[Congressional Record Volume 143, Number 23 (Thursday, February 27, 1997)]
[House]
[Pages H683-H689]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                HEALTH INSURANCE FOR AMERICA'S CHILDREN

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 7, 1997, the gentleman from New Jersey [Mr. Pallone] is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. PALLONE. Mr. Speaker, over the last couple of years congressional 
Democrats have been focusing their attention on addressing some of the 
most important health care challenges facing this country. Last year 
Congress took a small but important step in the right direction when it 
passed the Kennedy-Kassebaum health insurance reform bill. Because of 
that bill, citizens who change jobs will continue to receive health 
coverage, insurance companies may no longer deny individuals health 
coverage when they switch jobs due to preexisting medical conditions.
  Although congressional Democrats were happy to see Republicans join 
us in passing this important piece of legislation, we did emphasize at 
the time of the bill's passage that we believed much more needed to be 
done. And as a result of this belief and as a result of the GOP's 
refusal to consider any other health issue other than portability, 
Democrats immediately set about to build on the momentum the passage of 
the Kennedy-Kassebaum bill created by pushing for legislation that 
would make health care available to every child in this country.
  There are now about 10 million uninsured children in the United 
States. To combat this problem, Democrats incorporated a children's-
only health care plan into their family-first agenda. The plan was not 
only developed because Democrats believe our children deserve better 
health care, it was developed because of the recognition that today it 
is increasingly harder for even those parents with jobs to secure 
health insurance for themselves let alone for their children.
  Unfortunately, we have not made any progress on this issue because 
the Republican majority has refused to allow our plans to move forward. 
We are 2 months now, 2 months, into the 105th Congress, and the 
Republicans who are the majority do not have anything of major 
importance for the Congress to consider. Unlike Democrats and the 
President, they do not have a plan to ensure that all children have 
access to health care nor do they appear to have any intention of 
letting our plan move forward.
  The American people sent us here to develop legislative solutions to 
societal problems, such as providing health care to uninsured children. 
Every day we waste is a day another sick child goes without health 
insurance and we cannot continue to let this happen for moral as well 
as financial reasons.
  A couple of days ago I brought the House's attention to a report that 
was issued by the New York City public advocate, Mark Green. It 
basically talked about the growing number of New Yorkers who are living 
without health insurance.
  I know today that I am joined here on the floor with one of my 
colleagues from New York, Mr. Serrano. The report, as the New York 
Times put it, quote, is filled with disturbing information that has 
implications for the entire country.
  We are going to be talking with my colleagues from New York and from 
Texas about this report this afternoon. And although it does deal with 
New York City, I need to stress that the phenomena and the conclusions 
and findings that it comes to really apply all over this country, to 
every State and every city.
  With respect to children, the report found that between 1990 and 
1995, the proportion of uninsured children in New York City rose 6 
percent. In 1990, 14 percent of children had no health insurance. By 
1995, that figure was 20 percent. One out of every five kids in the 
largest city in the country has no health insurance.
  Overall, the report found that the number of uninsured children under 
age 18 in New York City rose from 277,500 in 1990 to 323,800 in 1995, a 
one-sixth increase, more than twice the increase in the adult 
population.

[[Page H684]]

  The trend is particularly distressing when it is recognized that not 
only was Medicaid expanded during the same period to include more 
children, but that New York State has an insurance program for children 
as well. Its own insurance program. And despite that, the number of 
uninsured children continued to increase.
  This report underscores the need to expand, not decrease, the 
accessibility of health care to children. In short, it underscores what 
congressional Democrats have been saying since last year: that 
portability is good but it is not enough. We need to build upon the 
Kennedy-Kassebaum amendment by adding a children's-only health program.
  Before we can do that, I have to stress we must convince the 
Republicans to let us move forward. Yesterday, Democratic leaders Dick 
Gephardt and Tom Daschle sent a letter to the Republican leaders Newt 
Gingrich and Trent Lott once again asking them to join the Democrats on 
making progress on this issue.

