Democrats offer stricter children's health insurance bill

McClatchy NewspapersOctober 24, 2007 

WASHINGTON — Ignoring an eleventh-hour overture from the White House, Democratic leaders in House of Representatives late Wednesday crafted an amended bill to expand health coverage for low-income children and scheduled a vote on the measure, hoping to garner enough GOP support to overcome another presidential veto.

The House will vote on the legislation to renew and expand the State Children's Health Insurance Program on Thursday, a day after Health and Human Services Secretary Michael Leavitt said that the Bush administration was willing to make some concessions to end the political stalemate.

The revised bill includes stronger language to prevent children of illegal immigrants from getting coverage under SCHIP. It also blocks federal SCHIP funds for states that cover children from families earning more than three times the federal poverty level, or $61,950 for a family of four. The legislation also phases out adults from the program in a year instead of two years under the previous proposal.

Like the previous bill, the new legislation would increase program funding by $35 billion over five years and increase program enrollment to more than 10 million children. The SCHIP program is designed to provide health insurance to children from families that can't afford private coverage but earn too much to qualify for Medicaid, the public health insurance program for the poor.

Leavitt said the cost of the new proposal remains a major sticking point for President Bush. "We're not prepared to fund a bill with $15 billion more money than is necessary," he said. Doing so, Leavitt added, would prompt more affluent families to drop their children's private coverage to enroll in the taxpayer-funded SCHIP program.

However, Leavitt said that if state program allotments are trimmed to reflect actual need, the tighter immigrant language and the expedited phase-out of adult coverage would allow the bill to be implemented for an additional $20 billion rather than the $35 billion now being sought.

The new proposal includes a number of revisions designed to win over a dozen or so House Republicans who previously opposed the measure. Their support could provide the two-thirds House majority needed to override another veto. On Oct. 18, the previous bill failed to garner enough support from GOP House members to override Bush's veto.

House Speaker Nancy Pelosi, D-Calif., credited Sens. Orrin Hatch, R-Utah, and Charles Grassley, R-Iowa, for Wednesday's breakthrough. Both senators met with the staffs of 38 GOP House members to address their concerns about the original legislation.

"We hope that tomorrow this legislation will be overwhelmingly approved," House Majority Whip Steny Hoyer, D-Md., said Wednesday night. "We hope the Senate will approve it next week, and we will again send it to the president. This time, responding to his concerns, we hope that he will sign it."

Several Republicans have urged Democrats to postpone the vote for a few days so that Republican members can read over the new legislation. But Hoyer said Democrats wanted to vote on the measure as soon as possible, in case Bush decides to again veto it if it passes both houses.

That could leave states without federal funding for the program, which is now operating under a temporary funding agreement that expires Nov. 16 — the day that Congress breaks for the holidays.

"If the president doesn't sign it, we don't want to be in a position where we're not here to take appropriate action," Hoyer said.

On Wednesday, Leavitt sent a letter to Senate Majority Leader Harry Reid, D-Nev., and Pelosi outlining the concessions the administration was willing to make to try and resolve the stalemate over the proposal.

Leavitt said the administration could support SCHIP coverage of children from families earning up to three times the federal poverty level — $61,950 for a family of four — but only if the bill included a "rigorous requirement" that states first enroll a high percentage of children in families of four earning less than $41,300, which is twice the poverty level.

Leavitt didn't say what would constitute a "rigorous requirement." But he indicated that he was prepared to talk about a figure below the administration's current requirement that 95 percent of these children be enrolled before a state can cover those from higher-earning families.

State SCHIP officials have said that the 95 percent threshold is nearly impossible to meet. The administration previously had supported SCHIP coverage only for children in families that earn up to twice the poverty level.

McClatchy Newspapers 2007

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