WASHINGTON — Congress and President Bush are locked in a nasty fight over the future of the federal-state program to provide health care for needy children.
Congress approved a bill to add $35 billion to the State Children's Health Insurance Program and extend it over the next five years; the House vote on Sept. 25 was 265-159, and the Senate's vote two days later was 67-29.
Supporters say the $35 billion expansion would allow SCHIP to cover 4 million additional children on top of the 6 million currently enrolled.
On Oct. 3, Bush vetoed the bill.
He has proposed expanding SCHIP by $5 billion by 2012 and limiting enrollment to children from families at 200 percent of the federal poverty level, or $41,300 for a family of four in most states.
SCHIP pays about 70 cents of every $1 states use to insure kids from families that earn too much to qualify for Medicaid, the government-funded insurance program for the poor and disabled but too little to afford private policies.
The House, which does not appear to have enough votes to override Bush's veto, has scheduled a veto override vote for later this month. The Senate needs 67 votes to override the veto.
The administration's point man on health issues, Health and Human Services Secretary Mike Leavitt, explained the reasons behind Bush's veto and elaborated on the philosophical difference between the Republican White House and the Democrat-controlled Congress.
Question: Why did President Bush veto the $35 billion SCHIP bill?
Answer: Because it's bad for America's health care system. Its real goal is greater government control over the private health care system. The policies of the government ought to be helping people find private insurance, not federal insurance.
The president strongly believes every American ought to have an affordable, basic insurance policy and has laid out plans in which we could assist millions, including children, to get insurance.
He does not believe SCHIP ought to be the vehicle to create national health insurance.
Question: Bush says the congressional proposal would allow families earning up to $83,000 a year to get SCHIP coverage. Congressional critics disagree. They say only New York state seeks to increase the income ceiling and there's nothing in the law overturning the Bush administration's rejection of New York's "waiver" request to go that high. Could you clarify this for us?
Answer: If this bill became law, there would be no need for a waiver because the bill includes a specific allowance for New York to go to 400 percent; and, with that, New York families (would be) eligible for SCHIP at $83,000.
Many of those families also would be required to pay the alternative minimum tax. Only in Washington can you be rich and poor at the same time. The AMT is a tax for rich people to make sure they pay their share.
Question: Let's say Congress passes a compromise measure expanding SCHIP by $10 billion instead of $35 billion. Would the president support that?
Answer: If Congress believes it will require more money to cover those who are currently eligible for the program, he's prepared to have that conversation.
But what he does not want to see is a program intended for poor children being used to insure adults, being used to insure children from much higher income levels than generally intended.
What he believes is that states ought to be doing the hard work of finding the half-a-million children that are currently eligible that are not being insured.
Question: Some Republicans say the veto is hurting the party's chances in next year's elections. Many Democrats are blasting Bush for the recent $190 billion request for the war, saying poor kids are less important to the administration. What is your response?
Answer: Health care for children is an easy subject to demagogue. The Democrats made (it) very clear months ago they were going to send the president a bill that he would have to veto. They did and he has.
Now it's time for us to get on with the conversation of how we reauthorize it in a sustainable way.
Question: How many additional children would the president's $5 billion plan cover?
Answer: What the president's program accomplishes is it continues to fund every child that is currently eligible for the plan. Adults that the states have put on the rolls, it does not eliminate them. It simply says we are not going to pay the SCHIP reimbursement; we're just going to pay the (Medicaid) reimbursement (of about 50 cents for every dollar).
A lot of this is about the money for some people. To us, it's about how we create a system that assures that every poor child has insurance.
We have, for almost a year now, been asking Congress to deal with us not just on SCHIP but the larger conversation of how we get every American insured.
Democrats have said for years that's what they advocate. We have a president who has said, "I want to engage in that conversation." And he's offered proposals that would not only cover children who are poor but allow millions of Americans who currently don't have coverage (to) afford it.
We need to get SCHIP reauthorized and we need to get on to the bigger conversation of how we get all Americans, including children, insured.
Question: In talking to Congress since the veto, have you laid out a new set of principles that you'd like to see in a future compromise bill?
Answer: The conversation on where we go from here is essentially deferred until two weeks while we listen to more rhetoric over the disagreement. We ought to have this vote now and get on with solving it. But no one is, at this moment, talking about the future.