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GOP's risk in opposing expanded child health care

The spectacle Tuesday of 151 House Republicans voting in lock step with the White House against expansion of the State Children's Health Insurance Program (SCHIP) was one of the more remarkable sights of the year. Rarely do you see so many politicians putting their careers in jeopardy.

The bill they opposed, at the urging of President Bush, commands healthy majorities in both the House and Senate but is headed for a veto because Bush objects to expanding this safety net for children of the working poor.

SCHIP has been one of the most successful health care measures created in the past decade. It was started in 1997 with support from both parties, in order to insure children in families with incomes too high to receive Medicaid, but without the wealth to afford private insurance. The $40 billion spent on SCHIP in the past 10 years financed insurance for roughly 6.6 million youngsters a year. The money was distributed through the states, which were given considerable flexibility in designing their programs. The insurance came from private companies, at rates negotiated by the states.

Governors of both parties have praised the program. And they endorsed the congressional decision to expand coverage to an additional 4 million youngsters, at the cost of an additional $35 billion over five years. The bill would be financed by a 61-cent-a-pack increase in cigarette taxes.

If ever there was a crowd-pleaser of a bill, this is it. Literally hundreds of organizations -- grass-roots groups ranging from AARP to United Way of America and the national YMCA -- have called on Bush to sign the bill. America's Health Insurance Plans, the largest insurance lobbying group, endorsed the bill on Monday. But Bush insists that SCHIP is "an incremental step toward the goal of government-run health care for every American" -- an eventuality he is determined to prevent.

Bush's adamant stand may be peculiar to him, but the willingness of Republican legislators to line up with him is more significant. Bush does not have to face the voters again, but these men and women will be on the ballot in just over a year -- and their Democratic opponents will undoubtedly remind them of their votes.

Rep. Pete Sessions, R-Texas, argued that "rather than taking the opportunity to cover the children that cannot obtain coverage through Medicaid or the private marketplace, this bill uses these children as pawns in their cynical attempt to make millions of Americans completely reliant upon the government for their health care needs."

In his new book, former Federal Reserve Board Chairman Alan Greenspan wrote that his fellow Republicans deserved to lose their congressional majority in 2006 because they let spending run out of control and turned a blind eye to misbehavior by their own members. Now, those Republicans have given voters a fresh reason to question their priorities -- or their common sense.

Saying no to immigration reform and measures to shorten the war in Iraq may be politically defensible, because there are substantial constituencies who question the wisdom of those bills. But the Bush administration's arguments against SCHIP -- the cost of the program and the financing -- sound hollow at a time when billions more are being spent in Iraq with no end in sight. Bush's alternative -- a change in the tax treatment of employer-financed health insurance -- has some real appeal, but it is an idea he let languish after offering it last winter. And, in the judgment of his fellow Republicans on the Senate Finance Committee, Bush's plan is too complex and controversial to be tied to the renewal of SCHIP.

This promised veto is a real poison pill for the GOP.

© 2007, Washington Post Writers Group

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