End the Echo weblog

You may recall, that new catch phrase that was run during the 2000 election – compassionate conservative, this was to describe the new face of conservatism brought to you about George W Bush.

Sadly, he was high on conservatism, and very lacking in compassion.  As a perfect example, which you were probably ignorant of thanks to corporate media and their crush on candidate Bush.

As Christopher Brauchli reported in Common Dreams last fall,

In 1997 Texas was allotted $561 million that it was required to spend in full by 2000. According to the Dallas Morning News, mid-way through 2000 Texas had only spent $112 million leaving $449 million unspent. By June 2000, 123,000 Texas families had applied for assistance but only 27,000 children had been enrolled. According to the Children’s Defense Fund Report, Texas ranked 45th among the states enrolling children in CHIP. Texas was one of only 8 states where the number of children with any form of health insurance declined from 1997 to 1999.

Failure to implement CHIP was not Mr. Bush’s only success in protecting Texans from the greedy needy. His other successes were described by U.S. District Judge William Wayne Justice. On August 14, 2000 Judge Justice entered a ruling on a case that had been filed against Texas for its failure to live up to a 1996 consent decree involving other health care programs. The judge gave Mr. Bush a report card that looked a lot like ones he probably got in grade school. It had lots of “needs improvement” on it. He said Mr. Bush had failed to improve children’s access to Medicaid, checkups under the program’s managed care arm were inadequate and fewer than 10 percent of children were receiving immunizations. He said the state had failed to inform indigent families about the availability of health services. He said managed care plans to which some indigent Texans had been assigned were not providing the required services and 1 million eligible individuals had received no dental care. In response to the judge’s findings Mr. Bush said: “[W]e’ve got a good record in signing up children for Medicaid and we’re going to continue to do so.” He must have been thinking of something the judge had overlooked.

So his record as Governor Bush was pretty dismal in helping the poor-more conservative than compassionate in my book.

Now the reason this is important is because Bush has done a couple of things to limit access to SCHIP from the top down, as the magical unitary executive that he is.  One is that he has vetoed increased funding for SCHIP to expand the number of children that are covered.

At issue is a program that provides health insurance for children whose families earn too much to qualify for Medicaid but cannot afford private health insurance. The vetoed measure would expand the $5 billion-a-year program by an average of $7 billion a year over the next five years. Supporters say that would be enough to boost enrollment to 10 million, up from 6.6 million, and dramatically reduce the number of uninsured children in the country, currently about 9 million.

The other method he used was to have the Centers for Medicare and Medicaid Services (CMS) issue a letter explaining the statutory and regulatory reason to limit SCHIP to families whose income is below 250% of the federal poverty level (FPL).  Ironically, this letter has this sentence:

In addition, section 2102(c) of the Act requires that State child health plans include procedures for outreach and coordination with other public and private health insurance programs.

It sure would have been nice if that spotlight had been directed to Governor Bush’s record.

Back to this letter, I have a huge problem with the FPL because it is a one size fits all for the whole contiguous 48 states, and do we really think that $13,690 for a family of 2 can be stretched the same in Manhattan as in Topeka, Kansas?  That is why some of the states with a higher cost of living are expanding coverage past 250% of FPL.

The bigger issue for conservatives, who rely heavily on corporate campaign contributions, is that SCHIP could cause children with current private coverage to switch to public health insurance under SCHIP, this is called “crowd out.”  Of course, this is about private insurance not wanting to compete with public insurance, guess there some doubts in the church of free market!

The good news is that the Government Accounting Office has informed Congress that the letter constitutes a rule, and as such must be submitted to Congress and the Comptroller General before taking effect.

The August 17 letter from CMS to state health officials is a statement of general applicability and future effect designed to implement, interpret, or prescribe law or policy with regard to SCHIP. Accordingly, it is a rule under the Congressional Review Act. Therefore, before it can take effect, it must be submitted to Congress and the Comptroller General.

Hopefully this ruling by the GAO will lead the CMS to withdraw the letter.

-Josh