[Congressional Record Volume 143, Number 30 (Tuesday, March 11, 1997)]
[House]
[Pages H854-H856]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     HEALTH INSURANCE FOR 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, for several weeks now I have been coming to 
the House floor on a daily basis to talk about the need for this 
Congress to enact legislation that would ensure every child in the 
country has access to health insurance. Many of my statements have 
focused on how the Republicans were blocking progress on the various 
Democratic proposals to provide health insurance to the Nation's 10 
million uninsured children. I stress that again, 10 million uninsured 
children in this country.
  It is now 3 months into the 105th Congress and literally we have 
really barely done a thing. Today was just another indication of that. 
Just last week, the House Republicans basically put together an agenda. 
It appeared in the Washington Times, and I talked about it a little bit 
this morning. Again, much of this agenda is just a rehash of what the 
Republicans had been talking about since they took control of the 
Congress back in 1994.
  Most importantly, nowhere in this 12-point agenda is there a plan to 
pass a health insurance plan or a health coverage plan for children. 
Despite the fact that these 10 million children remain uninsured, 
despite the fact that the congressional Democrats have expressed a 
willingness to work with the Republicans to fashion a bipartisan 
agreement, the GOP still could not find it in its heart to make 
children's health insurance a congressional priority.
  I do not know why they left this out of their agenda. I find it truly 
disturbing. I will continue to mention it. Over the last several weeks 
there has been a steady stream of studies, visits by children's 
organizations, and media reports detailing the problem with the lack of 
health insurance coverage for children. Yet, still nothing from the 
Republican leadership.
  This week we had 4 different children's organizations, the March of 
Dimes, the Children's Defense Fund, the Child Welfare League, and the 
National Association of Children's Hospitals, had been and are still 
making visits to congressional offices all over the Capitol. They are 
not limiting their visits to Democratic officials. They have, Mr. 
Speaker, been urging all Members of Congress to do something about the 
growing number of children who do not have any kind of health coverage 
at all.
  With respect to stories in the newspapers, and they continue to grow, 
in yesterday's USA Today there was a lead story on the front page which 
really did a very good job of outlining the problem with the 10 million 
kids in the country that lack health insurance. The article talks about 
various proposals floating around the Congress that address the 
problem. It provides many details about the nature of the problem, 
including the observation that 86 percent of uninsured children live in 
families with one working parent, 63 percent live in two-parent 
families, 500,000 of the uninsured are infants younger than 1 year old, 
and 65 percent live in families with annual incomes of $25,000 or less. 
A lot of interesting information here that shows increasingly that this 
is a problem that affects primarily working families, two-parent 
families, people whose incomes are not as low as one might expect.
  Another disturbing trend noted in this article and others within the 
last few weeks is the decline in employer-based coverage. Between 1985 
and 1995 the percentage of children covered by private employer-based 
coverage has dropped 12 percent, from 65 percent to 53 percent. This 
decline in worker-based coverage is an indication that working parents 
are finding it increasingly more difficult to purchase insurance for 
their children.
  I think a lot of people increasingly, or many people think that if 
you are working, particularly if both parents are working, that they 
are going to be covered through their employer by a health insurance 
policy for the kids. Increasingly, that is simply not the case.
  The article in USA Today also provides examples of those struggling 
to live without health coverage for their kids. I like to use examples 
because, as much as we talk about statistics, it is always better to 
have specific examples where you can bring the problem down and show 
how it affects an individual.
  I wanted to mention in the USA Today article a person named Dee Sweat 
of Liberty, MT. She works at a salary of $14,000 a year. She does not 
have health insurance for her 15-year-old daughter. Paying out of 
pocket, in the last year she paid $1,700 or 12 percent of her yearly 
salary for medical treatment for her daughter. She has not been able to 
take her daughter to the dentist for 5 years. Five years without going 
to the dentist. I repeat that. She simply cannot afford health 
insurance. I wonder how many in this body have gone 5 years or would 
even contemplate letting their children go 5 years without going to the 
dentist.
  The working parents that are mentioned in this USA Today article, who 
oftentimes earn too much money to qualify for Medicaid but not enough 
to afford health insurance for the kids, are the individuals the 
Democrats are

