[This post originally appeared at Lean Left, a general-issues blog KTK also contributes to. The founders of Lean Left graciously allowed me to re-post it here to bring all my health-related posts into one place. Original posting: 9/27/2004]

One of the few decent things in Bush’s speech at the Republican Convention this month was his promise of $1 billion in new funds to provide healthcare to uninsured children. Inevitably, when Bush promises money for something, you have to look for the way he is simultaneously undercutting his own promise. In this case, he has ordered the withholding of $1.1 billion in unspent funding for the same children’s health insurance program he promised to fund, meaning that if his promise of future funding is ever kept (they rarely are), his new funding will still represent barely 90% of the money he could provide right now if he chose to do so.

The program is “SCHIP” – the “State Children’s Health Insurance Plan” – which provides an extension to Medicaid for uninsured children. The money is funneled through state Medicaid programs, and some states have been slow in enrolling children, leaving some funds allocated to the program unspent this year. But those funds can be shifted to other states that are overburdened, or they can be held as a surplus for the states that will need them as their enrollment increases – if Congress approves. Bush has actively opposed a bill to extend the spending deadline for the funds that have already been allocated, meaning the money will be lost to the program when the deadline passes next week. His promised $1 billion “increase” in funding would take effect only after that, if ever, meaning that he is at best promising to restore $100 million less money than he is currently demanding to take away. The money would provide health insurance for 750,000 children who will now be left behind.

The Washington Post has the story:

In his convention address in New York, President Bush announced a new $1 billion initiative to enroll “millions of poor children” in two popular government health programs. But next week, the Bush administration plans to return $1.1 billion in unspent children’s health funds to the U.S. Treasury, making his convention promise a financial wash at best.

The loss of $1.1 billion in federal money means six states participating in the State Children’s Health Insurance Program face budget shortfalls in 2005; it is enough money to provide health coverage for 750,000 uninsured youngsters nationwide, according to two new analyses by advocacy organizations. . . .

Over the objections of the National Governors Association and a bipartisan coalition of lawmakers, Bush opposes giving states more time to spend the money. In previous years he supported an extension, but he struck it from this year’s proposed budget. . . .

Initially, states had difficulty enrolling many of the millions of children eligible for the program. In some instances, language barriers or a parent’s reluctance to register with the government prevented broad participation; in other cases states had devised complicated multi-page applications or were unwilling to spend their portion of the funds.

But SCHIP enrollment has steadily risen from fewer than 1 million in 1998 to the current 5.8 million, and most experts say states are depleting previous years’ surpluses.

“SCHIP spending is now exceeding annual allotments,” said Edwin Park, a senior health policy analyst at the Center on Budget and Policy Priorities. According to the center’s analysis, six states will drain those surpluses this year if the $1.1 billion is returned to the Treasury as planned at midnight Sept. 30. By 2007, 17 states are projected to run out of money.

Kevin Keane, spokesman for the Department of Health and Human Services, said the vast majority of states estimate they cannot spend their entire 2005 federal allocation. If some states have shortfalls, he said, the HHS secretary can shift some funds. Keane said the administration views the president’s new “Cover the Kids” campaign as an additional $1 billion for SCHIP.

“Additional” funding, in Bush-speak, means “less”, of course. It’s only sick kids, though . . . nothing that matters.