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'Compassionate' Bush fails children on health

| Sunday, Aug. 19, 2007

The story should have gone like this: "In a rare moment of bipartisan goodwill, the Democrat-controlled Congress delivered the politically ailing President George W. Bush a much needed domestic accomplishment: legislation to provide health coverage for 5 million poor or near-poor children."

It didn't quite turn out that way.

In a stunning rebuke to congressional leaders, and to the six (out of 10) Republican Senate Finance Committee members who supported legislation to expand the State Children's Health Insurance Program, the White House threatened to veto bills that would have covered millions of children.

To see just how poor the administration's excuses are for saying no, here are a few choice quotes from the Office of Management and Budget's veto-threat statements.

Poor excuse one: "The legislation dramatically expands federal spending far beyond what is necessary to reauthorize S-CHIP responsibly."

The program, pushed and signed by President Bill Clinton in 1997, has been a clear success. Over the course of last year, it provided health coverage to 6.6 million low-income children at a cost to the federal government of $5 billion.

According to a Congressional Budget Office report from May, S-CHIP has led to a 25 percent reduction in the number of uninsured children who are between 100 percent and 200 percent of the poverty level, while children at higher income rates saw no decline.

At current funding rates, however, nearly 1 million children covered under S-CHIP in an average month will be dropped from coverage, while more than 5 million currently eligible for that program or Medicaid will remain uninsured. The White House proposed kicking in an average of only $1 billion a year through 2012, which would mean that hundreds of thousands of children would lose S-CHIP coverage.

So why is allowing children to be dropped from a proven program -- as opposed to insuring 4.2 million more in the House version -- the right way "to reauthorize S-CHIP responsibly"?

Poor excuse two: The proposed expansion "essentially extends a welfare benefit to middle class households."

When you hear statements like that from the administration, you get the sense that the $35 billion to $50 billion S-CHIP expansion over the next five years would go directly to suburban parents lounging at their swimming clubs.

Yet the CBO shows that more than 85 percent of the children who would gain insurance under both congressional bills -- including 4.6 million out of 5 million in the House -- are from families near poverty, or of very modest means, who are already eligible under current guidelines.

Almost all these children come from families earning below 200 percent of the poverty line, or $34,000 a year for a family of three.

Poor excuse three: The proposed expansion "would cause millions of individuals to drop their private insurance in order to be involved with a government insurance plan."

It is true that one-third of the 6 million children who would be newly covered by either S-CHIP or Medicaid currently have private insurance. But the White House well knows that every coverage-expansion plan -- conservative or progressive -- benefits some people who already have insurance.

In fact, the proposed S-CHIP expansions are highly efficient compared with the White House's proposals. About 77 percent of the benefits of Bush's plan to expand health savings accounts and 80 percent of his most recent proposal to subsidize purchases of premiums go to those who are already insured.

MIT economist Jonathan Gruber wrote to House Energy and Commerce Committee Chairman John Dingell, explaining that the House S-CHIP expansion was among the "most cost-effective means of expanding health insurance coverage."

And as the Center on Budget and Policy Priorities points out, the disappointing rhetoric and name-calling about government-run health care is just a ruse. Seventy-four percent of children covered by Medicaid and more than three-quarters of children covered by S-CHIP are enrolled in private managed-care plans. And virtually all states contract with private providers to deliver health-care services.

Poor excuse four: "It transforms the program into an effectively unlimited entitlement program."

Forgive me if I gag. This is the administration that was willing to finance a half-trillion-dollar prescription-drug benefit completely with borrowing and deficit spending. It is off the chutzpah charts for the White House to cry fiscal responsibility in regard to S-CHIP-expansion bills when the Democrat-controlled Congress is paying for its entire proposal with spending cuts and tobacco revenue.

What is most inexcusable about the White House stance is what they don't say. They offer nothing -- no better idea, no alternative, no plan -- that has been shown to keep even a chunk of these 5 million to 6 million children from going to sleep every night without health insurance.

They are content to keep the status quo even with heartbreaking reports that uninsured infants with congenital heart problems are 10 times more likely to die because of delayed treatment than those with coverage.

Before, "compassionate conservatism" may have seemed like a political bumper sticker. Now it seems like the punch line of a sad joke, at the expense of millions of impoverished children.

Gene Sperling, author of "The Pro-Growth Progressive," was President Bill Clinton's top economic adviser. He is a senior fellow at the Center for American Progress.

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