[[Page H855]]

essentially trying to help. If you and your children qualify for 
Medicaid, we will work to get you enrolled. For those who do not, we 
will continue working to convince the Republicans that the time to act 
is now.
  Every day that goes by is a day that another parent stays up late at 
night suffering through the hard reality of not being able to provide 
for a sick child. As a parent myself, Mr. Speaker, I can think of few 
things that could be more difficult to confront.
  In the coming weeks, Democrats will be redoubling their effort to 
jump-start this process. We have asked Speaker Gingrich for a date 
certain for consideration of legislation that would ensure that every 
child in America has health insurance.
  I just wanted to talk a little bit about the issue and about what I 
think should be the basic principles of a kids' health insurance 
proposal. As far as the issue is concerned, the figure of 10 million 
American children has been mentioned several times. The number of kids 
with no health insurance coverage reached an all-time high of this 10 
million figure in 1994, according to a recent General Accounting Office 
report, and that is one out of seven children.
  Again, the problem is getting worse. According to the Children's 
Defense Fund, 3,300 kids get dropped from private health insurance 
coverage every day. If this trend continues, there will be 12.6 million 
uninsured children by 2000.
  Again, this is a problem of working families. Nine out of 10 children 
without insurance have working parents. Medicaid helps the poorest 
children, and families who are well off can afford private coverage. 
But millions of working parents are trapped in the middle, unable to 
afford health insurance for their kids. Again, many of these parents, I 
am sure, are staying awake at night worrying about what would happen if 
their child fell seriously ill.
  Also, what we really need is preventative care. It may be that when a 
child gets very sick, that they can go to the emergency room and have 
access to care. But children deserve to see family doctors and not go 
to the emergency room. Many children without health insurance never see 
a family doctor. The only time they get health care is when they are so 
sick that they need to be taken to the emergency room, where they often 
get treated for medical conditions that could have been prevented 
through regular care at much less cost.
  For those who talk about the cost, I think they have to continue and 
should realize that in the long run the lack of preventative care, the 
lack of having a child being able to visit a doctor on a regular basis, 
in the long run only costs more when the child gets sick and has to 
have more serious care that involves hospitalization or other kinds of 
institutionalization.

