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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 passage of the bill last month.

For now, the insurance vote stands as the latest example of how Bush can still get his way on Capitol Hill. Through artful use of veto threats and his veto pen, 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. 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.”

Pelosi and her lieutenants later crossed the Capitol to discuss options with the Senate majority leader, Harry Reid, D-Nev., and Republican senators who had helped write the legislation.