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Showdown Looms as Child Health Bill Passes

But Democrats, and their Republican allies on the issue, made it clear that Bush's veto will not be the last word. They said that they will keep coming back to the bill every six weeks to three months until the White House relents or Republican opposition collapses.

"If the president refuses to sign the bill, if he says, with a veto, 'I forbid 10 million children in America to have health care,' this legislation will haunt him again and again and again," said House Speaker Nancy Pelosi (D-Calif.).

Yesterday's vote put Bush in a position he has never faced. The president has used his veto for only two issues in seven years in office: federal funding for stem cell research and constraints on his Iraq war policies. But on those issues, Bush retains strong Republican support and a coalition that unites social, economic and national security conservatives.

The children's health bill, in contrast, has the support of moderate Republicans and conservatives, business interests and even abortion opponents such as the Roman Catholic Church. The measure has the backing of the health insurance industry and children's and disease-control advocates, most of the nation's governors, AARP and the American Medical Association.

The compromise would expand the $5 billion-a-year program by an average of $7 billion a year over the next five years, for total funding of $60 billion over the period. That would be enough to boost enrollment to 10 million, up from 6.6 million, and dramatically reduce the number of uninsured children in the country, currently about 9 million, supporters say.

Bush and GOP leaders say that the measure would push millions of children already covered by private health insurance into publicly financed health care. They say it would also create an "entitlement" whose costs would outstrip the money raised by the bill's 61-cent increase in the federal tobacco tax.

The coalition backing the bill could also face risks after a veto. House Majority Whip James E. Clyburn (D-S.C.) said he would push Democrats to come back at Bush with a new version that adds vision-care coverage to the expanded coverage for dental and mental health and restores benefits for the children of legal immigrants.

But by adding benefits, especially for immigrant children, Democrats could lose support in the Senate.

Sen. Orrin G. Hatch (R-Utah), one of the compromise measure's strongest advocates, suggested that he would like to see Congress look for a compromise with the White House after a veto. "If we want to cover these kids and we've got a stultification of that effort, then we're going to have to do the best we can," Hatch said.

Democratic leaders are convinced that no such compromise is necessary. Health care is again rising as a concern among voters, they say, citing Democratic polls that show overwhelming support for expansion of the children's health insurance program. Bush's unpopularity will affect sentiment among those against a veto, they say.

Republicans facing tough reelection bids appeared to agree.

"It's the White House that needs to give," said Sen. Susan Collins (R-Maine).

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