  I think the New York City public advocate's report illustrates just 
how important it is to begin the process of passing a children's-only 
health bill. Considering nothing, which is what we are doing here every 
day, day after day, and adjourning, in this case today at 12 noon, 
especially with the problem growing, as plans to confront it sit on the 
shelves collecting dust, I believe, is irresponsible and inhumane.
  I hope the Republicans accept our invitation to move forward and deem 
the issue of providing health care to our children worthy of 
congressional attention. I do not think it is too much to ask and I, 
for one, and I know my colleagues will continue to be here every day 
over the next few months until we see the majority take some action on 
this issue.
  Mr. Speaker, at this time I want to yield to my colleague from New 
York, Mr. Serrano.
  Mr. SERRANO. First, Mr. Speaker, I want to thank the gentleman for 
putting together this special order today to discuss such an important 
issue.
  I must say, as the gentleman has well pointed out, this is a very 
disturbing situation, disturbing because on this floor we take great 
pride, and we should, on a daily basis, in the fact we live in the 
country we do live in. With that, we understand that there are some 
problems we have yet to solve, but there are some basic problems that I 
think we should have solved a long time ago, and for some reason we 
continue to have these problems.
  Lately, these problems have been compounded by the fact that there is 
a feeling that somehow if you are not getting certain care in this 
country it is your own fault; that you somehow created this problem on 
your own. After all, what we have been hearing lately is if you are 
poor, it is because somehow you do not get off the chair and do 
something about your problem.
  Well, now we are talking about children specifically in this report. 
Children are at the mercy of their society. We are in this society what 
we do for children. That is who we are. We are people who either take 
care or do not take care of children. And we have a report that says 
that there are that many children throughout the Nation, 10 million 
American children according to the chart that is next to the gentleman 
from New Jersey, 10 million American children.
  Now, what is interesting about that statement is it does not say 10 
million children throughout the world. That is bad enough. It does not 
say, which would be also very bad, 10 million children in the Third 
World countries, the underdeveloped countries, 10 million children in 
one country, it says 10 million American children. And yet, as the 
gentleman states, we cannot get our colleagues on the other side to 
move on the issue of full coverage for all children.
  Now, this problem not only affects children, it affects the whole 
family. We hear a lot these days about family values, about how 
families should do for themselves. Well, there are some things that 
families cannot do for themselves. No family, except for maybe one-half 
of 1 percent in this Nation, can pay the amount of money it takes to go 
into a hospital or to get health care. That is why we have insurance 
companies. And that is why we have insurance plans, and that is why we 
have government subsidized plans.
  When we have 10 million children, and that many children, a figure 
that continues to go up in New York City and other places throughout 
the Nation, that are not insured, we have a serious problem that 
affects the whole family.
  Picture, if you will, the next study, which should be of all the 
children that are not insured; how many, because of related issues to 
not being insured, miss X amount of days from school? How many of those 
children are attending school in physical conditions that they should 
not be in? What is that doing to their ability to learn; to read and 
write, to do their work? What effect does that have on the family; the 
tension in a family? How many families have to worry about money in 
this country and that strains their relationship at home? How many have 
to deal with problems of drug addiction and that strains the 
relationship at home?
  Perhaps one of the studies should be how many of the families that 
are not insured, how many of the families who have children that are 
not insured have this extra added strain on their relationships in the 
home? And so to speak about family values, and to allow 10 million 
children to be uninsured, is really something that is hard to fully 
understand.
  One last point before I turn the microphone back to the gentleman 
from New Jersey.
  Mr. Speaker, every time that we speak in these Chambers, and on so 
many talk shows throughout this Nation our elected officials make 
public statements, we seem these days to want to attack people from 
certain communities. As I said before, one of the communities we attack 
is the poor. This one should be an easy one. This one should be one 
that no one should be politically uptight about.
  I do not know a community in this country that would be upset if 
Congress tomorrow did something about insuring children. If a community 
got upset, then there should be a study about what is wrong with that 
community. There cannot be an American family who would want for a 
neighbor's child anything less than the basic health care needs that 
they would want for their own family.
  So I would hope that today's special order begins to put forth the 
notion that there are some things that we do because they sound good 
politically, and there is opposition we take on issues because it is a 
good political stance. But this is good for our country, this is good 
for humanity, this is good for children; and we should attack this 
problem soon and attack it like we have attacked no other problem.
  Mr. PALLONE. Mr. Speaker, I want to thank the gentleman and I 
particularly appreciate when he began and talked about this notion that 
I think we do hear down here from time to time, that somehow it is your 
own fault. In other words, the reason why you do not have health 
insurance or the reason why your children do not is because it is your 
own fault and you have not done something about it.
  I think this New York City report by the public advocate really 
belies that, because it points out that the overwhelming majority of 
the uninsured, not only children but adults, everyone, are working 
people. And that, in fact, many of them are, or a significant 
percentage, are actually working in large corporations.
  So these are people that are working. These are people, in some 
cases, that are working more than one, two, or even three jobs, and yet 
their employer does not provide the health insurance and they do not 
have the option because they cannot afford the health insurances.
  Quickly, and I am quoting from the summary of this New York City 
report, it says the majority of uninsured New Yorkers work. One-half of 
New York City's uninsured residents between the ages of 18 and 64, 
because, of course, after 65 you have Medicare, they had full-time jobs 
in 1995. And among uninsured 35 to 53 years old, 62.8 percent were 
employed full time.
  Interestingly enough, again the uninsured are employed in both large 
and small companies. While nearly 30 percent of New York City's 
uninsured workers were employed in companies with 10 workers or less in 
1995, a large percentage, 22 percent, had jobs with companies with a 
thousand or more employees.
  So the bottom line is what is happening not only in New York but 
across

[[Page H685]]

the country is that more and more people, even if they work for large 
corporations, they simply have taken away health insurance and they are 
not providing it to their employees. So this is something that is 
happening across the board for working people primarily. So that whole 
notion about it is your own fault is just not the case.
  I want to yield now, Mr. Speaker, to the gentlewoman from Texas, who 
I know is very concerned about children's issues in general.

