[Congressional Record Volume 146, Number 54 (Thursday, May 4, 2000)]
[Extensions of Remarks]
[Pages E660-E661]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       INTRODUCTION OF THE MEDIKIDS HEALTH INSURANCE ACT OF 2000

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                         Thursday, May 4, 2000

  Mr. STARK. Mr. Speaker, I join today with my colleagues 
Representatives Charlie Rangel, George Miller, Jim McDermott, Stephanie 
Tubbs Jones, Barney Frank, John Conyers, and Carrie Meek to introduce 
the MediKids Health Insurance Act of 2000. Senator Rockefeller is 
introducing a companion bill in the Senate. Our legislation has been 
endorsed by the American Academy of Pediatrics; the National 
Association of Community Health Centers; and NETWORK: a Catholic Social 
Justice Lobby.
  Children are the least expensive segment of our population to insure, 
they are the least able to have any control over whether or not they 
have health insurance, and maintaining their health is integral to 
their educational success and their futures in our society. Even though 
we all recognize those facts, we still have over 11 million uninsured 
children in this country.
  Despite our success in reaching out to low-income children through 
Medicaid expansions and the passage of the State Children's Health 
Insurance Program, a study released last week showed that the percent 
of children in low-income families without health insurance has not 
changed in recent years. The most recent available census figures 
confirm that the number of children without health insurance continues 
to creep slightly upward.
  In addition, increasing health insurance costs are causing many small 
businesses to drop coverage altogether or are increasing the employee 
contribution to the point of being unaffordable for many working 
parents.
  Our society continues to become increasingly mobile, with parents 
frequently changing jobs and moving between states. Families working 
their way out of welfare fluctuate between eligibility and 
ineligibility for means-tested assistance programs. Even with perfect 
enrollment in S-CHIP and Medicaid, our children are not going to have 
the consistent and regular access to health care which they need to 
grow up healthy.
  That is why we are introducing the MediKids Health Insurance Act of 
2000. This bill would automatically enroll every child at birth into a 
new, comprehensive federal safety net health insurance program 
beginning in 2002. The benefits would be tailored to the needs of 
children and would be similar to those currently available to children 
under Medicaid. A small monthly premium would be collected from parents 
at tax filing, with discounts to low-income families phasing out at 300 
percent of poverty. The children would remain enrolled in MediKids 
throughout childhood. When they are covered by another health insurance 
program, their parents would be exempt from the premium. The key to our 
program is that whenever other sources of health insurance fail, 
MediKids would stand ready to cover the health needs of our next 
generation. By the year 2000, every child in America would be able to 
grow up with consistent, continuous health insurance coverage.
  Like Medicare, MediKids would be independently financed, would cover 
benefits tailored to the needs of its target population, and would have 
the goal of achieving nearly 100 percent health insurance coverage for 
the children of this country--just as Medicare has done for our 
nation's seniors and disabled population. It's time we make this 
investment in the future of America by guaranteeing to all children the 
health coverage they need to make a healthy start in life.
  The MediKids Health Insurance Act would offer guaranteed, automatic 
health coverage for every child with the simplest of enrollment 
procedures and no challenging outreach, paperwork, or re-determination 
hoops to jump through. It would be able to follow children across state 
lines, or tide them over in a new location until their parents can 
enroll them in a new insurance program. Between jobs or during family 
crises such as divorce or the death of a parent, it would offer extra 
security and ensure continuous health coverage to the nation's 
children. During that critical period when a family is just climbing 
out of poverty and out of the eligibility range for means-tested 
assistance programs, it would provide an extra boost with health 
insurance for the children until the parents can move into jobs that 
provide reliable health insurance coverage. And every child would 
automatically be enrolled upon birth, along with the issuance of the 
birth certificate or immigration card.
  As we all know, an ounce of prevention is worth a pound of cure. 
Providing health care coverage to children impacts much more than their 
health--it impacts their ability to learn, their ability to thrive, and 
their ability to become productive members of society. I look forward 
to working with my colleagues and supporting organizations for the 
passage of the MediKids Health Insurance Act of 2000 to guarantee every 
child in America the health coverage they need to grow up healthy.
  A summary of the legislation follows.

          Details of the MediKids Health Insurance Act of 2000


                               Enrollment

       Automatic enrollment into MediKids at birth for every child 
     born after 12/31/2001.

[[Page E661]]

       At the time of enrollment, materials describing the 
     coverage and a MediKids health insurance card be issued to 
     the parent(s) or legal guardian(s).
       Once enrolled, children will remain enrolled in MediKids 
     until they reach the age of 23.
       During periods of equivalent coverage by other sources, 
     whether private insurance, or government programs such as 
     medicaid of S-CHIP, there will be no premium charged for 
     MediKids.
       During any lapse in other insurance coverage, MediKids will 
     automatically cover the children's health insurance needs 
     (and premium will be owed for those months).


                                BENEFITS

       Based on Medicare and the Medicaid Early and Periodic 
     Screening, Diagnosis and Treatment (EPSDT) benefits for 
     children.
       Prescription drug benefit.
       The Secretary of HHS shall further develop age-appropriate 
     benefits as needed as the program matures, and as funding 
     support allows.
       The Secretary shall include provisions for annual reviews 
     and updates to the benefits, with input from the pediatric 
     community.


                                PREMIUMS

       Parents will be responsible for a small premium, one-fourth 
     of the annual average cost per child, to be collected at 
     income tax filing.
       Parents will be exempt from the premium if their children 
     are covered by comparable alternate health insurance. That 
     coverage can be either private insurance or enrollment in 
     other federal programs.
       Families up to 150% of poverty will owe no premium. 
     Families between 150% and 300% of poverty will receive a 
     graduated discount in the premium. Each family's obligation 
     will be capped at 5% of total income.


                  COST--SHARING (CO-PAYS, DEDUCTIBLES)

       No cost-sharing for preventive and well child care.
       No obligations up to 150% of poverty.
       From 150% to 300% of poverty, a graduated refundable credit 
     for cost-sharing expenses.


                               FINANCING

       During the first few years, costs can be fully covered by 
     tobacco settlement monies, budget surplus, or other funds as 
     agreed upon.
       During this time, the Secretary of Treasury has time to 
     develop a package of progressive, gradual tax changes to fund 
     the program, as the number of enrollees grows in the out-
     years.


                             MISCELLANEOUS

       To the extent that the states save money from the 
     enrollment of children into MediKids, they will be required 
     to maintain those funding levels in other programs and 
     services directed at the Medicaid population, which can 
     include expanding eligibility for such services.
       At the issuance of legal immigration papers for a child 
     born after 12/31/01, that child will be automatically 
     enrolled in the MediKids health insurance program.

     

                          ____________________