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Children’s Health Insurance Bill Provides a Case Study

by The New York Times - Aug 10,2007

Among the many odd moments on the House floor in the tumultuous week before the start of the August recess, this may have been the oddest: Republicans waving goodbye to Democrats after they pushed through an expansion of a popular federal health care program for children.

While Democrats celebrated passing what they considered a can’t-miss piece of legislation, Republicans thought Democrats had just made a boneheaded blunder that would cost them control of the House next year: including in the bill a cut in a popular Medicare program.

“It was one of those rare times on the House floor when both sides thought the other side had just done something really dumb,” said Representative Roy Blunt of Missouri, the second-ranking Republican.

Time will tell, of course, as to which side was right. But the fight over the State Children’s Health Insurance Program (SCHIP) provides a glimpse into the emerging 2008 campaign strategies of Republicans and Democrats. It also illustrates some of the problems House Republicans face in their first election cycle as the minority party in 14 years.

To Democrats, extending and expanding the children’s health care program, which is set to expire Sept. 30, is a no-brainer. They believe they can easily paint Republican opponents of the measure -- abetted by President Bush - as being against helping poor sick kids.

“Health care is really the biggest issue outside of the war,” said Speaker Nancy Pelosi, the California Democrat who has made the health proposal a personal crusade.

With support from the nation’s governors and the medical community, House Democrats approved a $50 billion increase in spending on the program over the next five years, an amount that would provide new health insurance to millions of children whose families do not qualify for Medicaid but have trouble paying for private coverage.

The money would come from a boost in the tobacco tax and, most importantly from a political perspective, from reducing payments to private insurance companies that offer comprehensive health plans to Medicare beneficiaries.

To Republicans, that provides an irresistible opening to go after Democrats for cutting subsidies for the private Medicare plans that have grown increasingly popular in rural America.

“When seniors find out what is really going to happen, they are not going to be happy,” predicted Representative J. Dennis Hastert, the former Republican speaker, who said tens of thousands of older Americans in his district in northern Illinois rely on the private plans.

But analysts and others suggest this could be a tough sell for Republicans. First, Democrats have accumulated decades of credibility on Medicare while Republicans, until recent years, were identified more as foes of the program. They are still haunted by former Speaker Newt Gingrich’s remark that Republicans would be content to let Medicare “wither on the vine.”

In addition, Democrats are getting important political cover from AARP, the influential senior organization that is backing the expansion of the children’s health program. The advocacy group’s position so infuriated House Republicans that Representative John A. Boehner of Ohio, the Republican leader, demanded AARP withdraw support. That seems unlikely.

And Republicans, who as the majority party have been flush with campaign cash during recent election years, now find themselves trailing Democrats in fund-raising. That could hinder their efforts to make a complex health care issue reverberate.

“When Republicans were at the top of their game, they could stick Democrats with this issue and turn it into something,” said Charlie Cook, a nonpartisan political handicapper. “I am not sure they have the credibility to make it happen now.”

Lastly, Democrats built a little political insurance of their own into the bill. While they reduced what they see as excessive subsidies for private Medicare insurers, they turned a planned reduction in doctor payments into a slight increase, a proposal that soothed the American Medical Association. They would also increase aid to poor Medicare beneficiaries and eliminate co-payments for preventative health care covered by Medicare, putting more money in the pockets of seniors.

Those elements have Democrats preparing to go on offense. Instead of sitting back waiting for Republican attacks, Democratic campaign strategists are preparing a radio advertising campaign against selected Republicans, accusing them of opposing new Medicare benefits with their votes against the children’s health program. The idea is define the bill before Republicans define it for them.

It makes an interesting case study for 2008. Can Republicans persuade voters that Democrats are gutting Medicare, and will the Republicans have the resources to do so? Or will Democrats succeed in portraying Republicans as cold-hearted opponents of new health coverage for both kids and older folks?

“We will see what the repercussions are,” said Mr. Hastert.

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By CARL HULSE

Copyright 2007 The New York Times Company

 

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Florida Health Insurance Web Comments on Republican's Fight Against Health Insurance Program by Editor posted on Jul 27,2007
Senate nears vote on children's health bill under veto threat by President Bush by The-Daily-Dispatch posted on Aug 07,2007
Senate OKs wider kids' health program by AP-News posted on Aug 03,2007
Bush urges Democrats on health insurance by AP-News posted on Sep 21,2007
House fails to override kids' health insurance veto by USATODAY.com posted on Jan 23,2008
Panel approves children’s health insurance boost by tuscaloosanews.com posted on Jul 20,2007
Federal restrictions on children’s health insurance program worry state officials by The-Hill posted on Sep 18,2007
Study shows decline in state for job-based health insurance by Los-Angeles-Times posted on Jul 11,2007
Senate to Take Up Health Insurance Bill by Houston-Chronicle posted on May 09,2006
Prospects Dim for Health Insurance Bill by WashingtonPost.com posted on May 11,2006
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