                              {time}  1330

  Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank my colleague from New 
Jersey and I appreciate his leadership. I am delighted to join my 
friend the gentleman from New York [Mr. Serrano], speaking about some 
extremely important issues, because I think the value of our special 
order and this discussion is to indicate how far reaching this problem 
is. We are talking about New Jersey and New York, and I am 3,000 miles 
away in Texas and have discovered that this problem is extremely 
prevalent in the South and in the West.
  But we need to put a face on this question, so that we can say to 
those of us who have the responsibility to address the 10 million 
children that are uninsured, we must put a face on this issue and we 
must frankly say to those who would stall this very important issue, 
you can run but you cannot hide. And I say that because there is a face 
to this.
  Angela Pollatos of Washington Heights in northern Manhattan is 
typical of those who have lost insurance in the last 5 years. She was 
cited along with this New York City report. Her husband is a painter 
who made $30,000 last year. This is a working family. His company, 
however, does not offer health coverage. How many Americans can tell us 
that same story time after time after time? Are they taxpayers? Yes. 
Are they homeowners or renters? Yes. Are they paying their bills? Yes. 
But do they have health coverage? No.
  Three years ago when Mrs. Pollatos was working the family bought 
private insurance through a Government subsidized program. Remember, 
now, bought, was not given. But the premiums are rising quickly and 
when she stopped working after the birth of a son, the family could no 
longer afford the program. Now, someone is probably saying, ``They 
didn't budget, they didn't put their moneys together.''
  I want you to be able to understand. They tried buying insurance but 
were discouraged; $500 a month was the cheapest insurance. This is a 
young family that is trying to survive on $30,000 a year, living in, I 
know what my colleague might say, certainly in a State that has 
certainly increasing costs and responsibilities, but these are working 
people and you can see that and they could not afford $500 per month, 
and I think that is important.
  When we begin to look at the insurance, or the uninsurance if you 
will, of our American children, we do not have to point to the east 
coast, we do not have to point to the west, we can point to the United 
States of America. You can find uninsured children throughout the 
United States. This is a global problem, as the gentleman from New York 
[Mr. Serrano] has said, but it is certainly a national crisis when 10 
million children are not insured. And you can look at Oregon and 
Montana, you can look in Louisiana or Alabama, Mississippi. In Texas 
alone, 1,352,894 children are uninsured. These children are under the 
age of 18.
  And so we really have a key responsibility to move forward. Sixty 
percent of the insured children have a parent working full time. More 
than 90 percent of uninsured children live in families without working 
parents. Let me correct that. Sixty percent of the uninsured children 
have parents that are working. This is truly a responsibility that I 
think must be heard throughout these Chambers.
  The gentleman from New Jersey [Mr. Pallone] and I were talking today 
about the responsibilities we have to our constituents. We were 
discussing legislation that we were drafting on behalf of our 
constituents. I think it is important that as the agenda moves through 
term limits, I do not know how many citizens are concerned about that, 
some other issues that seem like they are not having the success of 
being placed on the agenda of the floor of the House, would it not be 
very simple to immediately begin hearings, immediately begin putting on 
the floor of the House the legislation that is so important to be able 
to stem the tide of this tragedy? Ten million uninsured children.
  Let me also emphasize something that I think might have been 
highlighted earlier by the speakers. Hispanic children comprise a 
disproportionate share of uninsured children. Over 25 percent of 
Hispanic children are uninsured, along with 15 percent of African-
American children and 11 percent of white children.
  I say that not to separate us but to bring us together, to realize 
that for some folk who may have been thinking it is not me, I do not 
have to worry about it, this attacks all of our children. We do not 
have the numbers for the emerging and growing Asian population, but 
certainly we realize that that is growing as well.
  Twenty-four percent of New Yorkers have no health insurance, up from 
20.9 percent 5 years ago. The proportion of New York City's children 
who are uninsured rose to almost 20 percent in 1995, up from 14 percent 
in 1990.
  It is important, as I said, to note that we have real problems in the 
South and the West, but this report out of New York was very eye 
opening. It is important to note that about 22 percent of the uninsured 
work for companies with more than 1,000 employees, contradicting the 
conventional wisdom that large companies usually offer comprehensive 
benefits. Fewer than one-half of New York City residents now have 
private health insurance, and most uninsured families in New York make 
between $15,000 and $45,000 a year.
  When I was in local government, one of the things that saddened me 
was our inability to serve our children. This number in Texas would be 
higher if I gave you the numbers of those who were not covered by 
Medicaid and also those who could not get the basic, what we call well 
care coverage. What does that mean? Most of us recognize that a child 
does not date or time his or her illness. So they could be 5\1/2\ or 6 
years old, you can be sure you will be taking them to the doctor.
  Well, we were faced in local government with eliminating what we call 
well care coverage for our children, meaning that children who were 
dependent on Government assistance could not see the doctor past age 5. 
We had no money to give anyone so that these children could go and have 
regular appointments beyond the age of 5. We call that well care 
treatment for our children, preventative health care.

  I want Americans to understand that when we uninsure 10 million 
children, what that means is that we open ourselves up to epidemics, we 
open ourselves up to a contagious outbreak, we open ourselves up to not 
being able to prevent children from having the diseases that would 
interfere with their education and their quality of life.
  So I would simply say that we have a challenge today. We have an 
administration proposal that proposes $3 billion a year to provide 
health insurance coverage, but it covers only 5 million children. We 
want to move forward on that. But I want us to recognize that we have 5 
million children left that we must address as well.
  I certainly will be supporting and working with the proposals that 
have been offered that cover 5 million children, to work to ensure that 
13-year-olds, 250,000 of them eligible for Medicaid for the first time, 
are covered.
  We want to bring down teenage pregnancy, I think that is extremely 
important. We want to extend health insurance coverage for 6 months to 
unemployed parents, and we also want to make sure that we find all the 
children that are not on Medicaid, to make sure that that occurs.
  I simply want to say to the gentleman from New Jersey [Mr. Pallone], 
in terms of the importance of this issue, that the question of timing 
is important. Every day that we waste, this map will never change. This 
map continues to reinforce the lack of insurance, the lack of 
accessibility of medical care for our children. Let me simply raise a 
question with you.
  As we fought so hard last year to stop the drastic and draconian cuts 
of Social Security, or SSI, I am facing right now in my district 
numbers of single parents whose children received SSI for a number of 
disabilities. They could have been autistic, they had ailments that 
categorized them as being

