[Congressional Record Volume 143, Number 27 (Wednesday, March 5, 1997)]
[House]
[Pages H747-H748]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      CHILDREN'S ONLY HEALTH CARE

  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, I am here today to once again talk about 
the need for Congress to pass a children's only health care bill and 
the Republicans' continued refusal to let this Democratic plan move 
forward.
  Again we are here in the middle of another week, in the third month 
of the 105th Congress, and the Republicans basically have nothing to 
do. Ten million American children have no health insurance, yet day 
after day after day the Republican leadership schedules no real 
business for the House of Representatives to consider.
  Yesterday was a perfect example of just how little the Republicans 
have to do. Even though Democrats have legislative plans to provide 
health care to the Nation's 10 million uninsured children ready for 
consideration, the Republican leadership decided it was more important 
to debate a symbolic measure about the Ten Commandments.
  Let me repeat that, Mr. Speaker, because it is really kind of 
unbelievable when one thinks about it. Instead of allowing legislative 
plans to ensure that all American children have health insurance to be 
considered, the House Republican leadership felt it was more important 
to consider a symbolic measure on how Congress feels about the display 
of the Ten Commandments in Government offices and courthouses.
  The point is that children's health care, pure and simple, is 
something that needs to be addressed. The problem of uninsured children 
continues to grow as Congress watches from the sidelines. Indeed, last 
week I was joined by colleagues, some from New York, to discuss a 
report released by the New York City public advocate, Mark Green, that 
found a disturbing rise in the number of uninsured children in New York 
City.
  As congressional Republicans continue to prevent the Federal 
Government from taking action to confront this problem, what is 
happening, essentially, is that various States around the country are 
trying to make some progress on the issue. An excellent example of such 
action was just published in an article about the action the State of 
Massachusetts has taken to implement a children's only health plan. 
This was in the New York Times on Friday.
  I am pleased today to talk a little bit about that, because I think 
that the Massachusetts children's medical security plan, which is the 
name that is given to this proposal, is basically a good plan, designed 
to insure children whose parents earn too much money to qualify for 
Medicaid coverage but still cannot afford to purchase health care for 
their kids.
  We have been through this before. If the family is eligible for 
Medicaid, then they have health insurance coverage. But we have a lot 
of people, working people, people that are on the job, in many cases 
both parents working at separate jobs, who do not get health insurance 
through their employer. They are not eligible for Medicaid because 
their income is not low enough, and so they simply go without health 
insurance for their children because they cannot afford to pay a 
premium that they would have to obtain privately or through some other 
means.
  So basically what Massachusetts did was to try to come up with a plan 
to deal with those individuals who were above the income level for the 
Medicaid threshold but still do not get health insurance on the job for 
their children or who cannot afford to pay for health insurance 
privately.
  The article in the New York Times details some individuals. For 
example, Mark Leary, of Lawrence, MA, was able to take his 3-year-old 
daughter to doctors to receive treatment for an ear infection even 
though the supermarket he works for does not offer health insurance.
  It also talks about another individual, Paula Lincoln of Rockland, 
MA, who was able to still bring her children in to the doctor for 
checkups after she lost her teaching job.
  It mentions another self-employed person, Elaine Choquette of 
Blackstone, MA, who uses the program to pay to bring her two sons to 
the doctors as well. Miss Choquette was quoted as saying, ``I pay my 
taxes, and I never thought of it being anything compared to welfare.''
  This is not a welfare program. This is a program in the State of 
Massachusetts for working people. The program in Massachusetts is very 
much like many of the proposals that Democrats here in Congress have 
developed. Most of the programs awaiting consideration are like the 
Massachusetts program. They are designed to help hard working parents 
who make too much money to qualify for Medicaid yet still cannot afford 
health insurance for their kids.
  The really big difference between the Massachusetts program and the 
various Federal programs awaiting consideration is that theirs has been 
enacted. In other words, the Massachusetts Legislature actually 
considers and passes legislation in response to societal challenges, 
and the Republican-controlled 105th Congress clearly does not.
  The New York Times article on the Massachusetts plan reports that 
Representative Bill Thomas, the California Republican who heads the 
Subcommittee on Health of the Committee on Ways and Means, said in 
early February that he would soon hold hearings to get a sense of the 
scope of the problem of kids not having health insurance. But it is now 
March, and although we have debated the merits of hanging the Ten 
Commandments on the wall of Government buildings, I have yet to see a 
hearing on the issue held or a legislative plan examined.

