[Congressional Record Volume 146, Number 47 (Thursday, April 13, 2000)]
[Senate]
[Pages S2744-S2745]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. L. CHAFEE (for himself, Mr. Bryan, Mr. Thompson, and Mr. 
        Sarbanes):
  S. 2434. A bill to provide that amounts allotted to a State under 
section 2401 of the Social Security Act for each of fiscal years 1998 
and 1999 shall remain available through fiscal year 2002; to the 
Committee on Finance.


 state children's health insurance program (schip) preservation act of 
                                  2000

 Mr. L. CHAFEE. Mr. President, I am pleased to be joined today 
by Senators Bryan, Thompson, and Sarbanes in introducing the State 
Children's Health Insurance Program (SCHIP) Preservation Act of 2000.
  This legislation addresses what I believe to be an unintended 
consequence of the Balanced Budget Act of 1997 (BBA), which created the 
State Children's Health Insurance Program (SCHIP) to provide health 
insurance coverage to millions of our nation's uninsured children. 
Specifically, the BBA called for states to enroll 2.5 million uninsured 
children in SCHIP within three years of enactment of the bill. 
According to the Health Care Financing Administration, states enrolled 
1.98 million children in SCHIP in 1999. While this represents an 
increase in states' enrollment efforts, we need to ensure that the 
federal government is financially committed to this program, and thus 
to providing health insurance to our nation's children.
  SCHIP was designed to allow states to spend each year's allotment 
over a three-year period; if a state began its program in 1998, it has 
until the end of 2000 to spend its 1998 allotment. The legislation we 
are introducing today will extend this year's looming deadline through 
the end of Fiscal Year 2002, thus allowing states to keep their 
unexpended SCHIP allotments for up to a total of five years. Many 
states have had difficulties conducting outreach and enrolling SCHIP-
eligible children. We must not penalize states that need more time to 
identify and enroll children in this important program.
  Without this bill, the result--whether intended or unintended--would 
be a potential reduction of up to $4 billion for children's health 
programs throughout the country. A reduction of this magnitude would 
undermine many critical programs that provide quality health coverage 
to needy children. It may also inhibit the ability of states to provide 
services for children already enrolled in SCHIP, as well as encouraging 
some states to scale back on outreach and enrollment efforts. For 
example, under current statute, Rhode Island will lose approximately $8 
million annually starting in Fiscal Year 2001. This loss will undermine 
the efforts of the state to target and enroll every child who is 
eligible for SCHIP in Rhode Island. Reductions in SCHIP allotments to 
states will mean that SCHIP-eligible children who are not yet enrolled 
in the program may continue to go without health insurance.
  Data from the U.S. Census Bureau shows that the number of children 
without health insurance increased from 9.8 million children in 1995 to 
11.1 million children in 1998. This increase in the uninsured rate 
occurred in spite of the enactment of SCHIP in 1997. We must not allow 
this trend to continue. States need to be able to tap into their 
unexpended SCHIP funds to continue their outreach and enrollment 
efforts. At a time when our nation's uninsured rate continues to climb 
above 44 million, it makes little sense to be reducing these much 
needed SCHIP payments to states that are desperately trying to reach 
out to and enroll these vulnerable and needy children.
  I urge my colleagues to join me in supporting this important 
legislation, and ask unanimous consent that the legislation be printed 
in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2434

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``State Children's Health 
     Insurance Program (SCHIP) Preservation Act of 2000''.

[[Page S2745]]

     SEC. 2. AVAILABILITY OF FISCAL YEAR 1998 AND FISCAL YEAR 1999 
                   ALLOTMENTS UNDER SCHIP.

       Notwithstanding subsection (e) of section 2104 of the 
     Social Security Act (42 U.S.C. 1397dd), amounts allotted to a 
     State under that section for each of fiscal years 1998 and 
     1999 shall remain available through September 30, 
     2002.

 Mr. BRYAN. Mr. President, I am very pleased to join Senators 
Lincoln Chafee, Paul Sarbanes, and Fred Thompson as an original 
cosponsor of the State Children's Health Insurance Program Preservation 
Act of 2000, and I thank Senator Chafee for his leadership on this 
bill.
  This important legislation provides that Federal funds allotted to 
States under the state children's health insurance program for each of 
fiscal years 1998 and 1999 will remain available to the states through 
fiscal year 2002.
  The enactment of the 1997 Balanced Budget Act's state children's 
health insurance program (CHIP was a seminal event in addressing the 
problem of uninsured children in this nation. The $24 billion funding 
reflected the seriousness of the national commitment to ensuring 
children will have access to health care services. It provided my state 
of Nevada and the nation with an incredible opportunity to address a 
most stubborn problem--the increasing number of children who have no 
health care insurance.
  States were provided three options to provide child health care 
services through the federal funding allotments: to expand Medicaid 
coverage under enhanced Medicaid matching rates; to create or expand 
separate child health insurance programs; or to use a combination of 
the two. All options, rightly I believe, require the States to spend 
some of their own funds as a condition of participating in the program.
  The choices states face under the CHIP program reflect the 
flexibility they wanted to tailor these programs, within federal 
guidelines, to the specific needs of each state to reduce the number of 
uninsured children.
  Nevada's CHIP program--``Nevada CheckUp''--was approved by HCFA in 
August 1998 and began operating in October 1998. The program is 
separate from the Medicaid program, but the two are coordinated in the 
application process to ensure those children eligible for Medicaid are 
enrolled in that program. The Nevada CheckUp program covers applicants 
up to 200% of the federal poverty level, and children up to age 18.
  Since its October 1998 beginning, Nevada CheckUp has enrolled over 
9,000 children, representing almost 60% of the anticipated total 
eligible children. But there are approximately 6,000 children in Nevada 
who thus remain uninsured, who need health care coverage, and who must 
be found and covered. We can and must do better.
  It took the state some time to develop its program, create a state 
plan, get state and federal approval, hire and train the staff and 
begin the marketing outreach and enrollment activities. In the one and 
one-half years the program has been operating, the state has learned 
what has worked successfully, and what has not worked. They are in the 
process of developing a new marketing plan, which will allow us to 
reach more uninsured Nevada children. The new proposal will use more 
media and broadcast tools to target the low income population.
  The CHIP program is still in its infancy, and states are still 
learning how best to develop programs to provide children with much-
needed health insurance. I am hopeful as this program matures, we will 
see a most successful effort to cover our nation's children, and ensure 
their health care needs are met into the next century.
  Allow the states to keep their federal allotment for an additional 
two years should provide Nevada, and other States, the opportunity to 
reach the total number of eligible children, and increase the number of 
children with health insurance.
  I sincerely hope Nevada will find the means to make its full match, 
so our state can draw 100 percent of its available federal funds. Wise 
use of these Federal funds, with a continued commitment to our 
children, and with a 100-percent effort by our state will get the job 
done. Our children simply deserve no less than a fully-funded 
effort.
                                 ______