Children's Health Bill Approved By House

By Jonathan Weisman
Washington Post Staff Writer
Thursday, August 2, 2007

The House yesterday approved legislation vastly expanding a federal health insurance program for the children of the working poor, shrugging off a fresh veto threat from President Bush and the fierce opposition of House Republicans.

The Senate, where the legislation has strong bipartisan support, is expected to follow suit as early as today, voting on a more modest version of the program and probably setting up a showdown between congressional supporters and the White House, which says the measures are far too expansive.

The legislation would launch the most significant growth in federal health care in a decade, and Democrats hope it will fortify their members as they head home soon for the summer recess amid voter perceptions that they have accomplished little since taking control of Congress.

"This is the children's hour," House Speaker Nancy Pelosi (D-Calif.) declared last night. "We are able to meet our moral obligation to our children."

The 225 to 204 vote in the House -- largely along party lines -- came after hours of delaying tactics, strident rhetoric and trench warfare from Republicans who called the bill the first step toward "socialized medicine," financed by an unfair tobacco tax increase and cuts for managed-care companies in Medicare.

But in the end, the Democrats had weapons that were just too powerful -- a promise to insure 5 million more children who otherwise would have no access to health care, adding to the 6 million children already covered -- and the backing of Republican and Democratic governors, the American Medical Association, AARP, the March of Dimes, the Catholic Health Association, the American Academy of Pediatrics, and even cyclist Lance Armstrong. And the prospects are good in the Senate, where a key Republican, Orrin G. Hatch (Utah), said, "It's difficult for me to understand how anyone wouldn't want to do this."

But Bush opposes such a major expansion of the program. In an interview with The Washington Post last month, he said, "When you expand eligibility . . . you're really beginning to open up an avenue for people to switch from private insurance to the government."

The House bill would enlarge the State Children's Health Insurance Program, or SCHIP, by $47 billion over five years to provide coverage to the additional 5 million children.

Those children would have access to dental and mental health care. And the bill would offer new options for states to extend Medicaid and SCHIP coverage up to age 20 and to cover some legal immigrants and pregnant women. It would expand coverage for preventive health screening for seniors under Medicare and would provide $19 billion over five years to prevent scheduled cuts to physician reimbursements under Medicare. Nearly $3 billion is included for rural health care.

To pay for itself, the bill would raise the federal tobacco tax by 45 cents a pack, while making federal payments to managed-care plans under Medicare equal to reimbursements for the federally managed Medicare program.

The bill, which last month appeared to be politically unassailable, stirred a pitched battle on the House floor. Democrats charged that Republicans were fighting to deny health care to children, using scare tactics and false charges to mask their true intentions. Republicans accused Democrats of pushing nationalized health care while accusing them of slashing Medicare and imperiling seniors.

"Folks, that's the bottom line: It's government-paid health care," Rep. J. Dennis Hastert (R-Ill.) said in a rare speech since he lost the House speakership in the Democratic takeover. "It's a bad bill for a bad time, and it's coming under the false pretenses of trying to do something for children."

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