House begins debate on children's health care bill

WASHINGTON (AP) - The House was poised to increase spending on children's health insurance Wednesday as Democrats tried to give President-elect Barack Obama an early win on health care.

The bill includes an additional $32.3 billion for the State Children's Health Insurance Program over the next 4 1/2 years. The federal excise tax on a pack of cigarettes will increase 61 cents to a total of $1 to pay for the program's expansion.

Democratic lawmakers said the struggling economy gave lawmakers more reason to expand the program.

"With rising unemployment, covering children is even more important than ever and the need grows each day," said Rep. Russ Carnahan, D-Mo. "No longer will children be forced to visit an emergency room to receive basic medical care."

A vote on the measure was expected at midday following House debate.

Legislation to expand the State Children's Health Insurance Program was vetoed twice by President George W. Bush in 2007. This time, supporters are confident that a deal can be struck and the bill passed shortly after Obama's inauguration.

The measure includes a provision that would expand coverage to children of legal immigrants as well as pregnant immigrants.

Current law requires a five-year waiting period before legal immigrants become eligible for coverage under the two programs. Supporters say expanding coverage would mean children could get treatment for acute conditions like asthma and diabetes so they were less likely to need care in an emergency room.

The bill also mandates that states include dental coverage in the program.

SCHIP was created in 1997 to provide health coverage for children in families that earn too much to qualify for Medicaid, but not enough to afford private insurance.

Some Republicans say expanding the program undermines its original intent-to serve low-income families. They noted estimates from the Congressional Budget Office that an estimated 2.4 million children currently with private coverage would end up in SCHIP by 2013.

"We must pass legislation that first reaches those who are the most in need of assistance," said Rep. Phil Gingrey, R-Ga.

Gingrey said he was referring specifically to children in families up to twice the federal poverty level-or $42,400 for a family of four.

The CBO also projected that nearly 83 percent of the 4.1 million uninsured children who would gain coverage if the bill becomes law are in families with incomes below current eligibility limits. About 700,000 children would gain coverage because their states broadened eligibility.