WASHINGTON, Feb. 26 —
Governors clashed with the White House on Monday over the future of the
popular Children’s Health Insurance Program, an issue that some members
of both parties said was as important as money for the Iraq war.
In the session at the White House, when President Bush reported on
progress of the war, governors pressed him to provide more money so
they could guarantee health insurance for children. In response,
administration officials said states should make better use of the
money they already had.
Gov. Sonny Perdue of Georgia, a Republican, said afterward, “Health care for children ought to be a priority, irrespective of anyone’s views on the war.”
Georgia will exhaust its allotment of federal money for the
Children’s Health Insurance Program within three months, Mr. Perdue
said. Thirteen other states expect to run out by September, according
to data released here at the winter meeting of the National Governors Association.
Governors said the Clinton and Bush administrations had encouraged
them to expand children’s coverage and had granted waivers allowing
them to cover parents and even some childless adults.
Having successfully expanded the health insurance programs in their
states, some governors now suggest that the Bush administration is
pulling the safety net out from under many children.
In his budget this month, Mr. Bush said he wanted to return the
program to its “original objective” of covering children with family
incomes less than twice the poverty level. Budget documents note that
16 states cover children above that level and that “one state, New
Jersey, covers children up to 350 percent of the federal poverty
level.”
A family of four is classified poor if its annual income is less than $20,650.
An influential member of Congress said Monday that he would not be
taking up White House proposals to restrict eligibility and financing
for the child health program.
“I have absolutely no intention of moving the president’s proposals
through our subcommittee,” said the lawmaker, Representative Frank
Pallone Jr., Democrat of New Jersey.
Mr. Pallone is chairman of the Health Subcommittee of the Energy
and Commerce Committee, which has authority over the children’s program.
Speaker Nancy Pelosi
said Monday that “Democrats in Congress understand the urgency” of the
problem and would provide money to the 14 states that did not have
enough to cover their current enrollment. Although Mr. Bush would
reduce federal payments for adults and for children with family incomes
above 200 percent of the poverty level, Mr. Pallone said states should
have discretion to cover children above 200 percent of the poverty
level and adults in some circumstances, too.
“In New Jersey, we made a decision to go up to 350 percent of the
poverty level, because we have the highest cost of living in the
country,” Mr. Pallone said.
Likewise, he said, New Jersey found that covering adults increased the likelihood that their children would stay on the rolls.
“The hallmark of all this is flexibility,” Mr. Pallone said. “A
robust Children’s Health Insurance Program is an important part of any
effort to try to achieve universal coverage.”
The federal government spends $5 billion a year on the program. Mr.
Bush wants to continue that level, and he is seeking an ”additional
allotment” of $4.8 billion over the next five years.
States would need substantially more to continue their programs with
current eligibility rules and benefits. New estimates from the Congressional Budget Office show that the states face shortfalls of $700 million this year and a total shortage of $13.4 billion from 2008 to 2012.
Gov. Jim Douglas of Vermont, a Republican, said the Bush proposals
would jeopardize his state’s phenomenal success in covering children.
In Vermont, he said, fewer than 4 percent of the children are
uninsured, and “we don’t want to lose ground.”
Bush administration officials emphasized that states received a
fixed amount of federal money each year, and they said individual
children did not have a legal entitlement to benefits. Michael O. Leavitt,
secretary of health and human services, said he would work with
Congress to find “a short-term solution” for states exhausting their
allotments this year. He said states could avoid shortfalls by managing
their programs better.
In his experience as governor of Utah, Mr. Leavitt said, “when we
were out of an allotment, we just discontinued enrolling people until
we had room.” Likewise, he said, states could cover more people if they
provided less comprehensive benefits.
Gov. Ted Strickland of Ohio, a Democrat, said: “If we don’t get the money we need, children will go without coverage.”
“In the meeting with the president and Secretary Leavitt,” Mr.
Strickland said, “when questions were raised about children maybe
having to be removed from the program or eligible children not being
able to participate, we were told that that was basically a management
problem.”
Gov. Jon Corzine
of New Jersey, a Democrat, said that under the president’s proposals
“we will end up having fewer children covered.” That prospect “was
chilling to some of us,” Mr. Corzine said, adding that states wanted to
avoid “rationing health care to our most vulnerable and our most needy.”
Gov. Edward G. Rendell
of Pennsylvania, a Democrat, said Mr. Bush’s budget request was
“clearly insufficient” to continue coverage for the six million
children enrolled in the program.
Many governors want to expand the program, which they see as a foundation for their efforts to expand coverage generally.
Mr. Rendell framed the issue as a choice, asking: “Should we be
giving tax cuts to billionaires and millionaires or should we be giving
health care to children? Should we make health care for children, at
the very least, an entitlement?”
Domestic policy is in a straitjacket because of the cost of the war,
the cost of tax cuts and the president’s plan to balance the budget
within five years, Mr. Rendell said.
Gov. Arnold Schwarzenegger
of California, a Republican, said federal aid was essential to his $12
billion plan for universal health coverage. Mr. Schwarzenegger said
that in a private meeting he told the president, “We need the federal
government’s help.” He did not say whether he got a commitment.