Insurance expansion advances

WASHINGTON -- Making a down payment on President-elect Barack Obama's promise of universal health coverage, the House voted overwhelmingly yesterday to expand government-sponsored insurance to 4 million more children in working families with income too high to qualify for Medicaid.

Between 300,000 and 600,000 of the new enrollees could be noncitizen children of legal immigrants who have been in the country less than five years, a sticking point for some Senate Republicans who will consider a similar bill.

The bill would raise the federal excise tax on cigarettes by 61 cents to $1 a pack to pay for the $32.3 billion cost of expanding the State Children's Health Insurance Program for the next 4½ years. Other tobacco products would experience a comparable tax increase.

Forty Republicans joined Democrats in passing the bill 289-139. Congress passed similar legislation in 2007, but it was vetoed both times by President George W. Bush.

The Congressional Budget Office projected that nearly 83 percent of the 4.1 million uninsured children who would gain coverage are in families with incomes below the current eligibility limit. In most states, that is less than twice the federal poverty level -- $42,400 for a family of four. Virginia uses that standard.

"If that didn't get reauthorized, we were not going to have enough money just to finish this federal fiscal year," said Cindi B. Jones, chief deputy director of the Virginia Department of Medical Assistance Services.

Budget projections show a $30 million shortfall in the state's SCHIP program if it did not get additional funds.

Enrollment in Virginia's program, called FAMIS, was 96,130 children as of Jan. 1. An additional 373,698 are enrolled in Medicaid.

Officials estimate there are an additional 100,000 to 120,000 Virginia children eligible for one or the other program who are not enrolled.

In Virginia's House delegation, 9th District Democrat Rick Boucher did not vote, and Frank R. Wolf, R-10th, voted for the bill. The others voted along party lines.

GOP critics believe Democrats are underestimating participation in the program, and thus its price tag, especially as more people lose private health insurance in the economic downturn and become eligible for government support.

Staff writer Tammie L. Smith contributed to this report.