Orrin Hatch's stances on children's coverage coming back to haunt him

Sen. Orrin Hatch (R-Utah) is taking hits from all sides on a children's healthcare program he has long touted as part of his legislative legacy.

Facing a potentially tough reelection fight in Tea Party-friendly Utah, Hatch has voted against recent efforts to preserve the Children's Health Insurance Program he helped create in 1997 in partnership with the late Sen. Edward Kennedy (D-Mass.). The shift has failed to shield him from conservative attacks, however, while some advocates say it imperils his legacy as a champion for children.

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Utah state Sen. Dan Liljenquist, a potential Hatch challenger in 2012 — he's not expected to announce until next year — has accused Hatch of supporting an "unconstitutional" government healthcare program for children, the Salt Lake Tribune reports. Liljenquist also criticized Hatch's support for the unpaid-for Medicare prescription drug program and a Republican alternative to Hillary Clinton's healthcare proposal that included an individual mandate.

"He is the one who passed national children's health care. That is a key difference between him and me," Liljenquist told reporters on Monday, according to the newspaper. "I've been working to bring these programs back to the states."

Hatch's office has pushed back, pointing out that Liljenquist voted to expand the program in Utah.

"Sen. Hatch voted against recent expansions of this program because they were power grabs by Washington over the states," spokesman Matthew Harakal told The Hill. "At the same time, Dan Liljenquist was voting in the Utah State Senate to expand the program in the state. Now Dan Liljenquist says he made a mistake, but that sounds a little bit like ‘the dog ate my homework’.”

The increasing conservatism of the Republican Party has put Hatch in a bind. He has long touted SCHIP as a successful bipartisan effort to tackle a pressing social issue, but in recent years has found fault with Democratic efforts to expand it.

"Ten million children in our society of the poorest of the poor families, not on Medicaid, meaning the working poor, did not have adequate healthcare," Hatch said at a Republican Debate at Dartmouth College in 1999. "They were the only people fully left out of our healthcare system. So we fought day in, day out, until we passed the Hatch 'CHIP' bill, the Children's Health Insurance Program, that now provides full coverage for 7 to 10 million children."

When it came time to reauthorize the program 10 years later, however, Hatch balked. He joined 31 Republicans who voted against the bill in the Senate in 2009, arguing that its expansion to legal immigrant children and families at 400 percent of the federal poverty level (from 200 percent in the original bill) "makes a mockery of the original intent by expanding CHIP to cover people for whom the program was never intended."

In May, Hatch went one step further and introduced legislation allowing states to roll back their CHIP coverage, by toughening eligibility standards and setting up waiting lists for care, for example.

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At the time, Bruce Lesley of the children's advocacy group First Focus spoke out against Hatch's bill.

"Our nation's leaders must not allow a rollback of such coverage," Lesley wrote. "Turning back the clock now would undermine the very work that Senator Hatch is so proud to have championed."

Hatch has shown no sign of backing down, however.

On Tuesday, he sought to rekindle his stalled bill after the National Governors Association released its latest fiscal survey showing state budget deficits cumulatively add up to at least $365 billion over the next five years. Medicaid enrollment makes up the largest portion of state budgets.

"As this bipartisan report illustrates, Medicaid's soaring costs are crowding out states' ability to support other vital programs like education and transportation," Hatch said in a statement. "Giving states the flexibility they need to manage their budgets by eliminating federal Medicaid eligibility requirements is essential as a first step toward a desperately-needed overhaul of this unsustainable health care entitlement."

Update: This post was updated with a statement from Hatch's office at 5 p.m.