Senate Democrats

President Bush Was for CHIP Before He Was Against It

President Bush’s repeated veto threats against the bipartisan children’s health care bill are just more examples of his signature “go it alone” style. The compromise bill, worked out with both Republicans and Democrats at the table, has garnered broad bipartisan majorities in both the House and the Senate. However, the most curious thing about the President’s veto threat is that he was for CHIP before he was against it. During the 2004 campaign he repeatedly called for covering more kids under the CHIP program. Similarly, while he now decries the bill for providing coverage to kids whose families make more than 200 percent of the federal poverty level, his Administration has provided waivers to numerous states to provide coverage to kids from higher income families, touting the Administration’s efforts to give states the flexibility to tailor their programs to meet their citizens’ needs. It’s time for President Bush to end his hypocrisy on CHIP and sign this bipartisan bill to ensure that America’s low-income children receive the care they deserve.

During the 2004 campaign, President Bush pledged to enroll millions of low-income children in CHIP:

During the 2004 Campaign, President Bush Pledged to Enroll Millions of Poor Children in CHIP. “America’s children must also have a healthy start in life. In a new term, we will lead an aggressive effort to enroll millions of poor children who are eligible but not signed up for the government’s health insurance programs. We will not allow a lack of attention, or information, to stand between these children and the health care they need.” [Bush Speech the 2004 Republican National Convention, 9/2/04]

During the 2004 Campaign, the White House Touted Bush’s Plan to Expand CHIP Enrollment. “The President will launch an aggressive, billion-dollar effort to enroll children who are eligible but not signed up for the government’s health insurance programs. The goal will be to cover millions more SCHIP and Medicaid-eligible children within the next two years.” [White House Fact Sheet, “Making Health Care More Affordable,” 9/2/04]

During the 2004 Campaign, President Bush Called for Expanding CHIP. “In order to make sure that health care is available, we need to expand the government insurance program for children…. We’ve got a billion dollars available in the budget to encourage families to take advantage of government-sponsored health care for children, for low-income children. It makes sense to make sure that the programs are fully utilized in every aspect of our – in every corner of our country.” [President Bush, Focus on Health Care, 9/13/04]

During the 2004 Campaign, President Bush Called for Improving Outreach Efforts to Make Sure Low-Income Kids Were Enrolled in CHIP.  “We got more to do on health care. We got to make sure health care is available and affordable. We’ll have a safety net for those with the greatest needs….  We’ll do more to make sure poor children are fully subscribed in our programs for low-income families.” [President Bush, 10/21/04]

Bush Administration also touted the success of CHIP, vowing to cover even more children …

Former Health and Human Services Secretary Thompson Took Pride in CHIP’s Coverage for Millions of Children.  “‘Working with governors, we’ve made tremendous progress in providing millions of children with needed health coverage,’ Secretary Thompson said. ‘These new numbers show that even in economic hard times, the states place a high priority on getting needed health insurance to children. As a result, more children now have needed access to regular health care services.’” [HHS News Release, 2/12/04]

Secretary Thompson Vowed the Administration Would Make Children’s Health Care a Priority.  “The Bush Administration will continue to work together with states to find ways to improve the health and welfare of our children.” [HHS News Release, 8/28/03]

Former CMS Administrator Mark McClellan Said He Was Committed to Enrolling As Many Eligible Children as Possible in CHIP. “CMS wants to build on the successful enrollment in SCHIP and is committed to finding and enrolling as many eligible children as possible. As we approach the 10-year anniversary of the program, I am excited for the opportunity to take stock of the success of SCHIP and begin the process of working with you to reauthorize this landmark health care program.” [Mark McClellan Written Testimony to the Senate Finance Committee, 7/25/06]

Now, White House is threatening to veto the Bi-partisan CHIP bill:

President Bush Said He Would Veto CHIP Bill. “I believe government cannot provide affordable health care. I believe it would cause — it would cause the quality of care to diminish. I believe there would be lines and rationing over time. If Congress continues to insist upon expanding health care through the S-CHIP program — which, by the way, would entail a huge tax increase for the American people — I’ll veto the bill.” [President Bush, 7/18/07]

