Revised child health bill heads for vote in House

Congressional Democrats, having made changes to a children’s healthcare bill that President Bush vetoed, plan to bring the issue to another vote today in hopes of scoring a victory on a top domestic issue.

House Democratic leaders, and key Republicans supporting them, said Wednesday that they believed they had altered the measure enough to pick up the handful of GOP members they needed to assemble a veto-proof majority, or two-thirds of the House. Republican leaders urged their colleagues to resist, saying the changes were too insignificant to justify abandoning the president on a high-profile issue.

Democrats said they would not know whether they had attracted enough Republican converts until the vote was taken. If enough Republicans stick with the president, Democrats said, they will pay a political price.

The revised bill “addresses all the concerns that were expressed by our colleagues and by the president,” House Speaker Nancy Pelosi (D-San Francisco) told reporters. “This is a clarification of the legislation” vetoed by Bush.

Moderate Republicans who opposed the veto urged colleagues to embrace the revised bill.

“The reason Congress is held in low esteem is lack of achievement,” said Rep. Michael N. Castle (R-Del.). Expanding the healthcare program, with or without Bush’s consent, would be a major accomplishment, he said.

The proposed changes would not affect the heart of the bill that drew Bush’s veto, which the House narrowly sustained last week. The measure still would add $35 billion over five years to the State Children’s Health Insurance Program, a figure the administration has called too high. It would enable the program, which now covers 6 million children, to cover 4 million more.

The increase would be paid for with a 61-cent increase in the federal excise tax on a pack of cigarettes. Bush has said he opposes any tax increase.

The proposed revisions, designed to woo a few more Republicans, involve eligibility matters. Families earning more than three times the federal poverty rate would be excluded, except in New Jersey, where a higher threshold could continue at least for a while.

Low-income adults without children, whom some states cover, would be phased out in one year. And states would have to be more rigorous in checking the validity of applicants’ Social Security numbers, an effort to exclude illegal immigrants.

The 10-year-old health insurance program is designed for families that earn too much money to qualify for Medicaid but not enough to buy medical coverage. The main targets are families earning twice the federal poverty rate or less, or $41,300 for a family of four.

Pelosi rejected requests from several Republicans to postpone a vote in order to give GOP moderates more time to round up support. If Bush vetoes the revised version, Democrats said, the showdown will occur when supporters seek the two-thirds majority needed for an override. The Senate passed the first proposed expansion by a veto-proof margin, so the House is the focus of the political battle.