We live in our great nation at a peculiar time when our leaders approval massive spending on such things as a war of occupation in Iraq and tax relief for the ultra-wealthy, while nickel-and-diming poor children on Medicaid.

This point was driven home last week when the Bush administration, in a letter to state Medicaid directors, announced a variety of new requirements before the federal government will help meet the basic health care needs of America's most vulnerable children.

This will most affect states like those in the Pacific Northwest that work hardest to make sure all children have access to the doctors and medicines they need. For example, by setting the Medicaid eligibility level at two and a half times the federal poverty rate, our states are trying to make sure that the children of employed, but relatively low-paid parents are covered.

Now, if states want to cover these children, they must leap through a variety of additional hoops. One of the most objectionable is that states must impose a one-year waiting period without insurance for kids before they can receive Medicaid.

There is a fundamental and shameful inequity of placing needy children at risk - a sorry situation in which the U.S. stands alone among leading industrial countries. This parsimony also is financially counterproductive. Delaying the treatment of children's health problems often results in additional emergency room visits and a lifetime of chronic ill health.

Congress shares the blame and shame for permitting the administration to go so far down this road. It can begin redeeming itself by making sure children's health care is fully funded immediately, without unduly burdensome eligibility requirements.

Though it will have to await a new administration, the ultimate answer is nationwide health care reform for all Americans. No one in this wealthy and sophisticated country should ever have to decide between eating and going to the doctor.


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