$35 Billion Boost In Works for Kids' Health Care

By Christopher Lee
Washington Post Staff Writer
Tuesday, September 18, 2007

Key lawmakers in the House and Senate negotiated into the night yesterday on a deal that would expand the State Children's Health Insurance Program by $35 billion over the next five years.

That would set up a clash with President Bush, who has promised to veto such a plan.

The emerging compromise would bring total enrollment to 10 million children. Congressional aides said it would be funded by an increase in the federal excise tax on cigarettes, which is now at 39 cents a pack. It would also attempt to blunt rules the Bush administration imposed last month that restrict the eligibility of middle-income children.

The package borrows heavily from a Senate version that was passed with bipartisan support by a 68 to 31 vote, the aides said. It would not include measures in the House version that would cut payments to private Medicare plans, nor would it deal with a scheduled 10 percent cut in Medicare payments to doctors.

The proposed $35 billion would bring total funding for the program to $60 billion over five years, the same as the Senate version. The House version, which passed by a 225 to 204 vote, largely along party lines, called for $50 billion in new SCHIP funding, for a total of $75 billion. President Bush has proposed an increase of just $5 billion, for a total of $30 billion.

The details may change and some issues are unresolved, according to several people familiar with the discussions. Lawmakers hope to vote on the compromise before Sept. 30, when the current authorization will expire.

"We are pushing toward agreement, and working hard to shape a final package for broad, bipartisan support," said an aide to Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee. The 10-year-old program serves 6.6 million children annually and enjoys bipartisan support in Congress and many statehouses. Expanding it to cover more of the nation's 9 million children who remain uninsured is a top priority for Democrats.

Bush has said he objects to both the Senate and House bills, contending they would inappropriately enlarge the federal government's role in health care and encourage middle-class parents to drop private insurance coverage for their children.

"This should be focused on children in poor households," White House spokesman Tony Fratto said. "We should not be creating policy that substitutes a government-run program for private health insurance."

But supporters of an expanded SCHIP say health insurance is a middle class problem, too. Of the 700,000 children 18 and younger who joined the ranks of the uninsured this year, about half were from families with annual incomes between $41,300 and $82,394, according to an Urban Institute study.

Rep. Rahm Emanuel (D-Ill.), chairman of the House Democratic Caucus, said a veto, and the ensuing attempt to overturn it, would leave many Republicans facing a tough choice between siding with the president or with their constituents.

"Health care is where the public is most anxious," Emanuel said. "They are going to have their first fight, and a defining fight, on health care for 10 million children."

Kevin Smith, a spokesman for House Minority Leader John A. Boehner (R-Ohio), said Democrats are "more concerned about scoring partisan points against the president than in working in a bipartisan fashion to make sure children continue to get the health insurance they need."

© 2007 The Washington Post Company