Senate Panel Backs Expansion of Child Health Plan

New York Times: By ROBERT PEAR

WASHINGTON, July 19 — Defying a veto threat from President Bush, the Senate Finance Committee approved a major expansion of the Children’s Health Insurance Program on Thursday, with a majority of Republicans joining all Democrats on the panel in supporting the legislation.

The vote, 17 to 4, sends the measure to the full Senate, which is expected to take it up within two weeks.

President Bush has repeatedly denounced the bill as a step toward “government-run health care for every American,” calling it a “massive expansion of the federal role” in health care, financed by “a huge tax increase.”...

To finance health care for children, the bill would increase tobacco taxes. The federal excise tax on cigarettes would rise to $1 a pack, from 39 cents....

Another co-author of the bill, Senator John D. Rockefeller IV, Democrat of West Virginia, said that Mr. Bush and his health secretary, Michael O. Leavitt, had been “pretty belligerent” in criticizing the bill.

But Mr. Rockefeller said, “It’s not clear to me that the president has any intention of vetoing this,” because the political consequences of such an action could be disastrous.

“There are very few symbols as powerful as kids,” Mr. Rockefeller said.

While I certainly don't oppose continuing and expanding health coverage for kids, there is a cost to pursuing this political, cherry-picking strategy --it makes it harder to build the constituencies necessary to support comprehensive, universal coverage down the road. With the most "attractive" and "deserving" groups--the elderly and the young--already covered (and some coverage for the very poor via Medicaid), there will be less impetus to push through changes for those in between, those poorly or partially or unreliably covered at work, or unable to procure or pay for individual coverage.

If the whole system is rotten, we should try to replace it with something better, not persist in trying to patch up its worst features. But that's what failed in 1993-4, and one can understand the appeal of politically potent incremental changes, like providing improved coverage for kids.