President Bush Said Bipartisan CHIP Bill Would Be a Step Toward Federalization of Health Care and that He Would Veto the Bill. “I believe this is a step toward federalization of health care. I know that their proposal is beyond the scope of the program, and that’s why I’m going to veto the bill.” [President Bush, 9/20/07]

  • The Bi-Partisan CHIP Proposal Operates as a Public-Private Partnership. The Children’s Health Insurance Program is a public-private partnership that focuses on providing low-income children with health care coverage. The bi-partisan proposal encourages public and private solutions to cover children.

Secretary Leavitt Said Bush Would Veto CHIP Bill. “The bill that the President will veto will — is represented to offer 2.6 million insurance. However, 1.2 million of those already have private insurance, and 900,000 of them already qualify.” [Secretary Leavitt, 9/20/07]

Press Secretary Dana Perino Said President Bush Would Only Sign a CHIP Bill that Was Limited to His Request of a $5 billion Spending Increase Over 5 Years – Not Enough to Continue Coverage for Children Currently Enrolled. Asked if there are any circumstances under which President Bush would sign a CHIP bill from Congress. Dana Perino responded, “Yes, the President would sign an S-CHIP bill today if they sent him one that was an extension and — he’s asked for an extension; I think it’s $5 billion more over five years.” However, the President’s proposed increase would not be enough to continue coverage for all of the children currently enrolled in the program. [White House Press Briefing, 9/18/07; New York Times, Editorial, 9/25/07]

Bush Administration supported covering children living in states with high costs of living …

Former HHS Secretary Tommy Thompson Touted Bush Administration’s Flexibility to Allow States to Best Meet the Needs of Their Residents.  “‘Working with governors, we’ve made tremendous progress in reaching millions of children with needed health coverage,’ Secretary Thompson said. ‘Since President Bush took office, we have given states more flexibility and freedom to develop SCHIP plans that best meet the needs of their residents. The strategy is working for children across America, but we must and will do more.’” [HHS News Release, 2/5/03]

CMS Administrator Mark McClellan Supported Granting States Flexibility to Set CHIP Eligibility Above 200 Percent. In written testimony before the Senate Finance Committee, McClellan wrote:“SCHIP eligibility requirements vary by state and are based on the structure of the individual state’s program. This flexibility allows states to use [their] SCHIP funding in the most appropriate way to respond to [their] unique demographics.  Currently, 36 States have eligibility levels up to and including 200 percent of the FPL.  An additional 14 States cover children above that level and five of those States set their eligibility up to and including 300 percent of the FPL.” [Senate Finance Committee, 7/25/06]  

Examples of Bush Administration Granting Waivers to States:  

