Bush Record Spotty on Aid to Texas’ Poor

George W. Bush was angry. Presidential debate No. 2 had gotten testy, with Democratic rival Al Gore accusing the Texas governor of presiding over a state where the numbers of uninsured children had increased.

“If he’s trying to allege that I’m a hardhearted person and I don’t care about children, he’s absolutely wrong,” Bush snapped, sidestepping the issue and continuing incorrectly, “I want to remind you, the number of uninsured in America during their watch has increased.”

With Campaign 2000 in the home stretch and far too close to call, Bush’s record as governor of Texas--particularly surrounding the poorest of his constituents--is under increasing attack.

Campaigning in Michigan on Saturday, Gore hammered away at Bush’s health care record for the needy. Sen. Joseph I. Lieberman of Connecticut, Gore’s running mate, toured the colonias along the Texas-Mexico border Friday, accusing Bush of neglect for the destitute Latino neighborhoods. E-mail flies daily from both camps: Bush is bad for the poor. No, Bush is good. Bad. Good.

Which is it? When it comes to poverty, probably both, depending on the issue. For a self-proclaimed compassionate conservative who has promised to help lift up those “living on the outskirts of poverty,” his record as governor has been mixed, according to recent studies, litigation and extensive interviews.

A study released Friday by the nonpartisan Kaiser Family Foundation said Texas has done little to help its poorest children get government-subsidized health insurance, even as many other states have simplified procedures to make it easier to enroll children.

The Children’s Defense Fund last month ranked Texas 50th out of 50 states and the District of Columbia in the percentage of children without health insurance and 46th in the percentage of children living in poverty. First is best, 51st is worst.

In August, a federal judge ruled that Texas had failed to adequately care for children under Medicaid, a federally funded health care program administered by the states to provide for the country’s poorest children. The judge ruled last week that Texas must submit a plan by the end of the month to correct the flaws. The state is appealing both decisions.

On the flip side is a single statistic that the governor’s office points to when talking about the Republican’s record: Every year since he took office, the percentage of Texans living in poverty has dropped.

Poverty Rate Down 10% in Texas

From 1995 to 1998, the most recent federal statistics available, the poverty rate in Texas decreased more than 10%, compared with an almost 9% drop nationwide. A family of four with a household income of $16,450 or less in 1998 was living in poverty, according to federal guidelines.

Bush cites a list of achievements in the fight against poverty here: Tax cuts and economic reforms that have resulted in the lowest state unemployment rate in nearly 20 years; welfare reform that has cut public assistance rolls in half; and legal changes that have expanded the role of religious groups in helping the poor.

“From the beginning, [Bush] has focused on leaving no one behind and increasing opportunity and helping people help themselves,” says T. Vance McMahan, Bush’s state policy advisor.

In many ways, Bush’s record dovetails with the Texas worldview, which places the burden for escaping poverty on the poor, not the government. Conservative groups and analysts praise the governor and his actions precisely for their strong embrace of basic Republican philosophies.

When Bush took office in 1995, he inherited a state with problems as big as its boundaries, whose up-by-the-bootstraps culture was formed by independent men and women often loath to give--or ask for--help.

The Texas Constitution prohibits the Legislature from spending more than 1% of the state budget on poor children. Cash welfare benefits in the state can best be described as flinty: $188 a month for a mother and two children in 1995, since raised by $13 on Bush’s watch. California, by comparison, pays $611 a month for a similar family.

But while the welfare rolls are dropping, those who still need a helping hand often do not get one, says Edward Sills, spokesman for the Texas AFL-CIO, which lobbies on behalf of workers’ rights. Participation in welfare and food stamp programs has dropped five times faster than the rate of poverty during Bush’s years as governor.

Texas has “a bad system for delivering benefits to people who are unquestionably entitled,” Sills says. “It’s not a badge of honor that the people entitled to the benefits are not receiving them.”

For those Texans who still reside on the wrong side of the economic tracks, life is often no less harsh than it was when Bush took office.

“For me, as a poor black woman, I don’t see anything [Bush] has done,” says Barbara Mills, 58, a nurse’s aide who is raising her granddaughter and working a job that pays $8.44 an hour. “I have never benefited. All I have done is contribute, like working and paying my taxes. When I need, I get nothing.”

Mills needs now. She’s not asking for much, just health insurance for 10-year-old Dedra. But getting such assistance in Texas--where advocates for the poor bemoan steep administrative hurdles--so far has been impossible.

Dedra Cheri Mills, who loves to read and loves to dance, most likely has glaucoma. Her glasses cost about $200. Eye drops cost more than $60 a month.

When Mills scraped together enough money to take Dedra to an eye doctor earlier this year, an unusual amount of pressure was found in the girl’s eyes. Glaucoma--which can result in blindness--was the initial diagnosis, but the doctor wanted to do a CT scan to make sure there was no underlying problem.

“Then I told her we had no health insurance,” Mills says. “She did a series of more tests, but no CT scan. . . . Dedra really needs a good checkup. There could be other things wrong. But where do you go?”

Not to Medicaid, not in Texas. And, so far, not to the federal Children’s Health Insurance Program, or CHIP.

Medicaid is federally funded health coverage administered by states to care for America’s neediest residents. CHIP was designed to provide cheap, basic health coverage for the children of low-income parents--men and women who make too much money to qualify for Medicaid but cannot afford private insurance.

