States and U.S. at Odds on Aid for Uninsured

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In the absence of federal action, governors and state legislators around the country are transforming the nation’s health care system, putting affordable health insurance within reach of millions of Americans in hopes of reversing the steady rise in the number of uninsured, now close to 47 million.

But the states appear to be on a collision course with the Bush administration, whose latest budget proposals create a huge potential obstacle to their efforts to expand coverage. While offering to work with states by waiving requirements of federal law, the Bush administration has balked at state initiatives that increase costs to the federal government.

State efforts have almost invariably begun with children, building on the Children’s Health Insurance Program, which is jointly financed by the federal and state governments. Many states are eager to expand eligibility for that program, and some are going far beyond the income levels deemed appropriate by the White House. In his budget last week, President Bush said he wanted to return the program to its “original objective” of covering children with family incomes less than twice the poverty level.

Sixteen states already cover children in families with incomes above 200 percent of the poverty level, and some want to go higher, even as the president seeks to reduce federal payments for children in families with higher incomes.

http://www.nytimes.com/2007/02/13/us/13insure.html?hp&ex=1171342800&en=a741d599e0fe152a&ei=5094&partner=homepage