President Bush Reiterates Threat To Veto Compromise SCHIP Legislation

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State Children's Health Insurance Program

HHS Secretary MikeLeavitt on Friday reiterated President Bush's threat to vetolegislation that would reauthorize SCHIP and expand enrollment in theprogram to about 10 million children, "just hours" after House SpeakerNancy Pelosi (D-Calif.) appealed to Bush to sign the bill, CQ HealthBeat reports (Carey/Epstein, CQ HealthBeat, 9/28).

Thecompromise bill 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. The House on Tuesday voted 265-159 toapprove the measure, with 45 Republicans voting in favor and eightDemocrats voting against the bill. The Senate on Thursday voted 67-29to approve the legislation, with 18 of the 49 Senate Republicans votingin favor. The program expired on Sunday (Kaiser Daily Health Policy Report, 9/28).

Bush likely will veto the legislation as soon as he receives it, according to USA Today (Wolf, USA Today,10/1). Leavitt on Friday said that Bush remains committed toreauthorizing SCHIP but that the administration and bill supporters"disagree on the path."

The White House has said the bill "goestoo far toward federalizing health care." Leavitt said, "Where themajor disagreement comes is in how we help those who are in better-offincome situations, that is to say greater than 200% of the" federalpoverty level," adding, "We think there are ways to be helpful toAmericans who have need, but don't think SCHIP is the way to do that" (CQ HealthBeat,9/28). White House spokesperson Tony Fratto said that Bush will risknegative political consequences for his veto because he feels that thepolicy is wrong (Russell Chaddock, Christian Science Monitor, 10/1).

Bushon Saturday in his weekly radio address also renewed his veto threat,adding that Democrats would use a large increase in taxes to pay forthe measure. However, Bush credited Democrats for passing an extensionof the program in a continuing resolution (HJ Res 52) (Crabtree, The Hill,9/29). The CR would provide $5 billion to fund 13 states' SCHIPprograms through Nov. 16. Leavitt said Bush would sign the continuingresolution (CQ HealthBeat, 9/28).

According to the Chicago Tribune,Bush's veto threat "is part of a new tactic to try to paint hispolitical opponents as reckless spenders, a posture that could win Bushadmirers among fiscal conservatives" and allow Bush "to draw a sharpercontrast between himself and Democrats" (Silva, Chicago Tribune, 9/29).

Pelosi Appeal

Pelosi at a bill signing ceremony with Senate Majority Leader HarryReid (D-Nev.) said Congress will take passage of the SCHIP bill "onestep at a time," adding that bill supporters need 15 more RepublicanHouse votes to override Bush's veto (Johnson, CongressDaily,9/28). Brendan Daly, spokesperson for Pelosi, said, "We hope thepresident will change his mind." Daly said that if a different SCHIPreauthorization bill is considered, "there are some things we will notcompromise, and that's the number of kids: 10 million" (Christian Science Monitor, 10/1).

Reidsaid he will not compromise further on the SCHIP bill. "If thepresident says, 'Let's sit down and talk about it,' ... it is somethingthat's not going to happen," Reid said, adding, "We have squeezedeverything we can out of this. This is the best we can do" (CongressDaily, 9/28).

Democratic Strategy

Democratic leaders on Friday outlined a strategy to obtain a sufficientnumber of votes to override a veto of the SCHIP bill by highlightingthe contrast between the president's request for larger funding for theIraq war and Congress' request for smaller funding for SCHIP, the New York Timesreports. The campaign will use grassroots advocacy and advertisementsto target House Republicans, initially focusing on about 15 who votedagainst the compromise bill.

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Pelosi said, "It's ironic that inthe very same week that the president says he's going to veto the billbecause we can't afford it, he is asking, what, for $45 billion moreover and above his initial request for the war in Iraq, money that weknow is being spent without accountability, without a plan for how wecan leave" (Pear/Herszenhorn, New York Times, 9/29).

Sen. Dick Durbin (D-Ill.) and Rep. Rahm Emanuel (R-Ill.) on Saturday at a news conference at the Children's Memorial Hospitalin Chicago said that one day's spending on the Iraq war, or $300million, could insure 246,000 children for five years under SCHIP(Black, Chicago Tribune, 9/30).

HouseMinority Whip Roy Blunt (R-Mo.) responded that there is a "100%probability" that the House will be able to sustain Bush's veto butthat the timing of the Iraq war spending bill and SCHIP "was nothelpful" (New York Times, 9/29).

However, someHouse Republican leaders view the SCHIP vote "as a watershed thatshould compel Democrats to grant them a seat at the table on futurebills" rather than a vote that will expose Republicans "to the wrath ofvoters," Roll Call reports. According to Roll Call,conservatives "believe the stand will repair relations with a base thathad grown disenchanted with Republicans backing big new spendingprograms" (Dennis, Roll Call, 10/1).

Domestic Agenda

The debate over SCHIP "is only the most visible sign of the new emphasis on domestic issues," the Washington Postreports. Democratic presidential candidates "are resurrecting a pushfor universal health care while talking up tax policy, poverty andcriminal justice," and Democratic congressional leaders are "revisitingClinton-era battles over hate crimes and federal funding for localpolice forces," according to the Post.

Meanwhile,the Bush administration "is spoiling for a fight on Democraticspending," and Republican leaders "are looking for any opportunity forconfrontations on illegal immigration and taxation," according to the Post. The Postreports that "[a]t the heart of it all is a central question: Thirteenyears after the 1994 Republican Revolution, has the country turned tothe left in search of government solutions to intractable domesticproblems?" Democratic pollster Peter Hart said, "As conditionsdeteriorate, Americans are asking, 'Who can make it better? Where canwe look for help?' And not surprisingly, government is increasingly theanswer" (Weisman, Washington Post, 10/1).

Tobacco Tax

In related news, Democrats chose an "unlikely source" to fund theexpansion of SCHIP by choosing to use a 156% increase in the tobaccotax, or 61 cents per pack, the AP/Contra Costa Timesreports. During House and Senate debates about the SCHIP bill, the"demographics of smoking and taxation received scant attention,"perhaps "because many Democrats and Republicans agree that cigarettesare the best target for tax increase if the insurance program were togrow," according to the AP/Times.

However, "a few lawmakers ... took a swing," the AP/Timesreports. About 33% of U.S. adults living below the poverty level aresmokers, as compared to 23.5% of those above the poverty level,according to government statistics (Babington, AP/Contra Costa Times, 10/1).

AMA

The $7 billion annually it will cost to expand SCHIP is worth the increased spending, American Medical Association board member Joseph Heyman said on Friday at the annual meeting of the Louisiana State Medical Society, the Baton Rouge Advocatereports. Heyman said, "By any measure," SCHIP "has been an extremelysuccessful program," adding, "It's insured almost seven millionchildren, and in spite of that, there are still eight million childrenuninsured in this country."

Of that eight million, two millionare eligible but not enrolled, Heyman said. Heyman addressed severalcriticisms raised by the administration, including that an expansion ofthe program will lead to government-run health care and that parentswill drop private insurance for their children to enroll them in SCHIP.Families who do so most likely are leaving "crummy" private healthinsurance plans, Heyman said. Heyman noted that AMA supports anindividual insurance mandate, under which insurance coverage forlow-income residents would be subsidized through tax credits (Griggs,Baton Rouge Advocate, 10/1).

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Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily Health Policy Report, search the archives, andsign up for email delivery at kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published forkaisernetwork.org,a free service of The Henry J. Kaiser Family Foundation.

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