Bush Administration Will Allow States ‘More Leeway’ on Health Programs
Across the gamut of domestic policy issues, including health care, state and local officials will have "far more leeway" to "shape and operate" federal programs under President-elect Bush's administration, the New York Times reports. Governors and other state officials expect that Bush will provide them with "more discretion" in using federal funds and "meet[ing] the goals" of federal laws. "George is more inclined than the current administration to trust state legislators and governors -- Democrats and Republicans -- to make decisions," Pennsylvania Gov. Tom Ridge (R) said. Vermont Gov. Howard Dean (D) added, "I do believe the states will end up with more flexibility to manage Medicaid and other health and human service programs." According to Bush spokesperson Ari Fleischer, the president-elect "believes deeply that many of the nation's answers can be found in the state capitals." The Times also reports that Bush nominated potential cabinet members with "extensive experience in state and local government" who have "already spoken out" about granting states more "leeway" to run federal programs "as they see fit."
In the area of health care, Dean said that while he has been "frustrated" by the federal government over his efforts to expand Medicaid and SCHIP to cover more state residents, HHS Secretary-designate Wisconsin Gov. Tommy Thompson (R) would likely prove "more receptive" to state "experiments." Thompson, "one of the innovators himself," has faced similar "frustrations in dealing with Washington," Dean added. Christine Ferguson, director of Rhode Island's Department of Human Services, predicted a "new climate" in Washington that will be "more hospitable" to proposals that would combine states' Medicaid and CHIP programs. According to Sara Rosenbaum, a professor of health law at George Washington University, with Congress "unable" to overhaul Medicaid, federal officials will likely waive provisions of the law "so states can reach more people with better quality health care" (Pear, New York Times, 1/7).