October 10, 2007
Wednesday PM

Washington sometimes goes out of its way to prove that it is so badly broken that it just can't work any more, which always surprises most Americans, who have long assumed that the problem is that Washington can't work any less.

But last week we saw a Washington Two-Step that proved just how unworkable this city can be, even when both parties in Congress are trying to be on their best adult behavior. First, congressional Republicans and Democrats came together on a plan to help bring health insurance to more than 9 million children who are now uninsured. Then President Bush demonstrated how in the spirit of the New Washington, good bipartisan deeds can be like campaign promises - easily broken.

Without ever attempting to be part of the bipartisan compromise, he vetoed the $35 billion expansion of the existing $25 billion State Children's Health Insurance Program (known as S-CHIP) and seemingly returned Washington to its unworkable ways. But with a poll showing 72 percent of Americans backed the bill, Bush said he was suddenly ready to compromise. His statements were as internally inconsistent as his actions. After contending the bill would "federalize health care," he declared: "And if they need a little more money to help us meet the objective of getting help for poorer children, I'm more than willing to sit down with the leaders and find a way to do so." Question: If the bill was ideologically wrong, why put more money into it? Answer: Because it wasn't.

The president's political mishandling of this issue has angered two groups with some influence on Capitol Hill: Republicans and Democrats.

Sen. Orrin Hatch, R-Utah, a leader of the bipartisan compromise: "Frankly, I think the president has had pretty poor advice on this (from his advisers)... he's been sold a bill of goods."

Senate Majority Leader Harry Reid, D-Nevada.: "...you cannot wring another ounce of compromise out of this... We're not going to compromise." Translation: Democrats hope to squeeze House Republicans who originally voted with Bush to switch and override his veto - or face public wrath.

Time out: There is a simple compromise that could always have been made and still can be done. It can meet the objectives and objections of all sides if those goals are still about the children and not about the politics. The basic goal has been clear to all: Bring insurance coverage to the 9 million children from poor and lower income families who don't qualify for Medicaid but can't afford health insurance.

The basic problem: How to prevent children who were already covered under private insurance from switching over to the government-provided S-CHIP coverage.

The solution: Write into the bill a provision requiring that the states, which administer S-CHIP, cannot place children in the public plan if they have been covered in a private insurance plan in the past year. The idea is as workable as it is simple, according to knowledgeable sources outside the administration. Ironically, Bush's administration issued a rule last August that adopted this very proposal for the current S-CHIP law that will expire if it is not extended. And that brings up another concern that can be easily addressed now - and could have been long ago if Bush had wanted to avoid this disastrous veto: While states can now enroll into S-CHIP children from families making twice the official $20,000 annual income poverty level without getting a federal waiver, Bush does not want to see uninsured children from families making $83,000 (four times the poverty level) allowed into S-CHIP, which is what New York state has sought.

Solution: So don't allow it. Set an annual income ceiling at, say, three times the poverty level, for all those who will be allowed into a publicly run S-CHIP but have the states put the other uninsured children into state purchasing pools where coverage can be bought at negotiated low rates. Let these children into a plan like the ones state employees now use, in fact. States are already buying private coverage for 72 percent of the children covered under the current S-CHIP law.

This give Democrats one big bold action they can tell voters their Congress achieved. Then again, Democrats may want to avoid a compromise so they can tell voters next year that Bush and Republicans are to blame for the fact that children remain uninsured.

But the health of children is at stake and that makes pin the Tale on the Elephant an unconscionably dangerous game to play.

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