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Both sides look for political gains in battle over SCHIP
The Hill - 7/17/2007
The high-stakes gamesmanship between President Bush and Congress over children’s healthcare could have significant ramifications in next year’s election cycle as both parties stake out ground on the politically potent issue.
A failure to enact a reauthorization and expansion of the State Children’s Health Insurance Program (SCHIP) could provide Democratic and Republican candidates next year — presidential and congressional — with stinging talking points.
Children’s health insurance may lack the political resonance of the war in Iraq, immigration and other hot-button issues, but both parties already are positioning themselves to frame the contest to their advantage next November.
With SCHIP’s authorization set to expire at the end of the fiscal year on Sept. 30, the endgame on children’s health insurance could coincide with showdowns between the White House and Congress on a plethora of issues, including Iraq and federal spending.
As congressional Democrats took the reins of Congress, their leaders identified the SCHIP bill as one of the highest priorities for the new majority. Democrats vowed to spend $50 billion in new money to expand the program to cover millions of additional children in low-income families.
Under current law, the federal government spends about $5 billion a year on SCHIP. House Democrats have proposed adding $50 billion, while a Senate plan would spend another $35 billion. In contrast, President Bush has called for only $5 billion in new spending.
If Democratic efforts fall short and SCHIP is either reauthorized on a smaller scale or extended at its current level, the GOP could point to children’s health insurance as another issue on which the new majority failed to govern.
“If the Democrats aren’t successful, here’s yet again an unsuccessful attempt that overreached,” remarked former Rep. Bill Thomas (R-Calif.), now a consultant at Buchanan Ingersoll & Rooney.
But Thomas added that Democrats could also try to use inaction on SCHIP for political benefit. “They may want to make a bunch of points and wait until the November ’08 election,” he said.
For their part, Democratic candidates could blame President Bush and his congressional allies for denying healthcare to the children of the working poor.
Democratic presidential candidates would “make enormous hay with that failure,” said Ron Pollack, president of the liberal healthcare advocacy group Families USA.
Vulnerable Republicans also could be forced to make tough decisions on whether to stand by their party’s attempts to scale back the Democratic bill or vote for a generous expansion.
Polls show that Democrats generally have a political advantage over Republicans when it comes to healthcare. On the other hand, one Republican lobbyist said, lower expectations for the GOP on healthcare could mitigate the political damage if the SCHIP bill comes up short.
As for the political risk to Bush, the lobbyist said, “There is a certain amount of freedom that comes with being at 25 percent approval ratings.”
The Senate Finance Committee is scheduled to convene this evening to mark up the SCHIP bill unveiled Friday by Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa), along with Sens. Jay Rockefeller (D-W.Va.) and Orrin Hatch (R-Utah).
The bipartisan working group attempted to devise a plan that would assuage the concerns of conservatives skeptical about the costly expansion of a federal benefits program. They also hope to retain the backing of Democrats, despite reducing the cost of the expansion to about $35 billion.
The panel’s draft bill would pay for the expansion mainly through a 61-cent increase in the tax on tobacco products, which would raise the federal levy to $1 per pack of cigarettes.
The debate has taken on a more ideological bent since the White House became more aggressively involved. Bush has taken a hard line against the proposal, describing it as the leading edge of a Democratic strategy to create a national health insurance program for all people.
The Finance Committee compromise did not satisfy the White House, which swiftly issued a veto threat.
“The program is going beyond the initial intent of helping poor children. It’s now aiming at encouraging more people to get on government healthcare,” Bush said last week. “I’ll resist Congress’s attempt to federalize medicine.” The White House also objects to the tobacco tax.
Bush instead has proposed focusing on providing benefits to the most needy and those already eligible but not enrolled, as well as ending federal subsidies for SCHIP benefits for adults.
The Finance Committee package also received a tempered response from left-leaning advocacy groups. Pollack praised the committee members for devising a plan but decried its “inadequate funding.”
The children’s advocacy group First Focus outright rejected the Finance Committee’s proposal, describing it as “disappointing.” Prior to the committee’s announcement, First Focus President Bruce Lesley suggested that he would rather see the program extended in its current form than the enactment of a smaller expansion.
“We support full funding of SCHIP but there becomes a breaking point when an extension becomes better than some of the options being discussed,” Lesley said.
The House is developing an SCHIP draft that would hold to the $50 billion set aside for an expansion by the budget resolution. Unlike the Finance Committee package, the House Ways and Means Committee is expected to partially fund the expansion by cutting Medicare funding for health insurance plans.
At the end of the day, however, the credit for a success might have to be shared. SCHIP itself is the product of a 1997 deal between President Bill Clinton and a Republican-controlled Congress.
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