Gop’s Welfare Bill Would Stop Health Coverage Little-Noticed Addition Severs Link Between Welfare, Medicaid

A little-noticed addition to the Republican welfare bill, now awaiting final action in Congress, would eliminate the longstanding guarantee of health insurance coverage for many welfare recipients.

The versions of the welfare bill initially passed by the House and the Senate would have retained the guarantee of Medicaid coverage for anyone qualifying for cash assistance under the standards in effect on June 1 of this year.

But a confidential draft of the report by a House-Senate conference committee, containing the full text of the compromise bill, shows that Republican negotiators from the two chambers intend to eliminate that guarantee. The conferees are considered likely to adopt the new provision, and Republicans have the votes to pass the compromise measure in both chambers.

The budget bill vetoed last week by President Clinton would have given states wide latitude to decide who gets what Medicaid benefits. But the latest version of the welfare bill would go further in some ways. It would sever the link between welfare and Medicaid that has existed since the health insurance program was established in 1965, and it would limit states’ ability to expand eligibility for Medicaid.

The proposal is part of a campaign by Republicans in Congress to curtail federal guarantees and requirements and to entrust more power to state officials.

President Clinton has already threatened to veto the welfare bill. Its elimination of the link between welfare and Medicaid might give him another reason to do so.

The new bill says, “A state is not required to provide medical assistance to any individual under the Medicaid program on the basis that the individual is receiving aid or assistance” in the form of Aid to Families With Dependent Children, foster care payments or adoption assistance.

A Senate Republican who worked on the legislation said on Monday that this provision “breaks the direct link between AFDC and Medicaid that currently exists.”

In debate on the welfare bill this year, Democrats often asserted that Republicans were shredding the social safety net, but until recently Republicans insisted that low-income people would still have Medicaid and food stamps even if they lost cash assistance.

Republicans intend to send Clinton a freestanding welfare bill in the next few weeks, testing his campaign commitment to “end welfare as we know it.” The bill has been delayed by a dispute over the school lunch program, but the two chambers have agreed on the other provisions.