House OKs expanded child health program

The Baltimore Sun

WASHINGTON -- The House approved a compromise bill to renew and expand a popular program that provides health insurance for low-income children yesterday, but backers came up short of the votes they would need to override a threatened veto from President Bush.

Although 45 Republicans joined most Democrats in supporting the measure, the 265-159 vote failed to reach the two-thirds majority that would be needed to override a veto - 290 if every House member votes.

That left the fate of the State Children's Health Insurance Program in doubt, with a Sept. 30 deadline for its renewal fast approaching. Some political maneuvering might extend the deadline to mid-November.

If the result is gridlock in Washington, state officials say hundreds of thousands of children could start losing coverage in a few months. And while the bill represents a compromise between Democrats and prominent Senate Republicans, the debate in the House and with the administration has turned increasingly rancorous.

At issue is more funding for the federal-state partnership, as well as state flexibility to help uninsured children in some middle-class families. The bill would boost federal tobacco taxes to pay for the program, raising the levy to $1 a pack on cigarettes - up 61 cents.

Speaker Nancy Pelosi of California vowed to keep sending the legislation back to Bush until he relents. "This legislation will haunt him again and again and again," she said. "We will continue to work in a bipartisan fashion to put bills on the president's desk and see how long he can hold a veto-proof majority."

The Senate might vote on the bill tomorrow.

The program currently covers about 6 million children, mainly in working families who earn too much to qualify for Medicaid but too little to afford their own coverage. Washington contributes about $5 billion a year, covering roughly 70 percent of the cost, and states put up the rest.

The congressional compromise would increase federal funding by $35 billion over five years, enough to cover an estimated 3 million to 4 million more children. Bush has offered a $5 billion boost over the same period - a sum that analysts say can't sustain the current caseload, let alone cover more of the 9 million uninsured children.

The congressional bill is supported by doctors' groups, the insurance industry, public health advocates and the United Way. The U.S. Chamber of Commerce, pointing to the tax increase, opposes it.

Some House Republicans say the compromise bill would expand government coverage to families making as much as $83,000 and make illegal immigrants eligible for benefits. Senate GOP backers of the bill said both charges were misleading.

States would be able to seek expansions to cover middle-class families, said a Senate Republican aide who worked on the legislation, but federal funding would be restricted. The Health and Human Services Department could also deny such requests. One outside analysis estimated that about 80 percent of the uninsured children who stand to obtain coverage are in low-income families.

As for immigrants, the bill would aim to keep them off the program. Under pressure from the Senate, House Democrats agreed to drop language that would have allowed foreign-born children who are here legally to obtain coverage. That prompted a coalition of 40 Hispanic organizations to oppose the measure.

Nonetheless, some House Republicans said a provision of the bill to ease identification requirements would open the program to illegal immigrants. But a leading author of the compromise, Sen. Charles E. Grassley, an Iowa Republican, said the change is intended to help citizens who have been excluded as an unintended consequence of tougher identification requirements.

Congressional Democrats unveiled legislation yesterday to keep the government running until mid-November, giving them more time to bridge gaping differences with Bush over the budget.

The stopgap legislation is needed as the Oct. 1 start of the fiscal year looms with none of the 12 annual spending bills, which fund government agencies and departments, passed into law.

At the same time, the bill temporarily extends health coverage for children from low-income families.

Ricardo Alonso-Zaldivar writes for the Los Angeles Times.

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