On Children’s Health Care and Iraq War Funding

“I HAVE STRONGLY SUPPORTED THE S-CHIP as a governor, and I have done so as president,” said President Bush at the beginning of a hastily called press conference on September 20.

He was lying.

Most elected officials lie. Two books have documented the president’s programmatic deceit. Yet the lie President Bush told about his position on the children’s health insurance program while he was governor of Texas is newsworthy. It was intended to mask an ideological rigidity that will adversely affect the lives of millions of children, just as Bush’s ideological rigidity in 1999 would have affected the lives of hundreds of thousands of children in Texas if the legislature hadn’t forced him to implement S-CHIP. His ideological rigidity also exposes Republicans to political consequences. Bush’s veto of the popular and effective kids’ program will make it more difficult for Congressional Republicans to make any gains in the House and Senate in 2008. In fact, it will cost them seats.

The State Children’s Health Insurance Program provides low-cost health insurance to children whose parents earn too much to qualify for Medicaid yet are unable to pay for private coverage. It was proposed by Bill Clinton and passed into law (and funded) in 1997 by a Congress in which Newt Gingrich was Speaker of the House and Trent Lott Majority Leader of the Senate. It currently provides seventy federal cents for every dollar states contribute to the program. Last year it provided low-cost health insurance to 6.5 million children at a cost of $5 billion to the federal government. It is immensely popular with state governors, legislators, physicians, hospital administrators (who see far fewer uninsured kids in emergency rooms)—and, of course, the population it serves.

Yet as governor of Texas, Bush used the legislative calendar to stall two years before implementing the program, then fought to limit the number of children covered. The Texas Legislature meets every other year and had adjourned before Congress enacted and funded the program in 1997. Bush could have signed an executive order and begun enrolling qualified children. Instead, he appointed a committee to study the program, buying time until the next legislative session. When the legislature convened in 1999, Bush recommended implementing the S-CHIP, but with enrollment requirements so stringent that hundreds of thousands of qualified children would have been locked out of the program.

His decision made no sense. Twenty-five percent of Texas residents lacked insurance, the highest percentage in the nation. And 1.4 million of the state’s uninsured were children, most of whom would have qualified for S-CHIP. The program’s funding formulas at the time would have brought in almost three federal dollars for every dollar the state spent. Other Republican governors, such as Florida governor Jeb Bush, set the qualifying threshold at 200 percent of the national poverty level. Some went higher. In New Jersey, Governor Christine Todd Whitman, whom Bush would appoint as his first director of the Environmental Protection Agency, set the threshold at 300 percent, opening the program up to greater numbers of children.

The state of Texas was running a substantial budget surplus. And accrued and accruing interest from $17 billion in state proceeds from tobacco litigation had been set aside for public health initiatives. The state’s $189 million commitment at the 200 percent level would have required no tax increase, because money was available in the tobacco fund. Texas is a low-tax and low-services state, so enrolling children up to 300 percent of the poverty level was unlikely. The Democratic legislature prepared to budget for enrollment at 200 percent, which would have opened the program up to 500,000 of the state’s 1.4 million uninsured kids. Bush drew the line at 150 percent, which would have insured 300,000 kids.

TEXAS TWO STEP—Bush’s position wasn’t grounded in a conservative aversion to taxation. It was an ideological reaction to government funding of health care. I was covering the governor and the legislature for the Texas Observer at the time. From the moment Bush staked out his position, it was evident he had picked a fight he couldn’t win. The Democratic Speaker of the Texas House, Pete Laney, summoned the Democratic House caucus to a closed meeting and described the governor’s position as untenable. “We’ve got him where we want him,” Laney said. A legislator walking out of the caucus meeting told me the Democrats had decided to “let the governor twist in the wind for a while.”

While the governor twisted, Democratic legislators worked a choreographed public-relations campaign that focused on three figures: the 1.4 million uninsured children, the 500,000 children the Democratic plan would insure; and the 300,000 children the governor’s plan would insure.

At first, Bush was unyielding. But he was running for president, watching polls. In the end, he capitulated, agreeing to the Democrats’ plan, with its enrollment of 500,000 children in the program. I was standing in the House chamber when Bush walked over to the Democratic legislator who had led the fight.

