The US House of Representatives has voted to pass a bill to extend state supported child health insurance in defiance of a threat by President George W Bush to veto it. The vote, cast yesterday, was 7 votes short of the the two-thirds majority needed to overturn a presidential veto and comes only one week after a vote on an earlier draft of the bill also failed to do so.

Representatives voted 265 to 142 in favour of the bill to extend the State Children's Health Insurance Program (SCHIP) to cover nearly 4 million more children whose families cannot afford private health insurance, but earn too much to qualify for Medicaid, the federal health insurance scheme for the poor. This would bring the total number of American children covered to 10 million compared to the current 6.6 million.

After the vote last week, the bill was redrafted, mostly to address Republican concerns that it would also benefit adults, higher income families and illegal immigrants.

But the White House said President Bush has repeated his intention to veto the bill because it costs too much, raises taxes, and does more than insure children from low income families and may even encourage families currently paying for private insurance to switch to SCHIP.

To fund the extension of SCHIP under the new bill would cost another 35 billion dollars proposed to be raised through higher taxes on tobacco.

Bush favours an alternative approach based on tax breaks to help more families pay for private insurance.

Republicans criticized the bill, saying the redraft was only "cosmetic" and there had not been enough time to read it properly before the second vote was cast.

Democrats said the bill had the support of most Americans as shown by polls and the redraft tightened up several areas, for instance more background checks would be made to stop illegal immigrants qualifying, there would be a phasing out of childless adult coverage, and children whose family income was more than three times the federal poverty rate would also not be covered.

But spokeswoman for the White House, Dana Perino, said that the bill did not sufficiently address the president's concerns "in a meaningful way":

"The bill still fails to ensure that poor children are covered first, it still allows states to cover adults, and it still raises taxes to move 2 million children from private health insurance to a government-run program," said Perino.

The bill will now go to the Senate, where it is said there is enough support to overturn a veto.

For the bill to become law without the President's signature, it must sustain a two thirds majority in both the House and the Senate, which on this occasion is not going to happen, and as the White House has indicated, Bush will exercise his power of veto and send the legislation back to Congress.

So the only way this bill will ever become law is by putting it before the House again at a future date and securing more Republican support. The big question is, will the bill lose rather than gain Republican support as more Representatives retrench behind party lines to prepare for their respective presidential election campaigns?

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