In 1993 the Bill Clinton administration put forth a proposal that was designed to provide health insurance to all American citizens. The plan largely was the work of a task force headed by first lady Hillary Clinton, and as detailed in Nigel Hamilton’s recent history, “Bill Clinton, Mastering the Presidency,” she ignored suggestions made by many of her husband’s advisers that it would be better to expand health insurance coverage in a gradual manner that would be supported by some Congressional Republicans.

After the defeat of that plan, Clinton, who had an ability to learn from his mistakes, later introduced a program that was enacted into law in 1997 with bipartisan support that extended health insurance coverage to children whose parents earned too much to qualify their children for Medicaid yet could not afford private insurance. The program was the State Children’s Insurance Program, and became known by the acronym “SCHIP” and is run by the individual states with input and partial funding from the federal government.

The program allows the individual states a certain amount of flexibility on how they operate their plans and some of them have been authorized by the federal government to extend coverage to adults whose children are eligible for the program’s benefits.

In Oklahoma, the SCHIP funds a large percentage of the Soonercare project that is operated by the state to provide health insurance to the children of the working poor. As documented in a recent study conducted by Georgetown University Center for Children and Families and cited by the Tulsa World, the number of uninsured children in Oklahoma declined from 18.9 percent of the population to slightly more than 14 percent as a result of SCHIP, with more than 50,000 children in Oklahoma having health insurance as a result.

An expansion of that program that was passed by both houses of Congress that would have provided coverage to all of the nation’s uninsured children, including almost 127,000 Oklahoma children who still do not have it, recently was vetoed by President Bush on the grounds that it was too costly and would increase the government’s role in the providing of health care. The program’s expansion would have been funded by an increase of the tax on tobacco products and its cost would have increased from $5 billion to $35 billion during a five-year period.

Despite the fact that Oklahoma’s underprivileged children would have benefited from the enlargement of SCHIP, all of the state’s representatives in Congress voted against it.

“A foolish consistency is the hobgoblin of little minds, adored by little statesmen and philosophers and divine,” Ralph Waldo Emerson wrote. And that type of consistency will be visible when all of the Oklahoma Congressional delegation — except for Congressman Dan Boren who now publicly says he regrets his vote against the SCHIP expansion — will vote against overriding the president’s veto.

The bipartisanship that characterized the creation of the program in 1997 also was evident in the legislation that sought to expand it. Republican lawmakers like Sen. Orin Hatch, R-Utah, was an enthusiastic supporter of the measure and publicly was critical of Bush’s veto.

The spokespeople for the nation’s insurance industry also publicly supported it, as did a variety of national medical and nursing associations. Polling data indicated the American public approved of the measure as well.

Future historians of the Bush presidency may conclude that Bush’s stated commitment to what he described as “compassionate conservatism” was overshadowed by his veto of a bill that would have extended health insurance to the nation’s underprivileged children.



WILLIAM F. O’BRIEN is an Oklahoma City attorney.

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