WASHINGTON -- Advocates for children and some administration officials are saying that President Clinton's health plan would eliminate some benefits received by millions of poor children on Medicaid, including many who are disabled.
Under the health plan's package of basic services, some Medicaid recipients under 21 could lose benefits they now have, including transportation to and from a doctor, certain types of hearing and vision care, physical rehabilitation and special education services.
Such extra services would still be available to 11 million children receiving welfare payments under Aid to Families with Dependent Children or the Supplemental Security Income program, but not necessarily to 7 million other children now covered by Medicaid.
The future of these children, and of the Medicaid program in general, has become an important topic of debate within the administration as the president prepares a legislative proposal to revamp the nation's health care system.
White House officials have repeatedly said that nobody should become worse off in the transition to the new system. But health and education officials who work with children are saying that they want to make sure that no Medicaid recipients lose benefits.
Carol Rasco, the president's top domestic policy adviser, and Education Secretary Richard Riley have expressed concern that many children with disabilities could be adversely affected by the president's plan as it now stands. Ms. Rasco is particularly sensitive to the needs of such children because her son, Hampton, 19, is mentally retarded and has cerebral palsy.
"The new benefit package excludes coverage for treatment needed by many low-income children with chronic physical, mental and developmental disabilities," said a senior administration official, who would speak only on the condition of not being identified. "The president's plan gives new benefits to the elderly and takes benefits away from children."
Dr. Judith Feder, a senior health policy adviser to Mr. Clinton, said the White House was aware of the problem. "The issue is under review," she said, insisting that Medicaid recipients would get all the care they needed under the Clinton plan.
The situation is politically awkward for the president and his wife, Hillary Rodham Clinton. She was chairwoman of the Children's Defense Fund from 1986 to 1992, and throughout his career he has presented himself to voters as a child welfare advocate.
The proposed changes have caused concern among advocates for children and for people with disabilities.
Kathleen McGinley, assistant director of the Association for Retarded Citizens said, "We are concerned that children will lose access to services they now have, like hearing aids, respiratory therapy and rehabilitation services."
Dr. Jennifer Howse, president of the March of Dimes, said that children with birth defects like spina bifida and cerebral palsy also could lose coverage for some services and equipment.
Mental retardation is not an illness or injury, said Ms. McGinley of the Association for Retarded Citizens. People with this condition may not qualify for rehabilitation services under the Clinton plan, though they get such services now under Medicaid.