  • The Centers for Medicare & Medicaid Services Granted New Jersey a Waiver to Increase Eligibility For Children in Families With Incomes Up To 350 Percent of the Federal Poverty Level. “CMS indicates that you will deny State requests to extend eligibility under the State Children’s Health Insurance Program (SCHIP) to children in families with effective family income levels above 250 percent of the Federal poverty level (FPL).  This is in direct opposition to the position that CMS has consistently taken in recent years.  In fact, SCHIP was designed with bipartisan support to provide states with the tools and the flexibility to address the distinct needs of each of our populations.  In New Jersey, where we face a high cost of living, this has allowed us to expand coverage up to 350% of poverty to insure more children in need since 1998.  We have undertaken this coverage pursuant to multiple approvals from CMS – most recently just last year. [Office of the Governor of New Jersey, 9/10/07]
  • Former HHS Secretary Tommy Thompson Approved Georgia’s CHIP Plan To Increase Eligibility to 235 Percent of the Federal Poverty Level. “President Bush and his administration will work closely with states to ensure flexibility at the local level to get health insurance to children who need it….  This is just an example of how the federal government can let states make decisions that make sense for them and their citizens….  Georgia’s decision to widen eligibility and streamline re-determination demonstrates how popular this program is with states and how vital it has proven to be for the families enrolled.” [HHS Press Release, 6/4/01]
  • CMS Approved of Hawaii’s QUEST Program, Expanding CHIP Coverage of Children in Families with Income between 200 and 300 Percent of the Federal Poverty Level. “The extension of Hawaii’s Section 1115 demonstration in January 2006 continues the State’s current coverage while also expanding coverage to children from 200 percent through 300 percent of the Federal Poverty Level using Title XXI [CHIP] funding.” [CMS Fact Sheet, 1/30/06]
  • CMS Approved Massachusetts’ Plan to Provide CHIP Coverage For Children With in Families with Incomes Up To 300 Percent of the Federal Poverty Level. “Effective July 1, 2006 Massachusetts expanded eligibility up to 300 percent FPL in their separate child health program.”[CMS Fact Sheet, April 11, 2007]
  • CMS Approved Pennsylvania’s Plan to Provide CHIP Coverage For Children In Families with Income Between 200 and 300 Percent of the Federal Poverty Level. “CMS on Thursday [February 22, 2007] approved an expansion of Pennsylvania’s Cover All Kids program to provide health coverage to children of parents with annual incomes up to 300% of the federal poverty level. [Kaiser Daily Health Policy Report, February 26, 2007]

And the White House wll not consider providing coverage for children in struggling families:

President Bush Claimed Bipartisan CHIP Proposal Would Cover Kids From Households with Incomes Above $83,000 Per Year. “Their proposal would result in taking a program meant to help poor children and turning it into one that covers children in households with incomes of up to $83,000 a year.” [President Bush Press Conference, 9/20/07]

  • Under the Bi-Partisan CHIP Proposal, States Determine Eligibility Levels. The Children’s Health Insurance Program is a federal-state partnership where states make the determination as to eligibility levels. The CHIP reauthorization agreement puts the lowest income children first in line by phasing in a new requirement for coverage of low-income children as a condition of receiving CHIP funding for coverage of children above 300 percent of the federal poverty level.  Under the bipartisan bill, only the Administration has the authority to grant approval for states to cover children in families earning $83,000. [HR 976, 2007]

President Bush Complained Bipartisan CHIP Proposal Would Cover Middle-Income Households. “The proposal congressional leaders are pushing would raise taxes on working Americans and would raise spending by $35 to $50 billion. Their proposal would result in taking a program meant to help poor children and turning it into one that covers children in some households with incomes of up to $83,000 a year.” [President’s Radio Address, 9/22/07]

  • Americans Overwhelmingly Support Increasing Taxes on Tobacco to Fund Children’s Health Care. The bi-partisan CHIP proposal is paid for with a slight increase in the tax on tobacco products. According to a recent survey, two-thirds of Americans support a tobacco tax increase to fund children’s health care and most want to vote for a candidate who does as well. [American Medical Association Press Release, 6/19/07]

Secretary Leavitt Said Bush Administration Efforts Have Been Focused on Providing Coverage for Children from Families Who Are Under 200 Percent of FPL. “And so our effort has been to focus on those who have under 200 percent and to lay out guidelines to say, before we start going to those who are in 300-400 percent of the poverty line and moving them from private insurance to government insurance, let’s focus on those who are poor. This is a program for low-income children. We still have many to reach, and that needs to be our first objective.” [Press Briefing by Secretary Leavitt, 9/20/07]

  • Over a Million Children and Pregnant Women Could Lose Coverage Under the President’s CHIP Proposal. According to the Congressional Budget Office, under the Administration’s proposal, the number of children and pregnant women covered through CHIP at some point during the year would decline from 7.6 million in 2007 to 6.2 million by 2012, a reduction of 1.4 million enrollees. [CBPP Statement On New Congressional SCHIP Agreement, 9/21/07; Center for Budget and Policy Priorities, 3/13/07]