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Another Vote on Children's Health Insurance Expansion Unlikely this Year

By Alex Wayne, CQ Staff

September 8, 2008 -- House Democratic leaders likely will not hold another vote on an expansion of children's health insurance, figuring that they still cannot overcome President Bush's veto of the bill and that they do not want to give vulnerable Republicans an opportunity to change their positions on the issue.

Bush vetoed two bills (HR 976, HR 3963) last year that would have expanded the State Children's Health Insurance Program (SCHIP) by about $35 billion, to $50 billion over five years—enough to cover about 10 million children, Democrats say. Democrats came into the 110th Congress promising that an SCHIP expansion would be a top priority, and have said they expect voters to punish Republicans who opposed it.

SCHIP is intended to provide health insurance to children from families who are low income, but not poor enough to qualify for the larger Medicaid program. Before they left for their August break, Democrats were discussing holding another vote on an SCHIP expansion this fall, to increase pressure on Republicans ahead of the November elections. But several factors have conspired to make another vote infeasible.

For one, members of Congress want to leave the Capitol by the end of September to campaign, and already face a busy schedule working on bills to fund the government and possibly to stimulate the economy and respond to high gas prices.

For another, the cost of an SCHIP expansion has grown. The $35 billion cost of the bill last year was to be offset by a large increase in tobacco taxes, including bumping the cigarette tax from 38 cents to $1 per pack.

But now, the same tobacco tax increase alone will not cover the cost of the bill. That is because the five-year period the bill would cover has shifted from fiscal 2008–2012 to fiscal 2009–2013. In essence, Democrats lost a "cheap" year of the expansion—2008—and added an "expensive" year—2013—but without an increase in revenue.

"No final decision on SCHIP has been made, but it is looking more likely that there will not be a vote while we still have a president unmoving in his opposition and a critical mass of Republicans to back up his veto," said a House Democratic leadership aide.

But other aides said that as a result, vulnerable Republicans will be left to defend their votes last year against an expansion, without an opportunity to change their positions.

"Republicans have some explaining to do," said Nick Papas, a spokesman for House Democratic Caucus Chairman Rahm Emanuel of Illinois. "Voters across the country will demand to know why Republicans stood between 10 million children and their health care."

The House attempted to override Bush's vetoes of both bills, but both tallies fell short of the two-thirds majority necessary. The override attempt on HR 976 failed 273–156, and the vote on HR3963 failed 260–152.

There are 25 House Republicans who voted against the expansion last year and are identified by as facing something less than a "safe" re-election campaign. Many of them have face opponents who have tried to highlight their votes against an SCHIP expansion.

Most House Republicans opposed the bill last year because they thought it would allow too many middle-income families to enroll their children in SCHIP and because they thought it did not contain sufficient safeguards against illegal immigrants enrolling in the program. A House Republican leadership aide said that the public would perceive a vote now as "purely political," and that party leaders are confident that few, if any, of their members have changed their positions on the issue.

"All of them remained pretty comfortable with their positions," the aide said. "If they weren't going to flip after last fall, when it was vote after vote after vote and a barrage of ads, etcetera, I think that was as bad as it possibly could be."

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