Bush Administration Withdraws Support for Bill Covering Pregnant Women

In an apparent reversal of position, HHS Secretary Tommy Thompson has said that he no longer supports legislation to extend CHIP program coverage to pregnant women, stating that a regulation enacted by the administration last month to extend CHIP benefits to fetuses will achieve the same end, the AP/Las Vegas Sun reports. The rule extends CHIP coverage to fetuses by altering the definition of children to allow coverage "from the moment of conception." Under the rule, pregnant women, including undocumented immigrants, may obtain prenatal care for their fetuses (Meckler, AP/Las Vegas Sun, 10/10). The Senate has been considering a bill (S 724) that would allow states the option of covering pregnant women in their CHIP programs (AP/Dallas Morning News, 10/11). Although Thompson previously stated that he supported the bill, this week he wrote in a letter to Sen. Don Nickles (R-Okla.) that he no longer backs the legislation because it would "duplicate" the rule issued by the administration. "I believe the regulation is a more effective and comprehensive solution to this issue. Therefore, there is no need for the Senate to pursue this legislation now," Thompson wrote (AP/Dallas Morning News, 10/11).

Supporters of the Senate bill say that the legislation is more comprehensive than the regulation because the bill would allow pregnant women to receive coverage for "a full range of medical services," whereas the regulation would provide care only for conditions that "immediately affec[t] the health of the fetus." A dozen senators wrote a letter to Thompson Thursday criticizing him for withdrawing his support of the bill. "Your own regulation explicitly ... acknowledges that 'gaps remain' and that a number of important health services for pregnant women, including postpartum care, are not provided for in the regulation," the letter states. The senators also note that the Senate bill would provide health coverage for a child for one year after birth, while the regulation might terminate coverage three months after birth (Rovner, Reuters Health, 10/10). Sen. Blanche Lincoln (D-Ark.), one of the supporters of the bill, said that the regulation places doctors in a difficult position because it does not guarantee that they will be paid for treating a pregnant woman with a health problem that does not directly affect the fetus, but it does make them liable to malpractice suits for failing to treat the condition. However, HHS spokesperson Bill Pierce said that the regulation is more comprehensive than the bill in several ways, including its provision granting coverage to pregnant immigrants. Pierce added that Thompson's earlier support of the bill was linked to the fact that the rule had not yet been finalized (AP/Las Vegas Sun, 10/10). "[A]ngry" at Thompson's withdrawal of support for the Senate bill, Sen. Jeff Bingaman (D-N.M.), one of the supporters of the measure, on Thursday put an official hold on Mark McClellan's nomination as FDA commissioner FDA commissioner. An aide to Bingaman said that the senator will not allow a vote to confirm McClellan until Thompson responds to the letter sent by the group of senators (Rovner, CongressDaily/AM, 10/11).