4-15-08, 10:59 am

It's not the biggest political story of the day, but maybe it should be. A behind the scenes confrontation between Congressional Democrats and the Bush administration could block a White House effort to cut or eliminate funding for programs that help children with disabilities and other health problems.

In order to pay for his tax cuts for the rich, George W. Bush proposed earlier this month a number of regulation changes to Medicaid, which could cut $20 billion from that health care program, according to Congressional Budget Office estimates.

Rules changes? Seems innocuous right? Wrong. These rules changes target children. According to the Coalition on Human Needs, Bush's proposed rules changes would hinder public school personnel from helping to enroll children with health care needs in Medicaid or from providing transportation to children with disabilities and other health care needs to schools that provide services to treat those disabilities or needs.

Bush's rules change would also disallow use of Medicaid funds for case management for children in foster care or children with chronic health care problems and disabilities. Funds for this program allow states to help children more effectively gain access to health care programs that are most suitable for their particular needs.

Another Bush-imposed rule would eliminate federal funds through Medicaid for graduate medical education at teaching hospitals.

It bears repeating: Bush plans to pay for tax cuts for the rich by eliminating programs paid for with federal funds that help low-income families find and access programs and services for their disabled or chronically ill children.

Congressional Democrats are working to block the rules changes and preserve funding for these programs by introducing a bill that would postpone Bush's rules changes. Leading House Democrat Rep. John Dingell (D-MI) put forward the Protecting the Medicaid Safety Net Act of 2008, which just passed in subcommittee with bipartisan support and has garnered 164 co-sponsors.

A similar bipartisan measure has been introduced in the Senate.

According to opponents of the Bush rules, one of the biggest problems with Bush's proposed rule changes is that if states, which receive Medicaid funds in block grants, want to keep the programs that are planned for elimination by Bush, they have to come up with the cash themselves. With tight budget constraints already hurting most state budgets, this means that many of those programs will not likely continue.

Bush's stance on this matter is little different from his successful effort, aided by Sen. John McCain, to veto a reauthorization of S-CHIP which would have inexpensively added from three to four million low-income children to the health care rolls.

--Reach Joel Wendland at