Congress advances new law expanding children's health insurance program

In a move toward health coverage for all Americans, the Senate voted Thursday to expand the State Children’s Health Insurance Program (SCHIP) to include some 4.1 million uninsured children.

The $32.8 billion bill aims to renew federal funding for SCHIP, set to expire on March 31, and broaden eligibility for children, pregnant women, and legal immigrants.

In all, new federal dollars are expected to allow states to cover more than 11 million children by 2013, including 7 million currently receiving SCHIP benefits. (That leaves some 5 million children still without health insurance, sponsors say.) The additional cost is to be covered by a 62-cent hike in the federal excise tax on cigarettes.

“As the worsening economy causes families to lose their jobs and health insurance, it is vital that we redouble our efforts to ensure that every child in America has access to affordable health care,” said President Obama in a statement on Friday.

Bush had vetoed a narrower bill twice

President Bush vetoed a narrower SCHIP bill twice in 2007 on the grounds that it favored government solutions over private insurance. Overrides of those vetoes narrowly failed in the House.

But with stronger majorities in both the House and Senate, Democrats were able to extend the reach of that bill­ and beat back Republican attempts to modify it. The SCHIP bill passed by a vote of 66 to 32, with nine Republicans joining Democrats and two Independents in favor.

The new version of SCHIP drops a five-year waiting period for the children of legal immigrants and allows some states to include families with higher incomes (three times the national poverty level) to be eligible for benefits.

“Democrats would have written this legislation to cover more children, but we compromised to create a bill that Republicans would support,” said Senate majority leader Harry Reid, in the run-up to the vote.

But some Senate Republicans who supported the bill in 2007 opposed it this week, citing concerns that the new bill takes the focus off poor children by including adults and higher-income families. In amendments on the floor, Republicans tried to cap eligibility for SCHIP at incomes no more than two times the poverty level (about $40,000 for a family of four.)

Sen. Charles Grassley (R) of Iowa, who helped mobilize Republican votes to override President Bush’s veto, opposed the new version of the bill this week. Citing the 2007 SCHIP bill, which drew 45 GOP votes in the Senate, he said: “If it was good enough then, it ought to be good enough now.”

Sen. Max Baucus (D) of Montana, who chairs the Senate Finance Committee, disagreed. “Now, the underlying bill is better: It covers more kids,” he said.

Faltering economy adds to need, advocates say

Launched in 1997 with broad, bipartisan support, SCHIP targets children in low-income families that make too much to qualify for the federal Medicaid program, but not enough to pay for private insurance. With more companies laying off workers -- or dropping health coverage altogether -- children who once had private health insurance are turning to states for help.

“No government program has been more successful in expanding children’s healthcare coverage than SCHIP,” said Bruce Lesley, president of First Focus, a children’s advocacy organization, in a statement after the vote. “In these dire economic times, this program serves as a critical lifeline for millions of American families. While it is clear that there is more work to do to ensure coverage for all children, indeed all Americans, we are grateful for this important step in that direction.”

In the House, 40 Republicans joined all but two Democrats to pass a similar version of the bill on Jan. 14, by a vote of 289 to 139. Next week, the House takes up the Senate’s version of the bill, expected to pass easily.

President Obama describes the bill, which he promises to sign, as the first step toward universal health care.

“Providing health care to more than 10 million children through the Children’s Health Insurance Program will serve as a down payment on my commitment to ensure that every American has access to quality, affordable health care,” he said on Friday.