Senate and House Reach Accord on Health Insurance for Children

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By Christopher Lee
Washington Post Staff Writer
Saturday, September 22, 2007

Senate and House negotiators from both parties reached a final deal yesterday on an expansion of a health insurance program for the children of the working poor, just a day after President Bush vowed to veto it.

House and Senate leaders scheduled votes for next week on the $35 billion expansion, a measure that has bipartisan support, even from some of the president's staunchest supporters. That broad backing could give Congress a long-shot chance to override a Bush veto for the first time.

"This legislation will get the Children's Health Insurance Program back on track and reclaim precious resources for low-income kids," said Sen. Charles E. Grassley (R-Iowa), one of the lead negotiators. "It breaks the legislative impasse and should have strong support from both Democrats and Republicans."

House Speaker Nancy Pelosi (D-Calif.) said, "We are hopeful that the president will reconsider his veto threat and sign this bill into law on behalf of our nation's children."

But White House spokeswoman Dana Perino said yesterday that the veto threat stands. "Once the Democrats finish their political posturing, the president looks forward to working with Congress to pass SCHIP reauthorization he can sign," she said.

The $5 billion-a-year program is set to expire on Sept. 30. A veto could force Congress to pass an emergency extension to keep it going, but that would make it difficult for many states to plan and manage their programs, said Martha Roherty, head of the National Association of State Medicaid Directors.

The House is expected to vote on Tuesday, with a Senate vote by Thursday, congressional aides said.

The compromise resembles a Senate version that passed in August with 68 votes, enough to override a veto. But getting the needed 290 votes in the House will be difficult, lawmakers said.

The measure would boost the program's total funding to $60 billion over the next five years, with the expansion to be paid for by a 61-cent increase in the federal excise tax on cigarettes, to $1 a pack. The added funding would increase total enrollment to 10 million children, from 6.6 million.

The bill would also block the implementation of new rules that the Bush administration imposed last month to restrict states' ability to enroll middle-class children. The measure would prevent states from enrolling adults except for pregnant women, and it would require states that already have adults on the rolls to remove them.

The original House version, which passed 225 to 204, largely along party lines, called for total funding of $75 billion over five years. Bush has proposed a funding increase of $5 billion over five years, which would bring the total to $30 billion over that period. Supporters of the compromise noted that the Congressional Budget Office has said that the Bush amount is not enough to continue covering the number of children who are already in the program.

Bush and many House Republicans contend that the legislation would inappropriately enlarge the government's role in health care and encourage middle-class parents to drop private insurance. They want the program to remain focused on its initial mission of covering children whose families earn too much to qualify for Medicaid but not enough to buy private insurance -- something that lawmakers from both parties said the compromise would ensure.

"We desire to see SCHIP continue to cover those children who are under 200 percent of the poverty line," or about $41,300 for a family of four, Health and Human Services Secretary Mike Leavitt said in a briefing Thursday. "We believe that the $5 billion is adequate to do that. If it isn't, then we're prepared to talk about what the number should be. But it's the policy, the ideologic question, that we want to focus on."

Staff writers Jonathan Weisman and Michael A. Fletcher contributed to this report.

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