Kids' health-care battle is tale of 2 parties
July 27, 2007
Page 1
By William Neikirk, Tribune senior correspondent
WASHINGTON Sen. Dick Durbin (D-Ill.) relaxed in his roomy suite of offices in the Capitol this week as he touted a bill to raise the number of children receiving government health insurance from 6.2 million to more than 9 million.
"This bill is worth fighting for," said the Senate's assistant Democratic leader, calling consideration of the legislation a "defining moment." Rep. Dennis Hastert of Illinois sat amid his Republican colleagues on the minority side of the House Energy and Commerce Committee's hearing room as he slammed a Democratic measure to provide government health insurance for 11 million children.
"A reckless expansion," said the former speaker of the House, sounding like the frustrated minority member Durbin was a year ago.
Durbin is now essentially the Senate's Democratic whip and Hastert simply has been whipped, losing his speakership in last November's election debacle for Republicans. The role reversal of these two prominent Illinois politicians shows in many ways, but profoundly so on health care.
If that election meant anything, it was that Democrats are going to be aggressive in enlarging health-care coverage, perhaps setting the stage for a broader debate in 2008 and 2009 over universal coverage. And now Congress is on the verge of casting the first big votes in what could be a precursor of health-care votes to come.
Bills before the House and Senate, which could come up for a vote next week, have caused President Bush to threaten a veto on grounds they are too costly and would extend health-care coverage to children from families that are not poor.
The president said the Senate bill represented "the beginning salvo of the encroachment of the federal government on the health-care system" and would "open up an avenue for people to switch from private insurance to the government."
There is some urgency to pass a bill. The State Children's Health Insurance Program (SCHIP) expires Sept. 30, and a vote is needed to keep it alive and fund it. The GOP wants a more modest expansion and is seeking reforms to reduce the number of adults also getting health insurance through the program.
The House bill would make children eligible in families earning four times the poverty rate, or about $82,000 for a family of four. The Senate bill would limit eligibility to three times the poverty rate, and it attracted bipartisan support in the Senate Finance Committee, giving Durbin hope that it may be able to survive a filibuster.
The House measure would expand an SCHIP program now costing $25 billion over five years by another $50 billion, for a total of $75 billion. It would also make a number of changes in Medicare, such as reducing government subsidies to private insurance companies for covering Medicare patients. The Senate bill, not nearly as ambitious, would cost an additional $35 billion over five years, or $60 billion in total.
The Senate measure would be financed by an additional 61-cent-per-pack tax on cigarettes, while the House bill would raise the tax by 45 cents a pack in addition to saving money on Medicare subsidies. The tax now is 39 cents per pack.
'Defining moment'
SCHIP is a federal-state program that works like a block grant, giving states some flexibility on use of funds. It is now 10 years old. But extending the program is proving more controversial than expected.
"To have strong bipartisan support on something this basic for families across America, we think it is a defining moment," Durbin said. "If President Bush's argument is that we're not being fair to the private health insurance companies, that is not going to carry the day."
Hastert sees it as a defining moment, too, but not in the same way Durbin does. He criticized provisions in the House bill to reduce subsidies for private health-care companies that serve Medicare patients -- subsidies added in the 2003 prescription drug bill to encourage more private firms to get in the Medicare market.
"We spent years trying to give people choices in Medicare," Hastert said in an interview. "Democrats don't want to people to have choice." If many private insurance firms drop out of the program even as more children are covered by SCHIP, he said, "there would be only a thin line of people with private insurance."
Veto threat
Bush's veto threat hangs over the deliberations. Durbin said he's hopeful Democrats can get enough Republicans to avoid a filibuster and send the measure to Bush. To override any veto would require a two-thirds majority vote, and that would be extremely challenging in both houses.
But vetoing a health-care plan for children would set up a tricky political situation for Republicans in both houses, since health care is expected to be a huge issue in the 2008 race. Rep. Rahm Emanuel (D-Ill.), one of the key players on the issue, said the House bill would "get close to universal health care for children." Other children are covered either by private insurance or Medicaid.
Cost has emerged as another factor. Hastert raised it in the committee hearing along with other GOP members, saying the House bill would cost much more than the $75 billion estimated by Democrats over five years.
Sen. Jon Kyl (R-Ariz.), chairman of the Senate Republican Conference, said when people discover how much the expansion of children's health care will cost, they will ask, "Is this a fair price for covering kids we'd like to see covered or, as usual, has Congress gone overboard?"
Durbin said it is hard for Republicans to argue that spending $12 billion a year on SCHIP is wasteful "at a time we are spending $12 billion a month on this war."
----------
wneikirk@tribune.com
