The politics of kids' health

Children's issues will top the agenda on Capitol Hill this week, as Democrats try to override President Bush's veto of a popular child-health bill.

It's a moment of political drama that could tip close congressional races next fall, as well as raise the profile of other bills dealing with children's health in the US and abroad.

House Democrats call it "Bush versus the kids." They put off an override vote for 15 days after Mr. Bush's Oct. 3 veto of a bill to renew the State Children's Health Insurance Program (S-CHIP) – that's about a day for every new GOP vote they need to prevail.

Meanwhile, Democrats and outside groups are stepping up ad campaigns targeting 21 Republicans who voted against the bill.

House majority leader Steny Hoyer calls the veto override attempt, expected Thursday, "a defining moment for this Congress." House GOP leader John Boehner of Ohio calls the lead-up to the override vote "the most partisan political activity I have seen in this Congress all year." But Republicans are open to compromise, he says.

"We think this is a compromise," responded Mr. Hoyer, appearing on "FOX News Sunday." House Democrats initially called for a $90 billion increase in the program.

Bush proposed increasing funding for S-CHIP by $5 billion over the next five years. Congress settled on an increase of $35 billion to cover 10 million children, up from 6.6 million in fiscal year 2006.

Should the House override fail, "We're going to go back and pass another bill," Hoyer said. "In the end, I think we're going to add 4 million children [to S-CHIP]."

Despite the partisan saber-rattling, broad and bipartisan support exists in Congress for reauthorizing S-CHIP – and other programs aimed at improving healthoutcomes for children.

"The issue of children transcends party and national boundaries. It's something people can agree upon," says Martin Rendon, vice president for public policy and advocacy for the US Fund for UNICEF, who is tracking legislation on children's health.

In addition to S-CHIP, Democrats aim to move a child-focused agenda, including new legislation on product safety, education, and global health. Sponsors say the focus on children growing out of the S-CHIP debate will help all these bills.

Last week, the US Coalition for Child Survival released a poll showing that 81 percent of Americans support the proposed US Commitment to Global Child Survival Act, even when told it would cost $7 per American per year to pay for it. The bill aims to strengthen the US government's role in reducing child mortality in the developing world by investments in "proven, cost-effective interventions," such as care for newborns, access to clean drinking water, immunization, and vitamin supplements.

"We have several Republicans already on this bill, and we haven't even begun to go out and look for sponsors," says Rep. Betty McCollum (D) of Minnesota, who is cosponsoring the bill with Rep. Christopher Shays (R) of Connecticut. "People are also ... aware that one of the quickest ways to restore our credibility and to relate to people around the world is by helping their children celebrate their first, second, and third birthdays," Representative McCollum says.

Ten years ago, the original S-CHIP bill passed with Republicans in control of Congress and a Democrat in the White House. The law aimed to subsidize health insurance for families with incomes too high to qualify for Medicaid but too low to afford private insurance. Over the years, some states expanded eligibility to include adults and families with higher incomes.

Although the Bush administration approved these waivers, the president now says that a renewed S-CHIP should move adults out of a program meant for children and "put poorer children first."

Republicans leaders, who are feeling the heat from embattled colleagues, wanted a quick vote on the veto override, which they say will not succeed. Then, both sides should sit down and work out a compromise bill, they say. Last week, Bush said he was open to spending more than $5 billion on the program.

"I can't imagine Democrats would let S-CHIP expire to make a political point," says Don Stewart, a spokesman for Senate Republican leader Mitch McConnell. "When the president is willing to sign something that will extend and increase it, I don't see how they let it expire."

But Democrats close to the 2008 campaign say the S-CHIP votes could be decisive in the next election. Nearly two-thirds of voters say that they support the Democrats' position on S-CHIP.

"You can see in editorials around the country and in local news stories how disconnected Republicans are from their constituents," says Jennifer Crider, a spokeswoman for the Democratic Congressional Campaign Committee.

Democrats are not sounding conciliatory. During a floor debate to postpone consideration of the veto until Oct. 18, Rep. Fortney "Pete" Stark (D) of California urged Republicans to think of it as the "time out" he uses with his 6-year-old twins.

"You go to your room and think about the mistake you made, and when you're ready to apologize and come back and set things straight, you can come out of your room. That is what the two-week period is all about," said the lawmaker, who chairs the health panel of the House Ways and Means Committee.

A two-thirds vote in both houses is required to overturn a presidential veto. The S-CHIP bill passed the Senate on Sept. 27 by a veto-proof vote of 67 to 29 and the House on Sept. 25 by a vote of 265 to 159, with 45 Republicans voting with Democrats.