GEORGE W. BUSH: Responsible for Texas’ Health Care Woes?
While Democrats, led by Vice President Al Gore, have blasted Texas governor George W. Bush (R) for failing to expand medical coverage to more than 500,000 low-income children in the mid-1990s, Bush has blamed the Clinton-Gore administration for the Lone Star State's health care mess -- a dubious claim according to a Democratic legislator and several health care advocates and policy experts, the Houston Chronicle reports. The debate centers around a 1995 health care initiative sponsored by the Texas legislature to apply for a federal Medicaid waiver that would have extended coverage to 570,000 low-income children two or three years before CHIP, which began enrolling applicants this spring. The measure failed to win approval from HCFA, and some critics blame Bush for the setback, accusing the Texas governor of "foot-dragging." Bush's office "did everything they could to keep it from getting approved in the manner in which the Legislature had envisioned," a member of former Democratic Lt. Gov. Bob Bullock's staff said. According to some critics, Bush's "belated" decision to remove adults from the state's original proposal led to the HCFA rejection. The Legislature's 1995 plan also would have offered Medicaid coverage, including prescription drugs, to 255,000 low-income adults. "It just sort of pulled the rug out from everybody when the governor came up and said, 'We're just doing kids,'" Consumers Union senior policy analyst Lisa McGiffert said, noting that the move "probably slowed the application process." Bush spokesperson Linda Edwards argued, however, that Bush removed adults from the waiver application to "make it easier to win federal approval."
While HCFA never denied the waiver "outright," Texas "let its application die" two years after the agency ordered the state to provide an additional source of doctors for new Medicaid recipients. Under the Texas proposal, county district hospitals would have served as the sole provider network. Mike McKinney, the former state health and human services commissioner, said Texas did not include insurance companies and HMOs as a second provider network because "the hospital districts opposed the alternative," adding that Bush "aggressively" backed the waiver. "This was a great deal for Texas. [Bush] was on this program big time," he said. According to state Rep. Garnet Coleman (D), however, the Bush administration "didn't try hard enough" to orchestrate a compromise with HCFA. "If you want something, you push. ... They (the Bush administration) didn't push," he said (Robison, 9/9).
More Texas Troubles
Meanwhile, citing a recent court order that will force Texas to improve its efforts to provide health care to children, the Houston Chronicle argues that the state "has not been vigorous enough in carrying out the programs," such as Medicaid and CHIP. The editorial also notes that, while "effort is being made to pin the blame on the administration of ... Bush in an obvious attempt to tarnish his presidential bid," both Democrats and Republicans "share responsibility" for the state's Medicaid mess. The editorial concludes, "efforts [should] be turned toward resolving the problems and letting the political machinations stand aside. ... The Legislature is going to have to take up the issue in next year's session, if not before" (9/8).