Senate Finance Backs Expanding S-CHIP

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The Senate Finance Committee approves a bill expanding a children's health insurance program that helps provide benefits to children of the working poor — those who earn too much to qualify for Medicaid, but too little for private insurance.

LINDA WERTHEIMER, host:

This is MORNING EDITION from NPR News. I'm Linda Wertheimer.

STEVE INSKEEP, host:

And I'm Steve Inskeep. Good morning.

The U.S. Senate is gearing up for what could turn into a major health care debate. A key committee yesterday defied a veto threat from President Bush. Senators voted to expand a popular children's health insurance program. In an unusual role reversal, the Republican president says he's opposing that measure because he wants to talk about overhauling the entire health care system.

Here's NPR Julie Rovner.

JULIE ROVNER: The bill approved 17 to four by the Senate Finance Committee would extend and expand the state children's health insurance program known as S-CHIP. The program helps provide health benefits to children of the working poor, those who earn too much to qualify for the low-income Medicaid program but too little to afford private insurance. Reaching consensus on the measure wasn't easy, said Iowa Senator Charles Grassley, the panel's top Republican.

Senator CHARLES GRASSLEY (Republican, Iowa): What we're doing here is what can be done and what needs to be done because this reauthorization has to be done by September 30th. That's because unless Congress acts, the program will expire and with it the funds that currently cover some six million children and several hundred thousand of their parents and other adults. The Bush administration wants to add just $5 billion to the program over the next five years. Grassley says that's not enough.

Sen. GRASSLEY: And I'm going to show them that their $5 billion increase that they have on their budget just will not work. I mean, unless you want to cut a million kids off.

ROVNER: Meanwhile, Democrats left room in their budget to add $50 billion to the program over five years. But with some Republicans threatening to filibuster, they realized they had to find a way to reach a compromise that would garner at least the 60 votes needed to break that threatened impasse. In the end, the bill adds only $35 billion and eliminates coverage for most of the adults. That was enough to win a majority of the Republicans on the committee, but it was still way too much for Republicans like Mississippi's Trent Lott. He also complained that the money runs out abruptly after five years.

Senator TRENT LOTT (Republican, Mississippi): Now, the argument might be, well, we may have Washington bureaucratic-run health care for everybody by then and so we don't have to worry about it.

ROVNER: But Democrats like Debbie Stabenow of Michigan said the bill is more fiscally responsible than many other things Congress has done recently.

Senator DEBBIE STABENOW (Democrat, Michigan): The war in Iraq, we're spending almost $12 billion a month now. This bill provides $7 billion in a year. It's paid for; the war is not. I don't think, when we look at what the American people are asking as to do, $7 billion a year to make sure that parents who are working have the opportunity to have their children be able to go to the doctor and get the health care they need is too much.

ROVNER: Arizona Republican Jon Kyl, echoing complaints from the Bush administration, also worried that the expansion will move too many children from private health insurance to government coverage.

Senator JON KYL (Republican, Arizona): For every 100 children who enroll in S-CHIP, there is a corresponding reduction in private coverage of between 25 and 50 children. So this crowd-out effect really means that we're not expanding coverage to as many people as we think we are. We're just taking them off of private insurance.

ROVNER: But Peter Orszag, head of the Congressional Budget Office, said that, in fact, the measure is a better deal for taxpayers than the president's health reform plan.

Mr. PETER ORSZAG (Director, Congressional Budget Office): In a voluntary system where you're trying to provide an incentive to reduce the number of uninsured children, I think this approach is pretty much as efficient as you can possibly get to get a reduction of roughly four million uninsured children.

ROVNER: In a speech in Nashville yesterday, President Bush again urged Congress to take up this health care tax changes instead of the children's health insurance expansion. Several senators said they support those changes but that they want to address them after the S-CHIP bill gets done. The bill is expected on the Senate floor next week.

Julie Rovner, NPR News, Washington.

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