WASHINGTON — Ignoring a presidential veto threat, the House of Representatives passed sweeping Democratic legislation Wednesday that would nearly triple the budget for a popular health-insurance program for low-income children.
By a 225-204 vote largely along party lines, the Children's Health and Medicare Protection Act moved a step closer to becoming law after a series of stalling tactics by Republicans failed.
Heated debate highlighted the ideological differences between Democrats and Republicans over health care. Republicans oppose a larger government role, Democrats generally favor it, and their divergent views frame the debate over universal health coverage in the 2008 presidential election and beyond.
The legislation would provide a five-year, $48 billion funding boost for the State Children's Health Insurance Program. It's designed to cover children whose families earn too much to qualify for Medicaid but not enough to afford private health insurance.
The measure would be funded, in part, through cuts in federal payments to private HMOs that provide Medicare coverage. Analysts have found that those payments are 12 percent higher than the cost of covering seniors under the standard Medicare program. The bill also would be financed with higher taxes on tobacco products, including a 45-cent per pack increase for cigarettes.
Of the estimated 9 million uninsured youngsters in the U.S., 5 million to 6 million are eligible for coverage under SCHIP or Medicaid, according to the Congressional Budget Office. The CBO projects that the bill would cover about 5 million of them.
The Senate is expected to vote later this week on a $35 billion companion bill that also would be financed by higher taxes on tobacco products. If that measure passes, as expected, the victories would be one of the signature accomplishments for Democrats since they took control of Congress last January.
" We are beginning to solve our nation's most important domestic crisis: access to affordable health care for every citizen," said Rep. Steve Kagen, D-Wis.
The Democrats' celebration probably will be short-lived, however. President Bush has vowed to veto the Senate and House bills, which would be the largest expansions of government-subsidized health care since the Medicare prescription-drug benefit was established in 2003.
In a statement Wednesday, the White House called the House measure a "wholesale, unapologetic move to government-run health care for large classes of children and a return to one-size-fits-all choices for Medicare beneficiaries."
Bush wants to expand the program by $1 billion a year, bringing total spending to $30 billion over the five years. The CBO estimates that 800,000 children in the SCHIP program will lose coverage within five years without additional funding over the program's current $5 billion-a-year budget.
The president and many Republican leaders say Democrats are using the bills as the first step toward government-funded universal health coverage for all Americans. Bush and the Republicans prefer tax incentives to help Americans buy their own coverage in the private market.
Critics also claim that the children's health bills would expand the program's eligibility well beyond the low-income youngsters for whom it was created. They say that will cause families that could afford private health insurance to opt instead for government-subsidized coverage.
Rep. Pete Sessions, R-Texas, said that was the Democrats' goal all along.
"This bill uses children as pawns in their cynical attempt to make millions of Americans completely reliant on the government for their health-care needs," he said.
Because the Senate bill was drafted with input from prominent Republicans who support expanding the program, the margin of victory in the Senate will be watched closely to see whether the measure garners the 67 votes needed to override a presidential veto.
"I really don't believe the president will veto this bill in the final analysis, but if that's the case, I hope we can get enough votes so that we can avoid a veto," said Sen. Orrin Hatch, R-Utah, who helped create the children's health program in 1997 and helped draft the current Senate legislation.
The program will expire if isn't reauthorized by Sept. 30, leaving states with no federal money to help cover the program's 6.6 million youngsters, though most analysts said there was little chance of that happening.
A more likely scenario, experts said, is that Congress will pass a stopgap measure to reauthorize and fund the program until it can enact comprehensive legislation.