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WHERE THE CANDIDATES STAND ON THE SAFETY NET. Dukakis says he's `on your side.' Bush calls for a `kinder, gentler' America. For the nation's needy, what do they have in mind? Ninth in a series on the issues of '88. BUSH

By Robert P. HeyStaff writer of The Christian Science Monitor / October 27, 1988



GEORGE BUSH'S proposals to aid poor Americans have paid particular attention to health issues. He proposes changes in current federal programs to improve access to health care for pregnant women, infants, older children, and adults. Mr. Bush's proposals are designed to aid both the poor and those who, while not officially poor, cannot afford medical insurance. (An estimated 37 million Americans lack health-care insurance.) His plans are not fully detailed, however.

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This year Congress expanded medicaid, the joint federal-state program established to finance health care for the poor, to finance medical care for all pregnant women and infants up to one year old who are living in official poverty (below about $10,000 a year for a family of four). But many experts and politicians say the changes do not go far enough.

Bush would change medicaid in four ways. First, he would provide medical coverage to pregnant women whose annual income is ``substantially above'' the poverty level, in the words of an aide. This proposal comes as two major studies of infant mortality in the US find that America has the worst record of 20 industrialized nations; the most serious problem is among impoverished pregnant women, who cannot afford prenatal medical care.

Second, Bush eventually would cover all young children who live in poor families, ideally up to the age of five.

Third, the vice-president would phase in expansion of medicaid to permit adults with modest incomes above the poverty line to purchase medicaid coverage at a cost below that of private insurance plans. In general, he says he would seek to ensure that all Americans have access to quality health care.

Finally, this year Congress eased medicaid rules so that people, primarily the elderly, did not have to spend so much of their assets, putting themselves on the brink of poverty, before medicaid would begin paying the cost of long-term care. Bush, who supports that liberalizing concept, would change medicaid rules still further so Americans would have to spend less before the program becomes available.

Bush says medicare's federal trust fund faces a financial crisis sometime in the next decade. The fund provides the bulk of the financing of the medicare program for the elderly. Bush says a ``bipartisan solution'' is necessary to prevent bankruptcy. He proposes that an independent commission be established to recommend a solution to the financing problem.

With regard to social security, Bush says it should be off limits to any budget cuts as the US struggles to meet the annual Gramm-Rudman deficit-reduction requirements. Bush also opposes any means test for social security recipients; such a test would make people with annual income above a specific level ineligible for social security benefits.

Bush says he would handle the housing problems of poor Americans in several ways. He seeks full funding of the new McKinney Act, which provides a variety of services to the homeless. This year Congress appropriated only $378 million of the $634 million the program authorizes. Bush would also provide vouchers to the poor to help finance the cost of housing that they would find themselves. In addition, he supports the concept of letting poor tenants purchase public-housing units.

The vice-president says he will ``request sufficient funding'' for federal programs to provide adequate nutrition to poor children, such as the Women, Infants, and Children supplemental food program. He has not specified the precise amount of money.