A Budget Battle Over Child Health Care

Twelve-year-old Deamonte Driver died for lack of a dentist when the bacteria from an abscessed tooth spread to his brain. He and his family were living in a homeless shelter. When he finally got the medical care he needed, it was too late—and it cost the taxpayers $250,000.

His story is one of many that Congress will hear as it considers the re-authorization of S-CHIP, the State Children's Health Insurance Program, which provides federal money to subsidize health care for kids who would otherwise be uninsured. Pioneered 10 years ago by former First Lady Hillary Clinton as a fallback when her more ambitious plan for universal coverage failed, the program is a huge success. Yet more than 9 million children are still without insurance.

Senator Clinton has a plan to expand the program, but it's modest compared to what her old pal and mentor Marian Wright Edelman, head of the Children's Defense Fund, says is needed. Clinton ratchets up existing coverage but stops short of adding pregnant women, mental, dental and vision care, or equalizing access throughout the country so children in poorer red states don't get shortchanged. Edelman has known Hillary since she was a law student and worked at the Children's Defense Fund. Hillary served on the CDF board, and when Bill Clinton was elected president, Marian Wright Edelman and her husband, Peter Edelman, were major FOBs. She had a pipeline to Hillary and he was named an assistant secretary at the Department of Health and Human Services. The two couples were best buds until President Clinton in the run-up to the '96 election signed a welfare-reform bill ending a 60-year federal guaranty to poor children and turning the responsibility over to the states.

Amid a flurry of hurt and angry rhetoric, Peter Edelman resigned from HHS, and Marian Wright Edelman quit talking to Hillary Clinton, effectively ending their long friendship and professional relationship. "We disagreed profoundly on some issues," Edelman says. "But she's a child advocate. The key is what she will do now. This is the basis for how we judge her and everybody else."

Edelman sat at the head of a conference table laden with lamb chops for 10-plus shrimp and pasta—at the CDF offices on Capitol Hill. The spread was part of Edelman's coming-out party for her new push for children's health care in what should be the most welcoming political climate since the early days of the Clinton administration. "We need to make a mighty noise," Edelman said. Democrats talk a good game when it comes to children, but will they walk the walk now that they're in power? Nancy Pelosi surrounded herself with children, her grandkids and others, when she accepted the gavel as Speaker. "It's all about the children," she exulted. "We're looking forward to her keeping that commitment," says Edelman. "She's a good person of faith. God didn't say 'do a few' —we're looking to see her act for all."

Under Edelman's proposed legislation, acting for all would cost $26.1 billion a year, the equivalent of 16 days of military spending or paying for three and one-half months of the war in Iraq. She's shopping around for sponsors. Health insurance for children is popular across party lines, and with money running out, the Democrats attached stopgap funding for the program to the administration's latest war-spending request. Still, Edelman is getting pushback from some Democrats, who say it's too expensive under pay-as-you-go rules (PAYGO), which they restored after winning control of Congress. "You didn't pay as we went into Iraq, or when we got prescription drugs for seniors," Edelman replies. "This is about choices—it's not about PAYGO." Under the rules, new spending must be paid for by cuts elsewhere or raising taxes—risky choices for Democrats looking ahead to the '08 presidential election. Neel Lattimore, who is working with Edelman at CDF, was on the First Lady's staff at the White House 10 years ago, when the two women had their very public falling out. He remembers the hurt feelings. "When you have a relationship with someone like the Clintons on such a personal level, you empower them to disappoint you because you have so much faith in them," he says.

This time Edelman is not counting on Hillary. Their relationship is polite but distant. After a decade of seeing her issues eclipsed in Washington, Edelman knows this is her moment. NO CHILD LEFT BEHIND was her slogan at CDF long before George W. Bush appropriated it as his own. To educate the public and put pressure on Congress to renew and expand children's health insurance, CDF launched this week a fictional presidential candidacy starring a fetching 10-year-old, Susie Flynn (not her real name)—whose ELECT SUSIE campaign to cover the 9 million uninsured children has already made it into Jay Leno's monologue; a request from "ER" in the works. One television spot shows Susie standing on Pennsylvania Avenue with a sign, HONK FOR CHILDREN'S HEALTH CARE, as the presidential motorcade screams by. Susie is one politician who won't disappoint.