President Bush heads into only the fourth veto of his presidency with most of America's health establishment and nearly two-thirds of the Congress arrayed against him.

A 12-year-old boy delivered the Democratic response to Mr. Bush's radio address this weekend, and children pulling red wagons are expected to deliver 1 million petitions supporting renewal of the State Children's Health Insurance Program (S-CHIP) to the White House on Monday.

Explaining a vote against healthcare for poor children is not the issue that Republicans wanted to take into the November 2008 elections. Last week, 18 Republicans in the Senate and 45 in the House broke with Bush to support the pending S-CHIP bill, and Democrats say they need to flip only 15 more House Republicans to give the Congress a veto-proof majority.

But the White House and GOP leaders in both houses of Congress say this is a fight worth fighting on policy grounds – and that it may do them some good in spending battles to come and even in next fall's elections.

"Health insurance for poor children is a tall hill for politicians to climb," says Rep. Mike Pence (R) of Indiana, a leading House conservative. "That will make all the other battles that much easier to fight."

A presidential veto of the S-CHIP bill in its current form is "a sure thing," says White House spokesman Tony Fratto. Bush will risk the political fallout because the policy is wrong. He adds, it "doesn't focus on the core population that needs to be served," that is, children in families earning less than 200 percent of the federal poverty level. (For a family of four, that's an annual income of $41,300 or less.)

By stripping out a requirement that S-CHIP cover 95 percent of the neediest children before extending it to higher-income children, Congress is undermining a key intent of the program, Mr. Fratto says. "We think this is a good program, and Congress should keep it focused on what it was intended to do."

The US Department of Health and Human Services estimates that some 794,000 children in these lowest-income families are eligible for S-CHIP and are not currently covered.

Moreover, the S-CHIP bill reaches so far into higher-income groups that it will "shift millions from private insurance to government-supported care," Fratto adds.

Ten states and the District of Columbia now cover children from families with incomes up to three times the poverty level, or $61,950 a year for a family of four. New Jersey has extended eligibility to families earning up to $72,275.

Bush often cites the case of New York, which sought to extend coverage to families earning up to $82,600, or 400 percent of the federal poverty level. Democrats note that Washington rejected that extension, and therefore it's not a valid concern. But "the law is still on their books and [would be] more likely to be accepted" by the terms of the law that Congress is proposing, Fratto says.

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