[Congressional Record Volume 146, Number 115 (Monday, September 25, 2000)]
[House]
[Pages H8038-H8040]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           LACK OF HEALTH INSURANCE FOR OUR NATION'S CHILDREN

  The SPEAKER pro tempore (Mr. Aderholt). Under a previous order of the 
House, the gentlewoman from Texas (Ms. Jackson-Lee) is recognized for 5 
minutes.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I believe there has been 
enough debate on the floor of the House and as evidenced by news 
reports around this Nation for everyone to be aware that our health 
care system in America is near crisis in many areas. But today, Mr. 
Speaker, I announce that the care of our children and health care for 
our children is in shambles.
  About 45 percent of the $4.2 billion provided in the 1997 legislation 
passed by Congress to provide health care for our children, health 
insurance, has not been spent by the States, State and Federal 
officials have announced. Any money left after a September 30 deadline 
will be redistributed to the 10 States that used their full allotments 
of Federal money under the children's health insurance program, a 
program created in 1997. Some 40 States are in jeopardy, and September 
30 is fast appearing.
  California and Texas, Texas is the State that I come from, together 
have 29 percent of the Nation's 11 million uninsured children, and my 
State of Texas, on September 30, 2000, stands to lose $446 million. 
Seven million of those children living in our Nation, 7 million of the 
11 million children needing to have health insurance, are uninsured. 
Two-thirds of those children live in families with incomes below 200 
percent of the poverty level.
  Mr. Speaker, this crisis, this state of shambles must end. This 
program, this State-run program, covers children from families that do 
not qualify for Medicaid but cannot afford to buy insurance. This 
effort was supposed to extend coverage to an additional 2 million 
children who do not qualify for Medicaid, yet millions of children are 
believed to be eligible for programs but remain uninsured.

[[Page H8039]]

