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House OKs $33 billion for children's healthcare

The legislation would provide health insurance for an additional 4 million children. Foes say it grants coverage to kids in families with incomes significantly above the federal poverty line.

January 15, 2009|Noam N. Levey

WASHINGTON — Congressional Democrats pushing to overhaul the nation's healthcare system -- a priority of President-elect Barack Obama -- notched an early legislative victory Wednesday as the House easily passed a bill to expand federally funded health coverage for children.

The measure, which would cover an additional 4 million children and nearly halve the number of uninsured youngsters in the country, came more than a year after President Bush vetoed similar bills in 2007, effectively blocking any growth in the State Children's Health Insurance Program.

This year, with Democrats in control of both ends of Pennsylvania Avenue, there appear to be no real obstacles to the planned expansion, expected to cost nearly $33 billion over the next 4 1/2 years.

The bill sailed through the House 289 to 139 and is expected to win swift passage in the Senate before Obama signs it into law soon after taking office next week.

"This is a new day in Washington," Rep. Frank Pallone Jr. (D-N.J.), a leading champion of the bill, said on the House floor. "Soon we will have a new president who has committed himself to reforming our nation's healthcare system so every American can access affordable and quality healthcare. The bill . . . makes a down payment on that promise."

Shortly after the vote, Obama issued a statement praising the measure. "In this moment of crisis, ensuring that every child in America has access to affordable healthcare is not just good economic policy but a moral obligation we hold as parents and citizens," he said. "I hope that the Senate acts with the same sense of urgency so that it can be one of the first measures I sign into law when I am president."

Democrats had hoped to expand the program after they took control of Congress in 2007. But they were rebuffed by Bush, who twice vetoed legislation citing concerns that it would expand government-run healthcare.

On Wednesday, House Republicans renewed that critique. They also criticized the legislation -- which Democrats brought to the floor without regular committee hearings -- for allowing states to provide health coverage to children in families whose incomes are significantly above the federal poverty line.

"We believe that the . . . bill should follow the original intent of the law, that is to cover children in low-income, working families," said Rep. Eric Cantor of Virginia, the No. 2 Republican in the chamber.

About 30 million of the nation's poorest children receive healthcare through the four-decade-old Medicaid program.

President Clinton worked with congressional Republicans in the late 1990s to create the State Children's Health Insurance Program, or SCHIP, for families that earn too much to qualify for Medicaid but struggle to buy insurance for their children.

The federal poverty line for a family of four was $21,200 in 2008. Family insurance premiums, meanwhile, averaged about $12,680 for a family of four, according to the Kaiser Commission on Medicaid and the Uninsured. Most of the 7 million children enrolled in SCHIP programs nationwide come from families that earn less than twice the poverty line, although several states have opened the program to families making more.

Republican lawmakers also complained that illegal immigrants could abuse the program thanks to provision in the bill that would allow states to offer coverage to legal immigrant children and pregnant women who have been in the country for less than five years. (The provision for care to immigrants is not in a Senate version of the bill.)

GOP leaders found an ally in the U.S. Chamber of Commerce, which objected to making children's health insurance dependent on additional tobacco taxes. The measure is funded primarily by boosting the federal tax on cigarettes by 61 cents, to $1 a pack. But Republicans could not overcome broad public support for the measure, which was also backed by governors, the insurance industry and many children's advocacy groups.

In the end, 40 Republicans crossed the aisle to back the measure. Two Democrats opposed it.


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