[Congressional Record Volume 146, Number 18 (Thursday, February 24, 2000)]
[Senate]
[Pages S824-S825]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  SENATE RESOLUTION 260--TO EXPRESS THE SENSE OF THE SENATE THAT THE 
  FEDERAL INVESTMENT IN PROGRAMS THAT PROVIDE HEALTH CARE SERVICES TO 
UNINSURED AND LOW-INCOME INDIVIDUALS IN MEDICALLY UNDER SERVED AREAS BE 
   INCREASED IN ORDER TO DOUBLE ACCESS TO CARE OVER THE NEXT 5 YEARS

  Mr. BOND (for himself, Mr. Hollings, Mr. Cochran, Mr. Daschle, Mr. 
Hatch, Mr. Kennedy, Mr. Hutchinson, Mr. Breaux, Mr. DeWine, Mrs. 
Lincoln, Mrs. Murray, and Mr. Inouye) submitted the following 
resolution; which was referred to the Committee on Appropriations:

                              S. Res. 260

       Whereas the uninsured population in the United States 
     continues to grow at over 100,000 individuals per month, and 
     is estimated to reach over 53,000,000 people by 2007;
       Whereas the growth in the uninsured population continues 
     despite public and private efforts to increase health 
     insurance coverage;
       Whereas nearly 80 percent of the uninsured population are 
     members of working families who cannot afford health 
     insurance or cannot access employer-provided health insurance 
     plans;
       Whereas minority populations, rural residents, and single-
     parent families represent a disproportionate number of the 
     uninsured population;
       Whereas the problem of health care access for the uninsured 
     population is compounded in many urban and rural communities 
     by a lack of providers who are available to serve both 
     insured and uninsured populations;
       Whereas community, migrant, homeless, and public housing 
     health centers have proven uniquely qualified to address the 
     lack of adequate health care services for uninsured 
     populations, serving over 4,500,000 uninsured patients in 
     1999, including over 1,000,000 new uninsured patients who 
     have sought care from such centers in the last 3 years;
       Whereas health centers care for nearly 7,000,000 
     minorities, nearly 600,000 farmworkers, and more than 500,000 
     homeless individuals each year;
       Whereas health centers provide cost-effective comprehensive 
     primary and preventive care to uninsured individuals for less 
     than $1.00 per day, or $350 annually, and help to reduce the 
     inappropriate use of costly emergency rooms and inpatient 
     hospital care;
       Whereas current resources only allow health centers to 
     serve 10 percent of the Nation's 44,000,000 uninsured 
     individuals;
       Whereas past investments to increase health center access 
     have resulted in better health, an improved quality of life 
     for all Americans, and a reduction in national health care 
     expenditures; and
       Whereas Congress can act now to increase access to health 
     care services for uninsured and low-income people together 
     with or in advance of health care coverage proposals by 
     expanding the availability of services at community, migrant, 
     homeless, and public housing health centers: Now, therefore, 
     be it
       Resolved,

     SECTION 1. SHORT TITLE.

       This resolution may be cited as the ``Resolution to Expand 
     Access to Community Health Centers (REACH) Initiative''.

     SEC. 2. SENSE OF THE SENATE.

       It is the sense of the Senate that appropriations for 
     consolidated health centers under section 330 of the Public 
     Health Service Act (42 U.S.C. 254b) should be increased by 
     100 percent over the next 5 fiscal years in order to double 
     the number of individuals who receive health care services at 
     community, migrant, homeless, and public housing health 
     centers.

