PORTLAND (AP) — When ballots turn up in Oregon mailboxes over the next few days, voters will have to decide whether to approve a plan to raise cigarette taxes in order to pay for an expansion of children’s health insurance programs.

But even if the proposal finds favor with voters — and with tobacco companies spending at least $10 million so far to defeat it, that’s by no means a sure thing — it won’t automatically cover the 100,000 children that supporters have promised.

That’s because state health officials have yet to get firm approval from the Bush administration to extend coverage beyond families who make more than twice the poverty level, or about $41,000 for a family of four.

The Oregon proposal, known as Measure 50, would give subsidized coverage to children in middle-class families who make three times as much as the poverty level, up to $62,000 for a family of four. Depending on their income, such families would pay monthly premiums on a sliding scale.

The Bush administration has been notably cool to states that want to help pay for coverage for anyone but the poorest families. A spokesman for the president has said Bush wants the program to zero in on the poorest children, and not become a replacement for private health care coverage for middle class families.

In August, the administration released new standards for states that wanted to set eligibility for children’s health coverage above 250 percent of the poverty level. They warned that states that didn’t abide by the new rules within 12 months would face “corrective action” from regulators.

In order to get such a waiver, states will now have to show that they’ve already enrolled at least 95 percent of children living below 200 percent of the federal poverty level.

State health officials in Oregon and elsewhere have said that level of enrollment is virtually impossible to achieve.

Gov. Ted Kulongoski told The Associated Press this week that he’d met several times over the past year with U.S. Secretary of Health and Human Services Michael Leavitt to discuss the possibility of Oregon getting a waiver, should Measure 50 pass. Leavitt has been receptive, Kulongoski said.

“You have to move beyond what we have done for the most vulnerable,” Kulongoski said. “We don’t do anything for the people who make between $30,000 and $70,000. They are the ones getting frozen out in their jobs because of their skill level. On every issue you can think of, they are losing ground.”

Other states, though, have run into problems with waiver requests. New Jersey, for example, covers families who earn up to 350 percent of the federal level, one of the highest cutoffs in the nation. Democratic Gov. Jon Corzine has so far refused to comply with the administration’s new income eligibility guidelines, and said the state could sue if its waivers aren’t extended.

Congress could pre-empt some of the debate by voting to increase the income eligibility guidelines, said Dr. Bruce Goldberg, who heads the Oregon Department of Human Services. That agency would administer the Healthy Kids program if the cigarette tax is approved by voters.

“(Congress) is looking to give states the ability to go up to and even above 300 percent of poverty,” Goldberg said. “Congress can pass legislation that prohibits the executive branch from instituting certain restrictions.”

That change, though, depends on a resolution to the ongoing wrangling in Congress over the state children’s health insurance program, or S-CHIP, the federal program that would provide matching dollars for the Healthy Kids plan. Oregon pays 30 percent of the cost of the coverage for its current S-CHIP program; the federal government kicks in the remaining 70 percent.

President Bush has vetoed a Democratic proposal to expand S-CHIP by $35 billion over five years; an attempt to override the veto failed to garner enough votes Thursday in the House of Representatives.

On Friday, Oregon Democratic Reps. Earl Blumenauer and Darlene Hooley said they expect a compromise S-CHIP bill to be introduced within the next few weeks. Both said they thought Oregon would be able to get the necessary federal waivers.

Until then, the most immediate impact of Measure 50 will be on the 50,000 or so uninsured children whose families earn less than 200 percent of the federal poverty level, Goldberg said.

“Right off the bat, we will be able to have the funding to insure about half of the uninsured kids in the state,” he said.