Kaiser Daily Health Policy Report

Wednesday, October 03, 2007

Administration News

      President Bush on Wednesday vetoed legislation that would have reauthorized SCHIP and expanded enrollment in the program to about 10 million children, the AP/Houston Chronicle reports (Loven, AP/Houston Chronicle, 10/3). House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) on Tuesday formally delivered the bill to the White House, which set Bush up to deliver the fourth veto of his presidency (Kaplan, The Hill, 10/3).

The compromise bill provided an additional $35 billion in funding over the next five years and brought total spending on the program to $60 billion. The additional funding would have been paid for by a 61-cent-per-pack increase in the tobacco tax. The House last week voted 265-159 to approve the measure, with 45 Republicans voting in favor and eight Democrats voting against the bill. The Senate on Thursday voted 67-29 to approve the legislation, with 18 of the 49 Senate Republicans voting in favor. The program expired on Sunday (Kaiser Daily Health Policy Report, 10/1).

The White House said that the president planned to veto the bill in private without any press (Loven, AP/Long Island Newsday, 10/3). According to The Politico, lobbyists supporting the legislation will focus their efforts on Capitol Hill, not the White House (Frates, The Politico, 10/3).

The House likely will postpone a veto override vote until after next week, House Majority Leader Steny Hoyer (D-Md.) said on Tuesday (Johnson/Koffler, CongressDaily, 10/3). "Maybe next week. Maybe the week after. There's no time limit" for holding the override vote, Hoyer said. Democratic leaders indicated they will delay the override vote "for days or weeks to allow political pressure to increase on House Republicans who opposed the measure," according to CQ Today (Wayne, CQ Today, 10/2).

Post-Veto Discussions
Republicans who voted against the bill "want the veto to represent the beginning of a [new] discussion on how to reauthorize" the program, CongressDaily reports (CongressDaily, 10/3). Senate Minority Whip Trent Lott (R-Miss.) said, "We should not allow [SCHIP] to be expanded to higher and higher income levels, and to adults. This is about poor children." He added that Democrats and Republicans "can work it out" (AP/Long Island Newsday, 10/3).

Hoyer said that Democrats had asked 15 Republicans to change positions and vote to override Bush's veto but that none had agreed to do so yet (Hunt, AP/Houston Chronicle, 10/2). Hoyer said he thought the goal was attainable.

However, House Minority Whip Roy Blunt (R-Mo.) said he is "absolutely confident" the House will be able to sustain Bush's veto (Lengell, Washington Times, 10/3).

White House spokesperson Dana Perino chided bill supporters for using a regressive tobacco tax increase "to pay for a middle-class entitlement" (Silva, Chicago Tribune, 10/3). Perino noted that smokers tend to come from the lowest income levels and added, "It's just completely irresponsible. Stop the madness on Capitol Hill" (AP/Houston Chronicle, 10/2).

If lawmakers are unable to override Bush's veto, Congress will send the bill back to Bush to sign, according to Senate Finance Committee Chair Max Baucus (D-Mont.).

Alternative Plan
Sen. Mel Martinez (R-Fla.) said he is working with House Energy and Commerce Committee ranking member Joe Barton (R-Texas) and the White House on a new SCHIP proposal that would provide enough funding for the program to maintain current beneficiaries. It would give $1,400 tax credits to families with annual incomes between 200% and 300% of the federal poverty level, which would cover an estimated two million additional children, Martinez said.

The bill has yet to be scored. Martinez on Tuesday said, "We, as Republicans, can't just be against something. We've got to be for something." Senate Finance Committee ranking member Chuck Grassley (R-Iowa) dismissed Martinez's plan. He said, "They were talking about that in March and April and May," adding, "If they were ready to go, why didn't they offer it?"

Medicare Revisions
Baucus on Tuesday said that lawmakers will not be able to address a scheduled 10% cut to Medicare physician reimbursements until they know the outcome of the SCHIP override vote. He acknowledged that some type of Medicare package needs to be discussed before lawmakers adjourn.

Baucus' committee is in discussions on a legislative package that temporarily would delay the cut to physician payments and make small revisions to the prescription drug program (CongressDaily, 10/3).

Presidential Candidates on SCHIP
In related news, while Democratic presidential candidates have been vocal about their support for SCHIP, Republican presidential candidates "are lining up behind Bush's vow to veto the legislation," CongressDaily reports. Even so, "none of the Republican presidential hopefuls appear to be going out of their way to call attention to their positions on SCHIP," according to CongressDaily.

Presidential candidate and Sen. John McCain (R-Ariz.) said that he would "probably vote to sustain the president's veto" because of concerns over whether the tobacco tax would raise sufficient funds to pay for the program expansion.

Presidential candidate and former Sen. Fred Thompson (R-Tenn.) expressed similar concerns, adding, "It's unfortunate that (members of Congress) pit people against one another. .... We're on an unsustainable spending path in this country and no one seems willing to put the brakes on anywhere."

Presidential candidate and former Massachusetts Gov. Mitt Romney (R) said he would veto SCHIP legislation because the program "is a very expensive way to spend more money and not get us much down the track of getting everybody insured."

Presidential candidate and former New York Mayor Rudy Giuliani (R) last month expressed concerns that the proposal would allow some states to increase income eligibility to 400% of the poverty level.

In contrast, presidential candidate Sen. Hillary Rodham Clinton (D-N.Y.) "frequently" mentions the SCHIP legislation -- "and Bush's threatened veto -- in her stump speeches to promote her record," CongressDaily reports (Aigner-Treworgy, et al., CongressDaily, 10/3).

Broadcast Coverage
CNN's "The Situation Room" on Tuesday included a discussion with CNN White House correspondent Suzanne Malveaux about Bush's veto threat (Blitzer, "The Situation Room," CNN, 10/2). A transcript of the segment is available online.

NPR's "Morning Edition" on Wednesday also reported on veto threats against the SCHIP bill and spending bills. The segment includes comments from Reid; Grassley; George Edwards, a presidential scholar at Texas A&M University; Perino; Dan Mitchell, a senior fellow at the Cato Institute; Rep. David Obey (D-Wis.); and Sen. Lindsey Graham (R-S.C.) (Welna, "Morning Edition," NPR, 10/3). Audio and a partial transcript of the segment are available online.