Senate Tackles Previously Vetoed Children's Health Bill

A children's health care bill that set congressional Democrats against the Bush administration last year now appears headed for passage - but with Florida's two senators splitting their votes.

Democratic Sen. Bill Nelson expects to vote for the State Children's Health Insurance Program bill - commonly called "SCHIP." Republican Sen. Mel Martinez, according to a spokesman, hasn't firmly decided but voted against the bill last year.

"There's no excuse for American children not getting health care," Nelson said.

The bill uses tobacco taxes, including an extra 61 cents a pack on cigarettes, to expand an existing program providing health insurance for children of the working poor. It's one of the most divisive issues Congress has considered recently.

The Democratic majority passed it in 2008 but couldn't muster the votes to override former President George W. Bush's veto.

This year, President Barack Obama says he'll sign the bill. The House passed it Jan. 14, and it's expected to come up for a Senate vote this week.

Republicans say the bill has real problems; Democrats, including Rep. Kathy Castor of Tampa, say those problems are "red herrings," in her words.

But even some Republicans worry that if they vote against it, they could be tarred in political campaigns as opposing health care for poor children.

Three Florida GOP House members who voted against the bill in 2008 voted for it this year: Reps. Ileana Ros-Lehtinen and brothers Mario and Lincoln Diaz-Balart, all from the Miami area.

All three experienced strong re-election challenges in the 2008 election. Spokesmen didn't return calls for comment on why they switched.

Castor has a particular interest in the bill: The program grew from an idea instituted in Florida by former Education Commissioner Betty Castor - her mother - and the late Gov. Lawton Chiles, who sold the idea to former President Bill Clinton.

Among the GOP arguments against the bill are:

• It doesn't require strict documentation to prevent children of illegal immigrants from receiving benefits, only a verbal statement of a Social Security number; and it allows states to cover children of recent legal immigrants.

• Increasing tobacco taxes will put the burden of paying for the program on lower-income people, who are more likely to smoke.

• It raises income eligibility levels too high, allowing states to cover families up to three times the $22,050 federal poverty level for a family of four.

That, Republicans charge, would cut business for insurance companies because those families can buy insurance, and leave less money for benefits for the truly needy.

"This bill will transform SCHIP from a health insurance program for disadvantaged children to a taxpayer-funded entitlement for adults and children from more affluent families ... imperiling care for the very children for which it was created," said Rep. Gus Bilirakis, R-Palm Harbor.

But not all Florida Republicans agreed. Besides Ros-Lehtinen and the Diaz-Balarts, Reps. Bill Young of Indian Shores, Vern Buchanan of Longboat Key and Alan Grayson of Orlando voted for the bill along with the Democrats.

Besides the cigarette tax, last year's bill also imposed huge increases on cigar taxes - a major concern in Tampa - but those increases have been lessened in the new bill.

The goal of the program is to provide benefits for children in working families who make too much money to qualify for Medicaid but not enough to have insurance.

Those under the federal poverty level are eligible for Medicaid.

Castor said the House bill provides benefits up to twice that level, or $44,100 - usually not enough to buy private insurance or even employer-offered family coverage in some cases, she said.

States can increase that limit only by obtaining a federal waiver, she said. Those with high-living costs may want to, but Florida hasn't.

Castor said the bill allows states to set their own citizenship requirements, including whether legal immigrants are eligible for the program. Florida has strict rules, she said.

She said tobacco taxes are a natural to pay for the program because of the health effects of tobacco.

The program, she said, "has been a wonderful success" and ought to be expanded.

"It's not government health care," she said. "They're going to private clinics and hospitals and seeing private doctors."