The White House and the Democratic-controlled Congress are squaring up for the next phase of what is perhaps the most bizarre political showdown of George W. Bush’s presidency.
Nancy Pelosi, speaker of the House of Representatives, will try on Thursday to override Mr Bush’s veto last month of an expansion in healthcare for impoverished children by seeking a two-thirds majority in its favour. The Senate has already approved the measure by a two-thirds majority – with considerable Republican backing.
Mr Bush says the $35bn (€25bn, £17.5bn) expansion over the next five years is fiscally irresponsible and a step towards European-style government healthcare. But a number of leading Republicans – including Charles Grassley and Orrin Hatch, senators from Iowa and Utah respectively – have dismissed his argument as a “red herring”.
They say the bill is consistent with Republican principles as it gives state governments the flexibility to allocate the funding, and it avoids turning health insurance spending into an “entitlement”.
According to the Kaiser Foundation, which monitors healthcare, more than three quarters of the 6.6m children who benefit from the existing programme do so through private insurers, rather than government channels. Under the expansion, another 3.5m children would be added, mostly from homes that are marginally above the poverty line.
“This bill is not a government takeover of healthcare,” said Mr Grassley in a Senate speech last month. “Screaming ‘socialised medicine’ during a healthcare debate is like shouting ‘fire’ in a crowded theatre. It is intended to cause hysteria that diverts people from looking at the facts.”
On Monday Mr Bush reiterated his view that the expansion would be a step down the road to “socialised medicine”. The veto was the first time since he became president in 2001 that he has used fiscal restraint as the reason for junking a bill. It coincided with the White House’s $190bn supplemental funding request for the wars in Iraq and Afghanistan.
Critics say Mr Bush’s proposed $5bn expansion over five years would lead to a substantial cut in the number of children receiving subsidised healthcare as it would not be linked to inflation. They point out the programme was originally negotiated 10 years ago between Bill Clinton, then president, and Newt Gingrich, former Republican speaker, who trumpeted it as a step forward for conservative principles.
Many Republicans worry they will be punished at the polls next year if they uphold Mr Bush’s veto on Thursday. “If I were a Republican in Congress I would sue the White House for political malpractice,” says Norman Ornstein at the American Enterprise Institute. “If they vote with Mr Bush they will be accused of cutting funding for children’s health. If they vote against, they open themselves up to attacks from the right.”
The White House has further puzzled allies by its attack on an increase in tobacco taxes to fund the healthcare expansion – a measure the Democratic Congress imposed on itself under the “pay-go” principle, whereby any spending increase or tax cut is matched by an equivalent tax increase or spending cut.
The White House says it would be regressive since the poor smoke in higher numbers than the rich. Many take this argument with a pinch of salt as the Bush administration has cut taxes for the wealthy by a greater amount than any of its recent predecessors. In addition, they say the White House itself pushed through a much larger expansion in Medicare – the system of healthcare for the elderly – when Capitol Hill was controlled by Republicans.
“It is really hard to explain the White House’s logic,” says Edwin Park of the non-partisan Center for Budget Policy and Priorities. “The White House was in favour of increasing healthcare through private insurers with Medicare but suddenly it is anathema when it comes to children.”
Others say Mr Bush’s motive is to shore up his Republican base, disaffected by big growth in public spending since 2001.
Mr Bush was rebuffed in June when he attempted to push through bipartisan reform of the immigration system – only 12 of 49 Republican senators supported him.
“He has gone from a half-hearted attempt at bipartisanship, to an unwavering stance of hyper-partisanship,” said a former member of the administration. “A lot of us are perturbed.”
