Published Online: February 19, 1997

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President Seeks To Extend Health-Care Coverage

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Washington

The spending plan President Clinton submitted to Congress this month promises to shrink Medicaid costs while extending the blanket of health insurance to cover millions of the nation's poorest children.

Mr. Clinton's proposed $376 billion budget for the Department of Health and Human Services calls for more than $8 billion in programs that would expand the Head Start rolls, offer health insurance to poor children, pay for efforts to reduce teenage pregnancy, and take a stab at thwarting advertising by tobacco companies when they aim to entice young people.

The budget request for the fiscal year that will begin Oct. 1 calls for a 7 percent increase in the agency's overall budget compared with current spending.

President Clinton's budget proposes to increase spending for the Head Start preschool program to $4 billion--a 10 percent hike over current spending.

The increased federal funds would allow Head Start to serve 36,000 more children and their families, according to HHS estimates.

In an effort to curb teenage birthrates, the administration is also asking for $14 million for the department's ongoing adolescent family-life program, which finances abstinence-based sex education in schools. Fighting adolescent substance abuse is also a priority in the fiscal 1998 budget.

The HHS budget includes an unprecedented $85 million request to wage a mass media campaign to thwart teenage drug use, pay for research on drug education, and finance state-run anti-drug programs.

At a press conference announcing the spending proposals this month, HHS Secretary Donna E. Shalala hailed the new budget as "a force for good."

"This budget makes an unprecedented commitment to lifting the lives of our children and adolescents by addressing the issues that keep too many parents up at night," Ms. Shalala said.

Extending Health Care

The cornerstone of the president's health initiatives is a $3 billion-a-year plan to extend health coverage to 5 million uninsured children by 2000. The plan would cover roughly half the children who currently lack health coverage.

The plan includes $1.7 billion to help low-income parents who are out of work pay for up to six months of health coverage.

HHS officials estimate this would help insure 700,000 children.

The children's health initiative would also earmark $750 million in annual grants to states to reach children who fall through the cracks because their families earn too much to be eligible for Medicaid, but not enough to afford private insurance.

No Great Comfort

For those eligible for Medicaid, the Clinton administration hopes that the new money would help supplement states' efforts to reach more eligible children and adolescents.

But some children's advocates said last week that the administration's plan is no great comfort to needy families.

At the same time that Mr. Clinton is proposing more health insurance for children, his budget calls for slicing overall spending for the Medicaid program by $9 billion over five years, budget documents show.

Debbie Weinstein, the director of the family-income division of the Children's Defense Fund, a Washington advocacy group, argued that scaling back Medicaid spending would undercut the president's goal of promoting child health.

"While one hand gives something like health insurance, the other hand is taking it away," she said.

Some Democratic leaders in Congress praised President Clinton last week for making children's health a legislative priority, but said that such incremental approaches won't go far enough to serve poor children.

Sens. Edward M. Kennedy and John Kerry, both Massachusetts Democrats, have introduced a bill to provide federal vouchers to poor and moderate-income families to buy insurance.

The bill would provide coverage to the country's 10 million uninsured children. Funding would be raised through a proposed 75-cent tax on tobacco, according to a spokesman for Sen. Kennedy.

It is unclear, however, how any new government programs will be received as the Republican-controlled Congress resumes efforts to balance the federal budget by 2002.

"This is a back-door approach to national health care," Kristy Khachigian, a spokeswoman for Rep. Ernest Istook, R-Okla., said of Mr. Clinton's proposal. "Besides, it's too costly."

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