The Bush administration sent a letter to state health officials last Friday outlining new standards for the Children's Health Insurance Program (CHIP), which is designed to help states insure low-income uninsured children.

Why is this such a big deal? Partly because it's another case of executive branch arrogance—Congress has been working to expand the program, and the letter was sent in the middle of the month-long Congressional recess.

But the real news is that Bush wants to make it harder for states to expand the program to middle-income families without insurance. Under the new rules, states must establish that a child has been without insurance for a minimum of one year, and a state can't expand the coverage to people making more than 200% above the poverty line until 95% of children eligible for the program are enrolled. Most states say this is impossible.

The official administration rationale is that it wants to keep the program focused on low-income children. But the federal poverty levels are set so low that many "middle-income" families who don't fall below the threshold still can't afford health coverage. Take a look at the federal poverty levels for 2007:

• Individual - $10,210
• Family of 2 - $13,690
• Family of 3 - $17,170
• Family of 4 - $20,650
• Family of 5 - $24,130

Maybe those numbers are realistic for a few remote regions of the country, but the costs of living vary state-to-state and city-to-city, and the new rules prevent states from adjusting the program based on relative differences. California, for example, passed legislation to allow families making 400% above the poverty line to be eligible for CHIP. That may seem a bit high for rural Missouri, but it's not so outrageous for many areas of California.

So what happens to children without health insurance whose family is ineligible for assistance? If he or she gets sick, they'll probably head to the emergency room, and the government will pick up the bill anyway, so the "fiscal conservatism" argument goes out the window. And the emergency room is no substitute for regular, preventative care.

And keep in mind this is happening while the administration is considering another round of corporate tax cuts. What it boils down to is some politicians are so afraid of the universal health care bogeyman that they're willing to risk the health of children to keep insurance private.