The U.S. Senate is the next stop for legislation to expand children's health coverage, revised by Democrats but rejected by President George W. Bush as little changed from their earlier offering.
"You can put lipstick on a pig, but it is still a pig," said Texas Rep. Joe Barton, one of the more pungent descriptions of a bill that cleared the House on Thursday with less than the two-thirds majority needed to overturn Bush's threatened veto. The vote was 265-142.
Democrats said they had a prize-winner, not a porker. "They won't take yes for an answer," Rep. Rahm Emanuel, of Illinois, said of Republicans.
He said that in the week since they failed to override Bush's first veto, Democrats had systematically addressed earlier complaints that the bill failed to place a priority on low-income children, did not effectively bar illegal immigrants from qualifying for benefits and was overly generous to adults.
Even so, House Majority Leader Steny Hoyer of Maryland raised the possibility that additional changes were possible before the bill would be sent to the White House.
At the same time, he said, "I don't want to be strung along" by Republicans merely feigning an interest in bipartisan compromise.
Senate passage is highly likely, particularly with senior Republican Sens. Chuck Grassley of Iowa and Orrin Hatch of Utah among the bill's most persistent supporters.
The legislation is designed chiefly to provide coverage for children whose families make too much money to qualify for Medicaid but not enough to purchase private insurance.
In general, supporters said it would extend coverage to children of families making up to 300 percent of the federal poverty level, or about US$62,000 (EUR43,329) for a family of four.
At that level, congressional officials said, it would cover about 4 million children who now go without, raising the total for the program overall to 10 million kids. The US$35 billion (EUR24 billion) cost over five years would be covered by an increase in the tobacco tax of 61 cents (43 euro cents) a pack.
The vote unfolded one week after the House failed to override Bush's earlier veto, and indicated that the changes Democrats had made failed to attract much, if any, additional support.
The 265 votes cast for the measure came up seven shy of the two-thirds majority needed to override a veto. In addition, 14 Republicans who voted to sustain Bush's original veto were absent.
Public opinion polls show widespread support for the issue, and the political subtext was never far from the surface on a day of acrimony.
One Republican, Rep. Thelma Drake of Virginia, accused Democrats of timing the events to dovetail with attack ads planned by organizations supporting the legislation.
In an interview, she said she had told Hoyer in a closed-door meeting that it appeared Democrats would not postpone the vote "because the ads had already been bought. That was the only thing that made sense to me."
She said she reminded Hoyer that Democrats delayed an override vote on Bush's earlier veto for two weeks while she and other Republicans were attacked in television commercials.
In response, Hoyer's spokeswoman Stacey Bernards said, "This vote is about providing health care coverage for 10 million children and has nothing to do with when independent advocacy groups decide to schedule ads. That accusation is completely ridiculous and more evidence of some Republicans looking for any excuse to vote against this bipartisan bill."
Brad Woodhouse, head of Americans United for Change, which supports the legislation, said commercials are currently running in the districts of a few Republicans who opposed the earlier measure.
He said more were planned - depending on the outcome of the vote - and that Drake was on the target list.