SCHIP veto draws ire of Democrats
President Bush last week defended his veto of the State Children’s Health Insurance Program (SCHIP) legislation, which would have expanded healthcare coverage for children of low-income families.

Speaking at the Lancaster, Pa., Chamber of Commerce after issuing the veto against the $35 billion expansion of SCHIP last Wednesday, the President said, “this program expands coverage, federal coverage up to families earning $83,000 a year.”

The President’s action follows three other vetoes he has made thus far during his two-term presidency: two vetoes on bills that would have allowed medical scientists to conduct research on embryonic stem cell lines and one veto of a funding bill calling for a timetable on the withdrawal of U.S. troops from Iraq.

The original SCHIP, created by the Balanced Budget Act of 1997, enacted Title XXI of the Social Security Act and allocated about $20 billion over ten years to help states insure more children. The law authorizes states to provide health care coverage to "targeted low-income children" who are not eligible for Medicaid and who are uninsured. States receive an enhanced federal match (greater than the state's Medicaid match) and have three years to expend each year's allotment.

The SCHIP expansion would offer health insurance for children of families with incomes of up to three times the federal poverty level, or $62,000 for a family of four. Under the program, states pay 25 percent of the costs, the federal government the rest.

Seven states already have extended coverage to the levels under the vetoed SCHIP expansion, and two states -- New Jersey and New York -- have taken it beyond.

Senate majority leader Harry Reid (D-NV) issued the following statement about President Bush’s veto:

“Never has it been clearer how detached President Bush is from the priorities of the American people. By vetoing a bipartisan bill to renew the successful State Children’s Health Insurance Program (SCHIP), President Bush is denying health care to millions of low-income kids in America.

“Congress will fight hard to override President Bush’s heartless veto. Not only is this a critical program – one that will improve the lives of 6.6 million low-income children currently in SCHIP and provide health insurance to 4 million more – but the vast majority of the American people know giving kids the care they need is the right thing to do. Bipartisan majorities in both houses of Congress and the governors of nearly every state, healthcare providers and patient advocates, rural and urban Americans, and citizens of all ages are united in strong support of our nation’s children. With today’s veto, President Bush has turned his back on America’s children and he stands alone.”
House Republican Leader John Boehner of Ohio countered with the following statement:

“Republicans are committed to reauthorizing SCHIP in a manner that puts poor children first, and we have outlined clear principles we hope can guide a bipartisan renewal of this critical program. The Republican Congress created SCHIP a decade ago to give millions of low-income, American children access to high-quality healthcare – not as a trial balloon for government-run health care or as a way to provide government benefits to adults and upper-income families who can afford private health insurance.

“Republicans will sustain this veto so we can begin working toward a bipartisan renewal of SCHIP that helps states provide health care to low-income children. Democrats now face an important choice: either work with Republicans to renew this program or continue to play politics on the backs of our nation’s children. If Democratic leaders are truly serious about reauthorizing SCHIP, then they will bring the veto override vote to the House floor immediately – not days or weeks from now – and join us in working to craft a responsible bill that puts low-income children first. To drag out this process any longer would only serve to underscore the fact that Democrats are more concerned with partisan politics than they are with expanding healthcare access for low-income children.”

Senator Edward Kennedy, D-Mass., one of the sponsors of the original 1997 SCHIP legislation, responded to President Bush’s assertion that the bill cost to much by posting the following message on his blog:

“He says the bill costs too much. But for the price of one day in Iraq, we could cover 256,000 children. One week would cover 1.8 million children. And just over one month of the Iraq war would cover the full cost of the bill and insure 10 million children for a whole year.

“Because the current SCHIP program falls far short of meeting the need, hundreds of thousands of children have lost their coverage on President Bush's watch. It's incomprehensible that the President would threaten to veto legislation that corrects this serious problem.

“There's one thing President Bush and I do have in common, though - American taxpayers cover 72 percent of our healthcare premiums, because current law has long-permitted good insurance coverage for federal employees.

“So I ask President Bush and the members in Congress who support his veto:
Would you deny your own family what you'll be denying to millions of other families if this bill is vetoed? If you don't believe the federal government should support children's healthcare, how can you in good conscience accept it for your own families?

“All members of Congress have the peace of mind that when their children are sick, they can afford to take them to the doctor. Why doesn't every American family deserve that peace of mind?”

Speaker of the House, Nancy Pelosi, D-Calif., also challenged the President’s assertion the bill was too expensive.

“It’s important to point out on the President’s response this morning that this bill is about American families, America’s working families, who are struggling to stay in or to reach the middle class. The legislation does not change SCHIP eligibility, and this bipartisan bill is fully paid for - no new deficit spending.”

The legislation vetoed by President Bush proposes funding the expanded eligibility for SCHIP by raising the federal tobacco excise tax on cigarettes from its current $.61 per pack to $1 per pack.

The Congressional Budget Office (CBO) and Joint Committee on Taxation issued a report on Sept. 25 this year that stated that net budgetary effect of the legislation in direct spending and on-budget revenues would cost $200 million from 2008 to 2017. The CBO analysis also concluded that the net budgetary effect of the SCHIP legislation in direct spending and all revenues would cost $1.3 billion over the same time frame.

Speaker Pelosi said she would try to get the 15 additional Republican votes she needed to overturn Bush's veto, noting that “2-to-1 Republican voters support SCHIP and oppose the president's veto.” She indicated that a move to overturn the veto could come within the next two weeks on “Fox News Sunday” this weekend.

“First they said we'd never come to a bipartisan compromise,” Pelosi said in response to a question about her party’s chances of overturning the veto. “Then when we did, they said we'd never get it passed, and we did overwhelmingly and in a bipartisan way. So we take it one step at a time. And right now, we have the next 10 days to two weeks to try to peel off about 14 votes in the House.”

The House of Representatives voted 265-159 in favor of the legislation last week. The bill would need the support of two-thirds of the representatives (289) to overturn President Bush’s veto and send the bill to the Senate.

The Senate voted 67-29 in favor of the legislation, more than the two-thirds necessary to overturn a presidential veto.

Speaking on ABC News “This Week” on Sunday morning, Healthcare and Human Services Secretary Mike Leavitt struck a conciliatory note in explaining the Bush Administration’s hope for compromise legislation.

“Everybody wants children to have health insurance,” Leavitt said. “The President has already said, ‘I want a compromise.’”

Leavitt added, “If it takes more money, we'll put it up.” He did not cite a figure.

In related news, David Dale, MD, president of the 124,000-member American College of Physicians (ACP), sent a letter to the White House today decrying the veto.

“This carefully-crafted House-Senate compromise is targeted at continuing to protect the nation's poorest of children whose parents are unable to afford health insurance on their own,” Dale wrote. “If SCHIP is not reauthorized, millions of children will be denied basic health care needs to give a child a healthy and successful start in life.”

“We disagree with your view of this legislation as an expansion of government-run insurance,” Dale wrote. “Rather, SCHIP is a public-private partnership where nearly 70 percent of children already receive coverage through private insurers and this legislation will expand private insurance even further.”

Dale concluded the ACP letter to President Bush by stating, "We are asking Congress to override your veto. In the unfortunate event that the veto is sustained, we will continue to urge Congress to again pass a bill that provides comparable levels of coverage and necessary increases in tobacco taxes. We hope that you will sign such a bill into law when it returns to your desk."