[Congressional Record Volume 145, Number 92 (Friday, June 25, 1999)]
[Extensions of Remarks]
[Pages E1405-E1406]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

[[Page E1405]]



            INTRODUCING THE FAIR CARE FOR THE UNINSURED ACT

                                 ______
                                 

                         HON. RICHARD K. ARMEY

                                of texas

                    in the house of representatives

                         Friday, June 25, 1999

  Mr. ARMEY. Mr. Speaker, today, I am introducing the Fair Care for the 
Uninsured Act, a bill to give the nation's 44 million uninsured a 
refundable tax credit of $1,000 per adult and $3,000 per family for the 
purchase of private health insurance.
  Right now, there are 44 million uninsured people. That number is 
growing by 100,000 a month. A decade from now, it could be 53 million, 
or 60 million if the economy softens.
  Most of these people are young, healthy, working people. Many are 
employed in small businesses. Many don't have full-time positions. 
Indeed, one recent study estimates that in California, nearly 40 
percent of Hispanics are uninsured--40 percent.
  There's something wrong when the richest nation on earth, with the 
best health-care system in the world, the lowest poverty, and the 
highest employment, has a constantly growing percentage of its 
population going without medical-expense protection, either because it 
is unavailable, unaffordable, or undesirable.
  Nowadays, the Democrats seem more eager to pile new mandates on 
health insurance than to help people who don't have any. In our haste 
to protect patients from HMO abuses--and we'll take up a bill on that 
subject in the House next month--we should never forget about what 
mandates and higher costs mean for the millions of Americans who don't 
even have the first patient protection, health insurance coverage.
  It's both for those who lack coverage, and those who dislike their 
coverage, that I'm introducing this bill. I think we can offer better 
solutions for the uninsured, help end frustrations with HMOs, and 
preserve the high quality of American medicine, all at the same time. 
How is this possible? By shifting more choice and control to individual 
patients, so they can take more responsibility for their health care--
and take their business elsewhere when dissatisfied.
  It's no secret why people are frustrated with work-based coverage 
today, or why they're calling on Congress for relief. Virtually all of 
today's problems in health care can be traced back to one source, the 
lack of a consumer-driven market. And the main culprit behind that 
problem is the tax code.
  Millions of Americans are innocent victims of what I call the Health 
Penalty Tax. They're actually punished for trying to buy their 
insurance on their own, outside the workplace. Just as the Marriage 
Penalty Tax punishes people for doing the right thing and getting 
married, the Health Penalty Tax punishes people for doing the right 
thing and buying their own health insurance. This tax falls hardest on 
low-income, part-time, and contract workers, and the unemployed. That's 
not fair. But we can remedy this injustice.

  The bill I'm introducing today would create a refundable tax credit 
of $1,000 per adult, $500 per dependent, and a maximum of $3,000 per 
family, for the purchase of private health insurance. It would be 
available to people who don't get their coverage through the workplace 
or a federal government program. People could use their credit to shop 
for a basic plan that best suits their needs and is portable from job 
to job. If they want more generous coverage, they could buy it with 
after-tax dollars. And of course the states could supplement the 
credit.
  Let's think about what this reform would do. For one thing, it would 
give 44 million uninsured Americans access to a modest level of private 
health coverage. It would give them access to insurance that's 
portable. And it would give them a real choice of plans. Best of all, 
it would give them the power to keep their doctor and fire their HMO, 
instead of the other way around.
  We shouldn't stop there, of course. We should give consumers 
additional tools--I'm thinking of innovative ideas like medical savings 
accounts, healthmarts, association health plans, and medical-
malpractice reform. We should also encourage state-based ``high-risk'' 
pools to act as charitable safety-nets for people who are too sick to 
insure at any price. In combination with the Fair Care credit, these 
market-oriented reforms would go far toward creating a true consumer-
driven marketplace in the 21st century.
  Some say we can't afford to restore tax fairness for the uninsured. I 
say we can't afford not to. If the wealthy CEO is going to receive 
government-subsidized health care, then so should the waitress earning 
the minimum wage. Period.
  Tax fairness is a nonpartisan idea. Even my liberal colleague from 
California, Mr. Stark, agrees we should use the tax code to help the 
uninsured. In fact, just the other day he and I published a joint 
opinion piece in the Washington Post on this very topic. It appeared on 
page A41 of the Washington Post of Friday, June 18, 1999. I would like 
to take the liberty here of quoting that article in full.

