Congress Unlikely To Override Veto Of SCHIP Legislation As Tension Grows In Effort To Reauthorize, Expand Program

Main Category: Medicare / Medicaid / SCHIP
Article Date: 01 Oct 2007 - 12:00 PDT

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House Democrats "are not in a negotiating mood" after garnering more than 40 votes from Republicans on Tuesday in support of a compromise SCHIP reauthorization and expansion bill, CongressDaily reports (Johnson, CongressDaily, 9/27). The compromise bill would provide an additional $35 billion in funding over the next five years and bring total spending on the program to $60 billion. The additional funding would be paid for by a 61-cent-per-pack increase in the tobacco tax. The Senate is expected to vote on the measure this week. President Bush has promised to veto the legislation (Kaiser Daily Health Policy Report, 9/26).

Even if Republicans are able to sustain Bush's veto, Rep. Diana DeGette (D-Colo.) said that any attempt to lower the level of funding or number of children covered would not be acceptable to House Democrats who accepted the $35 billion funding level after passing a bill at a $50 billion funding level.

House Republicans "said they hope the veto will begin a discussion about the SCHIP bill," according to CongressDaily. Sen. Orrin Hatch (R-Utah) on Wednesday said he hopes small changes could be made to the bill to gain Bush's support, noting that the president is protesting the "ideology" of SCHIP expansion. If Bush and Congress could reach an agreement on the ideology, then an agreement on funding levels could follow. However, Hatch conceded that this was unlikely to occur before the program expires on Sept. 30 (CongressDaily, 9/27).

Other bill supporters hope that the "wide margin of bipartisan approval will persuade" Bush not to veto the legislation, the AP/Contra Costa Times reports (Freking, AP/Contra Costa Times, 9/27).

Veto Override Prospects
House Minority Whip Roy Blunt (R-Mo.) said that he is "absolutely confident" that the House can sustain a veto. Blunt said, "We had exactly who we needed, and we had several more members who would have been there if we needed them." Rep. Heather Wilson (R-N.M.) said it is unlikely that Democrats will sway any Republicans to change their positions, and more likely that Republicans who voted in favor of the bill will not vote to override the president's veto.

However, Democrats expect some Republicans, especially those in politically sensitive districts, to come under enough pressure to change their vote on the bill, according to a House Democratic leadership aide. DeGette said that the "pressure on a number of members of Congress to override the veto will increase dramatically if or when the president vetoes the bill" (Wayne, CQ Today, 9/26).

Confrontation
The "volatile confrontation" between the president and Congress that likely will result from the passage of the SCHIP bill is "likely to reverberate in next year's congressional and presidential elections," Cox/St. Paul Pioneer Press reports. Rep. Chet Edwards (D-Texas) -- who in 2004 defeated his Republican opponent by highlighting that the opponent had sponsored a measure that cut 147,000 children from Texas' SCHIP -- said "the political consequences could be very significant" for Republicans "if the American people see the administration as out of touch with the health care concerns of everyday working families."

The Democratic Senatorial Campaign Committee -- "less than 12 hours after the House passed the bill" -- launched a public relations campaign against incumbent Republicans considered politically vulnerable in the 2008 election, according to Cox/St. Paul Pioneer Press. However, losing Republican seats over votes against the SCHIP bill "is a political risk the White House apparently is willing to take," Cox/Pioneer Press reports (Shepard, Cox/Pioneer Press, 9/27).

Minority Caucuses
Leaders of three minority caucuses -- the Congressional Asian Pacific American Caucus, Congressional Black Caucus and Congressional Hispanic Caucus -- on Wednesday said that they will include language requiring legal immigrants to be eligible for SCHIP and Medicaid in other "must-pass" bills after allowing the language to be removed from the compromise SCHIP bill, CongressDaily reports. Possible legislative vehicles for the provision include the Medicare physicians' fee fix or an omnibus spending bill.

Rep. Hilda Solis (D-Calif.), head of CHC's health task force, said, "We just have to continue to forge on in that matter and fully let our leaders know that we're together on this" because "the minute they see someone falling off or not on the same message, then they don't pay attention." Senate Majority Leader Harry Reid (D-Nev.) said that the provision likely will encounter the same resistance it did as part of the SCHIP bill (Johnson, CongressDaily, 9/26).

White House, Congress Tensions
"[T]ension" between lawmakers and the Bush administration "is bogging down efforts" to reauthorize SCHIP and is a "worrisome sign for Democrats seeking to make their agenda ... into reality," the Wall Street Journal reports. According to the Journal, the debate over SCHIP boils down to "a simple question: How involved should the government be in paying for health care for the uninsured?"

The White House and Congress "have little incentive to work together" because Democrats "are eager to spar with the White House on the popular issue of covering kids," while Bush "wants to rally the support of conservatives and portray the Democratic Congress as fiscally irresponsible and ineffective." Mark McClellan, a former White House policy adviser and former CMS administrator under Bush, said, "Despite all the good will and interest in trying to find a better way to cover the uninsured, I can understand why there are frustrations on all sides that we haven't been able to do better than this."

Bush has said he would rather provide coverage for children in families with annual incomes greater than 200% of the federal poverty level through revisions to the tax code. However, tax changes "appear unlikely to become law" this year, and because Republicans and Bush "haven't coalesced around an alternative to the [S]CHIP expansion that has momentum in the short term," it makes it "even more difficult, even for Republicans sympathetic to ... Bush's view, to sustain a fight against the popular idea of more health insurance for children" (Lueck, Wall Street Journal, 9/27).

SCHIP Debate
The AP/Las Vegas Sun on Wednesday examined "the claims and counterclaims being tossed about" in the debate over SCHIP and "what in fact the bill would actually do." One claim is that the expansion would encourage "crowd-out," where families opt to enroll in government programs rather than private insurance. The Congressional Budget Office estimates that about 3.8 million individuals would become eligible for SCHIP under the bill and that about two million additional people would switch from private coverage to public coverage if the legislation is approved.

The Bush administration and Republicans claim that the bill would allow children in families with annual incomes of up to $83,000 to be eligible for the program. However, the bill essentially caps the maximum eligibility level at 300% of the federal poverty level, or $61,800. At levels above 300%, states would receive a lower federal match that averages 70%.

The Bush administration and Republicans also claim that the bill would make it easier for undocumented immigrants to participate in Medicaid. However, the bill only changes how individuals prove U.S. citizenship. Rather than requiring a birth certificate or passport, the bill would allow individuals to present a Social Security number.

Another claim is that the proposed 61-cent cigarette tax would overburden lower-income residents. According to a study by Congress' Joint Committee on Taxation, two-thirds of federal tobacco taxes are paid by individuals with annual incomes of less than $40,000, while less than 1% are paid by individuals with annual incomes of greater than $100,000 (Freking, AP/Las Vegas Sun, 9/26).

WBUR's "Here & Now" on Wednesday included a discussion with Gail Chaddock, who covers Congress for the Christian Science Monitor, about the debate over SCHIP (Young, "Here & Now," WBUR, 9/26). Audio of the segment is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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