Articles
Washington Post: Children's Health Bill Approved By House
08/02/2007
By Jonathan Weisman
The House yesterday approved legislation vastly expanding a
federal health insurance program for the children of the working poor,
shrugging off a fresh veto threat from President Bush and the fierce opposition
of House Republicans.
The Senate, where the legislation has strong bipartisan
support, is expected to follow suit as early as today, voting on a more modest
version of the program and probably setting up a showdown between congressional
supporters and the White House, which says the measures are far too expansive.
The legislation would launch the most significant growth in
federal health care in a decade, and Democrats hope it will fortify their
members as they head home soon for the summer recess amid voter perceptions
that they have accomplished little since taking control of Congress.
"This is the children's hour," House Speaker Nancy
Pelosi (D-Calif.) declared last night. "We are able to meet our moral
obligation to our children."
The 225 to 204 vote in the House -- largely along party
lines -- came after hours of delaying tactics, strident rhetoric and trench
warfare from Republicans who called the bill the first step toward
"socialized medicine," financed by an unfair tobacco tax increase and
cuts for managed-care companies in Medicare.
But in the end, the Democrats had weapons that were just too
powerful -- a promise to insure 5 million more children who otherwise would
have no access to health care, adding to the 6 million children already covered
-- and the backing of Republican and Democratic governors, the American Medical
Association, AARP, the March of Dimes, the Catholic Health Association, the
American Academy of Pediatrics, and even cyclist Lance Armstrong. And the
prospects are good in the Senate, where a key Republican, Orrin G. Hatch (
But Bush opposes such a major expansion of the program. In
an interview with The Washington Post last month, he said, "When you
expand eligibility . . . you're really beginning to open up an avenue for
people to switch from private insurance to the government."
The House bill would enlarge the State Children's Health
Insurance Program, or SCHIP, by $47 billion over five years to provide coverage
to the additional 5 million children.
Those children would have access to dental and mental health
care. And the bill would offer new options for states to extend Medicaid and
SCHIP coverage up to age 20 and to cover some legal immigrants and pregnant
women. It would expand coverage for preventive health screening for seniors
under Medicare and would provide $19 billion over five years to prevent
scheduled cuts to physician reimbursements under Medicare. Nearly $3 billion is
included for rural health care.
To pay for itself, the bill would raise the federal tobacco
tax by 45 cents a pack, while making federal payments to managed-care plans
under Medicare equal to reimbursements for the federally managed Medicare
program.
The bill, which last month appeared to be politically
unassailable, stirred a pitched battle on the House floor. Democrats charged
that Republicans were fighting to deny health care to children, using scare
tactics and false charges to mask their true intentions. Republicans accused
Democrats of pushing nationalized health care while accusing them of slashing
Medicare and imperiling seniors.
"Folks, that's the bottom line: It's government-paid
health care," Rep. J. Dennis Hastert (R-Ill.) said in a rare speech since
he lost the House speakership in the Democratic takeover. "It's a bad bill
for a bad time, and it's coming under the false pretenses of trying to do
something for children."
House Minority Leader John A. Boehner (R-Ohio), pointing to
the cuts for Medicare managed-care plans, dashed off a letter to AARP, calling
for the powerful seniors lobby to retract its endorsement and halt its
full-throttle campaign for the bill's passage.
But John Rother, AARP's policy director, responded that
funding for Medicare physician reimbursements and free medical screenings more
than makes up for any difficulties managed-care companies might face when they
get the same reimbursement rates as the core Medicare program.
The Senate measure, a $35 billion expansion of the program
over five years, would continue coverage for about 1 million children who might
otherwise be dropped and add 3 million youngsters.
By forgoing the physician reimbursement issue and rural
health-care funding, senators could pay for its bill with a 61-cent increase in
the federal tobacco tax while avoiding any Medicare cuts. That has given the
Senate bill broad, bipartisan support, but House Democratic leaders say the
advocacy of Hatch and several other conservatives will give their members ample
political cover when negotiators try to reconcile the House and Senate
versions.
Hatch and Sen. Edward M. Kennedy (D-Mass.) said yesterday
that the House-Senate negotiations will aim to keep the final measure within
the scope of the Senate bill, in hopes of avoiding a veto.
"Personally, I believe if we can get enough votes, the
president doesn't want to veto this," Hatch said.
House Republican leaders believe they have turned the issue
against the Democrats. Earlier this week, Rep. Rahm Emanuel (D-Ill.), the House
Democratic Caucus chairman, huddled with his caucus behind closed doors to
soothe frayed nerves. His tool was an advertisement that Rep. Chet Edwards
(D-Tex.) depended on to win reelection in 2004, when an unprecedented
redistricting in his state had made his electorate strongly Republican.
"I don't want welfare. I just want to get insurance for
my child," Jenny Jones, 28, said in the advertisement, after explaining
that her husband had been killed two years before in a house fire, leaving her
3-year-old daughter, Bailey, dependent on the Children's Health Insurance
Program. "Look at my little girl, look into her eyes and tell her she's
not good enough to be taken care of."
Of the half-dozen Democrats targeted by
Republican-controlled redistricting in