It would be funny if the consequences weren’t serious. The lone holdout in the Washington state delegation to a congressional bill that would expand health care coverage for children is named Doc. Initially, Rep. Richard “Doc” Hastings was joined by the other two Republican representatives in the state in opposing a bill to spend $35 billion over the next 10 years to preserve health care coverage for the neediest children and to expand it to uninsured children on a higher economic rung. They had good reasons.

An early version would’ve helped pay for the measure by taking funds from Medicare Advantage, which potentially could have affected 10,000 Washington state seniors. Plus, it had a provision that would have cut off Medicare payments to physician-owned health care facilities in several towns, such as Wenatchee and Omak.

Once Congress eliminated those threats, Reps. Cathy McMorris Rodgers and Dave Reichert voted for the bill. Not Hastings. This time, he came up with new reasons:

“Rather than making certain the poorest children get care, Democrats are pursuing a Canadian-style government-run health care system.” And, “We should first help the poorest kids we promised to 10 years ago, not expand the program to the point that families of four earning $83,000 a year switch from private insurance to taxpayer-funded health care.”

First, families earning $83,000 wouldn’t be making that switch. New York was the only state seeking to expand enrollment to 400 percent of the poverty level. To do so, it needed a federal waiver, which the feds have denied.

Second, Washington state enrolls 91 percent of the children who are eligible. The feds require 95 percent, which in practical terms is very difficult to achieve. Some parents haven’t heard of SCHIP. Some have heard of it but for whatever reason won’t enroll. Short of mandating enrollment, the current compliance rate is about as good as it’s going to get. In effect, these holdout parents have been given the power to delay expansion.

Hastings’ talking point about Canadian-style health care makes it clear that he was always going to oppose the bill, because SCHIP has always been a government program, even when he supported it at its inception. The private market has had 10 years to fill the gap created when families earn too much to qualify for Medicaid but not enough to buy their own health care plan, which averages about $12,000 a year for a family of four. It has failed to do so.

Economically, it’s counterproductive not to cover children’s health care. The conservative Milken Institute released a study just this week showing that the lack of preventive medicine is costing the U.S. economy billions of dollars is terms of worker productivity (staying home with kids) and higher health care costs (emergency medicine).

President Bush has vetoed the expansion. It’s just a matter of time – and a new president – before popular, bipartisan support for SCHIP wins the day. In the meantime, we trust that McMorris Rodgers and Reichert will stick with their votes as Congress seeks to override the veto. Hastings should search his