   ``Medical Coverage for All: The Ultimate Congressional Odd Couple 
                               Weighs in

                     (By Dick Armey and Pete Stark)

       ``We may be the ultimate congressional odd couple. We 
     seldom agree on anything. But on this we do agree: Congress 
     should act now to help the 43 million Americans who have no 
     health insurance.
       ``The ranks of the uninsured are growing by 100,000 a 
     month. And this is happening during a time of strong economic 
     growth, despite continuing congressional attempts to expand 
     coverage. Imagine what will happen come the next economic 
     downturn.
       ``For individuals being uninsured is a problem because too 
     often it means health care forgone, small warning signs 
     ignored and minor illnesses allowed to become costly crises. 
     It's problem for families because unpaid medical bills are a 
     leading cause of personal bankruptcy. And it's a problem for 
     the nation because uncompensated care is an unfair burden on 
     doctors, hospitals and taxpayers.
       ``Why is the problem growing? Because Americans are 
     increasingly unable to get coverage through their jobs. With 
     health premiums going up, employers are bearing a smaller 
     share of those premiums, and the work force is becoming 
     increasingly mobile, and part-time. More and more people find 
     themselves working in places where coverage is either 
     unavailable, unaffordable or undesirable (``one crummy 
     HMO''). And when these workers try to buy insurance outside 
     their jobs, they lose a generous tax break, making coverage 
     that much less affordable.
       ``Indeed, today's tax code discriminates against not only 
     insurance purchased outside the workplace but also lower-
     paid, part-time and small-business workers. The highly paid 
     CEO gets a more lavish health-care tax break than the 
     waitress earning the minimum wage.
       ``These problems cry out for remedy. And happily, a 
     bipartisan remedy is available. We think Congress should 
     create a new refundable tax credit to enable all Americans to 
     buy decent health coverage.
       ``Properly designed, such a credit could bring about near-
     universal coverage without new mandates or bureaucracy. It 
     would eliminate barriers the uninsured face in today's 
     system, enabling them to shop for basic coverage that suites 
     their individual needs and is portable from job to job.
       ``To be successful, the credit would need to be 
     sufficiently generous to buy a decent policy; available to 
     those who owe no tax liability; and, to prevent fraud, paid 
     directly to insurers or other entities, not to individuals.
       ``Would the existence of such a credit prompt some 
     employers and employees to drop workplace coverage? 
     Unavoidably. But job-based coverage is already eroding. And 
     the erosion can be minimized by making the credit less 
     attractive than most company plans.
       ``To be sure, we don't want to end workplace coverage. We 
     do want to permit a gradual transition to a world in which 
     individuals are free to obtain the kind of insurance they 
     want, regardless of where it's purchased.
       ``What amount is `sufficiently generous'? That's open to 
     debate. But we note that $3,600 per family is roughly the 
     amount the federal government spends on its own employees' 
     families.
       ``Obviously this proposal would produce a revenue loss of 
     tens of billions a year, risking a return to deficits. So how 
     do we `pay' for it? Well, a portion of the surplus could be 
     used. And we note that reducing the numbers of the uninsured 
     would free billions in current federal cross-subsidy 
     programs.
       ``Admittedly, a tax credit can't help people who are too 
     sick to insure at any price. Although we differ, fairly 
     strongly, about the best way to help such people, we agree a 
     reasonable way can be found to do so, and we'll keep looking 
     for it. (Rep. Stark would prefer to get insurers to take all 
     customers at a common price, regardless of health status. 
     Rep. Army would set up `high-risk pools' to subsidize sick 
     people's coverage in the 22 states that haven't already done 
     so.)
       ``Too often, when Congress turns to health issues, it ends 
     up applying legislative Band-Aids. It's time to address 
     underlying causes. The biggest health problem facing the 
     country is the uninsured. The tax code can be used to help 
     them. We urge a bipartisan consensus to do so.''


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  I urge my colleagues to cosponsor this legislation.

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