[Congressional Record Volume 146, Number 53 (Wednesday, May 3, 2000)]
[House]
[Pages H2486-H2487]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
ENSURING THAT CHILDREN RECEIVE NEEDED IMMUNIZATIONS
The SPEAKER pro tempore. Under a previous order of the House, the
gentleman from Texas (Mr. Green) is recognized for 5 minutes.
Mr. GREEN of Texas. Mr. Speaker, most Americans are surprised to
learn that in some States one in four children are not receiving the
immunizations they need to prevent disease and death. Yet despite gains
in recent years, we are still not doing enough to make sure that
children get the right immunizations when they need them.
As this chart shows, in some States, like my home State of Texas,
Michigan, and Nevada one in four children are not receiving one or more
of the immunizations they need by the time they are 2 years old. In
Houston, we share seven Members of Congress in Houston, and that is my
district, over 44 percent of our children do not receive one or more of
the immunizations. Over 44 percent of the children receive less than
one or more of their immunizations.
I am introducing two bills that will help correct this situation. The
first is the sense of Congress that calls for increase in funding to
crucial State immunization infrastructure programs. The second bill,
the Comprehensive Insurance Coverage of Childhood Immunization Act,
will require health plans to begin providing immunizations to children
as a covered benefit.
America's children need our help. In recent months, some have
questioned why vaccines are needed at all. Some have linked them to
adverse effects, such as autism. While there is no scientific link
between immunizations and autism, and I will repeat, no scientific link
between immunization and autism, I support efforts to completely and
thoroughly research this issue to put the minds of parents at rest.
We should not lose our focus, however, on the huge health gains that
have resulted from immunizations. The Centers for Disease Control list
vaccinations for children as the number one public health achievement
of the last century. Before we had the smallpox vaccine, 48,000
Americans per year had this disease; 1,528 died. Before we had a
measles vaccine, close to one-half million children a year got this
disease, and over 400 died. Before we had the mumps vaccine, close to
150,000 died each year of this disease. Before we had diphtheria
vaccination, over 175,000 children got sick each year.
None of these diseases have been eliminated. Only smallpox has been
eradicated. An epidemic of unvaccinated children is entirely possible,
as we saw with measles in 1989.
Children still die of the measles, mumps, rubella, and whooping
cough. These are dangerous and harmful, painful and sometimes fatal
diseases. Measles can lead to seizures and death. Mumps can lead to
deafness. Polio causes paralysis that can lead to permanent disability
and death. Diphtheria can result in coma and death. Whooping cough can
result in death for infants.
Providing access to lifesaving vaccines should be one of our Nation's
top priorities. Tracking children who have not been vaccinated, in
order to prevent future outbreaks, should be another priority.
To meet these goals, the sense of Congress resolution I have
introduced with my friend and colleague, the gentleman from
Pennsylvania (Mr. Greenwood), calls for an increase in Federal funds to
the Public Health Service's Section 317 infrastructure program. A
similar resolution was approved by the Senate Budget Committee in
March. These funds are used by States and cities to support a complex
array of programs and activities, including implementation of
registries, community outreach, management of vaccines, quality
assurance services, and surveillance and outbreak control.
As this chart of funds illustrates, infrastructure funds have reduced
rather dramatically in the last 5 years, from $271 million in 1995, to
$139 million today. That is a 40 percent decrease in funds for
infrastructure immunization. Yet the need for outreach and registry and
infrastructure development is greater today than it was in 1995.
If you have not heard from your State health director on this issue,
you will. Cuts in infrastructure funding have meant different things in
different States. In Florida, for example, the State reports that it
has reduced surveys on pockets of need and has reduced monitoring due
to lack of adequate staffing. The State has reduced community outreach
staffs and reduced the number of reminder cards it sends. Florida has
also reduced its school-based immunization clinics and has had to cut
back on efforts at day care centers.
In California, where infrastructure funds have been reduced from $27
million in 1997 to $14.9 million in 1999, only 35 percent of children
have been vaccinated against chicken pox, and the State has no system
to monitor chicken pox cases.
In California, a targeted immunization information campaign aimed at
Latino, African and American Southeast Asian families has been
eliminated.
The need for increased infrastructure funding is particularly
important in light of a recent journal of the American Medical
Association showing that 50 percent of America's children are either
over- or under-vaccinated.
Mr. Speaker, the JAMA study shows that 21% of toddlers received at
least one extra immunization while 31% missed at least one. In other
words, over 50% of American children are receiving too few or too many
vaccinations. We should do a better job of tracking these children.
A Section 317 funding increase is supported by: the American Academy
of Family Physicians, the American Academy of Pediatrics, and the
American Public Health Association.
The increase is also supported by the Association of Maternal and
Child Health Programs, Every Child by Two, the Association of State and
Territorial Health Officials and the Association of County and City
Health Officials.
My second legislative initiative, the Comprehensive Insurance
Coverage of Childhood Immunization Act of 2000, requires all health
plans governed by the Employee Retirement Income Security Act (ERISA)
to provide coverage of immunizations for children 18 years old and
younger.
The vaccines required to be covered are those recommended by CDC's
Recommended Childhood Immunization Schedule, issued periodically by the
CDC's Advisory Committee on Immunization Practices.
This schedule is approved by the American Academy of Pediatrics and
others and serves
[[Page H2487]]
as the standard for immunization in the United States. Plans may not
charge any payment for the immunizations or vaccines. And vaccines must
be made available to children as soon as they are approved by the
Advisory Committee.
Beginning for plan years in 2001, ERISA governed health plans must
provide the benefit.
For plans that are negotiated as part of a collective bargaining
agreement, the effective date is delayed until plan years following the
termination date of the current underlying collective bargaining
agreement.
The adoption of collectively bargained plan amendments made solely in
order to comply with the new requirements will not affect the timing of
the effective date under this special rule.
Why is federal legislation needed? The federal government gives this
benefit to its own workers: it requires plans that contract with the
Office of Personnel Management to provide immunizations for children as
a covered benefit.
Many states have recognized the importance of covering vaccines.
Twenty-four states, including Texas, have enacted laws to require
state-regulated plans to provide vaccines.
How big is the problem? A March, 2000 William M. Mercer survey done
for the non-profit Partnership for Prevention showed that nearly one in
five employer-sponsored plans do not cover immunizations for infants
and children.
Nearly one in four children in Preferred Provider Organizations (PPO)
and Indemnity plans do not have coverage for immunizations.
The Comprehensive Insurance Coverage of Childhood Immunization Act of
2000 is endorsed by the American Medical Association, the American
Academy of Pediatrics and others.
It, and our Sense of the Congress resolution, will improve the health
of millions of American children is a cost-effective manner.
For each dollar we spend on vaccines we save twenty-four dollars in
future health costs. That's a good investment.
I urge my colleagues to support these two bills and I yield back the
balance of my time.
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