WASHINGTON, Oct. 18 — The House on Thursday upheld President Bush’s veto of a bill to provide health insurance to 10 million children, but Democrats vowed to send it back to him next month, with minor changes, in the belief that they could ultimately prevail.
Despite a multimillion-dollar advertising campaign and intense lobbying by children’s advocates, supporters of the bill were unable to convert a single House Republican who voted against the bill last month.
For now, the insurance vote stands as the latest example of how Mr. Bush can still get his way on Capitol Hill. Through artful use of veto threats and his veto pen, Mr. Bush has fended off attempts to force a change of course in Iraq — a feat Democrats would never have imagined when they pushed Republicans out of power a year ago. He has twisted Democrats into knots over domestic surveillance, and forced them to rethink a resolution condemning as genocide a century-old massacre of Armenians.
The outcome on Thursday, reminding Democrats of the limits of their power, came as Congress and the president prepared to square off over a dozen spending bills needed to finance the government in the new fiscal year. President Bush has threatened to veto at least 10 of those measures, while also holding the Democrats responsible for not acting more quickly on the bills, which were supposed to be enacted by Sept. 30.
In the vote on Thursday, the roll call was 273-156. That was 13 votes short of the two-thirds majority needed to pass the measure over the president’s objections. In the Senate, the bill was approved last month with more than a two-thirds majority.
The bill would have increased spending on the State Children’s Health Insurance Program by $35 billion, bringing the total to $60 billion over the next five years. It would have provided coverage for nearly 4 million uninsured children, while continuing coverage for 6.6 million already on the rolls.
After the House vote, Speaker Nancy Pelosi of California said, “In the next two weeks, we intend to send the president another bill that provides health care for 10 million children.” That goal, she said, is “not negotiable.”
Ms. Pelosi and her lieutenants later crossed the Capitol to discuss options with the Senate majority leader, Harry Reid, Democrat of Nevada, and Republican senators who had helped write the legislation.
At the White House, aides to Mr. Bush said they took heart that enough Republicans were willing to stand with the president to keep the veto intact.
“This isn’t the last fight we’re going to have where Democrats will try to put forth legislation that is populist or will tug at the heart strings,” said Tony Fratto, the deputy White House press secretary.
Mr. Fratto added, “Is it a good day? No. A good day will be the day that we pass legislation that the president can sign. But it is gratifying to know that we’ve got Republicans with sufficient backbone who are willing to stand tall and fight on principle in order to get the policy right.”
But some Republicans, like Representative Thomas M. Davis III of Virginia, who was chairman of the National Republican Congressional Committee when Mr. Bush ran for election in 2000, were furious with Mr. Bush for putting them in such a difficult spot on children’s health.
“He’s not going to get his way on this,” said Mr. Davis, who voted to override the veto and predicted that Mr. Bush would ultimately be forced to sign a measure similar to the one he rejected.
“And he’s jeopardizing people’s careers,” added Mr. Davis, who is contemplating a race for the Senate.
On the House floor, Democrats told Republicans they would pay a political price for their opposition.
Representative Charles B. Rangel, Democrat of New York, who is chairman of the Ways and Means Committee, said that “President Bush is going to be there at his ranch in Texas” at the time of the next election.
“He will not be with you at the polls,” Mr. Rangel said. “By that time, the truth will have caught up with the message that the president and you are using to sustain his veto.”
Democrats are seeking ways to revise the bill to answer criticism from Republicans who said it did not focus enough on low-income children. Critics say the bill would allow coverage of children from middle- and upper-income families and of adults and some illegal immigrants.
Mr. Bush has named three senior administration officials to negotiate with Congress. But Democratic leaders would prefer to deal directly with the president.
“We intend to sit down with the president any time he is ready,” Ms. Pelosi said. “We hope that will be soon.”
Chances for a quick compromise with the White House looked slim.
Representative John B. Larson of Connecticut, a member of the House Democratic leadership, said, “We have a president frozen in the ice of his own indifference toward the children of this country.”
Ms. Pelosi said she had no interest in an idea promoted by some Republicans in Congress: providing tax credits to middle-income families to help them buy private insurance for their children.
Tempers flared when House Democrats compared Mr. Bush’s veto of the child health bill with his support for the war in Iraq.
Representative Pete Stark, the California Democrat who is chairman of the Ways and Means Subcommittee on Health, told Republicans: “You don’t have money to fund the war or children. But you’re going to spend it to blow up innocent people if we can get enough kids to grow old enough for you to send to Iraq to get their heads blown off for the president’s amusement.”
Representative Kevin Brady, Republican of Texas, said Mr. Stark’s comments were “despicable and beneath contempt.”
In the vote Thursday, 229 Democrats and 44 Republicans supported the bill. Two Democrats and 154 Republicans voted against it. The House passed the bill in September by a vote of 265 to 159. Six Democrats switched from no to yes, and one newly elected Democrat, Nicola S. Tsongas of Massachusetts, voted to override the veto just hours after she was sworn in on Thursday.
Republicans said Democrats were blocking renewal of the program so they could retain a powerful political issue. “Rather than playing politics with children’s health care or scoring points with radio and TV ads, Congress can show the American people that we are here to solve problems,” said Representative Michele Bachmann, a freshman Republican from Minnesota.
In some ways, the outcome of Thursday’s vote was not surprising; experts say it is extremely difficult for Congress to override a presidential veto. President Bill Clinton exercised 36 regular vetoes during his eight years in office; 2 were overridden. Mr. Bush’s father exercised his veto pen 29 times, with 1 override. What would have been surprising, scholars say, would have been for Democrats to prevail.
And in the end, the veto may not do Mr. Bush much good, especially if he signs a bill similar to the one he rejected.
“It was an ambiguous victory,” said John J. Pitney, a political science professor at Claremont McKenna College in California, “because Democrats may have lost on the legislation, but they won themselves a campaign issue.”