With Congress set to vote on a consensus, bipartisan bill to expand the State Children’s Health Insurance Program (S-CHIP), it’s clear that this is an issue on which Dems have decided to take a stand. They’re still getting pushed around on Iraq policy, but when it comes to passing a good bill to help more low-income kids see a doctor, the majority party will not stand down.
“This week’s showdown over children’s health insurance is the first skirmish in the new battle for universal health coverage. It is also the first confrontation between the president and Congress fought out almost entirely on terms set by the new Democratic majority,” E. J. Dionne Jr. explained. “On no spending issue do Democrats have broader public support — or more Republican allies — than on expanding the State Children’s Health Insurance Program. That is why they have chosen this as the issue on which they want to take their first stand.”
Dionne’s point about Republican allies is key. It’s one thing to take a stand on something like troop support or habeas corpus when you know Senate Republicans won’t even allow lawmakers to cast a vote; it’s another when some Senate Republicans are willing to fight Bush aggressively.
A senior Senate Republican accused President Bush yesterday of holding a bipartisan expansion of the popular State Children’s Health Insurance Program hostage to his broader policy goals of using tax deductions to help people afford private health insurance coverage.
With a five-year, $35 billion expansion of the children’s health insurance program due for a final vote in the House today, Sen. Charles E. Grassley (R-Iowa) and White House aides agreed that Bush’s opposition to the legislation stems not from its price tag but from far larger health policy issues. The White House wants to use the issue of uninsured children to resurrect the president’s long-dormant proposals to change the federal tax code to help the uninsured, adults and children alike, Grassley said, calling that a laudable goal but unrealistic politically.
Asked if Bush was holding the bill that offers healthcare to low-income kids hostage, Grassley said, “Yes.”
Better yet, Grassley even offered Dems a hint about what they should do next.
With a veto almost inevitable, both sides are gearing up for the next step. Congress is likely to pass a short-term extension of the existing SCHIP program before it expires Sept. 30, then begin a second legislative effort. Grassley said if he were the Democrats, he would send the SCHIP expansion to a vote every three months, along with campaign advertisements accusing Republicans of abandoning children. That way, pressure would mount either on Bush to sign the bill or on House Republicans to override the veto.
That’s actually good advice.
Rep. Rahm Emanuel (D-Ill.), one of the leading sponsors of the children’s health bill, added a nice soundbite, arguing that “it’s a bizarre thing that a president who believes in testing kids for math does not believe in testing kids for measles and mumps.”
At this point, the measure appears to have 69 votes in the Senate, which is more than enough to overcome a GOP filibuster and a Bush veto. The margin is much closer in the House, where Republican Reps. Heather A. Wilson (N.M.) and Ray LaHood (Ill.) released a letter to fellow GOP colleagues yesterday, urging them to vote for the bill. Moreover, the American Cancer Society has mobilized a stunning 400 lobbyists to implore lawmakers to back the legislation for the sake of millions of at-risk kids.
Finally, Dionne summarized the debate nicely.
By virtually all measures, the program has achieved exactly what it promised, and at a reasonable cost. But Bush argues that the $35 billion, five-year expansion of the program, worked out between the Democrats and such leading Republicans as Hatch and Sen. Chuck Grassley of Iowa, might push too many children into government insurance. Bush wants a $5 billion expansion over five years, which the Congressional Budget Office says would eventually shove more than 1 million children out of the program at a moment when the number of children without health insurance is growing after years of decline. (That decline, by the way, was due in significant part to the success of SCHIP.) The goal of Hatch, Grassley and the Democrats is to expand the program to 10 million children from the roughly 6.6 million covered now.
This battle is central to the long-term goal of universal coverage. If a proposal with broad bipartisan support that is friendly to state governments and covers the most beloved group in society — children — can’t avoid being gutted for ideological reasons, what hope is there for a larger health compromise?
Stay tuned.