W ASHINGTON ? Those were good words that President Bush spoke last week, when he pledged "bold action" to confront the poverty of New Orleans and the Gulf Coast, which he correctly said "has roots in a history of racial discrimination, which cut off generations from the opportunity of America."

We have heard similar words from presidents in the past. In 1992, when African-Americans rioted in Los Angeles following the acquittal of the white police officers who had beaten Rodney King, the first President Bush decried the violence but said, "After peace is restored ? we must then turn again to the underlying causes of such tragic events. We must keep on working to create a climate of understanding and tolerance, a climate that refuses to accept racism, bigotry, anti-Semitism and hate of any kind, anytime, anywhere."

But the capacity of us comfortable, affluent white Americans to put aside any lasting concern about those who are isolated by poverty or race from the mainstream of society is almost limitless.

Earlier this week, both John Kerry and John Edwards accused the Bush administration and the Republican Congress of turning their backs on the poor while lavishing tax cuts on the wealthy.

But this is not exclusively a Republican failing. Lyndon Johnson famously declared a "war on poverty," but then diverted the resources it required to the other war in Vietnam. Bill Clinton launched a much-publicized "national dialogue on race." It vanished in a torrent of words.

There is, however, a real difference in the records of the two parties. Poverty rates declined during those Democratic administrations ? especially for minorities. They have risen under this administration.

And even now, when the president is saying all the right things about the problems of poverty highlighted by the plight of the Katrina victims, his administration is dragging its feet on practical steps to help meet their needs.

Medical care for the evacuees from Louisiana, Mississippi and Alabama is urgently required. As Dr. Mark McClellan, the top federal health official in the Department of Health and Human Services, said last week, "The best and fastest way to provide help to evacuees is to support the state programs in place and support the local health care providers already in place, not to take time to build major new systems."

The way to do that, he said, is to make the evacuees eligible for Medicaid for the next few months, so they will know that their hospital and doctor and medication bills will be paid.

The governors, through their national association, agreed, and a measure to make all the evacuees Medicaid-eligible for the next five months (with an option for the president to extend the time) is pending before the Senate in a bill sponsored by the top leaders of both parties and the chairman and ranking minority party member of the Finance Committee.

But now, it appears that the Bush administration, rather than backing this simple and effective measure, is insisting on a slower, more cumbersome approach, requiring each state to negotiate its own waiver from the rules limiting eligibility for Medicaid benefits.

At a briefing for reporters, Robert Greenstein, the head of the liberal Center for Budget and Policy Priorities, cited the example of a 60-year-old Louisiana man with a chronic heart condition who has been moved to a shelter in a neighboring state. Not normally eligible for Medicaid, but out of a job and cut off from his regular caregivers, he must now scramble around on his own to find a hospital or doctor who is willing to take him as a patient ? and is willing to gamble that somebody will later pay for his care.

The administration has given Texas, which has the largest number of evacuees, a special Medicaid waiver to cover the costs of the thousands of hurricane victims living temporarily in that state. McClellan said similar waivers would be offered to other states, but more than two weeks after Katrina hit, those states were still "days away" from getting waivers, administration officials said.

Officials at the National Governors Association, who back the bipartisan bill, said they are not clear why the administration is balking at this simple solution. McClellan told me in an interview that "we're meeting all the needs," with the waiver approach. But with evacuees spread among all the states, it's hard to believe that's true.

David Broder writes for the Washington Post Writers Group. His e-mail address is davidbroder@washpost.com.

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