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September 05, 2007

As House and Senate negotiators sit down this month to hammer out a compromise on renewing the popular health insurance program for children of the working poor, President Bush has made sure he gets a seat at the table.

Not content with veto power alone, the Bush administration has unilaterally tightened the rules for a program Congress hopes to expand. He wants to drop thousands of children from the benefit rolls, including 3,700 in Maryland. If lawmakers fail to reach agreement before the State Children's Health Insurance Program is set to expire Sept. 30, Mr. Bush's policy prevails.

Some may regard this tactic as intimidation, but Congress should treat it as inspiration to quickly come to terms on how the program can be even more effective in making medical services available to this vulnerable group of young people.

The Senate has offered the best model for broad, bipartisan cooperation, voting by a veto-proof margin to approve legislation that would provide enough new money to ensure coverage for the 6 million children now included in the program and as many as half of the 9 million children who remain without health insurance.

Financed by a 61-cent-per-pack increase in the federal cigarette tax, the Senate bill would set an eligibility income limit of 300 percent of the federal poverty guideline, or about $62,000 for a family of four. That level has been adopted by many states, including Maryland, which requires premiums from families above 200 percent of poverty.

A more generous House bill would allow states to raise income limits up to 400 percent of poverty, a level probably too high for broad support. But the House bill includes a better means of financing: ending subsidies for private plans that cost more but offer no greater benefits than traditional Medicare.

Mr. Bush opposes both financing plans. Instead, he's moving to limit eligibility to families earning less than 250 percent of poverty - $41,300 in Maryland - unless a state has enrolled 95 percent of the children at that income level. No state has yet achieved that enrollment rate because such families are often hard to reach.

The president says he fears that if the federal program is too attractive, families will drop private insurance to take advantage of the government's largess. But with new census numbers showing the number of insured children on the rise - nationally, though not in Maryland - this fear seems unfounded.

Ensuring that children get screenings and other preventive care early in their lives is a bargain compared with dealing later with chronic ailments. Congress should not allow Mr. Bush to sour the deal.

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