[[Page H686]]

mentally challenged. Those children right now do not have services. 
Uninsured children likewise face not having the appropriate counseling 
services, not dealing with some of the mental illnesses that face our 
children, that could be treated to give them a better quality of life.
  My question to you is how much more do we have to document? How many 
of us will have to continue to confront these tragedies in our 
community? How many of the members of the New York community, this 
family that I have just mentioned, Pollatos, who did not have the 
dollars to pay $500 a month, will have to continue in order for us to 
be able to come to a bipartisan approach, and I would like it to be 
bipartisan, dealing with the 10 million uninsured children of working 
families, poor families, that do not have the ability to access health 
care?
  My question to you is, where are we going, and how many times will we 
have to rise to the floor, how many numbers and statistics will we have 
to give? I see my good friend from New York who is certainly aware of 
these problems, how much longer will we have to tolerate this condition 
for our children?
  Mr. PALLONE. Let me say, and I think that basically our colleague 
from New York has addressed this, that I think the problem with the 
other side of the aisle, the Republicans, is that they are following 
this philosophy that somehow it is the people's fault, it is their own 
fault.
  If you are faced with these overwhelming statistics that show you not 
only that there are 10 million American children that have no health 
insurance but that the numbers continue to grow every year and it is 
working people who are trying to make ends meet, the only conclusion I 
can draw is that you somehow, and I think many of my colleagues on the 
other side have convinced themselves that somehow it is not something 
that they can deal with, it is the people themselves that have created 
the problem. There is just no truth to that, no basis to that.
  One of the things that is most upsetting to me, and I will mention it 
briefly and then maybe yield to the gentleman from New York, is that 
when the Republican leaders of both the House and the Senate met with 
President Clinton just a few weeks ago to try to come to agreement on 
priorities, even though the President said emphatically in his State of 
the Union address and provided in his budget message to provide for a 
program that would cover at least half of these 10 million children and 
said he wanted action on that in this Congress, the Republican 
leadership refused to make that one of their priorities, so that these 
task forces or groups that were set up to try to move legislation 
through Congress on a bipartisan basis do not include children's health 
insurance, do not include the President's proposal, because the 
Republicans said that that was not a priority.
  So clearly we are not getting the message out, and we need to. We 
need to make our colleagues on the other side understand that this is a 
most important priority but we are not there yet.
  I yield to the gentleman from New York.
  Mr. SERRANO. Mr. Speaker, I thank the gentleman. One of the 
interesting things about this whole issue is that as my colleagues 
know, in many instances on these kind of issues the leadership comes 
from the White House, sort of emanates from the White House, and 
Congress reacts to it. In the past the White House did not speak, prior 
White Houses did not speak the issue of health care coverage.
  This White House did, and it was ridiculed for a plan that some 
people did not agree with. But the intent, rather than negotiating the 
plan, the intent was to stop the whole notion of coverage, universal 
coverage for everyone. And so now we find out that because of that lack 
of action and the inability to follow up on the family values agenda, 
which also should deal with this issue, you find, for instance, that 
the number keeps growing. A few years ago the number we threw around 
was 34 to 36 million Americans were not covered. The figure being dealt 
with now is 40 million Americans.
  I would also like to ask the gentleman from New Jersey to tell me if 
I am wrong on this issue, because he has been excellent on the issue of 
finding a fair immigration reform program in this country, and coming 
from New Jersey and coming from New York and from Texas, immigration is 
an issue. But is it immigration reform with a heart, immigration reform 
without a heart? Am I correct in suggesting, and I ask the gentleman to 
comment on this, that as we move to take benefits away from legal 
immigrants, we are now going to increase that number that we see on 
this chart above the 10 million children, or are those figures that we 
are dealing with these days already taking into account the possibility 
of all these folks that will be taken off the benefits, incidentally in 
many cases, for people who are interested, when you talk about people 
under 65, you are not talking about people who were here for the last 
20 years, worked, paid taxes, and so one issue seems to jump on top of 
the other one. Am I correct that this will actually increase these 
numbers?

  Mr. PALLONE. I think the gentleman is absolutely right. For example, 
in referencing the New York City report, I would take note of the fact 
that the last year that we were making reference to was 1995, well 
before any of these changes in the laws with regard to immigration 
would take effect. So there is no question that taking more people off 
the rolls as a result of those immigration policies would impact the 
numbers and create more uninsured.
  I would also suggest, again here I am speculating, that a lot of the 
problem is not even reported. In other words, the figures that our 
colleague from Texas is looking at on that map have to be based on some 
reporting that was actually done, and I would suspect that there are a 
lot of people, legal or otherwise, people that were born in the United 
States, who simply do not even get reported, so I suspect that the 
figures are much larger and there is no question that they are growing.
  Mr. SERRANO. The gentleman is absolutely right. I happen to know for 
a fact in my district that the poorer the person, the less likely they 
are to get counted in the Census. The Census does not speak about 
anything other than counting people who live within this country.