“Congratulations,” Bush said to him. “You shoved it down our throat.”

That was not the response of a governor who had “strongly supported” S-CHIP. It also describes the tactics that Speaker of the House Pelosi and Senate Majority Leader Harry Reid should pursue now that Bush has vetoed the S-CHIP bill, which passed the House by a 265-159 vote and the Senate by a 67-29 vote. (The House margin is lower than the two-thirds required to override a presidential veto.)

It’s hard to envision the Democrats losing on S-CHIP, unless they compromise. The president’s proposal eliminates a million children currently enrolled. This year the number of uninsured persons in the country reached an all-time-high of 47 million, with uninsured children increasing by 600,000.

The president has drawn the line at $5 billion for the program for the next five years. Democrats in the Senate started out months ago with a proposal to increase funding by $50 billion for five years, funded by an increase in the cigarette tax and a tax increase on people earning more than $1 million. The figure has been scaled back to $35 billion, funded by an increase in cigarette taxes alone, on which the Senate and House have both now voted. Lacking House votes to override the president’s veto, a continuing resolution has been passed, to maintain current funding levels.

There are other numbers working for the Democrats and the 45 Republicans in the House and 18 in the Senate who voted for the $35 billion increase. When polled, Americans identify health care as one of their top two public policy concerns. (Iraq is the other.) Polling done in the summer by Public Opinion Strategies found that 86 percent of respondents supported continuing S-CHIP and 81 percent consider 9 million uninsured children a crisis or very serious problem. A poll conducted by Fabrizio Mclaughlin and Associates in September found that Republican voters support expansion of the S-CHIP program by a 62 to 31 percent vote. The same poll found that Republican voters are less likely to want to re-elect incumbents who oppose expanding the children’s health program.

MARCHING OFF A CLIFF—A president who will never again face the American public at the polls is leading Congressional Republicans over a cliff. And by voting against the $35 billion children’s health appropriation, forty-one House Republicans in marginally Republican districts are following him. They might consider the 2004 campaign of Chet Edwards a cautionary tale.

Chet Edwards is George W. Bush’s Congressman. He represents the Texas district that includes the president’s ranch in Crawford. Until the 2004 election, he held a Democratic seat in a Republican state. In 2003, then-House Majority Leader Tom DeLay came to Austin and personally redrew the state’s Congressional districts. DeLay turned five districts represented by Democratic incumbents into districts almost impossible for Democrats to win. (DeLay is facing trial in Texas on charges related to fundraising he directed to elect a Republican House that would follow his orders on redistricting.)

DeLay and his political cartographers turned the marginally Democratic district that Edwards represented into a district that is 65 percent Republican. The district was custom tailored for Arlene Wohlgemuth, a legislator who defined the extreme right in the Texas House of Representatives. In 1999, Wohlgemuth supported Governor Bush’s attempt to limit coverage of uninsured children in Texas. In a speech on the House floor she described S-CHIP as an infringement on the civil rights of parents who don’t want their children enrolled in any health insurance program. She was also the sponsor of a 2003 bill that imposed further restrictions on S-CHIP.

Edwards ran right at Wohlgemuth’s vote on the program she derided as “socialized medicine.” The centerpiece of his media campaign was a TV spot focused on a widowed mother unable to afford private health insurance for a three-year-old who’d lost S-CHIP coverage because of Wohlgemuth’s bill. In an interview with the Texas Observer, Edwards said he didn’t want to defeat his opponent; he wanted to make an example of her. He wanted other elected officials casting anti-health-care votes to say, “Remember what happened to Arlene” in the 2004 election.

With the state’s favorite-son president at the top of the ballot, Edwards beat his opponent by a 6 percent spread in a district that was 65 percent Republican. He did it with a campaign that will soon be keeping Democratic consultants busy all day and Republican House members up all night.

