Senate Approves SCHIP Expansion, Reauthorization Measure

Main Category: Medicare / Medicaid / SCHIP
Article Date: 01 Oct 2007 - 11:00 PDT

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The Senate on Thursday voted 67-29 to approve compromise legislation that would reauthorize SCHIP and expand enrollment in the program to about 10 million children, "setting up the biggest domestic policy clash of [the Bush] presidency and launching a fight that will reverberate into the 2008 elections," the Washington Post reports. Eighteen of the 49 Senate Republicans voted for the measure (Weisman/Lee, Washington Post, 9/28). 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 House on Tuesday voted 265-159 to approve the measure, with 45 Republicans voting in favor and eight Democrats voting against the bill (Kaiser Daily Health Policy Report, 9/26).

Democratic leaders likely will send the bill to President Bush next week, which will give "advocates a few more days to pressure" the president to sign the measure, according to the Post (Washington Post, 9/28). If vetoed, the House later next week might hold a veto override vote, according to House Majority Leader Steny Hoyer (D-Md.) (Johnson, CongressDaily, 9/28). If Bush vetoes the legislation and Congress cannot override the veto, Democrats said that they will reintroduce the bill every six weeks to three months until Bush signs the bill or Republicans vote to override a veto. House Speaker Nancy Pelosi (D-Calif.) said, "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" (Washington Post, 9/28).

White House Response
White House spokesperson Tony Fratto on Thursday said that Bush will veto the bill after receiving it (CongressDaily, 9/28). Press Secretary Dana Perino in a statement said, "The president will veto this bill because it directs scarce funding to higher incomes at the expense of poor families" (Lengell, Washington Times, 9/28). Fratto said that if the veto is sustained, the next step should be conversations about the "philosophical differences" between the administration and the bill's supporters. "The money isn't the issue. It's the view of what the role of government has to be in health care," Fratto said (CongressDaily, 9/28).

Fratto said Bush might be amenable to increasing the funding level above his suggested $5 billion over five years if the expansion of eligibility was limited. Fratto said, "This should not be an issue where you decide what the funding is, and then (set) the policy," adding, "We should decide what the policy is and let the funding land where it lands." However, Fratto said that once a government program subsidizes children in families with annual incomes above 300% of the federal poverty level, "you are talking about people who are solidly within the middle class of America, and you are extending another unfunded entitlement to the middle class" (Alonso-Zaldivar, Los Angeles Times, 9/28).

Republican Support
Some of the "sharpest challenges" in the Senate to Bush's position "came from Republicans," who said that the "administration was misinformed -- and even misleading the public" -- on several provisions, according to the Los Angeles Times. Sen. Pat Roberts (R-Kan.) said, "The administration is threatening to veto this bill because of 'excessive spending' and their belief that this bill is a step toward federalization of health care," adding, "I am not for excessive spending and strongly oppose the federalization of health care. And if the administration's concerns with this bill were accurate, I would support a veto. But, bluntly put, they are not" (Los Angeles Times, 9/28).

Sen. Bob Corker (R-Tenn.) said that Bush's concern that the program would lead to "government-run health care" is unfounded. Corker said, "What will move our country toward socialized medicine is not this bill, which focuses on poor children, but the lack of action to allow people in need to have access to private affordable health care" (Pear, New York Times, 9/28).

Sen. Chuck Grassley (R-Iowa) said that he would lobby House Republicans to override a presidential veto (Schor, The Hill, 9/28). Grassley said that Bush's objections to the legislation are based on false assumptions, such as his concern that families with annual incomes up to $83,000 would qualify for the program. Grassley said, "In Iowa, you can't call a cow a chicken and have it be true" (Norman, Des Moines Register, 9/28).

Additional Comments
Reid said that despite Bush's veto threat, "I hope that he will come to his good side and put the well-being of millions of poor children ahead of his own flawed political agenda," adding, "I hope he realizes that this program is government at its best: lending a helping hand, providing a safety net to children" (Washington Times, 9/28).

Sen. Max Baucus (D-Mont.) said that Bush "can bring health coverage to 3.8 million low-income uninsured children who have no insurance today," or "he can cut it with his hatchet, cutting coverage for at least a million children who would otherwise get the doctor's visits and medicines they need."

Presidential candidate Sen. Hillary Rodham Clinton (D-N.Y.) said a veto would show the president is "putting ideology, not children, first" (Freking, AP/Philadelphia Inquirer, 9/28).

Opposition
Minority Leader Mitch McConnell (R-Ky.) said, "If Democrats want to expand government-run health care, they should do it in the light of day, without seeking cover under a bill that was meant for poor children, and without the politics," adding that "the poor kids who we were originally trying to help shouldn't be caught in the middle" (Washington Times, 9/28).

Sen. David Vitter (R-La.) in a statement said, "I strongly support reauthorizing the SCHIP program so it can continue to serve low-income children," but "I oppose this legislation because it is a dramatic expansion of the program to include some adults and families at incomes in the $75,000 range. This is tantamount to passing ... government-dominated health care -- through the back door" (Walsh, New Orleans Times-Picayune, 9/28).

Sen. Jim Bunning (R-Ky.) said that the compromise bill "takes a government program intended for low-income kids -- one that I support -- and by raising taxes the bill expands it to cover middle-income adults and illegal immigrants in other states" (Abdullah, Lexington Herald-Leader, 9/28).

Broadcast Coverage
Three broadcast programs on Thursday reported on the bill. Summaries appear below.

• C-SPAN's "Washington Journal": The segment includes a discussion with Sen. Blanche Lincoln (D-Ark.) about the bill ("Washington Journal," C-SPAN, 9/27). Video of the segment is available online.
  
  
• NPR's "All Things Considered": The segment includes comments from McConnell and Sen. Pat Roberts (R-Kan.) (Rovner, "All Things Considered," NPR, 9/27). Audio and a partial transcript of the segment are available online. Thursday's program also included a report on the tobacco tax provision of the bill. The segment includes comments from Daniel Smith, president of the American Cancer Society's Cancer Action Network; Alan Blum, director of the University of Alabama's Center for the Study of Tobacco and Society; and Rep. Jim McCreary (R-La.) (Elliott, "All Things Considered," NPR, 9/27). Audio of the segment is available online.
  
  
• PBS' "NewsHour with Jim Lehrer": The segment includes a discussion with Hoyer about SCHIP and other issues (Woodruff, "NewsHour with Jim Lehrer," PBS, 9/27). Audio and a transcript of the segment are available online. Video will be available Friday afternoon.
  

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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