                              {time}  1345

  So if that is true and we know that is a fact, then the gentleman is 
right. The numbers there, the 10 million staggering number, could be 
higher. Because if a significant number of those folks fall within the 
poor category, and as the gentlewoman from Texas well pointed out, it 
covers all people throughout the society, people who are working, 
people who are laid off for a while, but the ones at the lower rung of 
the ladder would not go out and report, there may be no way to find 
out, and that number may continue to increase in a country where this 
should not be happening.
  Before I yield, I just would like maybe to take this time to ask 
something that may sound a little dramatic, but there are millions of 
American families who tonight will come home and there will either be a 
spouse there or there will be two spouses coming home from work, and 
throughout the night there is the ``Turn off the TV set.'' ``Did you do 
your homework?'' ``Let me help you with your homework.'' ``Turn off the 
Nintendo set.''
  Maybe I am repeating my last night's statements, but my colleagues 
know this whole thing that we go through with discipline and love and 
affection, and yet many of those families know that they do not have 
this problem. Perhaps as they are putting their children to bed 
tonight, perhaps as they are turning in for the night, they realize 
that as bad as they have it in terms of tensions, living in this 
society, they still have something other families do not have.
  But maybe that is a sign of gratefulness for what they have been 
provided with, we have been provided with, that they take a few minutes 
and write a letter to their Member of Congress and their Senator and 
say: ``You know, I just put my child to bed, and I know if he is sick 
tomorrow I can take him to a clinic or to a doctor.''
  But there are 10 million children or more whose families cannot do 
that, and there are 40 million Americans who cannot do that, and we are 
not talking here about a rip-off, we are not talking here about a 
giveaway, we are not talking here about corporate welfare. We are 
talking here about basic human

[[Page H687]]

needs, and maybe tonight Americans will take some time to write a 
letter to a Member of Congress and say: ``If this is correct, and I 
believe it is, do something about it. This is not something I am upset 
about. I will not hold you negatively accountable for providing health 
care for 10 million children.''
  Mr. PALLONE. I appreciate the gentleman's comments, and I just wanted 
to say, if I could just follow up on one thing he said before, I am an 
advocate, as the gentleman has indicated he is as well, of universal 
health care. I believe very strongly that--and I did believe when the 
President 4 years ago came forward and said this is the issue, No. 1 
issue that we must deal with, and we have to make sure that every 
American has health insurance. I believed that.
  However, we know and the gentleman mentioned that, politics being the 
way it was in the last 4 years, we really realistically, politically 
realistically, cannot envision this Congress moving toward a universal 
health care system. So we did last Congress at least address the issue 
of portability and preexisting conditions.
  The reason I believe that children's health and covering children is 
the next step in this sort of piecemeal approach that we have to follow 
because of political realities, is because not only of compassion which 
we all share for children but also because it is doable. If we look at 
the actual costs, it is cheaper to insure children than it is for the 
adults or their parents. And from a prevention point of view it makes 
the most sense because if we-- we are all advocates of preventive care, 
but preventative care is so important for children, because if they do 
have proper health care in the early years, that prevents a lot of 
things happening later that are more costly and cause more damage to 
them later in life.
  So it is a logical extension. Even if one does not believe that 
everyone should be covered or it is the government's responsibility to 
do that, at least understand that this is the next logical step. I 
think maybe that is what we can get across to our Republican 
colleagues. It has not worked so far, but maybe that is how we can 
emphasize it as the next step.
  I would like to yield to the gentleman from Massachusetts.
  Mr. McGOVERN. I just briefly want to commend the gentleman and my 
other colleagues here for raising this issue, for highlighting this 
important issue of children's health care. It is a very important 
issue. We hear it every time we go back to our districts.
  In my district in Massachusetts there is not, literally not a day 
that goes by when I am there, when I am not approached by a parent who 
is concerned about the fact that they do not have health care for their 
children. They express also their frustration that, given that reality, 
why is not Congress doing something about it? And I have to say that I 
want to express my frustration, too, over the Republican leadership's 
failure to make health care for children a priority. It should be a 
priority, and we certainly have enough time on our hands.
  I am a freshman. I was sworn in on January 7, and we really have not 
accomplished a great deal in these first 50 days. We have the time. We 
spent an entire day on term limits, 12 votes on term limits. Term 
limits may be an important issue to some, but I got to tell my 
colleagues it is not as important as children's health care, and we 
need to do what we can to raise the pressure, to try to get the 
Republican leadership to follow the President's lead in making health 
care for children a priority.
  The gentleman mentioned prevention. From a fiscally conservative, 
dollars and cents point of view, prevention is very, very important. We 
save money. If we invest in health care for our children now, it means 
we are going to have healthy adults, means we are going to be able to 
control health care costs in a more reasonable and effective fashion.

