Congress finally seems ready to check the thinly veiled animosity the Bush administration has been showing toward Medicaid and other federal health programs for the poor and uninsured. The House voted overwhelmingly last week to delay new rules that would have reduced federal spending on Medicaid by $13 billion over the next five years. Among other things, the White House has proposed cuts in Medicaid payments to the nation's largest safety net hospitals, such as Grady Memorial Hospital in Atlanta.

The Senate is expected to consider the same one-year moratorium in the next few weeks. President Bush has threatened to veto the measure, but both chambers appear to have more than enough votes to override a veto.

The bipartisan rejection of the Medicaid regulations follows by only a few days a Government Accountability Office ruling that the administration violated federal law last year when it severely restricted states' ability to expand government-subsidized health insurance to children in middle-income families. The White House contends the GAO ruling is merely advisory.

The administration demands that states be able to prove they are covering 95 percent of children already eligible for the program before they are allowed to expand it to families with higher incomes —- a threshold the states say is impossible to meet. Federal officials have already used the rule to reject New York's effort to cover 70,000 additional youngsters under its children's health plan.

The two separate developments illustrate the ideological differences between the extreme right wing of the Republican Party and its more moderate middle when it comes to government health care programs. Two-thirds of the Republican members of the House crossed over and voted with Democrats to halt the proposed Medicaid cuts, which were opposed by the governors and Medicaid directors of all 50 states. (Georgia's GOP delegation —- with the exception of Rep. John Linder, who did not vote —- sided with the White House.)

The new Medicaid regulations would shift the funding formula so that states would have to pay any additional reimbursement to so-called "safety net" hospitals such as Grady, which last year had a record $48 million deficit. They would also eliminate the federal government's portion of Medicaid reimbursement to hospitals with graduate medical education programs, which would further crimp hospitals like Grady that rely on medical residents for staffing.

The administration said the new rules were needed to restore fiscal integrity to some Medicaid programs that have been riddled with fraud. But the changes went well beyond cleaning up fraud and abuse. They took aim at legitimate, long-standing financial arrangements between the federal government and the states over how to offset some of the costs hospitals and other health care providers must absorb when treating the poor and uninsured.

Many of those programs ought to be overhauled. But Congress is correct to wait for a new administration to take office —- one that shows more willingness to work with states on making changes that would protect taxpayers without jeopardizing the health of low-income patients and the financial stability of the institutions that have traditionally cared for them.

—- Mike King, for the editorial board (mking@ajc.com)