ROBERT SIEGEL, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

MICHELE NORRIS, host:

And I'm Michele Norris.

And the politics of health care are back at the forefront today.

President Bush made good on a promise, vetoing a bill to expand a popular children's health insurance program. The president says the bill could leave the nation towards a system of socialized medicine. Backers of SCHIP are working to override the veto. They say the president doesn't understand how the bill would actually work.

We'll talk with our political observers E.J. Dionne and David Brooks in just a minute.

First, to help us understand what the president vetoed, we ask NPR's Julie Rovner for a primer.

JULIE ROVNER: At issue is the State Children's Health Insurance Program, known as SCHIP. Right now, it covers some six million children in families who earn too much to qualify for Medicaid, but not enough to afford their own private health insurance. The bill the president vetoed would have added $35 billion to the program over the next five years - enough to cover about 10 million children.

Speaking to an audience in Lancaster, Pennsylvania this morning, Mr. Bush explained the veto this way.

President GEORGE W. BUSH: I believe at helping poor people, which was the intent of SCHIP now being expanded beyond its initial intent. I also believe that the federal government should make it easier for people to afford private insurance. I don't want the federal government making decisions for doctors and customers.

(Soundbite of applause)

ROVNER: But SCHIP isn't the kind of program where government officials make medical decisions. As Stan Dorn of the Urban Institute, a Washington think tank explains…

Mr. STAN DORN (Senior Research Associate, Urban Institute): Children are enrolled in private health insurance. Typically, children have a choice from among competing private health-insurance companies. There's no federally specified benefits package. There's no individual entitlement.

ROVNER: The president also complained that the bill would cover too many children who don't need federal help.

Pres. BUSH: This program expands coverage, federal coverage, up to families earning $83,000 a year. That doesn't sound poor to me.

ROVNER: But Dorn says that's not exactly right, either.

Mr. DORN: This bill would actually put new limits in place to keep states from going to very high-income levels.

ROVNER: In fact, states would no longer be able to use federal SCHIP money to cover children in families with incomes higher than three times the federal poverty line, about $60,000 for a family of four. The president gets to make the $83,000 claim because New York had wanted to allow children and families with incomes up to four times poverty onto the program. That is, indeed, $82,600.

The Department of Health and Human Services rejected New York's plan last month, and under the bill, that denial would stand. But White House officials warn the bill would allow a future administration to grant it.

Still, Dorn says, the real irony is that the bill, which was negotiated largely by Republicans in the Senate, goes a long way towards meeting the goals President Bush said he wanted for the program.

Mr. DORN: It's limited the ability of states to go up the income scale. It's focused resources on the poorest uninsured kids. It's imposed new duties on states to prevent the government funds from crowding out employer coverage.

ROVNER: In other words, the bill addresses all of the president's complaints, including his concern that families with private coverage now will drop it in favor of government-subsidized care.

But it's not just the president who's confused, Democrats are, too. Last week, at a news conference, House Majority Leader Steny Hoyer told the story of 12-year-old Deamonte Driver, the Maryland boy who died earlier this year after an untreated abscessed tooth turned into a brain infection.

Representative STENY HOYER (Democrat, Maryland; Majority Leader): He had a toothache, but he didn't have health insurance, and his folks could not access dental care.

ROVNER: Actually, Deamonte Driver did have health insurance. He had Medicaid. His mother just couldn't find a dentist who'd accept that Medicaid coverage, which is a whole different problem.

Meanwhile, Congress has continued funding for the SCHIP program through mid-November while the bigger battle plays out. A House override vote on the president's veto is expected later this month.

Julie Rovner, NPR News, Washington.

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