[Congressional Record Volume 142, Number 102 (Thursday, July 11, 1996)]
[Extensions of Remarks]
[Pages E1252-E1254]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 HEALTHY START: LEGISLATION TO GUARANTEE HEALTH CARE INSURANCE FOR ALL 
                           AMERICAN CHILDREN

                                 ______
                                 

                            HON. SAM GIBBONS

                               of florida

                    in the house of representatives

                        Thursday, July 11, 1996

  Mr. GIBBONS. Mr. Speaker, today, along with Representatives Rangel, 
Stark, George Miller, Gonzalez, LaFalce, Hilliard, Lantos, and Norton, 
I am introducing legislation entitled ``Healthy Start'', to provide 
Medicare-type health insurance for all women during pregnancy and for 
children from infancy through age 12.
  Just as Head Start has helped millions of children prepare for school 
and reduce the burdens of poverty, Healthy Start will ensure that all 
American children can obtain adequate

[[Page E1253]]

medical care in the first years of life. Health insurance has been 
shown to be the key to adequate access to health care; and adequate 
access to health care is a key to a healthier life. That is why the 
bill we are introducing will concentrate on ensuring that all American 
children and mothers during pregnancy have adequate health insurance.
  Today, there are approximately 7.1 million children under age 13 who 
are uninsured. Three-fourths of these children have parents who work, 
most of them full-time, but their employer either does not offer health 
insurance coverage or the family does not make enough to buy insurance. 
Because of the decline in employment-provided health insurance, it is 
estimated that each year, 1 million additional children lose private 
insurance coverage. If these trends continue, in 4 years--at the end of 
this decade--more than 2 out of 5 children will lack private health 
insurance. The failure to provide health care for our children costs 
our Nation a productive workforce for the future. It costs us at the 
hospital, in the schoolyard, in our ability to defend our Nation and to 
produce competitively. No industrialized or civilized society on earth 
treats its children so callously.
  This health disaster would be somewhat mitigated if our Nation had a 
reliable low-income insurance program that ensured access to quality 
care for children. But Medicaid provides an uneven and often inadequate 
protection that varies from State-to-State, and that program is under 
severe attack by Republican budget cutters here in Congress and in 
State capitols across the Nation. Rather than the uncertainty of 
Medicaid, we need a uniform, high-quality health insurance plan for all 
our children.
  We should be improving health insurance for our children--not 
slashing it. Although we are one of the richest, most advanced 
countries in the world, the United States ranks 18th among 
industrialized nations in overall infant mortality. Only Portugal has 
an infant mortality rate worse than ours. The infant death rate among 
African-American babies is two and a half times that of caucasian 
children. Poor children, many of whom come from working families with 
no health coverage, are 60 percent more likely than children with 
health insurance to die before their first birthday and four times more 
likely to suffer from infection or serious illness.
  The General Accounting Office has just issued a report to Senator 
Christopher Dodd, dated June 17, 1996, entitled ``Health Insurance for 
Children: Private Insurance Coverage Continues to Deteriorate'' [GAO/
HEHS-96-129]. The report states:

       The number of children without health insurance coverage 
     was greater in 1994 than at any time in the last 8 years. In 
     1994, the percentage of children under 18 years old without 
     any health insurance coverage reached its highest level since 
     1987--14.2 percent or 10 million children who were uninsured. 
     In addition, the percentage of children with private coverage 
     has decreased every year since 1987, and in 1994 reached its 
     lowest level in the past 8 years--65.6 percent.

  The GAO's report also provides an eloquent summary of why the lack of 
insurance is so important:

       Studies have shown that uninsured children are less likely 
     than insured children to get needed health and preventive 
     care. The lack of such care can adversely affect children's 
     health status throughout their lives. Without health 
     insurance, many families face difficulties getting preventive 
     and basic care for their children. Children without health 
     insurance or with gaps in coverage are less likely to have 
     routine doctor visits or have a regular source of medical 
     care. . . . They are also less likely to get care for 
     injuries, see a physician if chronically ill, or get dental 
     care. They are less likely to be appropriately immunized to 
     prevent childhood illness--which is considered by health 
     experts to be one of the most basic elements of preventive 
     care.

