[Congressional Record Volume 143, Number 75 (Wednesday, June 4, 1997)]
[House]
[Pages H3438-H3440]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  2300

  Mr. PALLONE. I want to thank the gentleman from Ohio Mr. Strickland 
for his comments. He brought up a number of things that I think are 
very important. I have tried and sometimes I am partisan, sometimes I 
am not. On this particular occasion, I tend to be very partisan.
  Really, for a long time, the Republican leadership was essentially 
ignoring this issue of kids' health insurance, the 10 million uninsured 
children that my colleague mentioned. Now that it is in the budget 
agreement, and presumably there is a pot of money, I think about $16 
billion over 5 years, that is available for this.
  It is not likely that that amount of money would cover, as my 
colleague said, more than about half of the 10 million children. But, 
obviously, what we want to do as Democrats is to make sure, on the one 
hand, that the $16 billion that is available covers as many kids as 
possible. Then we also feel very strongly as a group, and I know the 
Democratic task force does on health care, that we need to go beyond 
that and try to find a way to insure the other kids that are not 
currently insured.
  There are obviously various ways to go about this. The gentleman from 
Ohio mentioned the Medicaid program, which is of course our primary 
program now for those who are below the poverty level or close to the 
poverty level. One of the things that we have noticed in the task force 
in some of the hearings and meetings that we have had is that there are 
actually 3 million children who are now eligible for the Medicaid 
program that do not sign up for one reason or another.
  After meeting with some of the families and talking with some of the 
health care professionals, what we found is that there are a lot of 
reasons why those 3 million kids are not covered. First of all, as my 
colleague mentioned, a lot of times the parents are both working and 
they just do not have the time to be bothered. They are not aware or 
they just find that the bureaucracy of having to sign the kids up, I do 
not mean they do not want to be bothered in the sense they do not want 
to help, but they are just not aware, for whatever bureaucratic 
reasons, they just do not know to sign the kids up.
  There is also an extreme element of pride. I know a lot of people, 
unfortunately, I think see Medicaid as a welfare program. And if they 
are working, which most of these people that are eligible that are not 
signing up are overwhelmingly working, they are reluctant to sign up 
for Medicaid, they say they see it as some sort of Government handout.
  What we have done in our Democratic task force proposal is to, at 
least initially, and the President has talked about this as well, try 
to find a way to get these 3 million children who are eligible for 
Medicaid signed up. And our

[[Page H3439]]

plan, basically, provides grants to States to help local communities in 
the outreach programs to basically reach out in a flexible way to try 
to find ways in the community to do that.
  The other problem with the Medicaid program is right now many kids 
are not covered for the full year. In other words, what they do is they 
determine eligibility every three months or so. And so, a kid can be on 
Medicaid for one or two months and then off Medicaid again. So one of 
the things that we have said in our plan is that we want to make sure 
kids are covered year round; in other words, if they are enrolled 
initially in Medicaid, that they at least stay on the rolls for 1 year. 
I think that that allows a certain amount of continuity and probably 
also would encourage people who are eligible for Medicaid but have not 
signed up to do so.
  The other thing that my colleague mentioned is obviously we have the 
Medicaid program and we can find ways to expand it to stay just above 
the poverty level or a certain percentage above the poverty level, but 
I think we also need to go beyond the Medicaid program. Many people are 
simply not going to be eligible because they have a little higher 
income, but if their income is just a little higher than the so-called 
poverty level, they are still competing for this resource with the 
rent, with food, with clothes, and if they have to make a choice, a lot 
of times the choice cannot be to pay for health insurance because of 
the circumstances. They may not be eligible for a group policy. They 
may not be offered through their employment.
  So what we have talked about, basically, is what we call Medikids, 
which is sort of a matching grant program. That is, you provide a 
certain amount of money to the States with a matching grant, and they, 
again in a flexible way, try to find ways to expand health care 
coverage for people that are not eligible for Medicaid and cover people 
possibly up to maybe 300 percent of the poverty level. I think that 
will take us up to, depending on the situation, maybe up to something 
like 35 or 40,000 for a family of 4.
  Now, the other thing that we have talked about in the task force and 
as part of the legislation we put forward was a proposal or a component 
actually developed by another one of our colleagues on the Committee on 
Commerce, the gentlewoman from Washington Ms. Furse. What she has 
pointed out is that many times families are eligible for a group plan, 
which of course means lower costs than if they have to buy health 
insurance individually. But many group plans do not offer kids-only 
insurance, and the parents may find that they cannot afford to pay for 
the whole family but they would like to pay for the kids. So what we 
are doing in this proposal is mandating that they be able to buy kids' 
health insurance only if they want, if they are eligible for a group 
policy.
  The other thing is that under the Federal law, the COBRA legislation, 
which people who, for example, if they lose their employment or they 
want to take advantage of the COBRA law, oftentimes they also cannot 
buy a health insurance policy just for the kids. So we are saying also 
to mandate the COBRA provide kids-only health insurance.
  I believe very strongly with our task force proposal that we could 
get at almost all the 10 million children, because essentially what we 
are doing is expanding Medicaid, we are then providing a matching grant 
program for those above the Medicaid level, and then for those who get 
to the level of maybe 40, 45 thousand and above, who can afford private 
insurance, we are making those changes in the insurance law so that 
they would be able to buy kids-only insurance. These are the ways that 
we have talked about over the last 6 months of trying to enroll as many 
of these 10 million kids as possible.
  The last thing I want to mention, too, is that the number continues 
to grow. The estimate that I have seen from some of the advocacy groups 
is that by the year 2000, this number is going to be 12 million. So if 
we do not act now or do not act in a way that is going to provide as 
many kids as possible, we may cover five million and find out we have 
another 7 million by the year 2,000 that are not eligible.
  Mr. STRICKLAND. I would just like to point out that this is an issue 
that I would hope and I believe cuts across the political spectrum of 
different political philosophies. I really do not believe that if we 
were to search the hearts of any Member of this body that there is any 
Member in this body that would believe that we should have children in 
this country without health care coverage. The question is how to 
achieve it and how to achieve it in a way that is acceptable to 
conservatives and liberals and those of us who try to make up the 
middle ground.

