Thought Theater

GAO Calls Bush On His Game Of Chicken SCHIP genre: Econ-Recon & Little Red Ribbon-Hood & Polispeak & Six Degrees of Speculation

Last year, President Bush shut down legislation designed to provide health insurance to more low income families and rewrote the rules to limit the coverage states could provide. At the time, his minions were busy eviscerating a family that spoke in favor of the measure. According to the Government Accountability Office, it turns out that the President didn't have the authority he thought and and actually violated the law. Nothing new there, eh?

From The New York Times:

WASHINGTON -- The Bush administration violated federal law last year when it restricted states' ability to provide health insurance to children of middle-income families, and its new policy is therefore unenforceable, lawyers from the Government Accountability Office said Friday.

The ruling strengthens the hand of at least 22 states, including New York and New Jersey, that already provide such coverage or want to do so. And it significantly reduces the chance that the new policy can be put into effect before President Bush leaves office in nine months.

At issue is the future of the State Children's Health Insurance Program, financed jointly by the federal government and the states. Congress last year twice passed bills to expand the popular program, and Mr. Bush vetoed both.

In a formal legal opinion Friday, the accountability office said the new policy "amounts to a marked departure" from a longstanding, settled interpretation of federal law. It is therefore a rule and, under a 1996 law, must be submitted to Congress for review before it can take effect, the opinion said.

But Jeff Nelligan, a spokesman for the federal Centers for Medicare and Medicaid Services, said, "G.A.O.'s opinion does not change our conclusion that the Aug. 17 letter is still in effect."

What happens next is not clear. New York, New Jersey and several other states have filed lawsuits challenging the Bush administration policy. In addition, Congress may consider legislation to suspend the directive.

Under the Aug. 17 directive, states cannot expand the Children's Health Insurance Program to cover youngsters with family incomes over 250 percent of the federal poverty level ($53,000 for a family of four) unless they can prove that they already cover 95 percent of eligible children below twice the poverty level ($42,400).

Moreover, in such states, children who lose or drop private coverage must be uninsured for 12 months before they can enroll in the Children's Health Insurance Program, and co-payments in the public program must be similar to those in private plans.

The administration told states they must comply with the directive by August of this year or else they face "corrective action." Compliance could mean cutting back programs.

It amazes me that a President who sold himself to the electorate as a compassionate conservative is willing to restrict health care to the needy while insisting on spending billions of dollars year after year on his failed war in Iraq. It makes one wonder just who the President is protecting with his war on terror. I suspect those who risk losing coverage under Bush's arbitrary guidelines feel terrorized by their own government.

Then again, we shouldn't be surprised that a man of privilege (who acted out like a rebellious teenager until reaching the age of forty) lacks any tangible empathy for those in need. No, he would rather wax endlessly about the need to make permanent his tax cuts for the wealthy and finish the job his daddy didn't have the wherewithal to pursue.

When it's all said and done, I can't help but conclude that America has been the playground for an insecure and ego-challenged charlatan with little regard for anything that didn't serve to stroke his obtuse persona. Yes, his legacy will be legendary...though I'd wager it won't be of the nature he had hoped. In the end, I doubt many Americans will shed any tears when this 'little big man' rides off into the sunset.

Comments

1 On April 20, 2008 at 7:04 AM, Stanley Wilcox wrote —

This is from First Focus, a children's advocacy group, on the issue.

NEW GOVERNMENT RESEARCH CONFIRMS SCHIP DIRECTIVE ILLEGAL

FOR IMMEDIATE RELEASE Contact: Christopher Spina

April 17, 2007 (202) 657-0677 (202) 674-2450 (mobile)

WASHINGTON, DC – Today, the Government Accountability Office (GAO) and Congressional Research Service (CRS) confirmed that the Centers for Medicare and Medicaid Services (CMS) exceeded its authority in issuing a proposal threatening the health coverage of thousands of low-income American kids through the State Children’s Health Insurance Program (SCHIP).

The directive required that 95 percent of all children below 200 percent of the federal poverty level have verifiable health insurance before additional children could receive care through SCHIP, posing a serious threat to those already on the program. In essence, the GAO and CRS found that CMS did not have the authority to impose these changes in a letter. This confirms the findings of a report released in March by First Focus which determined, among other findings, that the new regulations are contrary to current law.

According to GAO, “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 [CHIP]. 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.”

“This confirms what we’ve already known – that CMS’s attempts to derail the effectiveness of the SCHIP program are patently illegal,” said Bruce Lesley, president of First Focus. “Now, even the federal government has offered definitive proof that the directive by CMS was not legal, and it should be ignored by the states. Moreover, Congress can wait no longer to take immediate action to halt all of CMS’s attempts to usurp Congressional authority through the six other Medicaid regulations. It is unfortunate that CMS staff have gone as far as undermining current law to place at risk the healthcare of our nation’s children.”

In March, First Focus released a report on the impact of the regulatory actions on children with special health care needs, finding they would have a disproportionate impact on that vulnerable population. Congressman Dingell later pointed to that report as the evidence that the CMS’ new Medicaid Regulations would weaken health care for children.

Lesley added, "The legal opinions from the General Accounting Office and Congressional Research Service confirm what the legal analysis issued First Focus and authored by George Washington University professor Sara Rosenbaum, also said, that the CMS directive is not legal and should be immediately withdrawn. The directive has resulted in negative health consequences for children across the nation and is now costing taxpayers millions of dollars in legal costs that would be far better spent improving the health and well-being of children."

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