A just-released report by the Government Accountability Office (GAO) charged that the Bush administration “violated federal laws last year when it restricted states’ ability to provide health care insurance to children of middle-income families.”

At least 22 states provide State Children’s Health Insurance (SCHIP) coverage to these youngsters. Bush’s diktat was conveyed in a letter to state SCHIP directors sent in violation of federal law requiring review by Congress and the Comptroller General.

Bush’s letter ordered the SCHIP directors not to provide benefits that would “crowd out” private coverage under group health plans. It threatened cuts in federal funding for states that did not obey the directive.

The administration is now attempting to impose similar unilateral cutbacks in Medicaid.
Health care advocates hailed the veto-proof 349-to-62 House vote April 24 to block seven Bush directives that would slash Medicaid coverage for low income people by $13 billion annually.

The bill imposing a one-year moratorium on the cuts is now pending before the Senate. Healthcare fighters demanded that Senator John McCain (R-Ariz.), the GOP presidential candidate, commit himself to vote to override Bush’s promised veto of the moratorium.

Last August, McCain voted against reauthorizing SCHIP and on Oct. 31, McCain supported Bush’s veto of a bill to increase SCHIP funding. Democratic presidential contenders Senators Hillary Clinton (N.Y.) and Barack Obama (Ill.) are Medicaid supporters who are expected to vote to override Bush’s new veto effort.

Deborah Weinstein, executive director of the Coalition on Human Needs, told the World, “We are very encouraged by the GAO report. It confirms the belief that the Bush administration overstepped its authority in imposing these directives without any of the normal review process. Congress seems to agree since there has been a series of overwhelming votes against the Medicaid rules.”

Sen. Jay Rockefeller (D-W.V.) has offered a similar bill reversing Bush’s SCHIP directives.

McCain unveiled his health care plan at the Moffitt Cancer Center in Tampa April 29. Florida union health care workers and Medicaid recipients convened a news conference the same day demanding that McCain and Sen. Mel Martinez (R-Fla.) stand up against Bush’s Medicaid and SCHIP cutbacks.

Bill Newton, executive director of the Florida Consumer Action Network, told the news conference, “We are calling on Senators McCain and Martinez to abandon the Bush way of putting insurance company profits first and the health care of the American people last. Support expanding SCHIP. Vote to override Bush’s $13 billion in cuts to Medicaid.”

Roselilly Story, a registered nurse and a member of the Service Employees International Union (SEIU), said McCain’s plan, like Bush’s, leaves “millions uninsured, billions in tax breaks for insurance companies. That’s not the prescription our country needs.”

Jeremy Funk, media director of the Campaign to Change America, pointed out that the $35 billion to expand SCHIP to cover 10 million children over the next five years equals “the amount America is spending in Iraq every 100 days.”

United For Peace and Justice (UFPJ) posted on its web site a warning that Congress will soon take up another $172 billion supplemental for the Iraq war. “The most direct way to protect those hit hard by the recession would be to stop sinking billions … into war and redirecting it toward … jobs, healthcare, education, civil infrastructure,” UFPJ said in a statement.

Jenny Sullivan, a health policy analyst at Families USA, told the World Bush’s directives would have an enormous and far-ranging impact on Medicaid programs including rehabilitative services, case management, transportation of disabled children and outreach to those unaware of their right to Medicare benefits. “We base our estimates of the impact of these directives on a survey of the state Medicaid directors. It totaled $50 billion in Medicaid cuts over five years,” she said.

“Obviously there is great momentum in Congress to impose a moratorium on those directives. If the Senate can muster the votes these regulations will go away at least for a year.”

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