The Senate late yesterday was expected to pass legislation to more than double funding for a popular health care program for low-income children — a day after the House approved an even more expensive and expansive version of the measure.
Republicans, who say it is a step toward government-run health care, failed to limit $35 billion funding increase in the Democrat-crafted bill, which President Bush has vowed to veto for its hefty price tag.
Supporters of the measure said such accusations are unfounded and disingenuous.
"This is not a health-insurance bill that is going to cover all Americans, [or] that's going to dramatically expand government," said Sen. Byron L. Dorgan, North Dakota Democrat.
"This [bill] ought to be considered a baby step forward, but an important baby step nonetheless, in doing what we are required to do in this country, and that is putting our children first."
Democrats add that the richest nation in the world has a moral obligation to ensure as many children have health care as possible.
"The bottom line is, this is just a good thing to do," said Sen. Max Baucus, Montana Democrat.
The Senate bill calls for a $35 billion increase to extend the 10-year-old State Children's Health Insurance Program (SCHIP) during the next five years, for a total of about $60 billion. The plan would add an estimated 3.2 billion children to the 6 million already enrolled in the program, which is set to expire Sept. 30.
To pay for the program, the measure calls for a 61-cent per-pack cigarette-tax increase.
The House version, which passed by a vote of 225-204, would spend an additional $50 billion over five years and would cover 5 million children not currently enrolled.
Republicans said the Democrat-crafted bills would extend coverage to families with incomes as high as 400 percent above of the federal poverty level — even if the majority of children in those families already have private coverage. Many Republicans favored capping eligibility requirements at 200 percent above the poverty level.
"If we just want to go to a government-run, socialized medicine, fine — this is it," Senate Minority Whip Trent Lott, Mississippi Republican. "I'll be back in years to come and say 'I warned ya.' This thing is going to continue to grow."
SCHIP, which is a joint federal-state partnership, subsidizes the cost of insuring children living in families that earn too much to qualify for Medicaid but not enough to afford private insurance. The federal government pays for about 70 percent of the program, and the states pay the rest.
States are allowed to set eligibility guidelines, with some opting to expand coverage to as much as four times above the poverty level, or about $70,000 for a family of four. Some states also have extended coverage to some adults.
A final draft of the legislation will be worked out in a conference between the two chambers.
Mr. Baucus said don't necessarily expect a straight compromise between the two bills.
"What's going to happen in conference? I have no idea," Mr. Baucus said. "They are really two different animals, and when that happens generally some other solution presents itself...There are all kinds of ways to do things around here."