President Obama on Wednesday signed a State Children's Health Insurance Program renewal and expansion bill (H.R. 2) that includes a provision to allow legal immigrant pregnant women and children who have been in the country less than five years to receive health benefits through SCHIP and Medicaid, the New York Times reports. The House voted 290-135 on Wednesday to give the bill final approval, with 40 Republicans voting in favor of the bill and two Democrats voting against it. According to the Times, the legal immigrant provision marks a "major change" that will enable states to extend coverage to legal immigrant pregnant women and young people up to age 21 without the current five-year waiting period. In addition, the bill requires states to verify that beneficiaries are U.S. citizens or legal residents. States will be able to verify eligibility by matching an individual's name and Social Security number against federal records, rather than requiring applicants to provide documentation proving citizenship. The bill was approved last week by the Senate by a vote of 66 to 32, with support from nine of the 41 Republicans.

SCHIP is designed to provide insurance to children in families with incomes too high to qualify for Medicaid but too low to afford private health insurance. The passage of the bill marked the end of a two-year battle over the measure, which former President George W. Bush had said would lead to "government-run health care for every American" (Pear, New York Times, 2/5). SCHIP was set to expire March 31 (Pulizzi/Johnson, Wall Street Journal, 2/4). The bill will allow states to provide coverage to more than four million uninsured children by 2013, in addition to the seven million children already enrolled. Funding for the expansion, which is estimated at more than $32 billion during the next four-and-a-half years, will be partially offset through an increase in tobacco taxes (New York Times, 2/5).

At the signing ceremony, Obama said the bill is "just one component of a much broader effort to finally bring our health care system into the 21st century." He also said, "In a decent society, there are certain obligations that are not subject to tradeoffs or negotiation, and health care for our children is one of those obligations." Obama said that SCHIP is a "lifeline" for children whose parents do not qualify for Medicaid and cannot afford private insurance and that he "refuse[s] to accept that millions of our children fail to reach their full potential because we fail to meet their basic needs" (Wall Street Journal, 2/4).

Rep. Henry Waxman (D-Calif.), chair of the Energy and Commerce Committee, said, "While this bill is short of our ultimate goal of health reform, it is a down payment and is an essential start." House Speaker Nancy Pelosi (D-Calif.) said the bill's approval is the "beginning of the change that the American people voted for in the last election, and that we will achieve" under the Obama administration. However, most Republicans voiced concerns over the cost of the expansion, the Times reports. Rep. Steve King (R-Iowa) said the bill is "a foundation stone for socialized medicine," while Rep. Tom McClintock (R-Calif.) said the program is "slowly replacing employer health plans with government-paid health plans, with spiraling costs to taxpayers." According to the AP/Chicago Sun-Times, Republicans argue that an estimated 2.4 million children who would otherwise have access to private insurance will join SCHIP instead (AP/Chicago Sun-Times, 2/5).

NPR Coverage

NPR's "All Things Considered" on Wednesday reported on the signing of the bill, including the provision on legal immigrants. The segment includes comments from Reps. Phil Gingrey (R-Ga.), Diana DeGette (D-Colo.) and Steve King (R-Iowa) (Rovner, "All Things Considered," NPR, 2/4).

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