On Capitol Hill, a Senate committee is scheduled to take the first formal action on a bill to renew the decade-old program that provides health insurance to more than six million children.
The program to cover kids in working-class families who earn too much to qualify for Medicaid, has until now enjoyed broad bipartisan support. But lately, it has become caught up in the broader politics of health reform.
Unless Congress acts by the end of September, the State Children's Health Insurance Program (SCHIP) will cease to exist.
Senate Finance Committee Chairman Max Baucus says he's pleased with the bipartisan compromise bill his panel will vote on.
"This is a way to help address lack of insurance coverage in America, and it's starting with kids — and it's starting with low-income kids — and I can't think of a better place to start," he says.
The Montana Democrat says the measure will provide nearly $35 billion more over the next five years — that's enough to help an additional 3.3 million low and moderate-income children get health insurance. It would be financed largely by a 61 cents-per-pack increase in the cigarette tax.
But the bill is already getting pummeled from both sides of what's turning out to be an unexpectedly contentious debate.
Advocates like Marian Wright Edelman of the Children's Defense Fund say the bill doesn't do nearly enough.
"And we really do find it hard to believe that in a country with a $13.3 trillion economy, we can't find a way to cover all 9 million children," Edelman says.
Edelman says the fact that the bill doesn't even spend the entire $50 billion Congress set aside for the program in the budget resolution passed earlier this spring, is short-sighted on both a political and a practical level.
"The American people really do want to cover children and they understand it is the smart, cost- effective thing to do," Edelman says.
But the bill is also the subject of criticism from President Bush, whose aides have issued a veto threat. During a speech in Cleveland last week, President Bush said he supported SCHIP when he was governor of Texas.
"But now there are plans to expand SCHIP to include families — some proposals are families making up to $80,000 a year," Bush said. "In other words, the program is going beyond the initial intent of helping poor children. It's now aiming at encouraging more people to get on government health care. That's what that is. It's a way to encourage people to transfer from the private sector to government health care plans."
The Congressional Budget Office says it's true that expanding the SCHIP program to families with higher incomes means that some will give up private insurance to get government plans instead. But it also says such insurance "substitution," as it's called, is an inevitable byproduct of government programs to cover more of the uninsured.
Meanwhile, Baucus says the bill doesn't go as far as he'd like, because he had to compromise to win the support of his committee's Republicans.
"I would like to have seen more expansion of the children's health insurance program, but the bill we're going to mark up in committee will be much less than that," Baucus says. "So it's scaled down a bit. But it's good, it's solid. And I can't for the life of me understand why the president wants to play politics with it. He's just wrong."
House Democrats, meanwhile, are working on an even bigger — and more partisan — bill. It would use all the money set aside in the budget — and also make controversial cuts to private Medicare health plans the administration will oppose. House leaders are expected to unveil its decision later this week.