House approves children’s healthcare bill

The House on Tuesday approved a compromise bill to renew and expand a popular program that provides health insurance for low-income children, but supporters came up short of the votes needed to override a threatened veto from President Bush.

Although 45 Republicans joined most Democrats in supporting the measure, the 265-159 vote failed to reach the two-thirds majority that would be needed to override a veto -- 290 if every House member votes. That left the fate of the State Children’s Health Insurance Program in doubt, with a Sept. 30 deadline for its renewal fast approaching.

If the result is gridlock in Washington, state officials say hundreds of thousands of children could begin losing coverage in a few months. And while the bill represents a compromise between Democrats and prominent Senate Republicans, the debate in the House and with the administration has turned increasingly rancorous in recent days.

At issue is an increase in funding for the federal-state partnership, as well as state flexibility to help uninsured children in some middle-class families. The bill would boost federal tobacco taxes to pay for the program, raising the levy to a $1 a pack on cigarettes -- an increase of 61 cents.

Speaker Nancy Pelosi (D-San Francisco) vowed to keep sending the legislation back to Bush until he relented. “This fight will not end this week or next,” she said. “This legislation will haunt him again and again and again. . . . We will continue to work in a bipartisan fashion to put bills on the president’s desk and see how long he can hold a veto-proof majority.”

In a statement released after the House voted, Bush reiterated his intention to veto the bill, calling it “part of the Democrats’ incremental plan toward government-run healthcare for all Americans.”

In the California delegation, Rep. Diane Watson (D-Los Angeles) voted “present,” and Rep. Wally Herger (R-Chico) did not vote. All other Democrats voted for the bill, as did Rep. Mary Bono (R-Palm Springs). The remaining Republicans were opposed.

The Senate may vote on the bill Thursday.

Meanwhile, Lesley Cummings, the administrator of California’s version of the program -- Healthy Families -- said she was mulling over a dismal set of options if funding for more than 800,000 children covered in the state could not be secured. Even if Congress passed a stopgap extension at current funding levels, California’s program would run out of money in July, she said. That means the state might have to deny coverage to some children now, in order to cover others for a full year.

“It makes me sick to my stomach because in California we really have been building over the years to cover children, and we really didn’t see this political disagreement coming,” Cummings said. “Should I start disenrolling children now, or should I assume money is going to come later to make up the shortfall?”

Gov. Arnold Schwarzenegger, who has proposed an expansion of California’s program, is among a number of governors of both parties lobbying Congress and the administration for more funding and flexibility.

The program currently covers about 6 million children, mainly in working families who earn too much to qualify for Medicaid but too little to afford their own coverage. Washington now contributes about $5 billion a year, covering roughly 70% of the cost, and states put up the rest.

The congressional compromise would increase federal funding by $35 billion over five years, enough to cover an estimated 3 million to 4 million more children. Bush has offered a $5-billion boost over the same period -- a sum analysts say is not sufficient to sustain the current caseload, let alone cover more of the 9 million uninsured children.

The bill is supported by doctors’ groups, the insurance industry, public health advocates and the United Way. The U.S. Chamber of Commerce, citing the tax increase, opposes it.

Some House Republicans say the compromise bill would expand government coverage to families making as much as $83,000 and make illegal immigrants eligible for benefits. Republican senators who support the bill said both charges were misleading.

States would be able to seek expansions to cover middle-class families, said a Senate Republican aide who worked on the legislation, but federal funding would be restricted. The Health and Human Services Department could also deny such requests. One outside analysis estimated that about 80% of the uninsured children who stand to get coverage are in low-income families.

As for immigrants, the bill would aim to keep them off the program. Under pressure from the Senate, House Democrats agreed to drop language that would have allowed foreign-born children who are here legally to get coverage. That prompted a coalition of 40 Latino organizations to oppose the measure.

Nonetheless, some House Republicans said a provision of the bill to ease identification requirements would open up the program to illegal immigrants. But a leading author of the compromise, Sen. Charles E. Grassley (R-Iowa), said the change was intended to help citizens who had been excluded as an unintended consequence of tougher identification requirements.

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ricardo.alonso-zaldivar @latimes.com