Socialized Medicine's Front Door

Robert Novak's picture

WASHINGTON -- The Alice-in-Wonderland quality of legislating in Congress was typified this week. The Democratic Congress quickly passed a national health insurance bill, drafted in secret and protected from amendment, that constitutes the most important legislation of this session. While designed for a presidential veto, it is national health insurance -- through the front, not the back, door. Democrats view it as no-lose: either landmark health care will be enacted over President George W. Bush's veto, or, if overridden, they'll have a lovely 2008 campaign issue.

This outcome was previewed a week ago by Democratic Leader Steny Hoyer and Republican Whip Roy Blunt in a colloquy on the House floor. Blunt questioned the procedure under which radical expansion of the State Children's Health Insurance Program (SCHIP) would be passed as a "bill that has not been debated." No matter, Hoyer replied. It will not really be a new bill because "there will be nothing, I think, in the bill that was not in the House or Senate bills" that were passed previously. Such is the sad state of congressional procedure today.

This business as usual on Capitol Hill is worth noting because SCHIP extension covers much more than the poor children originally intended to be helped. The new bill covers families with income up to $82,000 a year, threatening to crowd out the private health industry. Only Congress could conceive making families simultaneously eligible for SCHIP to help the poor and AMT (the alternative minimum tax) to punish the rich.

SCHIP was conceived in 1997 by the Republican-controlled Congress, still uneasy about defeating Hillary Clinton's health care plan four years earlier and intending to provide supplementary health insurance for poor children. When Democrats took control of Congress this year, they sought to transform a relatively modest program into a government takeover of health care. Separate bills were passed in the House and Senate months ago along party lines, but Republican senators blocked a Senate-House conference to iron out the differences.

Following the summer break, key Democrats started meeting behind closed doors -- Republicans excluded -- the weekend of Sept. 14-15, seeking a way for the House to pass the Senate bill and send it to the president. The finished product was not put in Republican hands until 6:30 p.m. on Monday, Sept. 24, with the vote scheduled for 24 hours later and no chance to vote for a substitute, much less amend the bill. It extends SCHIP to families up to 400 percent of poverty ($82,000 a year) in New York, 350 percent in New Jersey and 300 percent elsewhere. States also can extend the aid to childless adults. Indeed, "children" includes anyone less than 21 years of age.

"A growing body of professional literature shows that when government health insurance expands, up to 60 percent of existing private coverage is 'crowded out,'" said a Heritage Foundation report last week. The program's $35 billion expansion is supposed to be financed by a 61-cent cigarette tax increase, but financing abruptly is scheduled to fall 72 percent halfway through 2012. With private insurance probably no longer available, Congress would then have no choice but to provide additional funding.

Bush's inevitable veto will face a certain override in the Senate, where supposedly conservative Republican graybeards have defected. Orrin Hatch is in another partnership with his friend, Ted Kennedy. Chuck Grassley, ranking GOP member on the Finance Committee, again has drifted leftward.

In the House, Republican Rep. Ray LaHood has worked closely with his fellow Illinoisan, House Democratic Caucus Chairman Rahm Emanuel, to round up Republican votes for a veto override. But LaHood and his allies were silent during Wednesday's House GOP conference. Rep. Paul Ryan, the top Budget Committee Republican, declared: "This is not a back door to get socialized medicine. They went straight to the front door." A headcount showed no more than 57 Republicans prepared to override Bush -- probably 11 short of what is needed.

Democrats flinched at giving Republicans a hard choice: override the veto or end the existing SCHIP program. Instead, funding is being extended by a separate bill. Nevertheless, Democrats will eagerly pummel Republicans for "voting against kids" by refusing to sanction a long step toward Hillarycare.


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