In 2003, the Bush administration bulldozed a $400 billion program through Congress that guaranteed prescription drug coverage for seniors. It has been touting that achievement ever since, and justifiably so.

This year, however, President Bush is threatening to veto a $50 billion increase in the State Children’s Health Insurance Program. How come?

The most obvious explanation — and one that destroys Bush’s claim of being a compassionate conservative — is this: Seniors vote, kids don’t.

Federal programs, chiefly Social Security and Medicare, see to it that the poverty rate among America’s 40 million seniors is less than 10 percent. Medicare guarantees seniors health insurance at a five-year cost of $2.6 trillion.

This story continues below
Advertisement

At the same time, the poverty rate among America’s 74 million children is 18 percent and rising. About 8 million kids under age 18 lack health insurance, 11 percent of the total. According to a study this year by the Urban Institute and First Focus, a children’s advocacy group, federal spending on programs for children is one-third that for seniors.

The number of uninsured children would be 6 million greater were it not for SCHIP, the 10-year-old program that expires on Sept. 30 and is up for renewal by Congress this year. A battle royal is under way between Congress and the administration over the terms of renewal, and hidden agendas dominate the debate as much as concern for kids.

The administration wants to renew SCHIP and increase its funding by just $4.8 billion over five years — enough, it says, to cover a portion of children in families with incomes under 200 percent of the federal poverty level ($41,300 for a family of four) who are eligible for coverage but not enrolled.

But Democrats, children’s advocacy groups and many Republicans, citing Census Bureau and Congressional Budget Office data, say the number of uninsured children in working-poor families is actually about 6 million. Covering them, they claim, would cost at least $50 billion and that the administration’s funding proposal would actually cause a decrease in coverage.

The administration recently served official notice that Bush will veto a bipartisan Senate bill pegged with a funding gimmick at $35 billion, but actually costing $50 billion, paid for with a tobacco tax hike and designed to cover 3.3 million kids.

At a White House event June 27, Bush said that “the Democrats’ proposal is part of a larger strategy. At the same time they try to expand SCHIP to older citizens, they are trying to expand Medicare to younger citizens. Their goal is to take incremental steps down the path to government-run health care for every American.”

Bush isn’t entirely wrong. Many Democrats — including Sen. Hillary Rodham Clinton of New York — do want to expand SCHIP to cover parents and to lift income caps to 400 percent of poverty, or $82,600 for a family of four. Others want to expand Medicare to cover 55-year-old early retirees.

But the Senate Finance bill sponsored by Chairman Max Baucus, D-Mont., and ranking member Chuck Grassley, R-Iowa, and backed by Sen. Orrin Hatch, R-Utah, actually peels the program back from coverage of childless adults — allowed in some states through waivers granted by the Bush administration — and forces states to bear more of the cost of covering persons over 300 percent of poverty.

If Democrats have a secret agenda beyond covering kids, so does the Bush administration. It wants to attach a wholesale reform of the nation’s health care financing system to SCHIP reauthorization.

Bush has proposed a grand idea — a $15,000-per-family tax deduction that would enable the uninsured to buy health insurance while removing the tax code’s discrimination against those who are not covered by employer-paid policies.

As meritorious as the proposal is, Democrats aren’t buying it. It will be offered on the Senate floor when SCHIP is debated — and almost certainly lose. Then the Bush plan is to veto SCHIP and bargain for the tax change.

It’s time to stop the games. It’s a scandal that 6 million low-income kids lack health insurance. Even if they don’t vote, they ought to have private coverage, just like seniors do for prescription drugs.

Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill.