Obama signs children's healthcare bill
Expansion to insure 4 million
WASHINGTON - President Obama signed legislation yesterday to expand publicly funded health insurance for children, marking a historic shift in Washington's political landscape and providing the White House its biggest victory since Obama took office.
Less than two years ago, former president George W. Bush blocked similar bills by congressional Democrats, labeling the proposed expansion of the State Children's Health Insurance Program as a step toward government-run healthcare.
But with Democrats now firmly in control of the White House and Congress, the party's leaders easily pushed through a $33 billion bill that is expected to provide government-subsidized insurance to 4 million mostly low-income children.
That would reduce the number of uninsured children in America by about half over the next 4 1/2 years and boost the number covered by the program to 11 million.
The measure - funded primarily by boosting the federal tax on cigarettes by 61 cents, to $1 a pack - sailed through the House earlier yesterday on a largely party-line vote of 290 to 135. The Senate overwhelmingly approved the bill last week.
The swift passage came in marked contrast to the economic recovery package, which is currently mired in debate on Capitol Hill despite pleas from Obama for congressional action.
The bill was an early benchmark in the planned Democratic campaign to reshape the nation's healthcare system .
"The way I see it, providing coverage to 11 million children . . . is a down payment on my commitment to cover every single American," Obama said before signing the bill in the East Room of the White House.
The president also drew on language from an earlier era, when Washington more openly embraced the expansion of the government-funded safety net. "We're not a nation that leaves struggling families to fend for themselves," he said.
SCHIP, as the program is called, was created in the 1990s when President Clinton and a Republican Congress addressed concerns that families earning too much to qualify for public assistance through Medicaid nonetheless could not afford insurance for their children.
The federal poverty line for a family of four was $21,200 in 2008, while family insurance premiums averaged about $12,680, according to the Kaiser Commission on Medicaid and the Uninsured in Washington.
Most of the 7 million children enrolled in SCHIP programs nationwide come from families with incomes less than twice that of the poverty line.
"Our country has just made a clear commitment to guarantee quality, affordable healthcare to 4 million more American children," Senator Edward M. Kennedy said in a statement. "Four million more children will have a family doctor and enjoy the opportunities in life that come from a childhood lived in good health."
Massachusetts already operates under a federal waiver that extends coverage to children in families that earn up to 300 percent of the poverty level, and that has helped the state make sure nearly all children have health insurance.
"This will fully fund our efforts to keep coverage in place and cover those few kids that are not insured in Massachusetts now," said Tom Dehner, the state Medicaid director.
The law, he added, is essentially "a federal authorization of other states to have an expansive program like Massachusetts already does."
Only about 1.5 percent of children in Massachusetts lack coverage; Massachusetts officials hope to shrink that number to zero in the coming years, a mission that could be complicated by the economic downturn.
Massachusetts will also recoup federal money for insuring children of legal immigrants who have been in the country for less than five years, something the state has paid for itself until now, Dehner said.
Lisa Wangsness of the Globe staff contributed to this report.