Dedra, so far, has been turned down for both and is still stuck in a bureaucratic maze, by agencies that agree she’s eligible for assistance--just not theirs.

Getting Coverage a Nightmare

When Barbara Mills applied for Medicaid and food stamps on Dedra’s behalf several years ago, she was denied coverage, she said, because her income was too high. When she heard about CHIP in May, she raced to sign Dedra up and was just as quickly denied. The reason: Dedra actually qualified for Medicaid.

Mills then signed Dedra up for Medicaid under her unemployed father’s name. He never showed up for the appointment with the social worker, and Dedra was denied coverage again. Mills has an appointment this morning to apply for Medicaid for Dedra under her own name. If she is denied again, she can reapply to CHIP.

“All I ask,” says a frustrated Mills, “is give me some health insurance.”

Dedra Mills’ experience highlights the roadblocks that advocates for the poor say Bush constructed--or allowed to stand--that keep people from getting the benefits they deserve.

Texas is one of only three states in the country that has not changed the complicated Medicaid application procedure for children, which includes a face-to-face interview and proof that a family has less than $2,000 in assets.

Other states--except for Utah and Montana--have gotten rid of one or all of these barriers between poor children and insurance. As governor, Bush could ease the enrollment process by changing the rules too. So far, his office has declined to take the step, pointing to the high cost.

As a result, Medicaid enrollment in Texas has dropped over the past three years, according to the Kaiser Foundation study, while it has been rising in most states. The biggest increases in coverage have occurred in states that have made a concerted effort to ensure that all eligible children get Medicaid.

Total enrollment in Texas dropped 7.6% between June 1997 and December 1999. The only state that lost more enrollment was West Virginia. California’s enrollment dropped 2.8%.

State Rep. Garnet Coleman, a Houston Democrat, says the Texas system is designed to prevent people from signing up for a federal program created to help them. And he notes that an estimated 600,000 Texas children are potentially eligible for Medicaid but are not signed up.

Texas’ Record on CHIP Enrollment

Although Dedra Mills is still being bounced back and forth between Medicaid and CHIP, the Kaiser study reported that Texas has a better record when it comes to enrolling youngsters in the latter program, which cares for children in working poor families.

When the Texas Legislature first began crafting regulations for administering CHIP, Bush originally supported a plan that would have left out 200,000 children of the working poor at a time when the state was enjoying a surplus.

But more generous regulations were enacted, and today, the Kaiser report said that Texas has eliminated many enrollment barriers.

Bush pointed this out Wednesday in the North Carolina debate, telling Gore that “we’ve signed up over 110,000 children to the CHIPS program.”

“You can quote all the numbers you want,” Bush continued, “but I’m telling you, we care about our people in Texas . . . and the percentage of the [uninsured] population is increasing nationally.”

There, however, the Kaiser report disagreed: “In 1999, the total number of uninsured Americans decreased for the first time, after steadily increasing for over a decade.”

Critics of Bush’s record concerning poverty issues often save their harshest attacks for the governor’s neglect of the colonias, which Lieberman visited on the second day of a “Failure of Leadership” tour last week.

In truth, Bush’s record with the colonias is mixed. He is routinely criticized for never visiting a colonia, and he vetoed an omnibus bill in 1997 to help the ramshackle neighborhoods. But he supported an effort two years later to coordinate state agencies to improve living conditions in the areas.

He also made his secretary of state focus on getting basic services to the colonias, so that $25 million would be provided to help pay for sewer and water hookups for about a quarter of the estimated 400,000 colonia residents.

“Ours is the first administration to aggressively pursue hookups for the colonias, and we have a fantastic record,” Bush said at a news conference this summer when asked about Gore’s attacks on his record.

Welfare reform is another area where the Texas governor points to progress. Bush made welfare reform a cornerstone of his 1994 gubernatorial campaign. Once elected, he worked with the Legislature to enact a program that focused on getting more people to work by setting up local job training for welfare recipients. On Bush’s watch, the Texas welfare rolls dropped by 53%.

Welfare Reform Success Story

Deborah Dickerson, an HIV outreach counselor and mother of four, is one of the success stories of Texas welfare reform.

Dickerson, 35, spent about eight years on public assistance before serving a year in a state prison on a drug offense. Since her release in 1997, she has been clean, sober and employed full time.

These days, she insists that welfare is for the old who cannot work and for those who have recently lost a job. “If you get welfare,” she says, and she knows this firsthand, “you don’t have the incentive, the willpower, to get a better job. You know someone will help you.”

But the good part is only half of Dickerson’s story. Her job teaching addicts and prostitutes about HIV prevention offers health insurance, but she cannot afford it for herself or her children.

In all, Bush aides vigorously defend the governor’s record, pointing to bountiful evidence that poverty in Texas has dropped while employment has skyrocketed. They acknowledge that a vibrant economy has played a role in those figures, but they also say that Bush-backed reforms have made Texas a place where the poor find a “hand up, not a handout.”

Patrick Bresette, associate director of the Center for Public Policy Priorities, readily acknowledges that Bush did not create poverty here. But he wishes the governor had done more to help allay it.

“If there was ever an opportunity to invest, our current booming economy provides that opportunity,” Bresette says. “The governor has not stepped up a lot to say, ‘We’ve got more revenue coming in than we’ve seen in a decade. How can we spend it to help the least among us move up?’ ”

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Times staff writer Alissa J. Rubin contributed to this report.