Congress taking up health care

WASHINGTON – Sweeping health care legislation that would affect benefits for millions of children and senior citizens – as well as the bank accounts of doctors and insurance companies – comes up for floor votes this week in Congress, in a debate fraught with political risk for both parties.

Starting today in the Senate, with the House expected to follow later in the week, lawmakers will consider separate proposals to renew a popular federal-state program that provides health insurance for about 6 million children, mainly from low-income working families.

A bipartisan effort in the Senate has led to a compromise that would expand coverage of the State Children’s Health Insurance Plan to about 3 million more children. But in the House, top Democrats are pushing a far more ambitious bill that also would make major changes to Medicare, the health care program for older and disabled Americans.

Republicans are calling the Democrats’ action a step toward “socialized medicine,” and the Bush administration has vowed to veto both bills.

The outcome is likely to influence the course of the presidential election debate over how to cover the estimated 45 million Americans who are uninsured. About 9 million of those are children.

The children’s program must be reauthorized by Sept. 30 or it will expire.

The House legislation would cover about 2 million more children than the Senate bill. But it would also improve preventive care for Medicare recipients, provide more financial help to low-income seniors in the Medicare prescription plan, and reverse a 10 percent cut, scheduled for next year, in Medicare fees to doctors.

Both bills call for stiff increases in tobacco taxes to pay for expanded coverage for children. But since the House version helps not only more children, but seniors and doctors as well, it comes with a price tens of billions of dollars higher than the Senate’s.

To pay for the added benefits, House Democrats want to cut payments to private insurers in Medicare’s managed-care program. Nonpartisan congressional analysts say those payments are 12 percent too high.

But many Republicans – even those willing to confront the administration over expanding coverage for children – are strong supporters of the Medicare managed-care program.

The children’s program badly needs a new infusion of funds, and a health care policy standoff in Washington could jeopardize coverage for millions of families across the country.

Backing the House bill are the American Medical Association, AARP and many grass-roots liberal organizations.

America’s Health Insurance Plans – the industry trade group – is trying to derail the House bill.

And tobacco companies and anti-tax conservatives are trying to sink both bills.