Room for compromise on child-health bill

After two weeks of vigils, targeted ad campaigns, and putting kids and their families in the klieg lights, House Democrats expect to fall short on a vote to override President Bush's veto of a popular child health-insurance bill.

But even before Thursday's House vote, GOP moderates were scoping out prospects for a Plan B on renewal of the State Children's Health Insurance Program (S-CHIP) – one that they could expect to see the president sign.

A starting point is more funding. Mr. Bush has asked for a $5 billion increase in the S-CHIP program over the next five years. Congress passed a bill calling for a $35 billion expansion.

"There is room for a compromise, but it has to come at the income level [determining which families qualify for government help], and the amount of funding," says Rep. Ray LaHood (R) of Illinois, who has been lobbying his caucus to support the current S-CHIP bill. The intense lobbying campaign on Capitol Hill in the days since Bush's Oct. 3 veto has moved a few votes into the "yes" column, he says, but not enough. "But a lot of Republicans want a bill to vote on."

In the run-up to the override vote, Bush restated his willingness to compromise with Congress over funding levels. "It's time to put politics aside and seek common ground to reauthorize this important program," he said during a press conference Wednesday. "If putting poor children first requires more than the 20 percent increase in funding I proposed, we'll work with Congress to find the money we need."

But a wild card is how and when Democratic lawmakers will agree to come to terms with Republicans on a bill that they say already represents a compromise – and on an issue that could be a winner for them in November 2008 campaigns.

On Wednesday, House Speaker Nancy Pelosi said that Bush's comments on the children's health bill "distort and misrepresent the facts."

"There is no better example of why Washington is not working for the American people than the president claiming to seek common ground at the same time he is bitterly attacking Congress," she said in a statement.

Other top Democrats also took a hard line on the prospects for a new deal on S-CHIP.

Republicans, meanwhile, are "talking about how to salvage themselves politically," says Rep. David Price (D) of North Carolina. "The president has already dropped his bluster about socialized medicine. If they try to find a way to thread this needle so that they can save face, we need to accommodate them, but only to a very limited extent that does not weaken coverage."

Deep vein of support for the program

Despite the partisan fireworks, there's support for the aims of the 10-year-old program on both sides of the aisle. Neither party wants to be seen as depriving poor children of health insurance.

"Everybody wants it. The program is not going to disappear," says Stuart Rothenberg of The Rothenberg Political Report, a nonpartisan newsletter, in Washington. One option, he says, is for Congress to simply extend the program, either through fiscal year 2008 or until the next administration, "when [Democrats] could take over the whole shebang."

"There's going to be something. The real question is whether it will stay on the radar screen between now and November 2008 as a political issue," he adds.

Other elements of a compromise bill GOP moderates are discussing with colleagues in both parties include an assurance that the neediest of poor families get coverage first, before expanding eligibility to higher-income families, and a stronger requirement to verify the US citizenship of families applying for S-CHIP benefits.

Ten states and the District of Columbia provide S-CHIP benefits to families with annual incomes that are 300 percent of the federal poverty level, or $61,900 for a family of four. New Jersey provides benefits for families making $72,275 a year (350 percent of the poverty level). New York requested, but was denied, a federal waiver that would have provided benefits to families with incomes up to $82,600.

Democrats characterize the administration's claims that families making up to $82,600 a year would benefit under the new S-CHIP reauthorization as "myths, inaccuracies, and outright lies." "There will be no wealthy people covered," said Rep. John Dingell (D) of Michigan at a Wednesday briefing on S-CHIP.

Even if the current bill were signed into law, no child in a family with an income of $83,000 a year would be eligible for S-CHIP unless the administration approved it, Democrats say. Moreover, it provides bonus payments for eligible and unenrolled children.

"We're looking for some minimum guarantee that from 85 percent to 95 percent of the poorest families are covered first," says a Republican leadership aide.

GOP seeks tougher citizenship rules

Republicans are also discussing a need to beef up requirements for verifying citizenship. The program currently requires states to verify a family's citizenship before providing S-CHIP benefits. The existing renewal bill allows states to require only an applicant's name and Social Security number – a move that critics say makes it more likely that those in the country illegally can claim benefits.

"There are a number of moving parts on this S-CHIP expansion that could get us to a compromise," says Rep. Phil English (R) of Pennsylvania, a GOP moderate working on a compromise bill. "There are ways to provide service more effectively targeted and [to] come in with a lower cost."

"But most unclear," he adds, "is whether there will be an open door" from the Democratic leadership.

In an op-ed on Wednesday, House Republican leader John Boehner said Democrats have a choice, after House Republicans sustain Bush's veto: "Work with Republicans to renew S-CHIP and accomplish something on behalf of low-income children or continue to play politics and refuse any ... discussions."

Democrats see another choice: Force Bush to veto the bill twice, as a GOP-led Congress did with President Clinton over the 1996 welfare reform bill, and let public opinion help change hearts and minds on the GOP side.

Meanwhile, Bush administration officials say that they are gearing up for a new round of negotiations with Congress on S-CHIP.

"Everyone understands we just need to let the veto process play out," said Health and Human Services Secretary Mike Leavitt, during a conference call with reporters Wednesday. After the House override vote on Thursday, Secretary Leavitt says that he, National Economic Council Director Al Hubbard, and Office of Management and Budget Director Jim Nussle will immediately make contact with leaders of both parties and relevant committees in Congress. "We would like to find the common ground that would allow us to get this reauthorized," he said.