have to wait 6 months. So there is going to be a period, 6 months, where kids will have no health insurance. Not only are they not covered under the Children’s Health Insurance Program, but they cannot get health insurance,” Baucus said.  “What if somebody gets sick during that 6-month period? They cannot get insurance in the public program. They cannot get private health insurance. They have to wait. Tell me what sense that makes. I cannot understand how that makes any sense at all. The first requirement makes no sense to me. It is wrong, in my view. The second adds insult to injury.”

By a vote of 36-62, the amendment was rejected.  All but five Republicans present voted for the amendment.  Every Democrat present voted against the amendment.  The end result is that the measure went forward without language that would have required states wanting to cover under SCHIP families earning more than 300 percent of the poverty level to instead pay a subsidy for private health care for them.