Defying a veto threat from President Bush, the Senate Finance Committee approved a major expansion of the Children's Health Insurance Program, 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.

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

Only 4 of the 10 Republicans on the panel sided with the president and voted against the bill: Senators Jim Bunning of Kentucky, John Ensign of Nevada, Jon Kyl of Arizona and Trent Lott of Mississippi.

The program subsidizes health care for children, and some adults, from families that earn too much to qualify for Medicaid but not enough to be able to afford private insurance. Congress faces a deadline because the program, which covered 6.6 million low-income children at some time in the last year, is set to expire on Sept. 30.

The bill calls for a total of $60 billion in spending over the next five years, which is $35 billion more than it would cost to continue spending at current levels. In the House, Democratic leaders are developing a proposal calling for a total of $75 billion. By contrast, President Bush has proposed a $5 billion increase, for a total of $30 billion.

One co-author of the legislation, Senator Charles E. Grassley of Iowa, the Finance Committee's senior Republican, said, "The White House is very unrealistic if they think they can continue to do what we are doing now with just a $5 billion increase."

Another co-author, Senator John D. Rockefeller IV, Democrat of West Virginia, said 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 could be disastrous.

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

To finance expansion of the program, the Senate bill would increase tobacco taxes. The federal excise tax on cigarettes would rise to $1 a pack, from 39 cents.

The bill would also roll back waivers granted by the Bush administration that have allowed some states to cover childless adults with money from the program.

A leading conservative Republican on the committee, Senator Pat Roberts of Kansas, said, "I am proud to support this important bill, which will provide health insurance coverage to approximately four million more children who would otherwise be uninsured."

But Senator Kyl said the bill made the unrealistic assumption that spending on the program would drop sharply after the next five years. At that point, he said, "we will have to cut benefits or raise taxes" because the revenue provided under the legislation falls far short of what would be needed to maintain the program beyond 2012.

Daniel E. Smith, a vice president of the American Cancer Society, hailed the proposed increase in tobacco taxes, saying it would "prevent more than 900,000 Americans from dying prematurely because of smoking." But Senator Bunning said it would put half the 32,000 tobacco farmers in Kentucky out of business.

A coalition of health care workers and providers began a $1.2 million television advertising campaign on Thursday to build support for the legislation in a dozen Congressional districts where they believe lawmakers might take a leadership role on the issue. The advertisements encourage House members — eight Democrats and four Republicans — to support higher cigarette taxes as a way to deter smoking and finance health coverage for children.

NYT

Güncelleme Tarihi: 20 Temmuz 2007, 15:29