Democrats set vote to tighten health gap

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By Sean Lengell

Democratic leaders on Capitol Hill, eager to score an early session victory and to give President-elect Barack Obama a high-profile bill to sign by Inauguration Day, are set to vote this week on legislation that would give medical coverage to millions of uninsured children.

Democrats had wanted to pass an almost $800 billion economic-stimulus intended to prime the slumping economy, a move that would have boosted their public image as a party of action.

But as work on the package slogged and the Democrats' self-imposed deadline for passage slipped to February, party leaders - fearful of being tagged as ineffective - now say they will call for a vote Wednesday or Thursday on a long-stalled measure to increase funding for the popular State Children's Health Insurance Program, or SCHIP.

The Democrat-controlled Congress twice in 2007 passed measures to expand SCHIP, only to have their efforts thwarted by a veto from President Bush. But with Mr. Obama supporting the proposed expansion - along with many congressional Republicans - the measure is destined to finally pass.

"I think they think it is a pretty easy win," said John Fortier, a congressional expert with the American Enterprise Institute, a conservative-leaning Washington think thank. "I'm not saying that they want to do health care incrementally, but I think they do see some [health care] pieces that can be done earlier, and they're just going to do them."

SCHIP, a federal-state grant program, subsidizes the cost of insuring children in families that earn too much to qualify for Medicaid but not enough to afford private insurance.

Mr. Bush vetoed the Democrat-crafted SCHIP expansion, saying it was too costly, would cover some adults and children in middle-class families and would be paid for in part with an increase in the federal cigarette tax.

Many congressional Republicans in 2007 also opposed the measure because they said it didn't provide enough assurances that the poorest children eligible would be covered first and provided insufficient safeguards to ensure money wouldn't be spent on people who are ineligible, including illegal immigrants.

But with Democrats holding an overwhelming majority in the House and sufficient Republican support expected in the Senate, the bill will face few obstacles on its way to Mr. Obama's desk once he is sworn-in as president Jan. 20.

An overhaul of the nation's health care system is one of Mr. Obama's major priorities for 2009. The man he has tabbed to lead the effort, Health and Human Services Secretary-designate Tom Daschle, has been a longtime proponent of major provisions of the president-elect's health care reform strategy, including some form of universal medical insurance coverage.

Mr. Daschle, a South Dakota Democrat and former Senate majority leader, faced few tough questions before a Senate health committee confirmation hearing Thursday, paving the way for his expected confirmation.

A quick SCHIP victory also would give Democrats confidence and momentum to tackle big-ticket items such as the economic-stimulus package and a comprehensive health care reform package.

"The same idea always makes sense, and that is: Pass something quick just to show you have some mojo and then worry about something else," said James Pinkerton of the New America Foundation, who worked in the administrations of Presidents Ronald Reagan and George H.W. Bush.

The Clinton administration used a similar tactic during its push for universal health care coverage soon after coming to power in 1993. Capitol Hill Democrats early in the year ushered through the Family and Medical Leave Act, which allows an employee to take unpaid leave for a family member's serious health condition, as a prelude to the administration's proposed health care reform.

The recipe is by no means a guarantee of success, however, as the Clinton administration's health care plan was shot down by Republicans later in 1993.

House Majority Leader Steny H. Hoyer, Maryland Democrat, said Friday that this year's SCHIP measure will be almost identical to the version that died on Mr. Bush's desk in 2007, which called for adding about 4 million children to the 6 million already served by the program. The expansion at the time would have cost an additional $35 billion for five years for a total of about $60 billion.

SCHIP program was to be paid for in part with a 61-cent tax increase on a pack of cigarettes.

But Democrats may be forced to scale back the 2009 version, as the pending economic-stimulus package and last autumn's $700 billion Wall Street bailout have strained the federal coffers, said some Democratic aides privately Friday.

The program's costs also have increased in the past two years. And with cigarette sales slumping, new revenue sources would be needed to expand the program to the levels specified in the 2007 proposal.