                              {time}  1845

  Well, I think it is important when I continue to talk about the 
problem of our Nation's children, or 10 million of them not being 
insured, that I have to basically say what we would do about it; what 
would be the outlines, if you will, of a children's health bill. And 
basically if you think about the basic principles the Democrats have 
been talking about, we have been saying that a children's health 
proposal must first make health insurance available for every uninsured 
child up to at least age 18; second, make insurance generally 
affordable for all families; third, give all uninsured children access 
to policies that provide for the range of appropriate benefits; fourth, 
provide for prenatal care for uninsured pregnant women; and, last, 
build on, not replace, the current employer-based system, Medicaid and 
public private programs that already exist in a number of States.
  The Children's Defense Fund has done an excellent job of putting 
together a fact sheet that basically gives some further details about 
the nature of the problem, and I do not want to read the entire fact 
sheet, but I just wanted to highlight some of the things that they 
brought out because they have been going around visiting with Members 
of Congress this week, as I mentioned before, and I think they 
basically summarized the nature of the problem very well.
  What they have been saying again is the fact that Medicaid helps the 
poorest children, but that millions of working parents in the middle 
cannot provide their children with health insurance.
  Again, why are these 10 million children uninsured? Because a lot of 
people are saying to themselves, you know, how is it that they fall 
through the cracks? Why are they uninsured? And what we are finding is 
that increasingly, again, it is the problem of working parents.
  Since 1989, the number of children without private coverage has grown 
by an average of 1.2 million a year. In 1980, the majority of employees 
at medium and large companies had employers who paid the full costs of 
family coverage. By 1993, more than three-fourths of these employees 
were required to help pay such costs. Most employers now require large 
payments for family coverage. For health insurance that covers the 
entire family the average employee must pay over $1,600 a year, $1,900 
in small companies. And when families cannot pay these costs, basically 
their children go uninsured. Other parents work for employers who offer 
no health coverage. Self-employed, part-time or temporary workers, 
independent contractors and parents working for very small businesses 
or service sector companies often have employers who offer no health 
insurance. Parents also must pay very high prices, $6,000 a year or 
more, if they buy family health insurance on their own rather than 
through an employer, and, as many cannot afford these costs, the 
children go uninsured.
  So if a parent is not able to tap into a health insurance policy for 
their kids through their employer, you can see the level of a premium 
up to $6,000 a year or more and why that would simply be unaffordable 
for somebody unless they are making a very large salary.
  Why is it crucial to help working parents buy health insurance for 
their children? And again this gets into the whole issue of prevention 
and how providing health insurance for kids in the long run would be 
saving the government money.
  Uninsured children are at risk of preventable illness. Most families 
with uninsured children live from paycheck to paycheck with little room 
to spare in the family budget. Many such families must choose between 
paying the full costs of prescriptions or doctor visits for an 
uninsured child and other basic family needs, including food and 
utility bills. So they are sitting there in the house deciding if they 
are going to pay for health insurance versus the rent versus utilities 
versus putting food on the table. Essentially it is a game of Russian 
roulette with their children's health, delaying care and hoping that no 
harm results.
  Again some information about the children with untreated health 
problems. They are very much less likely to learn in school. Many 
children with undiagnosed vision problems do not get glasses and cannot 
even see the blackboard. Children in pain or discomfort may have 
trouble concentrating. I guess that is obvious. If lead paint poisoning 
is not detected and treated early, children can suffer permanent mental 
retardation. Certainly the Federal Government has addressed the issue 
of lead poisoning from paint and its impact on children, but again 
without health insurance, without regular checkups, it will not be 
detected.
  And finally taxpayers save money when their children receive early 
preventive care. Each dollar invested to immunize a child saves between 
$3.40 and $16.34 in direct medical costs. Nine months of prenatal care 
costs $1,100. One day of neonatal intensive hospital care for a low 
birth weight baby costs $1,000. On average hospital costs for a low 
birth weight baby are 10 times the cost of prenatal care.
  Just an example, and again this is from the Children's Defense Fund, 
when one rural county in Florida provided all children and pregnant 
women access to outpatient health care, the rate of premature births 
dropped by 39 percent, the percentage of children receiving checkups 
doubled, and emergency room visits were cut by nearly 50 percent. In 
every industrialized country children get better health coverage than 
in America in terms of the percentages that are actually covered. Every 
other industrialized country provides health coverage to all its 
people.

[[Page H856]]

 America does not even cover all its children. The United States ranks 
eighteenth in overall infant mortality. Only Portugal does worse. If 
the United States matched Japan's infant mortality rate, more than 
15,000 American babies who died before their first birthday in 1994 
would be alive. And the United States ranks eighteenth in the 
percentage of babies born at dangerously low weight. No industrialized 
country does worse than that.
  Now again I do not want to keep coming up here and giving horror 
stories and talking about all the problems that we face because of the 
fact that the 10 million kids are not covered. But I think that the 
magnitude of this problem is such that if we do not do something 
quickly and if this House and this Congress does not address the 
problem fairly quickly, the problem only gets worse, the costs only get 
greater, and from a humane point of view it simply is something that we 
need to address, and so myself and other Democrats will be here on a 
regular basis tomorrow, the next few weeks or the next few months until 
our Republican colleagues on the other side of the aisle agree to take 
this up in a timely fashion.

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