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AP: Congress Nears Key Votes on Health Care

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Location: Washington, DC

AP: Congress Nears Key Votes on Health Care


This week's votes on a children's health program go to a key issue in next year's elections: How much should the government spend to insure families with modest but not poverty-level incomes?

The House was scheduled to vote Tuesday on whether to expand the State Children's Health Insurance Program by a greater amount than President Bush wants. The Senate plans to vote Thursday.

Lawmakers say both chambers will pass the bill, which would add $35 billion over five years to the program, allowing 4 million more children to join the 6 million now enrolled. Bush vows to veto it, however, and the House appears unlikely to muster the two-thirds majority needed to override a veto.

If that happens, lawmakers and the administration will haggle over a temporary extension of the 10-year-old program, set to expire Sunday. On the political front, Democrats say they will attack Republicans as too willing to support the costly war in Iraq while backing Bush's modest increase in children's health coverage.

"This vote gives a lot of Republicans a chance to show whether they want to help children or march in lockstep with the president," said Rep. Chris Van Hollen, D-Md., who chairs his party's House campaign committee for 2008.

Bush and his allies dismiss such talk. They say the legislation would cost too much, subsidize families that can afford insurance, and trigger an unacceptable tax increase. The bill, drafted by members of both parties and houses, would raise the federal cigarette tax to $1 per pack, a 61-cent increase.

"We don't want the creation of more government-run health insurance," House Republican leader John Boehner of Ohio said last week.

While few congressional Republicans have parted ways with Bush on Iraq, the children's insurance program is more troubling, especially for those in competitive districts. Many Republican governors, as well as Democrats, support the proposed expansion, and some GOP lawmakers say it is easy to characterize a vote against the bill as a vote against helping poor children.

House Republicans supporting the measure include Phil English, Pa., Wayne Gilchrest, Md., Ralph Regula, Ohio, Mark Kirk, Ill., Jim Walsh, N.Y., and Heather Wilson, N.M., all from districts that Democrats are eyeing.

On Monday, Wilson and Rep. Ray LaHood, R-Ill., urged colleagues to support the bill.

"While not perfect," their letter said, "this agreement retains the core principles" of the program, which is administered by the states under federal guidelines. "Federal assistance is reduced if states expand coverage to middle-income children," they wrote.

In an interview, Wilson noted that the program was created by a Republican-controlled Congress. "A lot of Republicans want to see it continued," she said.

Senate supporters of the bill include Republican veterans Orrin Hatch of Utah and Charles Grassley of Iowa.

The insurance program is designed to provide health coverage to families with incomes too high to qualify for Medicaid but not high enough to afford private coverage. Under the expansion proposal, states could steer funds to some families earning triple the official poverty-level income, provided they showed progress enrolling the main target: children in families earning no more than double the poverty rate.

The Bush administration says the legislation could qualify some families making $83,000 a year, or four times the poverty level. Such a scenario is unlikely, the bill's proponents say, noting that it would require waivers from the administration that already have been rejected.

Health coverage, always a prime issue for voters, is especially hot this month. Several presidential candidates, including Sen. Hillary Clinton, D-N.Y., recently unveiled their health care proposals, and Bush called a news conference last week to denounce the pending insurance legislation.

The liberal group Americans United For Change says it is spending $100,000 on a TV ad in Kentucky attacking Sen. Mitch McConnell, the Senate minority leader, for backing Bush on the children's insurance issue.

Bush's allies are pushing back. Congressional Republicans support a responsible expansion of the program, Boehner's office said in a statement Monday, "but they have warned a huge expansion of massive government-run health care would lead to a system of 'Hillary-care' that puts government rather than doctors and patients first."

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