Article September 18, 2000/Vol 6, Number 1
The Clinton-Gore Texas Two-Step
How the White House killed Bush's health care plan for poor kids.
By Kenneth Weinstein
The Weekly Standard
The Gore campaign has just launched a blistering $5.4 million ad
campaign that attacks George W. Bush's record as governor on
providing health care to children in Texas. After noting that
"George Bush says he has a plan to improve children's health
care," the ad rhetorically asks, "Why hasn't he done it in
Texas?" Well, the answer is quite simple: President Clinton and
Vice President Gore did all that they could to prevent Bush from
doing so.
In 1995, under Bush's leadership and with bipartisan support, the
Texas legislature authorized a sweeping social service reform.
Through the use of competitive bidding, the costs for
administering the state's health and human services programs
would be reduced. The aim was simple: to use savings generated
to improve services to the poor. Under the plan, the state would
contract with private companies to process Medicaid, food stamp,
and AFDC claims. Merging these various state aid offices and
contracting out their services would have saved taxpayers $10
million a month. These savings would have been plowed directly
into paying for health care for uninsured children in Texas,
whose numbers, according to some liberal activists, range as high
as 1,400,000.
For this program to be implemented, Texas needed to get a waiver
from the Clinton administration. Specifically, the federal
welfare regulations that prohibit employees of private firms from
deciding caseload eligibility would have had to be eased. Bush
spent nearly ten months seeking this waiver.
The waiver request caused heartburn for the Clinton
administration. An internal White House memo, dated April 4,
1997, indicates there was administration support for elements of
the Bush plan. The memo, signed by health and human services
secretary Donna Shalala, agriculture secretary Dan Glickman, and
Bruce Reed, assistant to the president for domestic policy, urged
a prompt response to Bush's "good faith" efforts at reform. In
particular, the memo noted that under Bush's plan, "the state
could save enough to expand health care coverage to up to 150,000
needy children." (Other estimates given in the press said that
the savings could have provided health care for up to twice that
number of needy youngsters.)
Recognizing the clear benefits of Bush's approach, Shalala,
Glickman, and Reed urged a compromise, forcing the private
contractors to work with public employees to screen applicants.
Signing off on this compromise, they noted, would encourage other
states to "explore innovative ways to deliver public services."
But even this compromise, which would have severely reduced the
savings generated, was too much for the administration's
politicos. Organized labor, fresh from its efforts on behalf of
congressional Democrats in the 1996 campaign, wanted to kill the
Bush plan as part of its drive to stop privatization in its
tracks. In their memo, Shalala, Glickman, and Reed frankly
attributed union opposition to fear of public sector layoffs.
In late March 1997, union leaders, including AFL-CIO president
John Sweeney, demanded and were granted a meeting with President
Clinton where they insisted that he scuttle the Bush plan. In
late April, when he addressed the American Federation of State,
County and Municipal Employees, Vice President Gore was urged to
kill the plan. Labor's threat, reportedly voiced in a variety of
ways, was that if the Texas plan were approved, labor would side
with Dick Gephardt, House minority leader, were Gephardt to
challenge Gore in the 2000 primaries.
Sensing both its debt to labor and this threat, the Clinton-Gore
administration decided to protect the jobs of public employees at
the expense of increased health care for the needy children of
Texas. In May 1997, reportedly at Gore's insistence, Clinton
rejected both the Bush plan and the Shalala-Glickman-Reed
compromise.
So the next time one of those ads runs, just remember: At least
150,000 children in Texas are doing without health care because
of the Clinton-Gore administration. �
By Kenneth Weinstein
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