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House Approves SCHIP Children's Health Insurance Bill

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State Children's Health Insurance Program

The House on Tuesday voted 265-159 to approve compromise legislationthat would reauthorize SCHIP and expand enrollment from 6.6 millionchildren to about 10 million children, USA Today reports (Wolf, USA Today, 9/26). Forty-five Republicans voted to approve the bill and eight Democrats voted against it (AP/Wall Street Journal, 9/26).

Thecompromise bill, which resembles the Senate version of SCHIPlegislation, would provide an additional $35 billion in funding overthe next five years and bring total spending on the program to $60billion. The additional funding would be paid for by a 61-cent-per-packincrease in the tobacco tax, as proposed in the Senate version. Thecompromise legislation does not include revisions to Medicare. TheSenate is expected to vote on the measure later this week (Kaiser Daily Health Policy Report, 9/25).

Houselawmakers who support the bill "ruefully conceded that they willprobably fall short of the 290 votes" needed to override PresidentBush's veto, according to the Washington Post. "I think it's a heavy lift," Rep. Heather Wilson (R-N.M.), who favors the legislation, said on Tuesday (Lee/Weisman, Washington Post, 9/26).

HouseMajority Leader Steny Hoyer (D-Md.) said that he is unsure how theHouse will respond to the expected veto. "We'll have to figure thatout. Our interest is to cover at least 10 million children," Hoyersaid. Democrats have included a $5 billion extension of the program ina stopgap spending measure that was introduced in the chamber onTuesday, with a vote expected on the bill Wednesday. The extensionwould continue to fund the program at its current level until Nov. 16(Dennis, Roll Call, 9/25).

Chance of Compromise

Supporters and opponents of the bill "have dug in" to their positions,with both sides during the day "lobb[ing] rhetorical strikes, eachaccusing the other of playing politics with children's health,"according to the Post. Moderate Republicans "openlyfretted" on Tuesday that Bush "had made the House GOP its firewall, totheir political detriment," the Post reports. Rep. RayLaHood (R-Ill.) said, "I'm a little baffled as to why the Bush peoplepicked this issue to fight it out on," adding, "It's very sensitive.It's about kids. Who's against kids' health care?"

Democratic Congressional Campaign CommitteeChair Rep. Chris Van Hollen (D-Md.) said that he will make sureRepublicans who voted against the measure will pay politically fortheir vote and that the political price might keep growing. Van Hollensaid that Democrats should keep sending the bill to Bush until he signsit (Lee/Weisman, Washington Post, 9/26).

However,House Minority Whip Roy Blunt (R-Mo.) said, "The longer this bill isout there, the more problems people will find in it" (Roll Call,9/25). Republican leaders on Tuesday only requested enough Republicansupport to sustain a veto, which allowed Republicans to support themeasure if they felt it was important to their constituents andre-election prospects, according to the Richmond Times-Dispatch (Hardin, Richmond Times-Dispatch, 9/26).

Proof-of-Citizenship Provision

Republicans on Tuesday objected to a measure of the compromise billthat would relaxed a provision of the Medicaid proof-of-citizenship lawto allow states to determine citizenship by checking a Social Securitynumber against the Social Security Administration, CQ Today reports. SSA Secretary Michael Astrue said that such a system could not reliably verify citizenship.

However,Sen. Chuck Grassley (R-Iowa) in a letter to House Speaker Nancy Pelosi(D-Calif.) and House Minority Leader John Boehner (R-Ohio) said thatthe current law "has caused a bureaucratic nightmare for some statesthat is keeping Americans from getting coverage." Grassley continued,"The overheated and misleading rhetoric from opponents of thischildren's health reauthorization bill is nothing more than a desperateattempt to divert your attention from voting for a children's healthbill" (Wayne, CQ Today, 9/25).

Immigrant Coverage

Pelosi on Tuesday told members of the Congressional Hispanic Caucusthat she would use other legislative vehicles to ensure that documentedimmigrants are eligible to receive benefits under Medicaid and SCHIP,caucus Chair Rep. Joe Baca (D-Calif.) said after a private meeting, CongressDailyreports. The caucus had threatened to oppose the SCHIP compromise billbecause it lacks provisions that provide coverage for documentedimmigrants that were present in the House version of the bill.

