[Congressional Record Volume 142, Number 139 (Tuesday, October 1, 1996)]
[Senate]
[Pages S12128-S12129]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KERRY (for himself and Mr. Kennedy):
  S. 2186. A bill to provide access to health care insurance coverage 
for children; to the Committee on Labor and Human Resources.


      the healthy children family assistance health insurance act

  Mr. KERRY. Mr. President, I am proud to introduce legislation today, 
joined by my friend, colleague, and esteemed senior Senator, Ted 
Kennedy, to help ensure that the 10 million uninsured children in this 
country get the health care they need and their parents get the peace 
of mind they deserve.
  Mr. President, the fact is that most of these 10 million uninsured 
children have parents who work--90 percent of these uninsured children 
have parents who work, according to the General Accounting Office 
[GAO]. And three out of five of these children have parents who work 
fulltime during the entire year.
  Unfortunately, the problem of uninsured children is getting worse, 
not better--each year, more than 1 million additional children lose 
private insurance. No parent should have to choose between medicine for 
a sick child and food for the family. The thought of a mother and 
father, working hard to make ends meet, waking up in the middle of the 
night with a child in pain, and waiting to see if the pain passes 
because they cannot afford to go to the hospital, is a stark image of a 
national tragedy. Mr. President, American children without health care 
are alone in the world--we are the only Western industrialized nation 
that does not provide health care for every child.
  I am proposing today with Senator Kennedy a voluntary subsidy program 
to help working families to purchase private health insurance for their 
children. Only families with incomes too high to qualify for Medicaid 
would be eligible to receive these vouchers. Participation in the 
voucher program would be voluntary. The premium subsidy would be 
provided on a sliding scale with families earning 185 percent or less 
of the poverty line receiving the full subsidy; the subsidy would phase 
down so that families earning more than 300 percent of the poverty line 
would not receive a subsidy. Cost-sharing would be limited but everyone 
would pay something. The proposal includes a comprehensive benefits 
package with a full range of the essential services needed by children. 
The total cost of the plan is $24 billion over 5 years and is paid for 
by a combination of cuts in corporate welfare and a tobacco tax 
increase. Although it is apparent there is no chance the plan will be 
enacted this year, with Congress now in its final hour before 
adjourning prior to the election, we are introducing it as a bill today 
because we want to place this issue prominently on the national agenda 
during the next few months preceding convening of the 105th Congress.
  Mr. President, I want to discuss 2 of the 10 million compelling 
reasons to provide basic health insurance to children who are not 
covered now.
  One of the first reasons is a 13-year-old student in Lynn, MA, named 
Costa Billias. He played football at Breed Junior High and loved the 
game, but said, ``For the past 2 years I gave my best to football, but 
my mom explained that we were not insured and if I got hurt we would 
lose our house and everything we own to pay the hospital.'' He quit the 
team, but he cannot quit life. If he gets hurt doing something else, 
his family still stands to lose everything. In addition, I think it is 
wrong that Costa Billias is being denied the opportunity to play 
football again.

