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Obama signs into law expansion of SCHIP health-care program for children

Passage of $33 billion bill marks historic shift in Washington's political landscape and provides the White House its biggest victory since Obama took office

WASHINGTON — President Barack Obama signed legislation Wednesday to expand publicly funded health insurance for children, marking a historic shift in Washington's political landscape and providing the White House its biggest victory since Obama took office.

Less than 18 months ago, President George W. Bush had blocked similar bills by congressional Democrats, labeling the proposed expansion of the State Children's Health Insurance Program as a step toward government-run health care.

But with Democrats now firmly in control of the White House and Congress, the party's leaders easily pushed through a $33 billion bill that is expected to provide government-subsidized insurance to 4 million mostly low-income children.

That would reduce the number of uninsured children in America by about half over the next 41/2 years and boost the number covered by the program to 11 million.

The measure—funded primarily by boosting the federal tax on cigarettes by 61 cents, to $1 a pack—sailed through the House earlier Wednesday on a largely party-line vote of 290-135. The Senate approved the bill last week.

The swift passage came in marked contrast to the economic recovery package, which is mired in debate on Capitol Hill despite pleas from Obama for congressional action.

The children's health bill was an early benchmark in the planned Democratic campaign to reshape the nation's health-care system over the next two years.

"The way I see it, providing coverage to 11 million children … is a down payment on my commitment to cover every single American," Obama said before signing the bill in the White House.

The new president also drew on language from an era decades earlier, when Washington more openly embraced the expansion of the government-funded safety net. "We're not a nation that leaves struggling families to fend for themselves," he said.

SCHIP, as the program is called, was created in the late 1990s when President Bill Clinton and a Republican Congress addressed concerns that families who earned too much to qualify for public assistance through Medicaid nonetheless could not afford insurance for their children.

The federal poverty line for a family of four was $21,200 in 2008, while family insurance premiums averaged about $12,680, according to the Kaiser Commission on Medicaid and the Uninsured in Washington.

Most of the 7 million children now enrolled in SCHIP programs nationwide come from families with incomes less than twice that of the poverty line. However, several states have opened the program to families making more.

About 30 million of the nation's poorest children receive health care through Medicaid.

Democrats made expanding the popular SCHIP program a top priority when they took control of Congress in 2007 following 12 years of mostly Republican control.

Bush vigorously opposed the move, twice vetoing SCHIP legislation despite substantial GOP support for the bills. He vetoed just 10 bills during his presidency.

On Wednesday, Republican lawmakers echoed many of the former president's critiques.

"The Democrats continue to push their government-run health-care agenda—universal coverage, as they call it," said Rep. Pete Sessions (R-Texas), who helped lead opposition to the bill.

Republicans also chafed at provisions that would allow states to provide insurance to the children of legal immigrants who have been in the country for less than five years and loosen identification requirements for those enrolling.

GOP lawmakers said that would result in illegal immigrants also receiving taxpayer assistance.

They also complained that the bill did not do enough to ensure that the most needy children receive coverage.

Republicans called for rules that would prohibit states from offering insurance to middle-income families unless states could ensure that more lower-income children had been enrolled, a requirement that many SCHIP advocates said was unworkable.

Facing overwhelming support for the SCHIP expansion, GOP lawmakers could do little to slow the momentum for the bill.

Groups ranging from the insurance industry to organized labor to the March of Dimes rallied behind the legislation.

Immigrant advocates applauded the end of the five-year waiting period that they said had prevented hundreds of thousands of children from gaining access to preventive care and driven up health-care costs by forcing many to rely on emergency rooms for health care.

But there also were signs of the difficulties that may confront Obama and his Democratic allies in their push to win GOP support for overhauling the nation's health-care system.

The SCHIP bill attracted 40 Republican votes in the House on Wednesday, fewer than the number won for similar legislation in 2007.


Related topic galleries: Poverty, Bill Clinton, Pediatrics, Heads of State, Pete Sessions, Medicaid, The White House

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