  So just from a purely dollars and cents point of view, forget the 
moral arguments and whether it is the right thing to do, and we all 
know that it is the right thing to do, we save money. We should be 
ashamed of ourselves, with the greatest country in the world, the 
richest country in the world, and yet 10 million of our children that 
we know of--and my colleague from New York is right, it is probably 
much more than that, but we know at least 10 million children in this 
country do not have health care coverage and we need to do something 
about it.
  So I just wanted to come on the floor here and express my gratitude 
to all of my colleagues for raising this issue. It is an important 
issue, and I hope that we will be able to do something about it in this 
session.
  Mr. PALLONE. I want to thank the gentleman for his contribution and 
appreciate him participating in this special order, because I know that 
in his State in particular many efforts have been made to try to expand 
health care coverage. But, as we noticed in this New York survey, even 
with the States going out of their way in many cases to expand coverage 
it still--we still see an actual decline in the number of insured.
  I yield to the gentlewoman from Texas.
  Ms. JACKSON-LEE. I thank the gentleman from New Jersey, and I am glad 
as well that the gentleman from Massachusetts has joined us, and I 
would like to maybe expand, Mr. Serrano, the gentleman from New York's, 
call. I think I would not put it as a pitch but a call to families who, 
although they face their daily responsibilities, can count their 
blessings.
  I would like to acknowledge and possibly add to that the many 
children's hospitals around the Nation. First, I would like to thank 
them. I think 2 to 1, the children's hospitals in our community, 
certainly the Texas Children's Hospital, I know that we can name so 
many others, keep their doors open as best they can.
  I know that we have had circumstances where we have that great 
tragedy of drive-by emergency rooms, where they just cannot, because of 
capacity, take in more children. Why is that? Because an epidemic of 
measles has broken out, because an epidemic of small--not smallpox but 
chicken pox has broken out. Thank goodness we have overcome that. But 
just think of the times we have had these sort of epidemics, and 
therefore the hospital or facility is filled beyond capacity.
  Part of the reason that this has come about is the very statement the 
gentleman just made. We have not had the kind of preventive health 
care, and I would like to add to his story that he has just given, an 
ounce of prevention is worth a pound of cure.
  And so I would like to add, to those who would be calling upon the 
need for health insurance to cover all of these children located across 
the Nation, our medical professionals, our pediatricians, our 
facilities that deal with children. They most of all know the 
seriousness of the need for having children have preventive care, and I 
would like to just bring a point to my colleagues' attention:
  Studies have shown that the majority of uninsured children with 
asthma never see a doctor. How many of us are aware of asthma but do 
not realize that it can be deadly, and that the survival of a child and 
the child growing into adulthood is the fact that they have good 
constant care? And many of these asthmatic children are later 
hospitalized with problems that could have been averted with earlier 
intervention.
  I have seen parents of children with asthma. Asthma has been in my 
family, though I have been very lucky that my children did not come 
down with it, but I have seen what asthma can do. We do not think of it 
sometimes as a debilitating disease. It is a chronic disease. To think 
of children with asthma not being able to see a doctor.
  Maybe we are more sensitive to a broken leg or an injured arm, but 
realize children who suffer every day with these sort of ailments, 
children who need--as I said earlier, I do not want to deemphasize the 
importance of children who need counseling, and of course that is 
another subissue of this whole question of being insured. But many of 
those that would be covered would be psychologists or psychiatrists. 
Those children, too, could be healed with the kind of insurance that we 
would have and be allowed to secure a better quality of life.
  I would simply say to the gentleman from New Jersey [Mr. Pallone], I 
hope people understand that what we are talking about is the quality of 
life for our children that many of us have been able to garner through 
hard work, of course. But these innocent children,

[[Page H688]]

who come into this world certainly not of their own accord, but we are 
blessed that they are here, they are uninsured and not able to take 
care of the illnesses that face them every single day.

  I think it is important, again, that this House gets down to the 
people's business and works on behalf of our children by passing this 
legislation both sponsored and supported by the President, many of our 
colleagues. Certainly leader Gephardt and minority leader Daschle were 
calling for this to move quickly. I hope that we can hear a date for 
this to be on the House floor posthaste.
  Mr. PALLONE. I appreciate that.
  Mr. SERRANO. Just as my colleague was speaking, I was reminded of the 
fact that just this week the New York State Health Department came into 
my congressional district or a certain part to do a special study on 
why that part of New York City has a higher rate of asthma attacks than 
anywhere else in the city.
  And, as the gentlewoman said, this is in many cases a silent 
situation because people take it as something: ``Well, I have heard 
about it. It does not affect me. It is not a broken leg,'' as she said. 
``It is not something I can see every day. I do not see it in the 
subway.'' We see somebody short of breath or something in the subway in 
New York, and we assume it is whatever, they were running down the 
stairs to catch the train because they were going to miss it.
  So this itself starts me thinking how much of an implication this has 
on this whole study that will be conducted now in my district. It would 
just seem to me that the last call that we can make here is to say we 
have been hearing a lot of statements about family values, I repeat 
once again.
  This is a family values issue, but it is an issue of how much we 
value families. And if we value families, then we must value the health 
care provided for the children. We cannot on one hand expect families 
to behave in a certain very nice, humanitarian American way, humane 
American way, and then at the same time have 10 million-plus children, 
families who are going through that situation, who face that on a daily 
basis, cannot react to everything else in society the way we expect 
them to.
  And so I would hope that we see this in fact as a family values 
issue, an issue of how much we value families, and solve it. We can. We 
have the ability. All we need is the word from the other side and it 
can happen, it can happen soon.
  Mr. PALLONE. I think the gentleman is absolutely right, and that is 
why this is a important part of the Democrats' ``families first'' 
agenda.
  What my colleague pointed out, though, if I could follow up--and we 
have I guess about 15 minutes left, and we do not have to use the whole 
time for our one hour--but if we could just focus a little bit on 
solutions, because there are solutions, and as we mentioned before, in 
many ways this is an easy problem to solve. It just takes the will, in 
this case, of the Republican majority to bring this bill or something 
like it to the floor.
  There are really a lot of ways of looking at this, but in the case of 
the New York public advocates' report, they actually advocate two 
things which I think I favor, and maybe I could mention one other thing 
that they did not mention.
  One is, they suggest essentially expanding the Medicaid program to 
cover people at higher levels; in other words, Medicaid now may take in 
people at 100 or even 200 percent of poverty, but not above that. Also, 
New York State, from what I understand, and maybe my colleague from New 
York would be more familiar with it, has a State-developed child health 
plus insurance program that essentially goes beyond Medicaid. The State 
subsidizes it, but it takes in people who would not normally be 
eligible for Medicaid. And most approaches to expanding health care 
coverage for children that I have seen either approach it by expanding 
Medicaid or looking at some other government subsidized, usually 
nonprofits program that would cover people that are not on Medicaid.