  Mr. BOND. Mr. President, I rise today to talk about the hot topic in 
the world of health care--health care access. Many people see this as 
the biggest problem in health care today.
  Part of the problem, and the part that has received the most 
attention, is that too many Americans lack health insurance--about 44 
million Americans aren't covered by any type of health plan. But an 
equally serious part of the problem is many people's simple inability 
to get access to a health care provider. Even if they have insurance, a 
young couple with a sick child is out of luck if they can't get in to 
see a pediatrician or another health care provider. And in too many 
urban and rural communities across the country, there just aren't 
enough doctors to go around.
  Several plans have been proposed recently on how to deal with the 
health care access problem. Senator Bradley has a plan. The Vice 
President has one. There's also a bipartisan proposal for tax credits 
to help people buy health insurance. All of these plans have at least 3 
things in common.
  First, they all address a worthwhile goal. I think we all want to see 
that people have access to good health care, even if we might disagree 
on how to get there.
  Second, they're all very ambitious. Senator Bradley in fact is 
basically proposing to use close to the entire $1 trillion surplus to 
provide people with health insurance.
  The third thing these plans have in common--and perhaps the most 
important thing--is that they probably have little chance of becoming 
law this year. Whether because of policy differences or political 
differences, it's just not likely that they will pass.
  So today, we're launching a bipartisan effort--called the REACH 
Initiative--that does have a chance this year. There's no need to wait 
for an election--we can do it now.
  Our proposal builds on the crucial work that organizations known as 
community health centers have been doing to ensure better access to 
health care. Health centers are private nonprofit clinics that provide 
primary care and preventive health care services in medically-
underserved urban and rural communities across the country. Partially 
with the help of federal grants, health centers provide basic care for 
about 11 million people every year, 4 million of whom are uninsured.
  The goal of the REACH Initiative is simple--to make sure more people 
have access to health care. We plan to achieve this by doubling federal 
funding for community health centers over a period of five years. We 
believe this will allow up to 10 million more women, children, and 
others in need to receive care at health centers. If we are successful 
with the REACH Initiative, we can practically double the number of 
uninsured and underinsured people that health centers care for.
  The REACH Initiative basically recognizes the key contributions that 
community health centers have already made in addressing the health 
care access problems. But there is so much more that can still be done.
  Now, out of all the ways we can address health care access problems, 
why are health centers a good solution and a worthwhile target for 
additional funding?
  1. Health centers are an existing program that produces results. Too 
many health care proposals want to practically start from scratch, and 
make breathtakingly revolutionary changes. When I look at the health 
system and its admittedly huge problems, I sometimes think that might 
not be a bad idea. But it's also extremely risky. We need to remember 
that despite the many flaws in our health system, many people are 
pleased with it. We should be wary about making too radical changes 
that could interfere with what's right in our system. Instead, we can 
expand an existing part of the system that's been proven to provide 
cost-effective, high-quality care.
  2. Health centers play a crucial role in health care, and are vastly 
underappreciated. It's amazing to me how few people are aware of the 
types of services community health centers provide, and just how 
prominent they are in health care. After all, health centers care for 
close to one out of very 20 Americans, one out of every 12 rural

[[Page S825]]

residents, one out of every 6 low-income children, and one of every 5 
babies born to low-income families.
  3. Health centers truly target the health care access problem. By 
definition, health centers must be located in ``medically underserved'' 
communities--which simply means places where people have serious 
problems getting access to health care. So health centers attack the 
problem right at this source. Unlike other health care proposals, the 
REACH Initiative doesn't create problems of ``crowding out'' private 
insurance by replacing private dollars spent on health insurance with 
federal dollars.

  4. Health centers are relatively cheap. Health centers can provide 
primary and preventive care for one person for less than $1 dollar per 
day--about $350 per year. Even better, health centers are able to 
leverage each grant dollar from the federal government into additional 
funding from other sources--meaning they can effectively turn one grant 
dollar into several dollars that can be used to address health care 
problems. With an extra billion dollars a year--the goal of the REACH 
Initiative in its fifth year--health centers could be caring for an 
additional 10 million people.
  5. Expanding health center access would not be a government takeover 
of health care. New funding within the REACH Initiative. But this new 
funding would not go to create a huge new government bureaucracy. 
Instead, the REACH Initiative would invest additional funds in private 
organizations that have consistently proven themselves to be efficient, 
high-quality, and cost-effective health care providers.
  To me, all of these reasons point to one logical conclusion--a need 
for drastically increased funding for health centers. Health centers 
are already helping millions of Americans get health care. But they can 
still help millions more--pregnant women, children, and anyone else who 
desperately needs care.
  At the start of my remarks, I said that we were here to talk about 
and address the problem of health care access--but that's sort of a 
cold way to talk about it. So let me try again, but this time in human 
terms.
  We're here to introduce the REACH Initiative to make sure that a 
young woman who has just found out she's pregnant--but who doesn't have 
health insurance--has a place to get prenatal care so she doesn't risk 
her health and her baby's health by waiting until late in the 
pregnancy.
  We're here to introduce the REACH Initiative to make sure that a 6-
year-old boy living in a heavily rural Missouri community--where there 
wouldn't otherwise be any health care providers at all--has a place to 
get regular checkups so he can stay health at home and in school.
  We're here to make sure that a young couple without anywhere else to 
go has a place to get their infant daughter immunized to protect her 
from a variety of dreaded diseases.
  These individuals, and millions more like them, are the reasons why 
we must make the goal of the REACH Initiative--doubled funding for 
community health centers--a reality.

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