WASHINGTON -- For Pennsylvania's Sen. Bob Casey, President Bush's decision to veto an expansion of the State Children's Health Insurance Program yesterday wasn't just a bad policy decision. It was a personal affront.
Fifteen years ago, the Democrat's father, Gov. Robert P. Casey Sr., approved an early version of SCHIP in Pennsylvania, using a tax on tobacco to provide health insurance for poor children. In 1997, Congress launched the national program. It faces reauthorization this year.
"It's deeply personal for me," Mr. Casey said of the veto -- only the fourth of Mr. Bush's presidency. "But that pales in comparison for what it means to one individual child."
He called the president's action an "insult" to the American people.
Last month, bipartisan majorities in both the House and Senate approved adding $35 billion to the program over the next five years, with a goal of covering an additional 4 million children. Lawmakers approved a 61-cent increase in the federal tax on cigarettes to fund the change.
During a visit yesterday to Lancaster, Pa., Mr. Bush said Congress went too far, taking an approach that would entice middle-class families to abandon their existing private insurance plans.
"I believe in private medicine, not the federal government running the health care system," he said. "I do want Republicans and Democrats to come together to support a bill that focuses on the poor children."
The president has proposed a smaller, $5 billion expansion of SCHIP, but he said yesterday that he was open to a slightly larger figure.
Democratic leaders in Congress are focused on trying to muster the two-third majorities needed in each chamber to overcome the veto. There are enough supporters in the Senate, but about two dozen members must switch sides in the House. A vote will come Oct. 18.
GOP leaders yesterday said they were confident that they would uphold the veto, while Democrats promised to make the issue a central focus on the campaign trail next year.
In Pennsylvania, Sen. Arlen Specter, a Republican, joined Mr. Casey as a supporter in the Senate. All 11 Democrats in the state's House delegation supported the initial bill. They were joined by five of its eight Republicans, including Reps. Phil English of Erie and Tim Murphy of Upper St. Clair.
Reps. John Peterson of Venango and Bill Shuster of Blair voted against the SCHIP expansion. "It's unfortunate that Democrats, under the facade of helping low-income children, are pushing their massive government-run, bureaucrats-know-best, health-care agenda," Mr. Peterson said.
Yet presidential critics appear to outnumber supporters in the Keystone State.
Advocacy groups for children said the president and Mr. Peterson were wrong to describe SCHIP as "government-run" health care, since private insurance companies provide the coverage as contractors in Pennsylvania and other states.
"The decline in private insurance is due to increasing costs and the reduced ability of families and employers to obtain affordable private coverage," said Alisa Simon, health policy director of Philadelphia Citizens for Children and Youth. "Blaming CHIP and punishing children for a broader economic trend is the wrong tactic."
Highmark BlueCross Blue Shield is one private insurer that participates in the program, providing coverage to 51,000 children. "Generally, we're disappointed with the veto," said Highmark spokesman Michael Weinstein. "We have consistently supported necessary funding for government programs for kids and their families."
Melissa Fox, deputy press secretary for the Pennsylvania Insurance Department, said officials in Harrisburg also were dismayed by the president's veto, although the state has enough money to provide coverage until May 2008.
The federal government this year approved Pennsylvania's "Cover All Kids" plan to provide subsidized coverage for families that are at or below 300 percent of the poverty level, meaning income of as much as $62,000 for a family of four. Those families pay sliding-scale fees for the coverage based on their incomes.
Families with incomes at 200 percent of the poverty level pay no monthly premiums; those with higher incomes up to 300 percent of the poverty level pay premiums ranging from about $38 to $60 per child. Families with incomes above 300 percent of the poverty level pay about $150 a month per child.
The program is having successes. More than 164,000 children across the state had coverage in September, up from 159,000 in June. In Allegheny County, 13,378 children use SCHIP.
Nationwide, the program covers 6.6 million people, mostly children, from families that earn too much to qualify for Medicaid but not enough to afford their own private coverage.
Of the more than 43 million people nationwide who lack health insurance, more than 6 million are under 18 years old, which represents 9 percent of all children.
The Democratic Congressional Campaign Committee launched radio ads Monday attacking eight GOP House members who voted against the bill and who face potentially tough re-election campaigns next year.
Gerald McEntee, president of the American Federation of State, County and Municipal Employees union, said a coalition of liberal groups was staging more than 200 events throughout the nation today to highlight the issue. The group, which includes MoveOn.org and several unions, also has a goal of more than 1 million contacts to Congress through calls, letters and e-mails demanding that lawmakers override Mr. Bush's veto. The coalition is spending $3 million to $5 million on that effort.