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Bacasaid, "I think we got a good commitment from" Pelosi, adding, "If wehadn't gotten the commitment, you probably would see a lot of 'no'votes." Pelosi said she personally supports allowing documentedimmigrants to receive benefits under the programs but that the"rationale is what can pass in the United States Senate" (Johnson, CongressDaily, 9/25).

Press Conference

House Democratic leaders on Tuesday held a press conference to warn Bush against vetoing the compromise bill, the Postreports. Rep. Frank Pallone (D-N.J.) at the conference said, "Theproblem, I think, for President Bush is that he doesn't personalizewhat's going on here," adding, "You are here today, and when we canactually give examples of how people are helped by SCHIP, then I don'tknow how anybody can say that they don't want to sign a bill." Wilsonpleaded with other Republicans to not "let the perfect be the enemy ofthe good" (Milbank, Washington Post, 9/26).

Pelosisaid, "This legislation will haunt [Bush] again and again and again.It's not going away, because the children are not going away." Sheadded that to help override the veto, advocates are "hoping togalvanize support of the American people for this legislation. Thepresident will find himself alone" (Pear, New York Times,9/26). "We will continue to work in a bipartisan fashion to put billson the president's desk and see how long he can hold a veto-proofmajority," Pelosi said (Alonso-Zaldivar, Los Angeles Times, 9/26).

Rep.Joe Barton (R-Texas) said that the bill was a vote on socializedmedicine, adding, "The most that can be said for it is that it doeshave money in it for the children of America" (Milbank, Washington Post, 9/26).

White House Response

Bush in a statement of administration policy said, "The bill goes toofar toward federalizing health care and turns a program meant to helplow-income children into one that covers children in some householdswith incomes of up to $83,000 a year." The White House said it would be"next to impossible" under the bill for federal officials to deny astate's request for a waiver to expand its program (New York Times, 9/26).

WhiteHouse press secretary Dana Perino after the vote in a statement said,"Unfortunately, the House of Representatives today passed SCHIPlegislation that pushes many children who now have private coverageinto a government-run system, part of the Democrats' incremental plantoward government-run health care for all Americans" (Schneider, Atlanta Journal-Constitution, 9/26).

Veto Threat Implication

The vote on Tuesday "ensures that lawmakers will confront the [SCHIP]issue again before Congress adjourns this year if President Bushfollows through on his promise to veto the measure," CongressDaily reports. According to CongressDaily, "Republicans are calling for more negotiation, but it is unlikely either side will budge."

House Ways and Means Committeeranking member Jim McCrery (R-La.) said, "That's the whole point ofsustaining the veto, to get us a seat in the room" (Johnson, CongressDaily,9/26). Pelosi said that bill supporters will continue to lobby for themeasure and hope that the increasing political pressure will garnermore Republican support and force Bush to sign the measure (Pugh, Miami Herald, 9/26).

Other Comments

Rep. Charles Rangel (D-N.Y.) said that the expense of the bill, orwhether it leads to socialized medicine, is irrelevant. When lawmakersreturn to their home districts, "the question is, 'Were you with thekids or were you not?'" (Babington, AP/Houston Chronicle, 9/25). Presidential candidate Sen. Barack Obama(D-Ill.) on Tuesday said that Bush's veto threat was an unacceptablereminder "that we must change the way Washington works and finally putthe people's interest ahead of the special interests," adding, "In therichest nation on Earth we must no longer stand by while nine millionchildren live without health care" (Shideler, Wichita Eagle, 9/26).

House Energy and Commerce CommitteeChair John Dingell (D-Mich.) said, "We are within shouting distance" ofreauthorizing the program, adding, "I wouldn't want to be the guy thatvetoes this bill" and "I would not want to be the guy that supports thefellow who did veto the bill" (Wayne, CQ Today, 9/25).

Boehnersaid, "Using this critical program to provide government benefits toadults, illegal immigrants and upper-income families who can affordprivate health insurance is bad policy" (Roll Call, 9/25).He continued, "Federal funds targeted for low-income children shouldbenefit low-income children. Period," adding, "The children thisprogram is intended to serve deserve better, as do American taxpayers"(Lengell, Washington Times, 9/26).

ChiefDeputy Minority Whip Eric Cantor (R-Va.) said, "This is a defining votefor Republicans. You are either for or against health care directed bythe Washington bureaucracy." Republican leadership also complained thatmembers, who received the bill Monday night, did not have adequate timeto read the 299-page bill in its entirety (Ota/Epstein, CQ Today, 9/25).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation.