Congress Votes to Extend, Not Expand, Child Health Program

WASHINGTON — Backing down from efforts to expand federal health coverage for children in low- and middle-income families, Congress agreed Wednesday to temporarily extend the program until a new president is in office.

The House voted 411-3 for the bill that extends the popular State Children's Health Insurance Program for 6.6 million children through March 2009. The Senate unanimously passed the bill Tuesday afternoon, and President Bush has indicated he will sign it.

As part of the same legislation, Congress also agreed to temporarily avert a 10.1 percent reduction in Medicare payments to doctors scheduled to take effect Jan. 1. Instead, the bill would increase doctor payments by 0.5 percent through June 30.

Doctors had warned that the pay cut could result in some Medicare patients being unable to find a physician who would accept Medicare.

The temporary extension of the SCHIP program at current spending levels came after Bush twice vetoed bills that would have expanded the program by $35 billion over five years and added about 4 million additional children, some from middle-income families.

Democrats grumbled that Bush had prevented them from adequately covering uninsured children. They also complained that the president had protected private managed-care plans that receive higher Medicare payments than are paid under the traditional fee-for-service system.

"We had a chance to strengthen our nation's health care safety net and improve the lives of our most vulnerable citizens, the elderly, the young, the poor and the disabled," said Rep. Frank Pallone, D-N.J., chairman of the House Commerce Committee's health subcommittee. "Now, we are left with a package that addresses the most immediate concerns but leaves any real health care improvements for another day."

But House Minority Leader John Boehner, R-Ohio, said the bill "provides all the resources necessary to cover low-income children who need quality health insurance. It's my hope that Democratic leaders will finally reject the political posturing and cynical tactics they've employed in the past, and work with Republicans to develop bipartisan policy solutions to reauthorize and improve SCHIP on behalf of low-income children."

Dr. Edward Langston, chair of the American Medical Association Board of Directors, praised Congress for extending SCHIP but criticized it for not permanently resolving the physician payment system.

Langston called the action "extremely disappointing" because the six-month delay in making the cuts "creates uncertainty for both Medicare patients and physicians."

He called on Congress to replace "a flawed payment formula that is a barrier to improving quality and access to care for seniors."