[Congressional Record Volume 142, Number 129 (Wednesday, September 18, 1996)]
[Extensions of Remarks]
[Page E1636]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          HEALTH CARE FOR KIDS

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                     Wednesday, September 18, 1996

  Mr. STARK. Mr. Speaker, I am introducing today a bill to require 
insurers to offer health insurance policies for kids, coupled with a 
sliding scale 80 percent refundable tax credit to help families buy 
such insurance policies.
  There are 10 million children in the United States without health 
insurance. Health insurance equals access to health care. Access to 
health care equals better health and a better quality of life. It is 
that simple. As a recent article in the Journal of the American Medical 
Association (JAMA, August 14, 1996, p. 477) so well said:

       . . .access to health care is dramatically increased if one 
     has health insurance, and this increased access has in turn 
     been shown to improve outcomes, such as whether one lives or 
     dies. The most significant action within the health system 
     that we can take to preserve health and improve longevity is 
     to provide health insurance to everyone.

  The bill I am introducing is about the life and death--and lifetime 
productivity--of our Nation's children.
  This bill is not a mandate; it does not require any individual to buy 
health insurance. It does, however, make sure that there is widespread 
competition in the offering of these health insurance policies and it 
does help families, even very low income families, buy a policy of 
their choice.
  Health insurance for children in America is getting worse--not 
better. With the cuts in Medicaid, it may get disastrously worse. We 
desperately need to reverse the trend of rising uninsured rates for 
children. The General Accounting Office recently issued 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.

  To repeat, health insurance can mean the difference between life and 
death--and between a good quality life and a stunted life. The GAO's 
report I have just cited provides a concise 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.

  My bill is a small, incremental step forward. If is by no means 
everything I would like. If I could waive a magic wand, I would make 
sure that everyone in America had high quality health insurance 
tomorrow morning. That is not going to happen--but this small step, 
starting with children, could help millions of children grow up to be 
healthier, more productive citizens. Like my amendment which started 
the COBRA Health Continuation Program which has been used by 40 million 
Americans, this bill could make a world of difference to millions of 
Americans in the years ahead.
  Under the bill, insurance companies would be subject to a tax penalty 
if they did not offer for sale--so-called guaranteed issue--a policy 
which provided a Medicare-type package of health benefits, with 
additions designed for well-baby and well-child care and with a 10 
percent--but no more than $10 per Part B service--rather than 
Medicare's 20 percent copay. By requiring insurers to offer such a 
benefit package, consumers will be able to shop widely for a policy 
they can afford. The competition in this sector should help make 
affordable policies available.
  The key problem is to make this policy affordable to the families of 
the 10 million uninsured. The basic reason so many children are 
uninsured is that they are in working families which are not eligible 
for Medicaid, but the families do not have health insurance offered 
through the workplace and cannot afford the $500 to $700 per child 
these policies will probably cost. Therefore, I propose a refundable 
tax credit to make the policies affordable. The tax credit/payment will 
be phased out at the rate of 50 cents per dollar of tax liability of 
the purchaser.
  In the past, refundable tax credits have had integrity problems. I 
propose to avoid this abuse of the program by requiring that the 
taxpayer submit a 1099 type form with their tax form, in which the 
insurance company will certify that a tax-qualified kid's insurance 
policy has been purchased. The companies will, of course, also submit 
this documentation directly to the IRS so that a data match can be 
performed before refunds are issued.

  I do not spell out how the 80 percent credit is to be financed, but 
the money can be found as part of a future reconciliation bill. If 
additional funds can be found, the credit percentage can be phased out 
more slowly to help additional families.
  To repeat, the bill is not a mandate, but a chance for parents to 
have affordable private health insurance for their children. It uses 
the private market exclusively. It is a first step and as additional 
moneys become available, we can add a maternity and prenatal benefit 
for mothers-to-be and a slower phaseout of the credit.
  I welcome cosponsors of the bill, and comments and suggestions from 
the public on ways to improve the bill and to help finance the 
proposal. I am introducing the bill late in this Congress so that the 
public can review the bill before the start of the 105th Congress and 
suggest changes and improvements before its reintroduction in the next 
Congress.

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