Bush Orders Exclusion of Children from Insurance Program


8-21-07, 9:29 am

Ahead of final passage of a congressional reauthorization of the Children's Health Insurance Program (S-CHIP), the White House yesterday ordered new rules to the existing program that would force children of working families who can't afford health insurance to go without.

The new rules come after more than six years in office during which states – governed by both Republican and Democratic governors and state legislatures – have sought to expand eligibility requirements in order to include more children in their children's insurance programs. Indeed, Republican and Democratic governors and state legislators have urged Bush to sign the current reauthorization bill.

Before the August recess, Congress passed two versions of the S-CHIP reauthorization that expands coverage to include an estimated 3 to 5 million more children.

The House version would provide an additional $50 billion over five years to the states and would make eligibility rules flexible. New eligibility would allow states with higher costs of living to include more uninsured children. The bill passed mainly on a party line vote.

The more modest Senate version provided only an additional $35 billion over five years, but also loosened the rules to allow states to provide families who cannot afford high premiums with affordable insurance for their children.

Despite a lot of hot air on the Senate floor from some Republicans staunchly opposed to adding children to the S-CHIP program, the bill passed by a hefty 68-31 vote margin, large enough for that body to override a veto.

When Congress returns, both parties and both Houses will send negotiators to a conference committee to hammer out the final version of the bill to be sent to the president.

Bush has said he would veto an S-CHIP reauthorization bill that attempts to include more children.

The White House letter sent out to the states yesterday forces state officials to scale back S-CHIP eligibility requirements or be able to meet impossible prerequisites.

One such stipulation is that a state must be able to prove to the satisfaction of the federal government that 95% of all uninsured children below 200% of the federal poverty level in that state be enrolled in the S-CHIP program before allowing children above 250% of the poverty rate to be enrolled.

While this seems like a reasonable demand to ensure the lowest income children get in the program first, state officials have already come forward with statements saying that it is an impossible requirement. It is impossible to do, and certainly impossible to prove.

In other words, the new White House top-down marching orders on providing access to uninsured children is not designed to address the needs of working families, but to prevent states from expanding their programs to include more uninsured children.

Because the new orders come on the eve of a congressional reauthorization of the program and after six years into the Bush administration's tenure, it is clear that the letter is mainly a political stunt. And it could be dismissed as such if it didn't so negatively and directly take aim at working families.

The new rules are meant as a signal of the White House's hardened position on the S-CHIP reauthorization issue and its hint at a renewed veto threat.

Essentially the White House is demanding that Congress back off of its more expansive legislation and accept something closer to the White House's position.

Some might even suggest that in manner as yet unfamiliar to it, the White House is staking out a negotiating position.

But before Democratic leaders in Congress take that bait, they have to remember that the concept of negotiations with this White House is pure fantasy.

Sure, some Democratic leaders are likely already rehearsing the Karl Rove line that if this Congress can't show a strong legislative record, then it could lose seats in 2008. Thus, they argue, we have to make an effort to come to an agreement with the White House on something that Bush will sign.

But that is a bad move, my friend.

For example, the Senate Democrats lost their shirts when they tried negotiating with the White House on warrantless wiretapping. Senate authors of a bill that would have revised current FISA laws to expand the powers of the intelligence community to fight terrorism originally sought to protect judicial oversight.

They thought they had a compromise agreement with the Director of National Intelligence Michael McConnell. McConnell even told Senate Democratic leaders he could accept their compromise proposal, saying it would 'significantly enhances America's security,' according to congressional Democratic leaders.

But the next day within hours of the vote, McConnell backed off of the compromise, surely on orders from the White House, and the compromise fell through. And after all of their participation in hysterical rhetoric about imminent terrorist attacks in Washington and apparently baseless claims about McConnell's integrity, few Senate Democrats felt they could take a firm stand on protecting civil liberties.

If only they had stuck to their guns from the beginning on protecting Americans from the secret and deliberate invasion of our private lives by the federal government – overseen by none other than Alberto Gonzales – they would not have been out-maneuvered by the administration.

My advice on S-CHIP? Take a stand. Send the White House a bill that allows states to provide affordable access to health care for uninsured working-class children. Don't back down. Bush can't be trusted to negotiate in good faith and will exploit any compromising gestures to demand more.

If Bush vetoes the reauthorization bill, it is one more feather in his ogre cap. And then vulnerable Republicans in Congress are going to have to decide whether or not they want to act as empty suits for a failed presidency one more time and force uninsured children off of S-CHIP.

--Reach Joel Wendland at

| | |