Senate OKs health insurance expansion for children

WASHINGTON — The Senate passed a bill on Thursday to provide health insurance to more than 4 million uninsured children, as a newly empowered Democratic majority brushed aside Republican objections. The vote was 66-32, with nine Republicans joining Democrats to support the bill.

President George W. Bush twice vetoed similar legislation. But President Obama is eager to sign the bill as a step toward providing insurance for all children and eventually all Americans.

The Senate debate showed the outlines of what promises to be a much larger political fight over universal coverage. While Democrats championed expansion of the child health program, many Republicans, including Sen. John McCain of Arizona, said they worried that it was part of a long-term effort to replace private health insurance with government programs.

The House passed a nearly identical bill two weeks ago, by a vote of 289-139, with 40 Republicans joining nearly all Democrats in support of the measure.

Democrats said the bill illustrated their priorities: "women and children first," in the words of the House speaker, Nancy Pelosi. On Thursday, Obama signed a bill that makes it easier for women to challenge pay discrimination in the workplace.

One of the most significant sections of the child health bill would allow states to use federal money to cover children and pregnant women who are legal immigrants. Under existing law, legal immigrants are generally barred from Medicaid and the State Children's Health Insurance Program for five years after they enter the United States.

"The bill would end an inequity that we have been trying to eradicate for more than a decade," said Jennifer M. Ng'andu, a health policy specialist at the National Council of La Raza, a Hispanic rights group.

The Congressional Budget Office said the bill would enable states to cover more than 4 million uninsured children by 2013 while continuing coverage for 7 million youngsters. The bill would increase tobacco taxes to offset the increase in spending, estimated at more than $32 billion over 41/2 years.

Cindy Mann, executive director of the Center for Children and Families at Georgetown University, said the bill was "needed now more than ever." Tens of thousands of children are losing health insurance as their parents lose their jobs, Mann said.

Sen. Sherrod Brown, D-Ohio, said, "It's my sincere hope that passage of this legislation will be the beginning of a major overhaul of American health care, which ultimately will provide coverage to all Americans."

But McCain said, "Some of us who look at this bill may view it as another effort to eliminate, over time, private insurance in America, and I am concerned about that."