                              {time}  1400

  The third arm of this, though, that is not mentioned by the public 
advocate, at least to my knowledge, but I think is just as important, 
is outreach, because what the public advocate in New York City actually 
identifies is that there are a number of people that are eligible for 
the Medicaid Program or eligible for the child health plus program that 
are not using it.
  So I think whatever we develop has to have an outreach program, 
because there are a lot of people who are not taking advantage of 
existing programs, for whatever reason, either because they are not 
aware of it, or if you talk about children, if their parents are not 
aware of it, they cannot take advantage of it.
  I do not know if she wants to talk a little bit about this, but I 
yield to my colleague, the gentlewoman from Texas [Ms. Jackson-Lee].
  Ms. JACKSON-LEE of Texas. I think the outreach is key. That was 
certainly part of the administration's proposal, to find individuals 
who could comply or meet the criteria of Medicaid who have not been 
aware of it, and would certainly be able to secure that coverage.
  I would like to add another piece for thought. Certainly I know we 
will hear from many of our local governments that they are 
overburdened, but many of our cities have city clinics, and one of the 
aspects of their service is what I described as well care. That is 
preventative care.
  I think if we can find some aspect of our legislation that would 
cover that aspect of treatment, where parents of certain eligibility 
could continue to take their children, say, to age 10 or 12 for well 
care, that is, all the preventative measures, to ensure that they have 
all of the immunizations.
  We have treated immunizations in this country as crises. That means 
we will have big campaigns, we will go out with vans. We have not 
gotten the mind-set of parents and the availability where, on a regular 
ritual, those parents who do not have regular physicians or 
pediatricians still are getting their children immunized; certainly our 
school districts, our work, but our health clinics certainly should be 
a component of the well care. We are not asking them to treat the 
emergencies, chronic illnesses, but if they are a component of delivery 
of health.
  And I can hear a lot of them right now say in horror, we do not have 
the money. But I think as we look as a national body about how we reach 
out, I would assume my colleague, the gentleman from New York, has 
several city health clinics and he might hear the same thing, they are 
overloaded, but they are still accessible to our communities, along 
with--let me add that I think I would like us to consider school-based 
clinics where children go most of all.
  I would like to say, we may cause a great deal of furor here on the 
floor of the House, but I would like to literally ask Americans to send 
us their stories. Tell us what is going on out there. We all know what 
is going on in the 18th District in Texas, in New Jersey and in New 
York.
  But I would like to hear the stories of Americans, the parents and 
guardians of these 10 million children, the grandparents, who equally 
are custodians of these children, who for several reasons would not 
have access to health insurance for these children. We want to hear 
your stories.
  Maybe that, along with stories from pediatricians and others, would 
be able to help build the argument, if you will, for the immediate 
response to try to come up with legislation that will cover these 
children.
  I hope that the question of reaching out will be addressed, as I 
said, by embellishing local city health clinics, giving them the 
resources they can treat in preventative care up to age 10 or 12, that 
we can look at school-based clinics. That is where parents and children 
go.
  Certainly I would like to ensure that we reach out to those who are 
eligible for Medicaid and cannot get it. Thank goodness we did not 
block grant, something we fought so very hard against. A lot of people 
do not even understand when we say block grant, but that is a fight we 
may have to see again; where there is a need, we may be able and should 
be able to serve Americans. And that was not the thrust of block 
granting; that was to cut off moneys. We fought hard, the Democrats 
did, against that. Now we have another cause that can be bipartisan 
from the very start, to be able to work with 10 million uninsured 
children.

[[Page H689]]

  Mr. PALLONE. Mr. Speaker, I am glad the gentlewoman brought up the 
community-based health clinics. I have some in my district, as well. 
The problem, of course, they face is scarce resources. In other words, 
increasingly the amount of money that has been made available to them 
has dwindled. That is another reason why we see the ranks of not only 
the uninsured but even people who have access to health care, because 
they are really dealing with the uninsured in many cases, but the 
access becomes more limited as resources become scarce.
  I yield to the gentleman from New York, [Mr. Serrano].
  Mr. SERRANO. I thank the gentleman, Mr. Speaker.
  My colleague, the gentlewoman from Texas makes an interesting point. 
That is, we should deal with the issue of prevention. You know, we 
Americans are really a very strange group of people at times. Who would 
not think of taking their car for an oil change or doing it themselves? 
There are some Americans who run the car into the ground, but most 
Americans know they have to do this. They either do it themselves in 
their driveway or somewhere, or they take it to a place to have it 
done. That is understood.
  But the whole idea of taking a human being at the age of under 10 to 
a clinic to get some preventative health care, some wellness care, is 
beyond our scope of thinking. Yet, at the end of the game when we talk 
about dollars and cents, as the gentleman has so well pointed out, and 
the gentlewoman, we are saving lots of money by going in the area of 
prevention. So I would hope that in this package, and I agree, there 
has to be something that perhaps begins to tell us about the area of 
prevention.

