[Congressional Record Volume 145, Number 137 (Tuesday, October 12, 1999)]
[Senate]
[Pages S12421-S12422]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BOND (for himself, Mr. Breaux, Mr. McCain, and Mr. 
        Baucus):
  S. 1717. A bill to amend title XXI of the Social Security Act to 
provide for coverage of pregnancy-related assistance for targeted low-
income pregnant women; to the Committee on Finance.


           mothers and newborns health insurance act of 1999

 Mr. BOND. Mr. President, I rise today to introduce a bill that 
I believe is vitally important to the health care of children and 
pregnant women in America. The goal of this legislation is simple--to 
make sure more pregnant women and more children are covered by health 
insurance so they have access to the health care services they need to 
be healthy.
  The need is great--on any given day, almost 12 million children and 
almost half a million pregnant women do not have health insurance 
coverage. For many of these women and children, they or their family 
simply can't afford insurance. Many others are actually eligible for a 
public program like Medicaid or CHIP, but they don't know they are 
eligible and are not signed up.
  Lack of health insurance can lead to numerous health problems, both 
for children and for pregnant women. A child without health coverage is 
much less likely to receive the health care services that are needed to 
ensure the child is healthy, happy, and fully able to learn and grow. 
An uninsured pregnant woman is much less likely to get critical 
prenatal care that reduces the risk of health problems for both the 
woman and the child. Babies whose mothers receive no prenatal care or 
late prenatal care are at-risk for many health problems, including 
birth defects, premature births, and low birth-weight.
  The bill I am introducing--along with Senators Breaux, McCain, and 
Baucus--deals with this insurance problem in two ways.
  First, it allows states to provide prenatal care for low-income 
pregnant women under the state's CHIP program if the state chooses.
  Through the joint federal-state Children's Health Insurance Program, 
states are currently expanding the availability of health insurance for 
low-income children. However, federal law prevents states from using 
CHIP funds to provide prenatal care to low-income pregnant women over 
age 19, even though babies born to many low-income women become 
eligible for CHIP as soon as they are born.
  As many as 45,000 additional women could be covered for prenatal 
care. There are literally billions of dollars of CHIP funds that states 
have not used yet, so I would hope that most states would choose this 
option. This provision will not impact federal CHIP expenditures 
because it does not change the existing federal spending caps for CHIP. 
Babies born to pregnant women covered by a state's CHIP program would 
be automatically enrolled and receive immediate coverage under CHIP 
themselves. It is foolish to deny prenatal care to a pregnant mother 
and then--only after the baby is born--provide the child with coverage 
under CHIP. Prenatal care can be just as important to a newborn baby as 
postnatal care, and the prenatal care is of course important for the 
mother as well.
  Second, the bill will help states reach out to women and children who 
are eligible for--but not signed up for--Medicaid or CHIP. 358,000 
pregnant women and 3 million children are estimated to be eligible for 
but not enrolled in Medicaid. Millions of additional children are 
eligible for but not yet enrolled in CHIP. When Congress passed the 
welfare reform bill back in 1996, we created a $500 million fund that 
states could tap into to make sure that all Medicaid-eligible people 
stayed in Medicaid. The problem is that only about 10 percent of that 
fund has been used, and most states are about to lose their 3-year 
window of opportunity to use these funds. My bill would allow states 
continued access to these funds by eliminating the 3-year deadline, and 
it would give states more flexibility to use the funds to reach out to 
both Medicaid and CHIP-eligible women and children.
  This legislation is a smaller piece of a bill I introduced earlier 
this year called Healthy Kids 2000. By extracting it from the larger 
bill, we get a chance to show the widespread support I believe exists 
for these measures. I believe this is crucial legislation, and urge my 
colleagues to join me in support of it so that we can pass this 
bill.
 Mr. BREAUX. Mr. President, I rise today to join Senator Bond 
in introducing the Mothers and Newborns Health Insurance Act of 1999. 
This is important legislation regarding our children's health.
  More than 12 million women of childbearing age--one in five--lacked 
health insurance in 1998, according to the Census Bureau. Lack of 
insurance leads to bad outcomes for pregnant woman and the children. 
Pregnant women without health insurance face barriers to care and do 
not receive the medical attention they need to have healthy babies. The 
Mothers and Newborns Health Insurance Act could provide insurance 
coverage to virtually all pregnant women in the United States. Such 
coverage will have an enormous impact on the health of children in our 
nation, by ensuring pregnant women have access to prenatal care and 
automatically enrolling their babies in their State Children's Health 
Insurance Program.
  In the United States, 7.6 out of 1000 babies die before their first 
birthday. Our nation is ranked 25th, in the world for our infant 
mortality rate. The statistics in my home state are even more 
disheartening; in Louisiana where 24.7% of childbearing age women are 
uninsured, there are 9.8 deaths per 1000 births. Many of these deaths 
are preventable, and good prenatal care is the first step to ensuring 
that babies see their first birthday.
  The Mothers and Newborns Health Insurance Act of 1999 addresses these 
concerns in three ways. One, it would amend Title XXI of the Social 
Security Act to give states the options to use Children's Health 
Insurance Program (CHIP) funds for health insurance coverage of 
uninsured low income pregnant women. Two, it would automatically enroll 
newborns to CHIP eligible women in CHIP for one year. And

[[Page S12422]]

three, our bill would provide states additional opportunities to tap 
into a $500 million fund created by the 1996 welfare reform act to help 
expand Medicaid outreach efforts. This bill would allow the fund to be 
used for any Medicaid or CHIP outreach initiatives.
  This Act could provide insurance coverage to 95% of currently 
uninsured women, by both increasing outreach efforts to pregnant women 
eligible for Medicaid and by giving states the option to extend CHIP 
coverage to low income pregnant women over the age of 18. Since the 
enactment of the welfare reform law, many people who are eligible for 
Medicaid or CHIP coverage do not realize it and remain unenrolled. It 
is estimated that 358,000 pregnant woman and 3 million children are 
eligible for but not enrolled in Medicaid. Millions of additional 
children are eligible for but not yet enrolled in CHIP.
  This legislation has the potential to lower healthcare costs and keep 
our babies healthy. By removing barriers to prenatal care access and 
automatically enrolling babies in their State Children's Health 
Insurance Program, we can give our children a head start on good 
health. Research shows that access to appropriate prenatal care 
improves the outcome of pregnancy. According to the March of Dimes, 
prenatal care--especially among lower income women--reduces the risk of 
low birth weight threefold and results in decreased infant mortality 
rates and healthier babies. According to the Institute of Medicine, 
each dollar spent on prenatal care for women at high risk, saves $3.38 
in medical care costs for low birth-weight babies.
  This legislation is an important step to ensuring our children have 
bright and healthy future. I thank Senator Bond for his leadership on 
this bill, and I urge my colleagues to join us in supporting the 
Mothers and Newborns Health Insurance Act of 1999.
                                 ______