                              {time}  1500

  Again, every day the Republicans waste is another day that parents 
have to endure the reality of being unable to take their children to 
the doctor. This is no small price to pay.
  I have to say that the Massachusetts State Health notes that while 
uninsured children had always had access to emergency treatment, the 
State's health plan now allows parents to bring their children in for 
routine medical visits, check on immunizations, and tests for lead 
poisoning.
  One of the points that we have been trying to make during this debate 
on kids' health insurance is that it may very well be that in some 
cases, perhaps even in most cases when an uninsured child gets really 
sick, that they end up going to the emergency room and they get some 
type of care. But that is not the way the health system should operate. 
They need preventative care. They need vaccinations. They need to go to 
the doctor for routine checkups. We do not want a situation where the 
only time children get any kind of medical treatment is if they really 
get ill and they have to go to the emergency room.
  It is my hope that the Republicans will recognize that while we seek 
to enable children to receive treatment, the matter itself is not 
routine. This is an urgent matter. Any kind of obstructionism on the 
issue of kids' health insurance I believe is really callous, and the 
Democrats, of course, continue to articulate and move forward with 
various plans that both the President and other of my Democratic 
colleagues have put forward.
  I just wanted to talk a little about some of the things that 
Massachusetts

[[Page H748]]

does to give an idea of how this would actually work.
  Again in Massachusetts, very similar to what happened here at the 
Federal level, there was an effort a few years ago to try to come up 
with a universal health care system where the State would basically 
provide health care or health insurance, I should say, for everyone. 
But in the same way that we were not able to accomplish that on a 
Federal level, the effort instead began to focus sort of in a piecemeal 
fashion on what elements of the uninsured could be insured effectively 
and at a reasonably affordable price.
  One of the points that we keep making, those of us who would like to 
see kids' health insurance enacted, is that it is very affordable. It 
does not cost a lot of money to provide health insurance for kids. And 
we are talking about 10 million children right now that do not have 
health insurance. If you look at it in the spectrum of things, it is 
relatively cheap to provide insurance for them.
  Basically, Massachusetts recognized this. They figured that if they 
could not move for health insurance for everyone, at least they could 
move for health insurance for children. Just to give some idea of how 
they did it, they expanded both their Medicaid program and the 
Children's Medical Security Plan, which was a State plan they had in 
effect beginning in 1993. Medicaid paid for a significant part with 
Federal dollars but now covers everyone up to 133 percent of the 
poverty level or all families of four with incomes up to $20,748 a 
year.
  So what they did is they expanded Medicaid so that it covered a 
little higher income level, 133 percent of the poverty level, for 
families of four with incomes up to $20,748 a year. But then they have 
this supplemental plan, the Children's Medical Security Plan, which 
provides a somewhat less generous package, if you will, than Medicaid, 
more limited mental health and prescription drugs; but for families 
with incomes of less than $31,200 a year, 200 percent of poverty, the 
coverage is free, and they have a copayment of $1 per doctor's visit.
  So now we are getting up to people, families at the 200 percent of 
poverty level. For families with incomes of $31,200 to $62,400, the 
charge is $10.50 per child per month, and the copayment is $3. And 
above that level, the charges are $52.50 a month and $5 a visit.
  So essentially what they are doing here is, on a sliding scale, 
making it possible for people at these higher income levels, they are 
not terribly high income levels, but at higher income levels would 
still be able to opt into this program. It is a way to guarantee that 
every child who does not have health insurance now would be able to 
take advantage of this program.
  Ultimately, no child would be ineligible for this type of program 
unless the parents, on their own, voluntarily decided that they did not 
want to participate in it. Everyone would be eligible on a sliding 
scale up to any income level.
  The program is administered for the State by the John Hancock Mutual 
Life Insurance Company at a charge of $10.50 a month for each child, 
and it allows parents to take their children to any doctor in the 
State. So again you have complete choice in terms of where you go to 
the doctor or the hospital.
  Again the reason why this is so successful is essentially because of 
what it means for preventative care. In the article in the New York 
Times there is a Dr. Robert Sorrenti, a pediatrician who is a vice 
president of John Hancock, and he said that the sort of routine 
treatment, regular doctor visits, vaccinations, the preventative type 
care, was often avoided by parents who were short of money, but 90 
percent of the registered children in this program are now seeing a 
doctor on a regular basis for preventative purposes.
  In Massachusetts, approximately 150,000 uninsured children, about 
60,000, will be covered through the expanded Medicaid program that 
Massachusetts now offers, and they expect that the expanded Children's 
Medical Security Plan program would reach 40,000 to 60,000 more 
children. It has enrolled about 7,000 more children since the expansion 
took effect in November.
  So if you are taking that full range of 150,000 uninsured children, 
between the 60,000 covered by Medicaid and possibly another 60,000 that 
would be covered under this supplemental insurance program, you can see 
how you are getting very close, really, to almost 100 percent of the 
uninsured children that would be covered by the plan.
  Of course, the real key is what we are going to do on the Federal 
level. Obviously, it is very good for States like New York and 
Massachusetts and others to experiment and to come up with different 
ways of trying to provide health insurance for children, but the 
problem will not be addressed on a universal basis on the Federal level 
unless this Congress takes up the issue.
  I myself and many of my colleagues are determined that we will 
continue to raise the issue, we will continue to point out the problem 
of the uninsured and how many children there are out there until the 
Republican leadership and our colleagues on the other side decide to 
finally bring this up, give it a hearing, bring the legislation to the 
floor, and move toward making sure that every child in this Nation has 
the opportunity to have health insurance. In the long run if we do not 
do this, the negative impact not only on our children but on our Nation 
as a whole, I think, could be catastrophic because the numbers of the 
uninsured continue to increase on a regular basis.

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