The bill would have reauthorized and expanded the State Children's Health Insurance Program, better known as SCHIP. The Senate passed its version of the SCHIP bill by a veto-proof margin, with 57 votes for the bill. In the House of Representatives, however, the bill received a majority but about two dozen votes less than would be needed to override the veto. As a result, Congress currently does not have enough votes to override Bush's veto, leaving the program's long-term future in limbo.

The dispute centers on the provision in the reauthorization bill that would raise the household income eligibility ceiling from 200 percent to 300 percent of the poverty level and insure another 4 million children nationwide whose parents income is too high to qualify for Medicaid but too low for them to afford health insurance. The proposed expansion would cost $35 billion over the five year period of the reauthorization. This amounts to $7 billion a year, or about what we spend in Iraq and Afghanistan each month.

President Bush had earlier proposed a $5 billion dollar increase in SCHIP funding for the next five years. Both the Congressional Budget Office and the Center on Budget and Policy Priorities had concluded that this proposed increase would have been insufficient to even maintain the current enrollment levels.

In vetoing the reauthorization bill, President Bush said the SCHIP bill would lead to a single-payer health care system -- which he considers unacceptable. While NAPHP would support a single-payer health care system, no reasonable person could believe that SCHIP is a move in that direction.

The president also complained that the compromise bill "would move millions of children who now have private health insurance into government-run health care.” In his view, “our goal should be to move children who have no health insurance to private coverage — not to move children who already have private health insurance to government coverage." Again, I’m not sure that either I or NAPHP would agree about what our goal should be, but analysts, including the leading trade group for the private health insurance industry, do not think that would happen and have endorsed the bill. In reality SCHIP is a public-private partnership where nearly 70 percent of children already receive coverage through private insurers and the reauthorization will expand private insurance even further

The Healthcare Leadership Council, which represents private health-care providers that normally side with the president, is among those who dispute the President’s opinion. HLC President Mary pointed out that to the contrary, the SCHIP reauthorization would allow states to use their SCHIP funds to help low-income parents pay for their children's' health care through their employer-provided insurance.

President Bush stated in his veto message that he objected to the reauthorization because it raises taxes for working people. It is nice to hear the President express concern for working people for a change but what he is referring to is an increase in the tobacco tax. Congress proposed an increase in the federal tobacco tax to pay for an expansion of SCHIP. The bill would increase the levy on cigarettes to $1 a pack from the current 39 cents. Advocates of this approach see it as having a desirable side effect in discouraging cigarette smoking. A valid criticism of this aspect of the bill might have pointed out the mismatch between a program that is likely to expand and grow more expensive over time with a revenue source that is likely to shrink over the same period, but such “sin taxes” are popular with Congress and it was part of the compromises necessary to get this much needed expansion through a closely divided Congress.