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Senate Approves SCHIP Expansion, Reauthorization

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State Children's Health Insurance Program

The Senate on Thursday voted 67-29 to approve compromise legislationthat would reauthorize SCHIP and expand enrollment in the program toabout 10 million children, "setting up the biggest domestic policyclash of [the Bush] presidency and launching a fight that willreverberate into the 2008 elections," the Washington Post reports. Eighteen of the 49 Senate Republicans voted for the measure (Weisman/Lee, Washington Post,9/28). The compromise bill would provide an additional $35 billion infunding over the next five years and bring total spending on theprogram to $60 billion. The additional funding would be paid for by a61-cent-per-pack increase in the tobacco tax. The House on Tuesdayvoted 265-159 to approve the measure, with 45 Republicans voting infavor and eight Democrats voting against the bill (Kaiser Daily Health Policy Report, 9/26).

Democraticleaders likely will send the bill to President Bush next week, whichwill give "advocates a few more days to pressure" the president to signthe measure, according to the Post (Washington Post,9/28). If vetoed, the House later next week might hold a veto overridevote, according to House Majority Leader Steny Hoyer (D-Md.) (Johnson, CongressDaily,9/28). If Bush vetoes the legislation and Congress cannot override theveto, Democrats said that they will reintroduce the bill every sixweeks to three months until Bush signs the bill or Republicans vote tooverride a veto. House Speaker Nancy Pelosi (D-Calif.) said, "If thepresident refuses to sign the bill, if he says, with a veto, 'I forbid10 million children in America to have health care,' this legislationwill haunt him again and again and again" (Washington Post, 9/28).

White House Response

White House spokesperson Tony Fratto on Thursday said that Bush will veto the bill after receiving it (CongressDaily,9/28). Press Secretary Dana Perino in a statement said, "The presidentwill veto this bill because it directs scarce funding to higher incomesat the expense of poor families" (Lengell, Washington Times,9/28). Fratto said that if the veto is sustained, the next step shouldbe conversations about the "philosophical differences" between theadministration and the bill's supporters. "The money isn't the issue.It's the view of what the role of government has to be in health care,"Fratto said (CongressDaily, 9/28).

Fratto saidBush might be amenable to increasing the funding level above hissuggested $5 billion over five years if the expansion of eligibilitywas limited. Fratto said, "This should not be an issue where you decidewhat the funding is, and then (set) the policy," adding, "We shoulddecide what the policy is and let the funding land where it lands."However, Fratto said that once a government program subsidizes childrenin families with annual incomes above 300% of the federal povertylevel, "you are talking about people who are solidly within the middleclass of America, and you are extending another unfunded entitlement tothe middle class" (Alonso-Zaldivar, Los Angeles Times, 9/28).

Republican Support

Some of the "sharpest challenges" in the Senate to Bush's position"came from Republicans," who said that the "administration wasmisinformed -- and even misleading the public" -- on severalprovisions, according to the Los Angeles Times. Sen. PatRoberts (R-Kan.) said, "The administration is threatening to veto thisbill because of 'excessive spending' and their belief that this bill isa step toward federalization of health care," adding, "I am not forexcessive spending and strongly oppose the federalization of healthcare. And if the administration's concerns with this bill wereaccurate, I would support a veto. But, bluntly put, they are not" (Los Angeles Times, 9/28).

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Sen.Bob Corker (R-Tenn.) said that Bush's concern that the program wouldlead to "government-run health care" is unfounded. Corker said, "Whatwill move our country toward socialized medicine is not this bill,which focuses on poor children, but the lack of action to allow peoplein need to have access to private affordable health care" (Pear, New York Times, 9/28).

Sen. Chuck Grassley (R-Iowa) said that he would lobby House Republicans to override a presidential veto (Schor, The Hill,9/28). Grassley said that Bush's objections to the legislation arebased on false assumptions, such as his concern that families withannual incomes up to $83,000 would qualify for the program. Grassleysaid, "In Iowa, you can't call a cow a chicken and have it be true"(Norman, Des Moines Register, 9/28).

Additional Comments

Reid said that despite Bush's veto threat, "I hope that he will come tohis good side and put the well-being of millions of poor children aheadof his own flawed political agenda," adding, "I hope he realizes thatthis program is government at its best: lending a helping hand,providing a safety net to children" (Washington Times, 9/28).

Sen.Max Baucus (D-Mont.) said that Bush "can bring health coverage to 3.8million low-income uninsured children who have no insurance today," or"he can cut it with his hatchet, cutting coverage for at least amillion children who would otherwise get the doctor's visits andmedicines they need."

Presidential candidate Sen. Hillary Rodham Clinton (D-N.Y.) said a veto would show the president is "putting ideology, not children, first" (Freking, AP/Philadelphia Inquirer, 9/28).


Minority Leader Mitch McConnell (R-Ky.) said, "If Democrats want toexpand government-run health care, they should do it in the light ofday, without seeking cover under a bill that was meant for poorchildren, and without the politics," adding that "the poor kids who wewere originally trying to help shouldn't be caught in the middle" (Washington Times, 9/28).

Sen.David Vitter (R-La.) in a statement said, "I strongly supportreauthorizing the SCHIP program so it can continue to serve low-incomechildren," but "I oppose this legislation because it is a dramaticexpansion of the program to include some adults and families at incomesin the $75,000 range. This is tantamount to passing ...government-dominated health care -- through the back door" (Walsh, New Orleans Times-Picayune, 9/28).

Sen.Jim Bunning (R-Ky.) said that the compromise bill "takes a governmentprogram intended for low-income kids -- one that I support -- and byraising taxes the bill expands it to cover middle-income adults andillegal immigrants in other states" (Abdullah, Lexington Herald-Leader, 9/28).

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.