  As far as solutions, what is really sad about this whole argument is 
that the solution we already have. The bad news is that 40 million 
Americans are not covered. The good news is that if you do quick math, 
over 200 million Americans are covered. Therefore, under existing 
plans, through expansion and with the desire to do so, you can invent 
ways and bring about ways of covering the other 40 million. So we do 
not have to reinvent the wheel. What we have to do is simply look at 
what we have now and use it as the existing solution to move on to 
cover other people in the area where we should not allow disparity 
between different folks.
  Because in other parts of the society we have these problems and we 
have to deal with them on a daily basis. The fact is that most likely 
the people that are on that chart will also be the people who will have 
less access to a computer in the home than other people in this 
society. We know that. But this one is a basic right at this moment 
that people all deserve and we should be dealing with.
  So the solution, in answer to your question, which is an interesting 
point you bring up, because we certainly do not want to end this hour 
having people say sure, they brought up the problem, they did not offer 
a solution, the solution is 200 million Americans, 99 percent of whom 
are not wealthy people, are covered under existing plans. It is now a 
matter of finding out how do we cover the other 40 million, how do we 
take care of people who may be unemployed, and how do we especially 
take care of children.
  I would end today, again, by calling on Americans who may have health 
insurance, who may have a difficult, at times, life, but most of the 
time can as our colleagues said, count their blessings, to reach out to 
their Members of Congress and say that this is not something that can 
go on. Let us do something about it. Let us expand existing programs. 
Let us find solutions to this problem.
  Once again, I thank the gentleman from New Jersey for bringing forth 
this issue today. This is one that I think really begins to speak to 
what this Congress should be about. If this Congress and this society 
cannot take care of its children, then it will not take care of 
anything else in this society.
  Mr. PALLONE. I agree, and I want to thank the gentleman. I know we 
are winding down.
  Ms. JACKSON-LEE of Texas. Before we close, let me thank the gentleman 
as well for gathering us together on this special order, and hopefully 
our voices were heard in this Chamber as my good friend, the gentleman 
from New York, has said, on behalf of the children and the solutions 
that we have offered. We can get busy right now and get moving on an 
ounce of prevention that will certainly create the wall against the 
pound of cure that we may face with children who have not had health 
care for all of their childhood.
  I thank the gentleman very much and look forward to working with him.
  Mr. PALLONE. Mr. Speaker, I want to thank both of the Members, and 
again issue our challenge to our colleagues on the Republican side of 
the aisle.
  Once again, I think we had one vote today on the Journal, on the 
Journal of the previous day, and no other legislative business, and it 
is only Thursday. I personally, and I know all of us, are getting 
frustrated coming down here day after day and not really doing 
anything.
  This is an issue, children's health care, that needs to be addressed 
immediately. We will continue to call upon our colleagues in the 
Republican leadership on the other side to address this issue this 
Congress, and as soon as possible.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise today to voice my 
concern for the 10 million children in our Nation who are without 
health care insurance. I am here to urge each and every one of my 
colleagues to work toward guaranteed access to health care for all 
children. It is time for us to make America's children and their health 
and well-being our highest priority. We must make health care 
available, accessible, and affordable for all of our children.
  I am concerned that many of my colleagues have dismissed these 
children as the offspring of the same disadvantaged persons that they 
condemned last year during the welfare debate. If that was an accurate 
characterization of America's uninsured children, I would beg you not 
to blame a child, for their parents' misfortune.
  But it is not an accurate picture, and so instead, I say you are 
wrong. Nine out of ten children who are without health coverage have 
parents who work. Nearly two in three of these children have parents 
who are employed full-time during the entire year. Two-thirds of these 
children live in families with income above the poverty line and more 
than three in five live in two-parent families.
  It is clear that these children are not uninsured because their 
parents are not unemployed. Instead, most of these children are without 
coverage because their parents work for companies who have cut health 
coverage for children or who offer no health coverage at all. Each year 
since 1989, 900,000 fewer children have received private health 
insurance coverage. In other words, every 35 seconds 1 less child is 
privately insured.
  Without private insurance, millions of working parents who labor to 
support their families cannot afford to provide health coverage for 
their children. The cost of health insurance when not purchased through 
an employer is often prohibitive. So while Medicaid helps our poorest 
children, and more affluent families can afford private coverage, 
millions of working parents in the middle cannot provide coverage for 
their children.
  Insurance coverage is critical to the health of our children. 
Children without health insurance coverage often do not receive 
necessary treatment services or even the most basic care. Medical 
expenses are sufficiently high that generally their financially 
burdened parents will delay or forgo needed pediatric preventive or 
medical care.
  Some examples--studies have shown that the majority of uninsured 
children with asthma never see a doctor. Many of these asthmatic 
children are later hospitalized with problems that could have been 
averted with earlier intervention. One-third of uninsured children with 
recurrent ear infections do not see the doctor and some later develop 
permanent hearing loss. Many children with undiagnosed vision problems 
cannot even read a blackboard. Finally, studies show that children 
without insurance do not receive adequate immunization, have higher 
rates of visits for illness care, and have more frequent emergency room 
visits.
  It is obvious that to deny children health care coverage, denies them 
the opportunity to lead healthy lives and to reach their fullest 
potential. We, in this Congress, have a responsibility to ensure that 
all children have these opportunities. We must commit ourselves to 
coverage for every American child and promise to leave no child behind.

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