Thursday, July 19, 2007

Bush Voted For It, Before Threatening to Veto It

In the latest act of political theater the Bush administration approved Wisconsin's Childrens Health Insurance Program waiver covering low to middle income parents/families. He then jumped on his high horse and threatened to veto a Congressional bill doing the same. Just last month the Bush team approved an extension of Wisconsin's waiver covering adults. So Mr. Presidential flip flopper, why did you vote for it, before railing to vote against it?

George's rationale for stopping such waiver programs is "Members of Congress have decided, however to expand the program to include, in some cases, up to families earning $80,000 a year--which would cause people to drop their private insurance in order to be involved with a government insurance plan." In Texas CHIP is provided by private insurance companies, thus the President's comment has no factual basis. Patients would simply switch from one private insurer to another. The difference is in who pays the majority of the premium.

President Bush is opposed to raising taxes on cigarettes as a means to cover more people. "If Congress continues to insist upon expanding health care through the SCHIP program--which, by the way, would entail a huge tax increase for the American people--I'll veto the bill."

But there's more to the Bush health care plan than stopping states from reducing the number of uninsured via expanded SCHIP or exhaling cigarette smoke while screaming "fire". By implementing a series of seemingly innocuous regulations President Bush has cut insurance coverage and funds for safety net hospitals caring for the uninsured. Dropping adults from existing state CHIP plans would add 300,000 to the nearly 47 million uninsureds.

The citizenship requirement caused 3,767 new applications for Medicaid in Texas to be rejected over from August to October 2006. Two hundred of those were children under 1 year of age. In Virginia from January to May 2007 some 1,932 people lost Medicaid coverage and 17,167 new applications were denied. Kansas lost 20,000 people on Medicaid or CHIP in just a few months after implementing the citizenship requirement.

Prior news reports on one state program indicated upon appeal, no previous denials had been overturned. When is the last time any government got it right 100% of the time, especially in a new program with lots of kinks or glitches?

And glitches brings me back to the last example of the Bush administration's balancing the budget on the back of the poor, dual eligibles covered under Medicare's Prescription Drug Program. Back in 2006 President Bush said in a speech in Dublin, Ohio. "And you probably read about kind of the dual- eligible problem. I don't know if you've had that problem here in Ohio, Governor. We're dealing with it. Our job is to solve problems when they arise." So what did George do? Not much as the problem lay in the pharmaceutical benefit design.

But he did shaft those same dual eligibles by not informing them of their ability to be reimbursed for past medication expenses. Recall, these are the poor, frail disabled and elderly. Hundreds of million in federal funds intended to help dual eligibles likely ended up in the coffers of insurance companies.

Bush balances his budget on the backs of the poor, the disabled, and children who can't control the circumstances into which they are born. Consider what the White House's latest budget update says about Medicaid in the FY 2007 Budget Mid Session Review on page 19.

"Medicaid outlays are projected to decrease by $7.4 billion in 2006, $6.0 billion in 2007, and $29.7 billion over the period 2007 to 2011. The largest factor in the decrease is a reduction in estimates for medical assistance payments, driven by lower estimates provided by the States this Spring."

But there's more. The President's latest rule change targets organizations providing care to the poor and uninsured, safety net hospitals. With the swipe of a pen, fewer federal dollars will soon go to government owned hospitals providing care to the underserved. The Bush cabal remains determined to push this through despite opposition from Congress and State Medicaid Directors.

There is a war going on led by our Commander in Chief, a war on the poor. So much for his promises after Hurricane Katrina. But then again he promised a thorough investigation into the federal response and that too was poorly performed to benefit his high dollar friends. He left out LifeCare Hospital with the largest number of patient deaths post Katrina. Weeks before landfall it had been purchased by none other than The Carlyle Group, just down Pennsylvania Avenue from the White House. The Congressional Report committed the same faux pas. Homeland Security's follow up conference did one better, it left out hospital patients entirely! I see a pattern emerging...

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