The controversial children's health care program is set for passage Wednesday — albeit for a short term — when lawmakers in the U.S. House of Representatives pass an extension that President Bush is expected to sign.
On Tuesday, the House voted 265-159 to expand the State Children's Health Insurance Program, or SCHIP, by $35 billion over five years.
President Bush proposes a smaller increase in SCHIP — $5 billion over five years.
President Bush has promised to veto the House bill due to its cost, dependence on a tobacco-tax hike and potential for replacing private insurance with government grants.
SCHIP is a state-federal program that provides coverage for 6.6 million children from families that live above the poverty level but have trouble affording private health insurance. The proposed expansion, backed by most governors and many health-advocacy groups, would add 4 million children to the rolls.
Under the expansion proposal, states could seek federal waivers to steer funds to some families earning at least triple the official poverty-level income, provided the states showed progress enrolling the main target: children in families earning up to double the poverty rate. That would be $34,340 for a family of three, or $41,300 for a family of four.
Democrats seek Republican Support
Speaker Nancy Pelosi warned that she'll keep bringing up the compromise bill, trying to win over enough Republicans who, unlike President Bush, are running for re-election.
President Bush's veto threat prompted a counterattack from Democrats.
"Members of this body will be faced with a simple choice: will you vote to provide health insurance to millions of children, or will you vote to take away health insurance from children who currently have it?," said Rep. Jim McGovern of Massachusetts.
But conservatives in the House, like Rep. Pete Sessions of Texas, sided with President Bush.
"Today is a defining moment for an insatiable appetite that the new Democrat majority has for spending taxpayer dollars and going well beyond the mission statement for SCHIP," Sessions said.
That "mission statement" — formed when the program was created a decade ago — purposed to provide health coverage for children of families with incomes too high to qualify for Medicaid but who still couldn't afford their own private insurance.
President Bush has said that the compromise bill puts too many children who might otherwise have private coverage onto the government dole.
Adds Rep. Jeb Hensarling, a Texas Republican: "Make no mistake about it; this is a government-run socialized health-care wolf masquerading in the sheepskin of children's health care."
But House Democratic Caucus Chairman Rahm Emanuel cautions that Senate Republicans — mostly backers of SCHIP — are hardly wild-eyed liberals.
"Excuse me," Rep. Emanuel said, "I never knew that Sen. Orrin Hatch, Sen. [Charles] Grassley, were members of the Socialist Party. I never knew that Gov. [Matt] Blunt, who asked for an extension in Missouri, was a member of the Socialist Party."
Senate Poised to Pass SCHIP
To overturn a presidential veto, both chambers of Congress must produce two-thirds majorities. The 265 yes votes in the House are two dozen fewer than Democrats would need to override Bush's veto, and House leaders expect few members to switch positions.
The Senate appears poised to pass the SCHIP expansion by a large margin later this week, but a Senate bid to override a veto would be pointless if the House override effort falls short.
Some 45 House Republicans joined nearly all the Democrats in voting for the bill, including moderates like Rep. Heather Wilson (R-NM) who was a state cabinet secretary in charge of children's services when the program began.
"It works. It gets kids health insurance that they need," she said. "We have big challenges in health care, but this isn't one of them. Don't let the perfect be the enemy of the good."
Eight Democrats opposed the bill. Some, from tobacco-growing districts, object to raising the federal cigarette tax to $1 a pack, a 61-cent increase. Some Hispanic members complained that the bill would make legal immigrant children wait five years to qualify for SCHIP, but voted for it anyway.
Emanuel said he's not surprised that Republicans are starting to break with President Bush.
"In the '80s, the GOPers used to attack the poor," he said. "This president has chosen to attack middle-class children getting health care, and it's one of the most bizarre turns in politics I've ever seen. The president says he's against providing health insurance for middle-class children. These are parents who work full time — they are too rich for Medicaid — and don't have enough money for private insurance."
From NPR reports and The Associated Press