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President Bush accused congressional Democrats on Thursday of playing politics with the health of children, and he warned again that he would veto a children’s insurance bill if it emerged from Congress in its present form.

Instead of posturing by sending him a bill they know he will reject, Bush said, the Democrats should embrace fiscal and social responsibility and pass a bill that provides for reasonable increases in spending on health insurance for uninsured children without veering toward the “federalization of health care.”

The president spoke at a White House news conference convened for the express purpose of trying to head off political damage from Democrats who are mocking Bush’s description of himself as a compassionate conservative because of his opposition to the increased spending in the children’s insurance bill.

While he responded to an array of questions on domestic and foreign issues, Bush led off with comments about the State Children’s Health Insurance Program, also known as S-Chip.

“What I’m describing here is a philosophical divide that exists in Washington over the best approach for health care,” Bush said. “Democratic leaders in Congress want to put more power in the hands of government by expanding federal health care programs. Their S-Chip plan is an incremental step toward the goal of government-run health care for every American.”

“I have a different view,” Bush went on. “I believe the best approach is to put more power in the hands of individuals by empowering people and their doctors to make health care decisions that are right for them. Instead of expanding S-Chip beyond its original purpose, we should return it to its original focus, and that is helping poor children, those who are most in need.”

Until the White House and Congress can come up with a health bill acceptable to both, Congress should pass “a clean, temporary extension” of the current program, which expires at the end of the fiscal year on Sept. 30, Bush said. The president said he had instructed Michael Leavitt, the secretary of health and human services, to work with state to minimize damage in the event that the program lapses.

Negotiators for the Senate and House have agreed on the outlines of a bill that would provide health insurance for an additional four million children who do not now have coverage. About 6.6 million children are now covered. Under the emerging bill, $60 billion would be provided for S-Chip program over the next five years — $35 billion more than current spending, and $30 billion more than Bush has recommended, but $15 billion less than the House originally wanted.

The House-Senate accord would increase tobacco taxes to cover more children. When Bush was asked if he would oppose a tobacco tax increase, he said, “We don’t need to raise taxes,” and added that lawmakers were trying to expand the health-insurance program beyond its original mandate to aid poor children.