Defying the threat of a presidential veto, the House and Senate both passed legislation last week to expand a health insurance program that covers nearly 2,500 children of the working poor in Jackson County.




The proposals, which rely on a tobacco tax increase for financing, would reauthorize the State Children's Health Insurance Program, or SCHIP, beyond its Sept. 30 expiration.




If not reauthorized by Congress and approved by President Bush, children who would not ordinarily qualify for the Oregon Health Plan could be booted from its rolls, said Maria Ramos Underwood, a spokeswoman for the Medford-based La Clinica del Valle, which serves thousands of the Rogue Valley's uninsured.




"The last thing we need in Jackson County are more people that are uninsured," Ramos Underwood said, noting that some 70,000 people in the county are either under- or uninsured.




"These are kids that are not going to be captured by the private insurance market," she added. "They are going to be uninsured."




Championed by U.S. Sen. Gordon Smith, R-Ore., the Senate bill would force smokers to dig a lot deeper into their pockets so that 3.3 million children can join the other 6.6 million children already covered by the program, designed for those children whose parents earn too much to qualify for Medicaid but cannot afford to purchase health insurance.




The legislation, which cleared the Senate by a veto-proof majority Thursday, would raise the cigarette tax 61 cents a pack &

from 39 cents to a $1 a pack. The excise tax on luxury cigars, meanwhile, would reach $10 for stogies with a wholesale price of $19 or more.




A day earlier, the House endorsed a broader proposal seen by some observers as less viable given its reach.




Opposed by Rep. Greg Walden, the Republican congressman who represents Ashland and Medford, the House-approved legislation would add 5 million more children nationally to the program and would make changes to Medicare, including cutting payments to managed-care plans and pay increases for physicians.




The House plan would raise the cigarette tax to 84 cents.




In Oregon, where the Oregon Health Plan administers the decade-old program, 39,586 children whose parents earn up to double the federal poverty level, or about $40,000 for a family of four, were covered as of June.




Under the SCHIP program, the federal government supplies $2 for every dollar the state pays for health insurance for low- and moderate-income children. During the 2007 fiscal year, the Beaver State received $56.7 million in SCHIP funding, according to Jean Phillips, interim deputy administrator of the Oregon Health Plan.




Dr. Allen Douma of Ashland, the former director of the Oregon Health Plan, said Tuesday that every penny the state can invest in children's health is money well spent.




"There are wider social benefits to this," Douma said. "Prevention programs for kids will create benefits for all of us."




Unfortunately, with health care costs soaring, the five-year SCHIP appropriation will buy less and less each year," said Douma, a member of the AARP Oregon executive council, which has endorsed the proposals.




"The real issue is how are we going to control costs," he said, noting that health care costs are rising 7 percent annually.




When Congress reconvenes after its monthlong August recess, the Senate and House proposals will move to conference committee, where lawmakers will hash out the differences and send a compromise bill to President Bush, who has said he objects to the hefty price tags.




With the Senate calling for a $35 billion increase over five years and the House wanting to double current SCHIP funding, to $50 billion, or 10 times what President Bush has proposed, the conferees have their work cut out for them.




Underwood, of La Clinica del Valle, said it is unlikely that the president would veto a compromise bill.




"I just don't see it being cut because it's for children," she said of the program. "It would be very difficult to (politically) explain that."




covers government for the Ashland Daily Tidings. He can be reached at csrizo@hotmail.com.