  I think what my colleague is describing, what he has described 
tonight, is a plan that is efficient, that does not create a new 
program as such but simply builds on what we already have, something 
that is already working, but that gives the individual States greater 
resources and some flexibility in choosing how best to provide this 
kind of coverage.
  So I know that we do a lot of arguing and debating in this Chamber 
and sometimes it is nonsense and sometimes it is serious, but I would 
hope that this is an issue that would rise above all others in terms of 
its ability to pull together both sides of the Chamber, Democrats and 
Republicans, as well as trying to find an agreement with the 
Administration.
  I think if this 105th Congress were to achieve health care coverage 
for America's children in spite of whatever failures that we may find 
ourselves having to admit to, that we would truly be able to say we had 
accomplished something that was of very significant importance to the 
entire country.
  I think my colleague the gentleman from New Jersey Mr. Pallone is 
right when he indicated that if we do not do it now, the problem is 
going to get worse and that it will be more difficult perhaps in the 
months and years to come if we continue to let this number escalate and 
mushroom.
  I guess I would end by saying it is the right thing to do. It is 
absolutely the right thing to do, and I cannot believe that, given the 
resources of this rich country, we cannot do this. It may require us to 
make some choices. It may require us to say that children are more 
important than something else. But we ought to be willing to do that. 
If we are not willing to do that, then I would suggest that some of my 
Members who use children as a way to express their values, we see a lot 
of Members, myself included, who walk around this Chamber with ``save 
the children'' ties on, with images of children hanging around their 
neck, and I assume that is in order to make a public display of their 
commitment to children.
  I think if we as a Congress do not take this step and make the 
decisions that are necessary to set our priorities such that children 
come first, we talk about families coming first, but I really believe 
that we ought to get even more specific than that, we ought to say that 
children come first. They are the most vulnerable, defenseless part of 
our society, and we need to commit ourselves to this effort. I commit 
myself, as I know my colleague does and the Members of the Democratic 
task force, and I also believe that there are a number of our 
Republican colleagues who share our concerns.
  So, hopefully, as this budget scenario plays itself out, we will find 
that we do what we need to do here. I thank my colleague for the 
opportunity to share these comments with him.
  Mr. PALLONE. I really could not have said it any better, so I am 
going to pretty much stop here as well. But I wanted to just reiterate 
one of the things that my colleague said before we end, and that is 
that what we really are trying to do here is build upon the existing 
system.
  That is, we know that most people get their health insurance through 
an employer-based system; and we want to build upon that with some of 
these private health care reforms. Medicaid generally has worked and it 
can be expanded and made better.
  Lastly, with the matching grant programs, there are a lot of State 
private-public partnerships that are out there. A lot of States have 
done some very innovative things with private-public partnerships. I 
hope the matching grant program, if we can get that into effect, will 
build upon those various States' activities as well.
  So, idealogically, this really is something that can cross party 
lines because it does not really have any

[[Page H3440]]

idealogy, it builds upon existing programs and it is something that I 
believe can be supported on a bipartisan basis.

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