Thursday, August 30, 2007

Bush finds spending he doesn't like...

With a Republican Congress, Bush was a spend-thrift. This is not too surprising since both were trying to preserve narrow margins-- and neither was particularly principled about digging into the wallets of current and future taxpayers. With split control since the last election-- Bush with a Democratic Congress-- it's a different animal. Now, we see Bush in the role of "fiscal conservative" (relatively speaking), both because he is relatively conservative compared to the Democratic Congress (even its so-called "blue dogs") and because the political benefits of spending more have changed.

In the Wall Street Journal, Mary Katherine Stout contributed a piece on how this relates to Bush's opposition to SCHIP, as well as his experience with the SCHIP program in Texas.

Give George W. Bush credit. He's drawn a lot of criticism for not doing more to control federal spending over the past six years. But he is now deep into a spending fight against a sacred liberal program. And he isn't backing away.

In recent weeks, Mr. Bush has confronted Congress over the State Children's Health Insurance Program -- which is substantially funded by the federal government and up for congressional reauthorization this year. Mr. Bush understands Schip has become a wedge for expanding government-run health care in Texas...

In 1999, Texas Republicans were divided on whether to authorize creating the program in the Lone Star State. Some GOP legislators opposed it. But Mr. Bush, then one year into his second term and preparing to run for the White House, favored it. He worked with Democrats, then in control of the legislature, to create Texas's Schip program.

It was supposed to have limits...It didn't work out that way, of course. Once it was up and running, the program mushroomed in cost and few officials wanted to control its growth. In 2001, its first full year, Texas's Schip cost $381 million. One year later, the program was up to $679 million and the state was headed into a $10 billion budget deficit. (The state has budgeted more than $900 million for the program for 2008.)

Not coincidentally, in 2002 Republicans won control of the legislature for the first time in more than 100 years. Shortly thereafter, Republicans cleaned up the Schip program by requiring that beneficiaries apply every six months instead of once a year (circumstances often change throughout year), and by mandating that those enrolled in the program meet specific income and assets tests. These reforms aimed to make sure the program really was a last resort for poor parents seeking health care for their children.

The assets test revealed evidence of abuse...


The number of people enrolled in the program fell precipitously between 2003 and 2005, to 326,557 from 507,259. The Texas Health and Human Services Commission estimates that 84% of that decline was a result of the reforms.

Reminiscent of the 1996 welfare reform

This is where President Bush's experience in Texas comes to play a role in his fight at the national level, where Schip must be reauthorized this year. As the governor who signed Schip into law in the state, he can remember the arguments and the promises made during the initial debates of the program. He can see how Schip has been used to expand government control of health care and how it has been abused. He can see how a program that started out for poor children has become an instrument for universal and, increasingly, socialized medicine.

Mr. Bush comes to this fight with an understanding of how Schip has played out in the states, which is why his administration recently instituted reforms to the program that aim to restrict eligibility to those it was originally intended to serve -- the truly needy -- and not provide an incentive for middle class parents to drop their private health insurance. Moreover, he has threatened to veto federal legislation that would allow states to expand their Schip programs.

It would be easy for Mr. Bush to give in on this fight. He is, after all, in the twilight of his administration. But next month, he'll square off against Congress to oppose an incremental advance of socialized medicine. We are fortunate he is today willing to do so at a time when Republicans in his home state were quick to abandon the fight.

Good luck with that, Mr. Bush! May the lame duck portion of your presidency be more productive than the earlier years.


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