U.S. Rejects New York’s Bid to Insure More Children

from The New York Times

By ROBERT PEAR

WASHINGTON, Sept. 7 — The Bush administration on Friday rejected a request from New York State to expand its children’s health insurance program to cover 70,000 more uninsured youngsters, including some from middle-income families.

The ruling was the first application of a restrictive new White House policy that has drawn ferocious criticism from Democrats since it was announced last month. New York wanted to expand its program to cover children in families with incomes up to four times as much as the federal poverty level, or $82,600 for a family of four. The state’s current limit is 250 percent of the poverty level.

Federal officials said the change would divert resources from lower-income children and “crowd out” private health insurance.


Gov. Eliot Spitzer denounced the ruling as “a cruel blow to New York’s uninsured children, and to uninsured families across the country.”

In an interview, Mr. Spitzer said New York was preparing a lawsuit to challenge the new policy, contending that it violates the intent of the federal law that created the Children’s Health Insurance Program in 1997.

In addition, he said, the policy was adopted without the required period for public notice and comment.

The New York proposal would have added 70,000 children to the state’s program, which now covers 390,000.

The new federal policy sets a number of requirements for states that want to cover children with family incomes exceeding 250 percent of the poverty level.

One of the requirements is a waiting period, to minimize the possibility that public coverage will displace private insurance. Under the new federal policy, a middle-income child who previously had private coverage must be uninsured for one year before enrolling in the public program. New York had proposed a six-month waiting period, with some exceptions.

Congress is working on legislation to expand the child health program, parts of which expire on Sept. 30. Democratic leaders in Congress want to overturn the new Bush administration policy, which they say could immediately affect up to 23 states that either have or want to set income limits above 250 percent of the poverty level. That is the maximum favored by the Bush administration.

“We have a moral imperative to work to overturn this arbitrary and mean-spirited policy,” said Representative Charles B. Rangel, the New York Democrat who is chairman of the Ways and Means Committee.

Mr. Rangel denounced the decision denying New York’s request. “I find it unconscionable that the president would stand between children and one of the most basic human rights, health care,” Mr. Rangel said.

Representative John D. Dingell, Democrat of Michigan and chairman of the Committee on Energy and Commerce, said he was “saddened to see the administration taking another step that would deny affordable coverage to the most vulnerable among us.”

Some Republicans have similar concerns. Three Republican House members from New York — John R. Kuhl Jr., Thomas M. Reynolds and James T. Walsh — said the new Bush administration policy could hurt low-income children in the state. A fourth , Vito J. Fossella, had urged federal officials to relax what he called the “burdensome new requirements.”

State officials around the country said the Bush policy could severely hamper their efforts to help people cope with the soaring costs of health care and insurance. Nationwide, the Census Bureau says, the number of uninsured people increased for the sixth consecutive year in 2006, to 47 million, and the number of uninsured children rose for the second straight year, to 8.7 million.

New York has become a prime exhibit in the debate over how to reconfigure the Children’s Health Insurance Program, which is financed jointly by the federal government and the states.

Mr. Bush has repeatedly attacked Democrats in Congress, saying they want to expand the program to reach “families making up to $80,000 a year.” This, he says, goes “beyond the initial intent of helping poor children” and could lead to “government control of health care.”

New York is the only state that has proposed increasing its income limit to 400 percent of the poverty level. Nearly half the states have limits of 200 percent.

The decision on New York’s request was set forth Friday in a letter signed by Kerry Weems, acting administrator of the federal Centers for Medicare and Medicaid Services.

Mr. Weems said New York did not meet the requirements of the new policy because “it failed to provide assurances that the state has enrolled at least 95 percent of children in the core targeted low-income child population, those with family incomes below 200 percent of the federal poverty level.”

New York says it has enrolled 88 percent of eligible children in such low-income families.