By Christopher Lee
Washington Post Staff Writer
Thursday, July 19, 2007
President Bush yesterday rejected entreaties by his Republican allies that he compromise with Democrats on legislation to renew a popular program that provides health coverage to poor children, saying that expanding the program would enlarge the role of the federal government at the expense of private insurance.
The president said he objects on philosophical grounds to a bipartisan Senate proposal to boost the State Children's Health Insurance Program by $35 billion over five years. Bush has proposed $5 billion in increased funding and has threatened to veto the Senate compromise and a more costly expansion being contemplated in the House.
"I support the initial intent of the program," Bush said in an interview with The Washington Post after a factory tour and a discussion on health care with small-business owners in Landover. "My concern is that when you expand eligibility . . . you're really beginning to open up an avenue for people to switch from private insurance to the government."
The 10-year-old program, which is set to expire on Sept. 30, costs the federal government $5 billion a year and helps provide health coverage to 6.6 million low-income children whose families do not qualify for Medicaid but cannot afford private insurance on their own.
About 3.3 million additional children would be covered under the proposal developed by Senate Finance Committee Chairman Max Baucus (D-Mont.) and Republican Sens. Charles E. Grassley (Iowa) and Orrin G. Hatch (Utah), among others. It would provide the program $60 billion over five years, compared with $30 billion under Bush's proposal. And it would rely on a 61-cent increase in the federal excise tax on cigarettes, to $1 a pack, which Bush opposes.
Grassley and Hatch, in a joint statement this week, implored the president to rescind his veto threat. They warned that Democrats might seek an expansion of $50 billion or more if there is no compromise.
They also said that Bush should drop efforts to link the program's renewal to his six-month-old proposal to replace the long-standing tax break for employer-based health insurance with a new tax deduction that would help people pay for insurance, regardless of whether they get it through their jobs or purchase it on their own.
"Tax legislation to expand health insurance coverage is badly needed, but there's no Democratic support for it in the SCHIP debate," said Grassley, the ranking Republican on the finance panel. "In the meantime, our SCHIP initiative in the Finance Committee takes care of a program that's about to expire in a way that's more responsible than current law and $15 billion less than the budget resolution calls for."
But Bush said he was not persuaded.
"I'm not going to surrender a good and important idea before the debate really gets started," Bush said. "And I think it's going to be very important for our allies on Capitol Hill to hear a strong, clear message from me that expansion of government in lieu of making the necessary changes to encourage a consumer-based system is not acceptable."
The Senate committee is scheduled to consider the compromise legislation today, and the House is expected to try to pass its own version before the congressional recess in August.
Rep. Rahm Emanuel (Ill.), the House Democratic Caucus chairman, said he is "bewildered" that Bush is fighting the expanded funding for a program supported by Republicans and Democrats alike. "This is the chance for him to finally be a uniter and not a divider," Emanuel said. "You have consensus across party and ideology, and a unity on the most important domestic issue, health care -- except for one person."
A recent analysis by the Congressional Budget Office concluded that the program would require about $14 billion in new money over five years -- on top of the current $5 billion in annual funding -- merely to keep covering the same number of children, in part because of rising health-care costs. Secretary of Health and Human Services Mike Leavitt, accompanying Bush yesterday, said: "We disagree with that number."
In the 15-minute interview, Bush also rejected the charges by former surgeon general Richard H. Carmona that the administration's political appointees routinely rewrote his speeches, blocked public health reports for political reasons and screened his travel.
"I can't speak to some of the complaints the surgeon general made," Bush said. ". . . He worked energetically in his job. And, obviously, at some point in time, he became very disgruntled and spoke out about it. But ours is an administration that attracts very smart, capable people. I'm very interested in their points of view, and I expect people to speak out. I also have my own points of view and feel very strongly about a lot of issues."
Bush said he is opposed to a bipartisan legislation that would allow the Food and Drug Administration to regulate the manufacturing, marketing and sale of tobacco products, which could lead to stronger warning labels and limits on nicotine and other ingredients.
"We've always said that nicotine is not a drug to be regulated under FDA," Bush said.
Leavitt added that one danger is that the FDA could be seen as giving its stamp of approval to a product "that will never be safe."