"Immigration Debate Roils Children's Health Bill"

RENEE MONTAGNE, host:

And now to an issue that's once again a source of heated debate: the State Children's Health Insurance Program, or SCHIP. The Senate gets down to work in earnest today on a bill to extend and expand SCHIP. It's been a bipartisan effort until now. As NPR's Julie Rovner reports, Republicans are hopping mad over some changes Democrats have made to the bill, particularly one that would expand the program to children of legal immigrants.

JULIE ROVNER: To listen to the early Senate floor debate yesterday, you'd think little about the SCHIP bill had changed since Congress last considered it back in 2007. Here's Senate Majority Leader Harry Reid.

Senator HARRY REID (Democrat, Nevada; Senate Majority Leader): With the support of Democrats and Republicans in Congress and a new president in the White House poised to sign this bill into law, we can ensure that more low-income families can provide their children with the medical care they need to grow up strong and healthy.

ROVNER: In fact, in many ways, the bill now before the Senate does resemble the one that passed Congress with bipartisan backing in 2007 but was vetoed twice by President Bush. It would extend for four and a half years the program that provides health insurance to almost 7.5 million children. The program is for kids and families who earn too much to qualify for Medicaid, but still can't afford private coverage.

The bill would also provide enough additional funds to add 4 million more children to the rolls by the year 2013. It would mostly do that by a 61-cent increase in the federal cigarette tax. But without a Republican in the White House and with larger majorities in both the House and Senate, Democrats decided they could roll back some of the compromises they made in the 2007 measure. That's not sitting well with Republicans like Arizona's Jon Kyl.

Senator JON KYL (Republican, Arizona): This year, however, the Democratic majority has decided to work it alone, to write a partisan bill without Republican input.

ROVNER: The change that has Republicans most outraged would eliminate the current five-year waiting period for legal immigrant children to qualify for SCHIP or Medicaid. West Virginia Democratic Senator Jay Rockefeller, who managed to get the language added as an amendment by the Finance Committee, has been working to eliminate the waiting period almost ever since it was imposed in 1996.

Senator JAY ROCKEFELLER (Democrat, West Virginia): The parents are working. They're paying taxes. They're doing everything they should be doing. And what I'm trying to do is not penalize those children who are legally here.

ROVNER: But Republicans, like John Ensign of Nevada, say it simply sends the wrong message.

Senator JOHN ENSIGN (Republican, Nevada): And it would seem to me that we are giving more incentives for folks to come to the United States, not just to participate in the American dream, but to come to the United States to get on the government dole. And that's - I think this is exactly the wrong direction that we should be going with our - with this piece of legislation.

ROVNER: Republicans said they also worried that if, down the road, millions of immigrants currently here illegally are made legal, that the cost of the provision could balloon. Again Arizona's Jon Kyl.

Senator KYL: So we are once again adding huge costs to one of the entitlement programs at the same time that we acknowledge that we can't even pay for things like, for example, the physician update every year, whereby American doctors take care of American citizens in the Medicare program.

ROVNER: The Senate is expected to spend much of the week debating the bill. Julie Rovner, NPR News, Washington.