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August 14, 2007 -- Marathon Florida Edition

Gov. Eliot Spitzer said yesterday that the state might sue federal officials who last week imposed rules that would prevent expansion of the state-administered children's health insurance program.

"We are calling on President [George W.] Bush to abolish these troublesome roadblocks to insuring our nation's children," Spitzer said in a statement. The new rules contradict the federal law creating the program and were imposed without notice or time for comment, he said.

The rules unveiled Aug. 17 by Dennis G. Smith, director of the Centers for Medicaid and State Operations, set new requirements for states seeking to offer the federally funded State Children's Health Insurance Program to families earning more than 250 percent of the poverty level, or $51,625 for a family of four.

Under the new eligibility rules, a state must show that a child whose family earns more than 250 percent of the poverty level must have been uninsured for a year. To make families earning more than 250 percent of poverty qualify, a state must also show that 95 percent of children in families making less than 200 percent of the poverty level are enrolled in the child health program or Medicaid.

State lawmakers wanted permission to cover children whose family income was as much as 400 percent of the poverty level, or $82,600. It estimates the extended coverage could add 60,000 children to the program.

White House spokesman Tony Fratto said last week that the rules would keep the program from becoming "essentially a middle-class entitlement." New York officials said they want a higher income limit so they can insure children in families whose parents' jobs lack insurance and who can't afford private insurance.

Presidential candidate and former Massachusetts Gov. Mitt Romney (R) on Friday before the Florida Medical Association outlined his health care proposal, which would allow states to develop their own plans to expand access to health insurance and make coverage more affordable, the Washington Times reports. The proposal would not mandate that individuals or employers purchase health insurance, both provisions included in the Massachusetts health insurance law enacted when Romney served as governor (Dinan, Washington Times, 8/25).

Under the proposal, states could use federal funds currently provided to help cover the cost of care for the uninsured to help purchase private coverage for low-income residents who do not qualify for public health insurance programs (Madkour, AP/Philadelphia Inquirer, 8/25). The proposal also would use federal funds as an incentive to prompt states to revise health insurance regulations to reduce the cost of private coverage (Washington Times, 8/25).

In addition, the proposal would make Medicaid into a block grant program with fewer federal rules to provide states with more flexibility to administer their programs and help residents purchase private health insurance (Kaiser Daily Health Policy Report, 8/24). The proposal also would provide tax deductions for individuals who purchase private health insurance and would cap damages in medical malpractice lawsuits (Alonso-Zaldivar, Los Angeles Times, 8/25).

Romney said, "A one-size-fits-all national health care system is bound to fail. It ignores the sharp difference between states, and it relies on Washington bureaucracy to manage. I don't want the people who ran the Katrina cleanup to manage our health care system."

Edwards Response

Presidential candidate and former Sen. John Edwards (D-N.C.) released a statement that criticized the proposal. He said, "Romney's cure is worse than the disease." According to Edwards, the proposal would not "take on" the pharmaceutical and health insurance industries and would "make a dysfunctional health care system even worse."

In addition, he said that the tax deductions included in the proposal in large part would benefit higher-income and healthy individuals and that "taking money away from emergency rooms is downright dangerous".

Editorial

The proposal, which would allow states to "work out their own approaches" to health care with some "crucial free-market assistance" from the federal government," represents a "step forward for Mr. Romney on health policy, largely because it doesn't take Massachusetts as its model," a Wall Street Journal editorial states.

According to the editorial, the Massachusetts law, which "is now praised by liberals as a prototype for national policy," has "done a great deal to set back the kind of tax reform" included in Romney's current proposal, and the "issue for GOP primary voters to consider is why he went such a different direction in Boston" and "how far and easily he'd bend to a Democratic Congress" on "core matters of principle."

The editorial concludes, "Romney's conversion to free-market health care thinking is nonetheless welcome -- assuming he believes it" (Wall Street Journal, 8/27).

Huckabee on Obesity In other election news, presidential candidate and former Arkansas Gov. Mike Huckabee (R) on Saturday at a meeting of the Southern Governors' Association in Biloxi, Miss., discussed the effects that increased U.S. obesity rates could have on the economy and national security, the AP/Boston Herald reports.

Huckabee said that 61% of active duty military personnel are overweight. "You've got a serious situation with a generation of kids coming up so unhealthy they won't be able to pass the military physical," Huckabee said, adding, "We keep talking about the war on terror -- who's going to fight it if we don't have enough people who are healthy enough to show up and pick up a backpack."

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