  We spend long hours debating whether there should be prayer in 
school, but no time discussing how much parents pray that their 
children don't get sick because the parents can't pay the bills. We 
spend days debating obscenity on the Internet, but little time debating 
how obscene it is for a society as rich as ours to have so many 
children and parents unable to seek adequate medical care.
  We must commit ourselves to insuring all pregnant women and all 
children, regardless of the financial ups and downs of the family unit. 
There is only one way to do this. Let me repeat: there is only one way 
to guarantee universal coverage. It is through a social insurance 
program in which we all pitch in to guarantee health insurance for all 
children at all times. I am here today to propose that we make that 
guarantee, once and for all.
  That is what the bill we are introducing today achieves. It uses the 
tested Medicare Program to cover all young American children and their 
mothers during pregnancy with the basic package of Medicare benefits 
plus additional benefits designed to ensure a healthy start for babies 
and young children. These additional benefits include full coverage for 
pregnancy care, immunizations, follow-up visits for new babies with 
pediatricians, routine check-ups to monitor development, and preventive 
dental care.
  Any parent can, of course, purchase additional medigap-type insurance 
coverage for more benefits and more coverage. Freedom of choice of 
doctor is preserved.
  The bill we are introducing ensures that every child and mother-to-be 
will have health insurance equivalent to Medicare plus the special 
prenatal and well-baby care provisions I've described. If a family 
already has this level of coverage, it is not affected by this bill; 
the family will see no change. If the family doesn't have such a level 
of coverage, it will purchase this package, or a similar package, 
through sliding scale, very affordable, income-related premiums 
administered through the Tax Code. Families below the poverty level 
will basically be exempt from the premium tax.
  This legislation is similar to the procedure we used in 1994, when 
the Ways and Means Committee approved a bill which, according to 
Congressional Budget Office estimates, achieved enough savings in the 
health care sector and in Medicare to both improve Medicare and expand 
coverage to all the uninsured. A comprehensive health care reform bill 
may not be possible in the near future, but we can surely find a way to 
protect our youngest and most vulnerable citizens. We can look to other 
spending cuts to find the resources to fund this basic right.
  Through the Social Security and Medicare Program, our society has 
advanced further than most in ensuring that old age is a time of 
security. We have reduced poverty among seniors to the lowest of any 
group in our society. In many ways, the health status of a 65-year-old 
in our society is better than younger groups'. Sadly enough, we have 
left our children behind. Poverty rates for children are higher than 
average. The health status of millions of our children is equal to that 
of a Third World country. What we have achieved for seniors we can 
surely achieve for their grandchildren.
  The bill we are introducing today would at long last give our 
children the same level of care we provide their grandparents.
  Following are facts and figures on how health insurance equals better 
health, and how we have failed to provide that better health to our 
Nation's future--our children.

           Child Health in U.S. Ranks Lower than Many Nations

       In the industrialized world, the United States ranks 18th 
     in overall infant mortality. Only Portugal's infant death 
     rate is worse. The infant mortality rate of African-American 
     babies is 2.5 times that of caucasian children, and is worse, 
     for example, than Sri Lanka's or Jamaica's. In 1993, more 
     than 33,000 American babies died before age 1. More than 
     16,000 of these babies would have survived if the United 
     States had the same infant mortality rate as the Japanese.


                low-income children need health coverage

       Compared to other children, poor children are 60 percent 
     more likely to die before the age of 1, 4 times more likely 
     to be hospitalized with asthma or pneumonia, and 5 times more 
     likely to die from infection or parasitic disease.


         health insurance for children is deteriorating rapidly

                              [In percent]                              
------------------------------------------------------------------------
                                                          1988     1994 
------------------------------------------------------------------------
Children under 18 with employment-based insurance.....       66       59
Children under 18 on Medicaid.........................       16       26
------------------------------------------------------------------------

       During their first 3 years of life, over 22 percent of U.S. 
     children were without health insurance for at least 1 month. 
     The number of children in working-poor families, who are 
     least likely to have Medicaid or employment-based insurance, 
     rose to 5.6 million in 1994, up 65 percent from 1974.


      medicaid cutbacks will increase number of uninsured children

       Forty percent of all pregnant women and infants are now 
     covered by Medicaid. More than half of all Medicaid 
     recipients are children, although less than 25 percent of 
     Medicaid spending is on children. Under current law, 
     additional low-income children are being phased into 
     Medicaid, but proposed changes would end that guarantee. 
     Experts estimate that if the decline in employment-based 
     insurance continues and Medicaid enrollment is frozen, there 
     will be a total of 67 million people of all ages who are 
     uninsured in 2002.


                         health insurance helps

       Since 1965, infant mortality has been reduced by \2/3\ds. 
     An increase of 15 percent in Medicaid eligibility for 
     children in the 1980's decreased child mortality by 4.5 
     percent. In 1987, only 22 percent of Medicaid beneficiaries 
     had no physician visits within a year, compared to 49 percent 
     of the uninsured poor.

[[Page E1254]]



              COMMEMORATIVE STATEMENT FOR GEORGE F. JONES

                                 ______
                                 

                       HON. JAMES B. LONGLEY, JR.

                                of maine

                    in the house of representatives

                        Thursday, July 11, 1996

  Mr. LONGLEY. Mr. Speaker, this month of June marks the anniversary of 
the passing of a very special constituent, George F. Jones, who died in 
June 1995, at the blessed age of 105. I would like to take this 
opportunity to commemorate his remarkable life.
  Born in Gardiner, ME, Mr. Jones was a direct descendant of Samuel 
Huntington, President of the Continental Congress and a signer of the 
Declaration of Independence. George was well respected by those who 
knew him. He was a sincere believer in the American ideals of hard work 
and honesty. A man who lived by his convictions, George Jones was 
dedicated to his profession as a furnituremaker and ascertained a 
worldwide reputation. It is even rumored that furniture was sent to him 
from Buckingham Palace in the 1930's for repair.
  As a talented violinist, George Jones played for the Lincoln County 
Community Orchestra, and even enjoyed playing a little fiddle at church 
services and area dances. George also worked to aid the community as a 
member of the Alna Lodge of Masons and the Saint Andrews Society of 
Maine.
  Mr. Jones is truly missed by the many individuals whose lives he 
touched, and stands as an example for all Americans who can learn from 
his dedication to those around him and to life itself.

                          ____________________