House Passes Revised Children's Health Insurance Program

WASHINGTON — The House of Representatives passed a revised bill aimed at providing health care insurance to 10 million children Thursday but the changes failed to win enough Republican support to override a promised veto from President Bush.

While the Democratic majority said the bill had been "fixed" to overcome the stated objections of Bush and the GOP minority, Republican opponents said the changes were cosmetic and the legislation still is not limited to insuring the children of the working poor.

Like the bill that Bush vetoed three weeks ago, the new legislation would increase spending on the State Children's Health Insurance Program, or S-CHIP, over the next five years by $35 billion to a total of $60 billion. Funding would still be provided by raising federal taxes on cigarettes by 61 cents a pack to a total of $1 a pack.

"We have a saying in Texas," said Rep. Sam Johnson, R-Texas. "If you put lipstick on a pig, it'll still be a pig."

But Speaker Nancy Pelosi, D-Calif., said the changes "addresses all the concerns that were expressed by our colleagues and by the president."

"The focus is on the poor children," she said. "The poorest children receive their health care through Medicaid. Then just above that tier, the working poor families, the focus is there and we're very proud of the legislation."

The decade-old program was designed to provide health insurance for children in families that earn too much to be covered by Medicaid but not enough to afford private health insurance. For a family of four, the Medicaid cut-off is about $21,000 a year. Within federal guidelines, states design their own systems. Federal taxpayers provide about two-thirds of the funding and state taxpayers pick up the rest of the tab.

The 265-142 vote in favor of the extension was not the two-third margin needed to overcome a veto. House Republicans likewise sustained Bush's earlier veto.

Michigan Democrat John Dingell, chairman of the Energy and Commerce Committee and a primary author of the bill, said that the new version capped eligibility at three times the federal poverty level — about $63,000 a year for a family of four — to satisfy Bush and other Republican opponents. He said the bill had always barred illegal immigrants from receiving the benefits but new safeguards had been inserted. And in a year, adults would be excluded from coverage.

"This is solid bipartisan legislation that addresses the concerns of the president," said Dingell.

But Texas Republican Michael Burgess pointed out that the new bill contains "income disregards" that would allow states to effectively add up to $45,000 a year to the eligibility limits.

In an exchange with Burgess, Dingell conceded that states could not count $20,000 a year for housing expenses, $10,000 a year for transportation expenses, $10,000 a year for clothing expenses and $500 a year for child care in determining eligibility. States would have the option of granting these benefits, Dingell said.

The 5 p.m. vote climaxed a long, contentious day in which Republicans used procedural delays to postpone a foregone conclusion after Democratic leaders refused to put off the proceedings until next week to accommodate members from California who had returned to their districts, which have been ravaged by wildfires.

Majority Leader Steny Hoyer, D-Md., was hooted by Republicans when he denied their requests to hold off until a dozen or so California representatives could return.

"I don't believe they're going out there to fight the fire," said Hoyer. "They're going out there to be with their constituents."

Rep. Gene Taylor, D-Miss., said he stayed in his storm-ravaged district rather than returning to Congress after Hurricane Katrina. However, "I did not ask to shut down the Congress so I could stay in Mississippi," he added.

But Republicans said the action was another example of the Democratic majority refusing to consider the opinions of the Republican minority.

Rep. Joe Barton, R-Texas, paced off the distance of 18 feet between the Republican and Democratic sides of the House floor.

"If each of us would come about nine feet, we could negotiate," said Barton, wearing a Lone Star necktie commemorating the Texas state flag.

"If this bill truly represented a genuine compromise, we would've been given more than a couple hours to read it," said Republican Whip Roy Blunt of Missouri. "As it is, we voted on legislation today that will never become law. And because of that, we missed yet another opportunity to send the president a bill that's committed to insuring poor kids first."

Before the House vote, the White House issued a statement saying that Bush would veto the revised bill.

The vote was along party lines, with Rep. Jim Marshall of Georgia casting the only Democratic vote against the legislation. Eight California Republicans who would likely have voted against the bill were in their districts.

Georgia Republican Phil Gingrey, a physician, objected to funding children's health insurance with taxes on cigarettes. The only way the legislation would, indeed, pay for itself is if more people started smoking, he said.