WASHINGTON -- The Senate followed the House late yesterday in approving by a 68-31 vote a major expansion of a popular children's health care program, but a veto threat by President Bush and deep conservative opposition remained huge obstacles.
Yet it did not appear to be a vote exclusively about the program known as SCHIP, which stands for the State Children's Health Insurance Program, created in 1997 during the Clinton administration.
To many observers, the SCHIP votes in the House and Senate served as early tests of far-reaching legislation to provide universal health insurance coverage for all Americans, a goal pushed by a number of Democratic presidential candidates.
By backing a large expansion of the insurance program, Democrats hoped for political advantage by appearing to be siding with children. In opposing the enlargement of the program, Republicans tried to cast Democrats as big spenders trying to impose big-government health care programs on Americans.
When the House passed its bill Wednesday, Speaker Nancy Pelosi, a California Democrat, said, "This is the children's hour." But in the Senate, Trent Lott, a Mississippi Republican, said too many adults are getting insurance under the program and that the number should be reduced.
Lott said he feared more expansion of the program in future years so that ultimately all Americans are covered. But Democrats said the only intention is to ensure that more needy children are covered.
"This is not a huge expansion of the program," said Sen. Max Baucus, the Montana Democrat who chairs the Senate Finance Committee. "This has nothing to do with national health insurance."
SCHIP now costs $5 billion a year and covers 6.6 million children, but the program expires Sept. 30. And before a bill is sent to the president, a House-Senate conference committee must reconcile differences between the two versions.
Bush has threatened to veto the measure, and it will be a difficult task for the conference committee to send him a bill that will avoid a veto. Overriding a presidential veto requires a two-thirds vote in each chamber. The House measure passed by a narrow margin, generally along partisan lines.
If a Bush veto should stand, Congress probably would come back with a modest expansion of the program. The White House has suggested $1 billion a year more over the next five years.
Maryland's senators, Democrats Benjamin L. Cardin and Barbara A. Mikulski, voted to expand the children's health insurance program.
The House bill would extend children's health insurance to 11 million enrollees at an added annual cost of $10 billion. The Senate bill would cover 9.8 million children at an added yearly cost of $7 billion.
The Senate bill calls for a 61-cents-a-pack increase in the federal tobacco tax, raising the tax to $1 a pack. The House bill would raise the tax to 84 cents a pack, a 45-cent increase. The House measure would reduce subsidies to private health insurance plans that serve Medicare patients.
The extra money would enable the House to cover more children than the Senate version, but Bush and GOP members said coverage would be extended to middle-class families. The Senate bill would cover children from families earning three times the official poverty threshold.
Sen. Saxby Chambliss, a Georgia Republican, said children from families earning $62,000 a year would be covered by the Senate bill. In the House last week, Rep. Dennis Hastert, an Illinois Republican, said that a family of four earning more than $82,000 could enroll their children in SCHIP because of the added money being pumped into the program.
Sen. John Thune, a South Dakota Republican, said some middle-income Americans who pay the alternative minimum tax, originally designed to prevent wealthy people from avoiding taxes, would have children eligible for SCHIP under the Senate bill. But the Senate defeated his amendment to deny health insurance coverage to children if their parents pay the AMT.
The White House issued a statement this week saying that the House bill "is structured in a way that clearly favors government-run health care over private health insurance. The result of this approach would be a dramatic encroachment of government-run health care resulting in lower quality and fewer choices, which the American people have repeatedly rejected."
But Rep. John B. Larson, a Connecticut Democrat, said Bush and GOP lawmakers "have blindly put forward nearly $42 billion on reconstruction efforts in Iraq. But they could not find the time nor the effort to ensure that children in our own country have access to health care."
William Neikirk writes for the Chicago Tribune.