"The Will of Texans": Health Care

There’s a barrage of opinion writing about the President’s decision to veto the bipartisan state health insurance reauthorization today (aka SCHIP), including Shawn’s post, a New York Times editorial, a Paul Krugman column headlined "Conservatives are Such Jokers"; and in the Washington Post, Eugene Robinson basically calls the President a liar.

All this reminded me that when I was working at the Progressive Policy Institute during the run-up to the 2000 election, Al From (the founder and then President of the Democratic Leadership Council) encouraged me to write an article for the DLC magazine about Bush’s health insurance policy choices as Governor of Texas.

The article, It’s Curious, George – all about Bush’s choices after states were given flexibility to use federal funds to strengthen the low-wage labor market – makes for bittersweet (at best) reading now.

In the mid-1990s, Republican governors pressed Congress and the Clinton administration to let them run welfare programs as they saw fit. The states, argued Texas Gov. George W. Bush, should be free to set welfare policy without federal interference.

"I don't want the will of Texans superceded by the federal government," he said. Bush and other GOP governors assured the public they knew how to meet the needs of their states' poor families far better than any elected official or bureaucrat in Washington….

Texas also has missed several chances to take advantage of federal options to extend health insurance to working- poor families.

In early 1999, nearly one out of four Texas children lacked health insurance. Many states moved quickly to take advantage of new federal health care funds for children provided under the Balanced Budget Act of 1997. Other states took advantage of changes in the federal welfare law to cover working parents under Medicaid. But Texas took neither step before this year's legislative session. (It appears that Bush tried to submit a plan for using the new child health care dollars, but with little input from lawmakers, the community, and consumers. Lacking support, the plan died.)

More than half of all Texas families would be eligible for health care coverage under the federal Children's Health Insurance Program if the state took full advantage of the flexibility it possesses under federal law. Yet Bush this year proposed to cover only those children in families with incomes below 150 percent of the poverty level, which would have deprived coverage to 200,000 otherwise eligible children. In the end, the legislature rejected Bush's plan and set the income threshold at 200 percent of the poverty level. Texas still has not taken advantage of federal flexibility available to cover additional poor working parents under Medicaid.

Finally, under Bush's tenure Texas has declined to tap into federal funds made available to all states to help ensure that people making the transition from welfare to work do not lose their federal health care coverage. The unrequested $27.5 million could have been used, for example, to inform working poor families of their eligibility for health insurance coverage.