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House approves child healthcare bill

Measure to boost SCHIP program faces Bush veto

WASHINGTON - The House voted yesterday to expand health insurance for children, but the Democrat-led victory may prove short-lived because the margin was too small to override President Bush's promised veto.

Embarking on a healthcare debate likely to animate the 2008 elections, the House voted 265 to 159 to expand the State Children's Health Insurance Program, or SCHIP, by $35 billion over five years. Bush said he will veto the bill because of its cost, its reliance on a tobacco tax increase, and its potential for replacing private insurance with government grants.

SCHIP is a state-federal program that provides coverage for 6.6 million children from families who live above the poverty level but have trouble affording private health insurance. The proposed expansion, backed by most governors and many health advocacy groups, would add 4 million children to the rolls.

The bill drew support from 45 House Republicans, many of them moderates who do not want to be depicted as indifferent to the health needs of children from low-income families when they seek reelection next year. But most Republicans, under pressure from the White House and party leaders, sided with Bush, a move that Democrats see as a political blunder.

It hardly matters that the expansion would be expensive or a step toward socialized healthcare, Representative Charles Rangel, Democrat of New York, said during the House debate. When lawmakers go home, he said, "the question is, 'Were you with the kids or were you not?' "

To overturn a presidential veto, both chambers of Congress must produce two-thirds majorities. The 159 House votes opposing the SCHIP bill should give Bush enough cushion to sustain his veto. House leaders expect few members to switch positions.

The Senate appears poised to pass the SCHIP expansion by a large margin later this week, but a Senate bid to override a veto would be pointless if the House override effort falls short.

"The House has voted for the most important advance in children's health in a decade and so will the Senate. After vetoing bills to end the war in Iraq and to support life-saving stem cell research, it would be outrageous for President Bush to make uninsured children the latest casualty of his veto pen," said Senator Edward M. Kennedy, Democrat of Massachusetts.

Despite the expected veto, many congressional Democrats welcomed the SCHIP debate as a way to open a second political front, in addition to Iraq, on which they feel Bush and his allies are out of step with voters. Representative Rahm Emanuel, Democrat of Illinois, said the president pours billions of dollars into the war but resists a significant expansion of a health program for modest- income children.

"It's no surprise the president finds himself isolated," Emanuel said at a Democratic event.

Some Republicans agreed that the debate over a greater government role in healthcare will resonate far beyond Capitol Hill this week. "This vote is huge for the next president, regardless of who it is," Representative Jack Kingston, Republican of Georgia, said in an interview. "I don't think anybody underestimates the philosophical importance."

Eight Democrats opposed the bill. Some, from tobacco-growing districts, object to raising the cigarette tax to $1 a pack. Some Hispanic members complained that the bill would make legal immigrant children wait five years to qualify for SCHIP.

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