By Ceci Connolly
Washington Post Staff Writer
Thursday, January 29, 2009
The Senate is expected to approve a bill today that provides health insurance to about 11 million low-income children, paving the way for President Obama to claim an early legislative victory and collect a quick down payment on his campaign pledge to guarantee care to every American child.
Senate Democrats, after easily defeating Republican attempts to narrow the bill yesterday, predicted they had the votes to renew and expand the popular State Children's Health Insurance Program.
Presently, the $25 billion program covers 7 million children living near the poverty level who do not qualify for Medicaid. Under the Senate bill and similar legislation passed by the House, an additional 4 million youngsters would be eligible for discounted care at an added cost of $32 billion over 4 1/2 years. That would leave Obama about 5 million children short of his promise to ensure that every youngster in the country has health insurance.
Proponents say the need for a health-care safety net has become all the more urgent, given the dire state of the economy. Opponents argue that the Democratic legislation goes beyond the original intent of the program by including children of legal immigrants and some families with incomes as high as $60,000 a year.
Both the House and Senate versions include millions of dollars for recruiting and enrolling youngsters. The expanded coverage would be paid for by increasing the cigarette tax by 61 cents a pack.
"This bill will make a real difference in the lives of children and families across America and is a great way to start the new year," said Sen. Debbie Stabenow (D-Mich.). "I am very pleased to be a part of this and to know that we have a president who will enthusiastically and quickly sign this bill as one of his first actions."
After the final vote in the Senate, House and Senate negotiators must resolve minor differences between the two versions before it can be sent to the White House for Obama's signature.
In 2007, many prominent Republicans joined with Democrats in efforts to expand the program. Twice, President Bush ignored the entreaties of those in his party and vetoed the legislation, calling the effort a dangerous shift toward "government-run health care."
Yesterday, those same Republicans reacted bitterly to changes made by the Democrats now that they control Congress and the White House.
In particular, Republicans objected to a provision in both the House and Senate versions that would, for the first time, lift a five-year waiting period for children of legal immigrants to enroll in the program.
"This is not the bill we intended," bellowed the normally mild-mannered Sen. Pat Roberts (R-Kan.). The Democrats' decision to "simply ram it down our throats . . . is very, very bad precedent," he said.
Sen. Orrin G. Hatch (R-Utah), who had helped craft the 2007 bipartisan bills, offered an amendment that would have required states to enroll 95 percent of eligible, native-born children before opening it to immigrants.
"Our U.S. citizen children should be covered first," he said.
"Those kids come from low-income families with parents that work hard and pay taxes just like citizens," countered Senate Finance Committee Chairman Max Baucus (D-Mont.). "And, those kids need checkups and prescriptions just like all other CHIP kids."
Republicans and some conservative analysts also noted that as many as 2 million children with access to private health insurance might switch to the cheaper government-subsidized program, a trend known as "crowd out."
Baucus said the bill aims to minimize that by giving states a new option to subsidize employer-sponsored coverage for low-income children. Those subsidies would help keep private insurance affordable.
An eclectic mix of business interests, consumer groups and medical providers lobbied aggressively for expansion of the program, including the National Governors Association, labor unions, the retiree group AARP, the Blue Cross/Blue Shield Association and the Pharmaceutical Research and Manufacturers of America.
When Congress enacted the $700 billion financial bailout last fall, "we were told you've got to take care of Wall Street if you want to take care of Main Street," said Sister Carol Keehan, president of the Catholic Health Association of the United States. "Well, Main Street can never be safe if their children don't have health care."
Staff writer Perry Bacon Jr. contributed to this report.