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Obama Sees SCHIP As First Step In Overhaul

ROBERT SIEGEL, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

MELISSA BLOCK, host:

And I'm Melissa Block. President Obama has signed his first piece of health legislation into law. It's a bill to provide health insurance to an estimated 11 million children over the next four and a half years. The signing ceremony took place in the East Room of the White House, just hours after the bill won final approval.

President BARACK OBAMA: This is only the first step. The way I see it, providing coverage to 11 million children through SCHIP is a down payment on my commitment to cover every single American.

(Soundbite of applause)

BLOCK: There was overwhelming support for the bill in the House - the vote was 290 to 135. But getting the bill passed exposed significant partisan divisions on healthcare. In a moment, we'll hear from a Democratic senator about the future of health reform plans. First, NPR's Julie Rovner reports on the emerging partisan split over healthcare.

JULIE ROVNER: Republicans and Democrats have always supported the State Children's Health Insurance Program, known as SCHIP. Today, it provides health insurance to an estimated 7.4 million children. In 2007, the bill to expand it further was bipartisan too, but it was vetoed, twice, by President Bush. This year though, Democrats have bigger majorities in both the House and Senate, and a Democratic president, who was anxious to sign the measure in the first days of his new administration. So, they jettisoned some of the compromises they'd made to win those GOP votes, much to the chagrin of Republicans like Phil Gingrey, of Georgia.

Representative PHIL GINGREY (Republican, Georgia): At no point in the development of this legislation has the majority even entertained the idea of allowing Republicans to work with them in a bipartisan manner, to improve the bill.

ROVNER: Among the changes, from the last time around, is the elimination of a five-year waiting period for legal immigrant children to get health benefits under SCHIP, or Medicaid. Democrats, like Diana DeGette of Colorado, hailed the change.

Representative DIANA DEGETTE (Democrat, Colorado): Frankly, Madam Speaker, it's about time that the most civilized country in the world give healthcare coverage to all of its children.

ROVNER: But Republicans like, Steve King of Iowa, criticized the change for legal immigrants - and another change that would make it easier for families to qualify without having to provide original copies of their children's birth certificates or passports.

Representative STEVE KING (Republican, Iowa): Opens the door and says, on the first day you come here, you'll qualify for welfare legally. To come here illegally, you can do the same thing for Medicaid by simply attesting to a Social Security number.

ROVNER: But children's health insurance isn't the only issue Republicans and Democrats are fighting over, when it comes to healthcare. Health provisions in the economic stimulus bill are causing partisan headaches. And the withdrawal of Tom Daschle, as the new administration's point person on healthcare, won't help. Daschle was known for his ability to negotiate across political lines. But Drew Altman, of the Kaiser Family Foundation, says the search for common ground between the parties is, at some level, futile, because the public itself is split along partisan lines, when it comes to healthcare. So, when politicians fight:

Mr. DREW ALTMAN (President and CEO, Kaiser Family Foundation): They're not just making it up. They, actually, do reflect real differences between Democrats and Republicans on health, about how they solve the problem, and how much they would rely on government versus the market and how much they're willing to pay.

ROVNER: Which means today's may be the first and last signing ceremony, at least, for a while.

Julie Rovner, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

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