Child health-care program gets congressional nod

WASHINGTON — Senate and House of Representatives leaders reached agreement Friday on compromise legislation to reauthorize and expand a popular insurance program for low-income children, but President Bush is still promising to veto the measure.

The debate over the State Children's Health Insurance Program (SCHIP) has become a battle for the direction of America's health care. Democrats and health advocates want to use the program to bring health care to millions of uninsured youngsters. Republicans and others see the expansion as a return to big government and prefer to use tax incentives to help Americans buy their own coverage in the private market.

The compromise bill would boost SCHIP funding by $35 billion over five years and help cover 4 million children who are now without health insurance. The proposal closely matches the bipartisan measure that passed the Senate by a 68-31 vote. But it eliminates several controversial provisions of the House reauthorization bill that would have increased spending by $47 billion, hiked Medicare payments to physicians and cut funding for HMOs that provide Medicare coverage.

The House is expected to vote on the new proposal on Tuesday, with a Senate vote expected later in the week. If the measure passes both houses, it will go to the president.

The White House issued a statement Friday evening restating the president's intent to veto the measure. Bush called on Congress to pass a temporary funding extension for the program, which is scheduled to expire on Sept. 30.

A presidential veto would send the measure back to both chambers for an override vote. Observers say the Senate has enough votes to overturn a Bush veto, but Republicans are confident that they have the necessary votes in the House to sustain the president's veto. The original House bill passed by only 225-204.

"We are hopeful that the President will reconsider his veto threat and sign this bill into law on behalf of all our nation's children," House Speaker Nancy Pelosi said Friday in a press statement.

Republicans believe that Democrats are expanding the program beyond it's original purpose of covering low-income children and that expanded eligibility will cause parents to drop their children's private insurance for cheaper coverage through SCHIP. That phenomenon is known as "crowd out."

But Republicans who vote against the measure could face tough sledding from constituents and state officials, most of whom support the SCHIP program, which is designed to cover children whose parents earn up to twice the federal poverty level.

Senator Orrin Hatch, R-Utah, said he's sympathetic to the president's concerns about SCHIP, but is supportive of the new compromise bill.

"I am hoping that he will work with us on this program because this is a true compromise within the Senate between Democrats and Republicans, and between the House and the Senate," Hatch said Friday in a statement.

Like the Senate bill, the compromise legislation would boost program SCHIP funding by $35 billion, to a budget of $60 billion over five years. The money would come from steep tax increases on tobacco products.

Bush wants to expand the program by $1 billion a year, bringing total spending to $30 billion over the five years. That's about 36 percent of what the Congressional Budget Office says is needed to preserve current program levels. The CBO estimates that 800,000 children in the SCHIP program would lose coverage within five years without additional funding over the program's current $5 billion-a-year budget.

Of the 6.1 million new enrollees the Senate bill would attract by 2012, the CBO projects that 4 million would have been uninsured and SCHIP-eligible. About 2.1 million would drop private insurance to enroll.

The new package also would provide dental coverage for SCHIP youngsters, allow states the option of covering pregnant women in the program and prohibit future coverage of any other adults.

The compromise bill also eases new restrictions imposed by the Bush administration that make it extremely difficult for states to expand coverage to youngsters from higher-earning families.