  One more of the 10 million reasons we must pass this bill is the 
Pierce family. Jim and Sylvia Pierce were married in 1980 and live in 
Everett, MA. Jim was a plumber and they had three children, Leonard, 
Brianna, and Alyssa. In October 1993, Sylvia was pregnant with her 
fourth child when Jim was tragically killed on his way home from the 
store. In that one horrible minute her life changed forever. She not 
only lost her husband, but, pregnant and alone, she lost her health 
insurance as well. Her survivor's benefits made her income too high to 
qualify for long-term Medicaid, and too low to pay the $400 a month it 
would take to extend her husband's health plan. Sylvia said, ``I've 
always taken good care of my children. I feed them well; I take them to 
the doctors immediately when they need it. All of a sudden I couldn't 
do that anymore.
  Mr. President, in addition to the moral imperative, the scientific 
evidence is overwhelming that lack of health coverage is bad for 
children, delaying medical care or making it impossible to get. A 
recent study in JAMA [the Journal of the American Medical Association] 
found that children with health coverage gaps were more likely to lack 
a continuing and regular source of health care--even when factors such 
as family income, chronic illness, and family mobility were factored 
out. Numerous studies by university researchers and by government 
agencies show that the uninsured are less likely to receive preventive 
care (such as immunizations for children), more likely to go to 
emergency rooms for their care, more likely to be hospitalized for 
conditions that could have been avoided with proper preventive care, 
and more likely to have longer hospital stays than individuals with 
health insurance coverage.
  Mr. President, every hour we wait to take this step, another 114 
children lose private health insurance. Every 30 seconds we wait, 
another child loses private health insurance. America's children cannot 
wait any longer. Families without insurance are forced to pay the full 
cost of medical services--an impossible burden for struggling families, 
one that often takes a back seat to putting food on the table and a 
roof over the children's heads.
  Mr. President, this plan is an important, incremental step toward 
guaranteeing health coverage for all Americans. I urge my colleagues to 
support it.
  Mr. KENNEDY. Mr. President, it is an honor to join Senator John Kerry 
in introducing this visionary and practical program. Senator Kerry has 
been a consistent leader in the Senate in fighting for children, for 
health care, and for working families. This initiative sets a benchmark 
for the next Congress and the American people. It is a proposal that is 
a reflection of true family values.
  Every American child deserves a healthy start in life, but too many 
don't receive it. Seventeen industrialized countries do better at 
preventing infant mortality than we do. A quarter of American children 
do not receive basic childhood vaccines. Every day, 636 babies are born 
to mothers who receive inadequate prenatal care, 56 babies die before 
they are a month old, and 110 babies die before they are a year old.
  Access to affordable health care is one of the greatest problems 
children face. Ten-and-a-half million children under the age of 19 have 
no health insurance--one in every seven American children. If it were 
not for the expansions of Medicaid over the past 5 years, the number 
would be seven million higher. Under Republican proposals to cut 
Medicaid, four million children would lose their coverage. Employer-
based insurance coverage is eroding. Too many pregnant women--more than 
400,000 a year--are uninsured, and lack access to critical prenatal 
care.
  Almost all uninsured children are members of working families. Their 
parents work hard--40 hours a week, 52 weeks a year. But all their hard 
work does not buy their children the protection they deserve. Every 
family should have the right to health security for their children. No 
parents should fear that the loss of a job or their employer's failure 
to provide coverage will put their children out of reach of the health 
care they need.
  Health insurance coverage for every child is a needed step in the 
fight to guarantee health care for every family. The cost is 
affordable. The benefits are great. The opportunities for 
bipartisanship are substantial.
  The legislation we are introducing today is a simple, practical 
proposal. It imposes no new government mandates on the States or the 
private sector. It does not substitute for family responsibility. It 
fosters it, instead, by assuring that every family has the help it 
needs to purchase affordable health insurance for their children.
  Our plan will establish no massive new Federal bureaucracy. Basic 
guidelines and financing would come from the Federal Government, but 
the plan

[[Page S12129]]

would be implemented and administered by States.
  The program will make a major difference in the lives of millions of 
families, but its basic principles are not novel or untested. Fourteen 
States already have similar programs in place and running. Earlier 
their year, for example, Massachusetts enacted a program very similar 
to our proposal.
  Under our plan, the Federal Government will assist all families with 
incomes under 300 percent of poverty to purchase health insurance for 
their children, if they do not already receive coverage under an 
existing public program. Families with incomes under 185 percent of 
poverty will receive a full subsidy. Families with incomes between 185 
percent of and 300 percent of poverty will receive assistance on a 
sliding scale. Between 80 and 90 percent of all uninsured children live 
in families with incomes below 300 percent of poverty. Even uninsured 
families with higher incomes might buy coverage for their children if 
policies designed for children were available. Families with income 
under 150 percent of poverty will also receive assistance with the cost 
of copayments and deductibles. Similar assistance will be provided to 
uninsured pregnant women.
  The program will be administered by States under Federal guidelines. 
In general, States will contract with private insurance companies to 
offer children's coverage to any family that wants it. Lower income 
families will receive assistance with the cost of coverage, but 
coverage will be available to all families at all income levels. Basic 
rules will guarantee that coverage is adequate and tailored to the 
special needs of children, especially the need for comprehensive 
preventive care.
  This plan does not guarantee that every child will have insurance 
coverage, but it gives the opportunity to every family to cover their 
children at a cost the family can probably afford. It will be a giant 
step toward the day when every member of every American family has true 
health security.
  The cost of a similar program has been estimated at $24 billion over 
5 years. We propose to finance our plan by a combination of tobacco tax 
increases and closing corporate tax loopholes. The Nation currently 
spends close to $1 trillion per year on health care. The additional 
cost of this proposal is substantial, but it is a needed step toward 
healthier lives for millions of American children and peace of mind for 
their parents.
  In this Congress, we made substantial progress toward improving the 
health care system. We turned back extreme proposals to slash Medicare 
and Medicaid. Working together in a bipartisan way, we were able to 
pass the Kassebaum-Kennedy Health Insurance Reform Act, take a 
significant first step toward mental health parity, and protect mothers 
and infants from premature discharge from the hospital. Every 
Democratic and Republican health plan in the previous Congress endorsed 
the idea of subsidizing private insurance coverage for children. This 
proposal should be a bipartisan health priority for the next Congress. 
I believe it is an idea whose time has finally come.

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