GOP Senator Says Bush Should Put Health Bill Before Policy Goal

By Jonathan Weisman and Christopher Lee
Washington Post Staff Writers
Tuesday, September 25, 2007

A senior Senate Republican accused President Bush yesterday of holding a bipartisan expansion of the popular State Children's Health Insurance Program hostage to his broader policy goals of using tax deductions to help people afford private health insurance coverage.

With a five-year, $35 billion expansion of the children's health insurance program due for a final vote in the House today, Sen. Charles E. Grassley (R-Iowa) and White House aides agreed that Bush's opposition to the legislation stems not from its price tag but from far larger health policy issues. The White House wants to use the issue of uninsured children to resurrect the president's long-dormant proposals to change the federal tax code to help the uninsured, adults and children alike, Grassley said, calling that a laudable goal but unrealistic politically.

"The president has a goal that I share, that we need to take care of the uninsured through private health insurance," said Grassley, relating a sharp conversation he had with Bush on Thursday morning. "But you can't put that on this bill."

"It's bad policy," White House spokesman Tony Fratto said of the children's health bill. "Why should we go along with bad policy if we've got something better?"

A day before the House vote, lobbying on Capitol Hill was in high gear. A broad coalition -- including liberal health policy advocates and their usual foes, the health insurance lobby -- endorsed the SCHIP bill, urging House Republicans to get on board and the president to sign it. The bill appears to have at least 69 votes in the Senate, a bipartisan, veto-proof majority, so White House lobbying has focused on House Republicans.

Reps. Heather A. Wilson (N.M.) and Ray LaHood (Ill.) released a letter to fellow Republicans yesterday, urging them to vote for the bill.

Perhaps two dozen or more House Republicans are likely to vote for the bill today, GOP leadership aides said, far more than the five who voted for a more ambitious House version on Aug. 1, which included cuts in subsidies for private Medicare plans. But that would still be well short of the 60 or so that would be needed to override Bush's threatened veto.

"That's not going to happen," said Brian Kennedy, a spokesman for House Minority Leader John A. Boehner (R-Ohio).

White House lobbying has targeted the bill's price tag and the mechanism that the bill uses to pay for itself, a 61-cent increase in the federal tax on a pack of cigarettes. Grassley said he was surprised to hear Bush bring up his broader health policy goals.

In talks this spring with Health and Human Services Secretary Mike Leavitt, White House National Economic Council Director Al Hubbard and Hubbard's deputy, Keith Hennessey, Grassley discussed linking an extension of the 10-year-old SCHIP program to a more ambitious effort to address the adult uninsured. Grassley encouraged the White House to try to round up Democratic support for that approach, but when White House officials made no such effort, Grassley told them in April that the children's health program would have to stand alone.

That is why he said he was surprised when Bush brought it back up in a phone call Thursday, just minutes before the president went before microphones at the White House to blast the SCHIP deal.

Asked if Bush was holding the children's health bill hostage, Grassley said, "Yes."

"It is a bigger issue. There's no question it is," Fratto said. "It's not a question of fiscal prudence. It's a question of appropriate policy."

The White House has argued that more people would benefit by creating new tax deductions to help families, including the uninsured, purchase private insurance coverage -- an idea that is decidedly unpopular among Democrats who control Congress.

Bush has said the compromise bill would expand SCHIP to middle-class families, prompting some parents to drop private insurance for their kids and dangerously extending the federal government's influence over the health-care system.

But Senate Finance Committee Chairman Max Baucus (D-Mont.), said yesterday the legislation "does just what the president says it should."

"It focuses on the lowest income kids," he said. "It keeps the children's health insurance program for children, not adults, and it does not raise the eligibility to higher income levels."

With a veto almost inevitable, both sides are gearing up for the next step. Congress is likely to pass a short-term extension of the existing SCHIP program before it expires Sept. 30, then begin a second legislative effort. Grassley said if he were the Democrats, he would send the SCHIP expansion to a vote every three months, along with campaign advertisements accusing Republicans of abandoning children. That way, pressure would mount either on Bush to sign the bill or on House Republicans to override the veto.

Americans United for Change, a group closely allied with the Democratic leadership, will begin airing television ads this week in Kentucky, accusing Senate Minority Leader Mitch McConnell (R-Ky.) of abandoning his state's children.

The White House is looking increasingly isolated on the issue. America's Health Insurance Plans, the largest insurance lobbying group, endorsed the measure yesterday, undercutting Bush's contention that the bill is a step away from private insurance and toward government-run health care.

"It repairs the safety net and is a major movement toward addressing the problems that states and governors have been trying to address, which is how to get access for children," said Karen Ignagni, the group's president.

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