By Alex Wayne, CQ Staff
October 25, 2007 -- The House passed its third children's health insurance bill of the year Thursday, a measure intended to draw more Republican supporters and overcome a threatened veto. It didn't.
The vote on passage of the latest version (HR 3963) was 265–142, with 43 Republicans voting "yes." A previous, bipartisan measure (HR 976) that President Bush vetoed passed the House Sept. 25 by 265–159, with 45 Republican votes.
The House fell 13 votes short of overriding Bush's veto Oct. 18.
Both the vetoed bill and the latest one are less generous than the original expansion of the State Children's Health Insurance Program, or SCHIP, passed Aug. 1 by the House (HR 3162).
Renewed Veto Threat
The White House said in a statement that Bush would veto the new bill because it "has not addressed in a meaningful way" the objections that led him to veto HR 976.
Democrats said they had rectified all the major Republican complaints about the vetoed legislation—that it could allow enrollment of some relatively well-to-do families, illegal immigrants and adults in a program intended for children.
"So those who vote against today's legislation can only be voting against the government providing health care to poor children who have no other means of obtaining medical care," said Pete Stark, D-Calif., the chairman of the Ways and Means Subcommittee on Health. "That's the only reason to vote against this."
Republicans insisted that their opposition is more substantial. "Republicans like kids, and not just medium-rare with a side of fries," said Rep. Thaddeus McCotter, R-Mich.
Both bills would expand SCHIP by about $35 billion over the next five years, to $60 billion. Under each, the expansion would be financed by a tobacco tax increase, including a 61-cent increase in the cigarette tax, to $1 per pack.
In most areas, the two bills are identical, and some of the changes Democrats touted in the new bill are cosmetic—one reason Democrats did not make gains among Republicans in Thursday's vote.
"In our cursory examination of the bill, at least, it doesn't appear to have changed very much," said Rep. Jim McCrery of Louisiana, the senior Republican on the Ways and Means Committee.
Republicans members also complained they did not have enough time to read the legislation, which Democratic leaders rushed through the Rules Committee late the night before. They also protested the rule for debate, which bars amendments. And they said it was unfair to force a floor vote when many Southern California members had flown home to be with constituents who are struggling to cope with devastating wildfires. They asked Democrats to postpone a vote on the bill until next week, but were rebuffed.
"I do not believe the absences of either party's members will impact on the outcome of this vote," said Majority Leader Steny H. Hoyer, D-Md.
With the current authorization for the State Children's Health Insurance Program due to lapse Nov. 16, he insisted it was vital to send the new bill to the Senate this week, so the notoriously slow-moving chamber can pass it and a final version can be sent to the president before then.
Republicans forced repeated procedural votes, delaying progress toward passage.
The Bills Compared
Among those objections Bush and House Republicans lodged against the vetoed bill was that it would cause millions of families to leave or forgo private insurance to join taxpayer-funded SCHIP or Medicaid, a phenomenon called "crowd-out."
The new bill contains no substantive new provisions to prevent families from dropping private insurance to enroll in SCHIP. Instead, it offers states an incentive to help low-income people with private insurance pay their premiums: If they do, the states might collect bonuses from the government. That provision has no projected effect on crowd-out—CBO estimates that both the new bill and the old bill would cause about 2 million families to leave or forgo private insurance to enroll in public programs.
In the most substantive change from the vetoed bill, the new measure would limit eligibility for SCHIP to families earning no more than three times the federal poverty level—about $62,000 for a family of four. But Republicans noted that states could evade that cap by disregarding some income—such as money parents spend on housing or transportation—for the purpose of calculating eligibility.
The new bill would result in slightly fewer children enrolling in SCHIP than under the previous bill, and slightly more enrolling in Medicaid. The vetoed bill would have allowed bonuses to states for increasing enrollment in both SCHIP and Medicaid; under the new bill, states will only receive the bonuses for enrolling more children in Medicaid.
The new bill is slightly more costly than the earlier bill—$35.4 billion over five years, versus $34.9 billion for the earlier bill, according to the Congressional Budget Office. Either bill would add about 5.8 million people to SCHIP and Medicaid, CBO estimates.