GUNS OR BUTTER?—As President Bush prepared a veto that would push more than a million kids off health insurance rolls, the Senate spent the penultimate week of September debating seven Iraq War-related amendments to the defense authorization bill. Six amendments lacked the sixty votes required by rules the Senate invoked. Congressional Quarterly Weekly kept a running tally on the six amendments that failed:

• An amendment by Patrick Leahy (D-VT) and Arlen Specter (R-PA) to restore habeas corpus rights to terrorism suspects by providing them access to U.S. courts;

• A troop-rotation amendment by Jim Webb (D-VA) requiring soldiers to spend at least as much time at home as they spend deployed in Iraq or Afghanistan;

• A faux-troop-rotation amendment by John McCain (R-AZ) expressing the sense of the Senate that the Webb amendment should be implemented “as soon as practicable” and “consistent with wartime requirements”;

• An amendment by Carl Levin (D-MI) and Jack Reed (D-RI) mandating a partial drawdown of troops in Iraq within ninety days and withdrawal of all troops not needed for a much more limited mission within nine months;

• An amendment by Russ Feingold (D-WI) and Majority Leader Harry Reid (D-NV) requiring troops to be withdrawn from Iraq, except those needed for limited service, by June 2008;

• An amendment by Barbara Boxer (D-CA) condemning attack ads on members of the armed forces, including MoveOn.org’s September 10 ad attacking General David Petraeus and 2002 and 2004 ads smearing former Senator Max Cleland and Senator John Kerry.

One amendment surpassed the Senate’s sixty-vote threshold by a veto-proof 72-25 margin. Texas Republican John Cornyn’s winning amendment reaffirmed Senate support for General David Petraeus and condemned MoveOn.org’s full-page “General Petraeus or General Betray Us” ad in the New York Times.

The House delivered a 341-79 veto-proof resolution praising the patriotism of General Petraeus and condemning MoveOn.org. Also in the House, Virginia Republican Tom Davis asked the House Oversight and Government Reform Committee to investigate the discount the New York Timesallowed for MoveOn’s Petraeus ad.

Until the Democrats won a majority of House seats in 2006, Davis was the chair of the House Government Reform Committee. In 1995, House Republicans had dropped “oversight” from the committee title then completely abandoned oversight of the executive branch when George W. Bush was elected. Illinois Republican Dan Burton, who chaired the committee before Davis, served 1,052 subpoenas on the Clinton White House. Only five subpoenas were subsequently served on the Bush White House. As ranking minority member, Davis now wants to extend the committee’s oversight into the business dealings of the New York Times, as publisher of the Petraeus ad.

A Congress that hasn’t addressed funding for the Iraq War is saluting a general, and a House committee that wouldn’t investigate the president is now in hot pursuit of a newspaper. The Congressional hyperventilation over an ill-advised newspaper ad attacking a military officer is a symptom of a cult of militarism described in Andrew J. Bacevich’s The New American Militarism. Bacevich, a retired career Army officer who lost a son in Iraq after his book was published in 2005, sees the Iraq War and the failure of Congress to confront the president as symptoms of an obsession that is anathema to a democratic society.

Two years ago Bacevich wrote:


To state the matter bluntly, Americans in our own time have fallen prey to militarism, manifesting itself in a romanticized view of soldiers, a tendency to see military power as the truest measure of national greatness, and outsized expectations regarding the efficacy of force. To a degree without precedent in U.S. history, Americans have come to define the nation’s strength in terms of military preparedness, military action, and the fostering of (or nostalgia for) military ideals.

The militarism that concerns Bacevich, a West Point graduate and Vietnam veteran, is more than a national ethos. It is a fiscal imperative that limits all other government spending: “In 2002, American defense spending exceeded by a factor of twenty-five the combined defense budget of the seven ‘rogue states’ then composing the roster of U.S. enemies. Indeed, by some calculations, the United States spends more on defense than all other nations in the world together.”

In late September, the administration requested an additional $42.3 billion in emergency funding for the Iraq War, increasing the fiscal year 2008 tab to $190 billion. The New York Times did the math (not in a paid ad but in its editorial space) and came up with $800 billion for the Iraq and Afghanistan wars. This year’s $190 billion will fund a war that former Defense Secretary Donald Rumsfeld said would cost $50 billion and Deputy Defense Secretary Paul Wolfowitz promised would be paid for with Iraq oil revenues.

Ultimately, all economic decisions come down to guns or butter. As he prepared to veto $35 billion for five years of health care for children at home, President Bush requested a supplemental $42.3 billion for one year in Iraq.

Bacevich argues that the problem is larger than George W. Bush. No Democratic presidential candidate has addressed the overarching issue of defense spending, a topic we will be considering in future issues.

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