  Texas has the second highest rate of uninsured children in the 
Nation, with over 25 percent of children under the age of 19 lacking 
health insurance throughout the years 1996 to 1998. There are 1.4 
million uninsured children in Texas, 600,000 eligible for but not in 
Medicaid, nearly 500,000 qualify for CHIP. We are at the bottom of the 
totem pole; the bottom of the heap.
  And, frankly, Mr. Speaker, we are all in the mix. Texas is in the mix 
and the governor of the State of Texas is in the mix, for we had a 
number of years to outreach to those parents, those schools, those 
children to provide the information, to encourage them to sign up 
painlessly for the CHIP program. Yet in Dallas we have a young boy 
waiting for a wheelchair for months and months and months because he is 
uninsured; or in the city of Houston we have a child waiting for 
eyeglasses months and months and months because they are uninsured.
  There is $446 million to be lost to the Nation's children, 
particularly in the State of Texas; children suffering from asthma, 
children who are HIV infected, children who have been diagnosed with 
cancer, children who need to be able to have good health care, children 
who are fighting against the Texas rate of infant mortality, which is 
5.9 percent with white children and 10.9 percent with black children.
  This is a tragedy. And so my call is not only to the State of Texas 
and other States but it is also to the Federal government. We should 
delay the September 30 deadline and provide the opportunity for 
America's children to be insured. It is a shame, it is a crisis to take 
the money and to redistribute it to States, who may be in need, I agree 
with that, but do not leave unfulfilled the need of States that have 
not even touched the surface.
  Texas is well-known for having the second highest number of uninsured 
children. I am calling on Secretary Shalala and the governing body for 
these CHIP programs to delay the time frame for States to be able to 
regroup and to reoffer to the Federal Government a strategy that will 
allow them to draw down on the respective monies. My State of Texas 
cannot afford to lose these dollars. Our children need immunization, 
our children need treatment for asthma, cancer, HIV-AIDS, our children 
need eyeglasses and wheelchairs and basic preventive health care.
  At any moment now an outbreak of children's disease could cause a 
disaster in the State of Texas. It is not without being heard. Need is 
great, and we must help them. I ask Secretary Shalala, with the 
administration, to delay the time, and I ask Governor Bush to come home 
and solve the problem.
  Mr. Speaker, I rise today to point out the tragedy that nationally, 
over 44 million Americans are without health insurance and this number 
is increasing with each passing day. Of this number of uninsured 
Americans 11 million are children, which means that one in seven of 
those children living in our nation are uninsured. Two-thirds of these 
children live in families with income below 200% of the poverty level 
($33,400 for a family of four in 1999).
  Unfortunately the plight of the uninsured in our nation has grown 
worse although we are experiencing the longest economic expansion in 
the last thirty years. Our nation's unemployment rate is at its lowest 
point in 30 years; core inflation has fallen to its lowest point in 34 
years; and the poverty rate is at its lowest since 1979. The last seven 
years we have seen the Federal budget deficit of $290 billion give way 
to a $124 billion surplus. Medicaid provides health insurance coverage 
for more than 40 million individuals--most are women, children, and 
adolescents--at an annual cost of about $154 billion in combined 
federal and state funds.
  The Childrens Health Insurance Program (CHIPS), was passed in 1997. 
This state-run program covers children from families that do not 
qualify for Medicaid, but cannot afford to buy insurance. This effort 
was supposed to extend coverage to an additional 2 million children who 
do not qualify for Medicaid. Yet millions of children are believed to 
be eligible for these programs, but remain uninsured.
  Texas has the second highest rate of uninsured children in the nation 
with over 25% of children under the age of 19 lacking health insurance 
throughout the years 1996-1998.
  There are 1.4 million uninsured children in Texas, 600,000 are 
eligible for, but not in Medicaid; nearly 500,000 qualify for CHIP.
  Texas, attempt to combat the number of uninsured children is by 
combining the options available to states in order to expand health 
insurance coverage. Texas' combination includes the expansion of 
Medicaid and state-designed, non-Medicaid programs.
  At present time, there is a need for eligibility reforms and 
aggressive outreach for low-income health programs in Texas.
  Texas is at the bottom of retaining low-income kids on Medicaid since 
welfare reform in 1996. 193,400 Texas children fell off the Medicaid 
rolls during the past three years, a 14.2% decline.
  Medicaid data collected finds an increase in the number of people 
enrolled in Medicaid in June 1999 compared to June 1998, but the 
magnitude of this success rate is dampened due to the decline of 
Medicaid in nine statess--one of them was Texas.
  The status quo in Texas is that children (up to age 19) in families 
with incomes at or under 100% of the federal poverty income level (FPL, 
$14,150 for a family of 3) can qualify for Medicaid.
  Texas has been given the choice to adopt less restrictive methods for 
counting income and assets for family Medicaid; for example, states can 
increase earned income disregards, and alter or eliminate asset tests. 
Texas has been slow compared to other states in implementing CHIP.
  Children enrolled in Texas CHIP will get a comprehensive benefits 
package--includes eye exams and glasses, prescription drugs, and 
limited dental check-ups, and therapy.
  CHIP does not serve as an alternative to Medicaid for those families, 
who based on their income, are eligible for Medicaid.


                        Morbidity and Mortality

  The U.S. ranks 22nd among industrialized nations.
  Infant mortality rates are twice as high for Black infants than for 
White infants and Black infants are four times more likely to die 
because of low birthweight than are white infants.
  In Texas, the infant mortality rate is 5.9% for children with a White 
mother versus 10.9% for those with a Black mother.
  Although the absolute number of deaths due to cancer in children and 
adolescents is low relative to adults, cancer remains the second 
leading cause of death among Texas children ages 1 to 14 years.
  Cancer is diagnosed in about 800 Texas children and young adults 
under the age of 20 each year.
  Although lead has been banned from gasoline and paint, it is 
estimated that nearly 900,000 children have so much lead in their blood 
that it could impair their ability to learn.
  The estimated number of children under age 13 who acquired AIDS 
before or during birth increased each year during the period from 1984 
through 1992.
  New case rates and death rates for HIV/AIDS are disproportionately 
higher for children of color than for White children. AIDS among Black 
and Hispanic adolescents accounted for approximately 83% of reported 
cases in 1997.
  Hospitalizations for children with asthma have been increasing for 
most of the 1990's. Low-income children are more likely to suffer from 
asthma with the sharpest increases being among urban minority children. 
If trends continues, asthma will become one of the major childhood 
diseases of the 21st century.


                          childhood nutrition

  Teen obesity has more than doubled in the past 30 years. Next to 
smoking, obesity is the leading cause of preventable death and disease. 
Obesity continues to disproportionately affect poor youth and minority 
children because of poor diet and lack of exercise.
  13.6 percent of all American children are overweight. Yet, 11.8 
percent of low-income children experience moderate to severe hunger, 
compared with 1.9 percent of children in households with income above 
the poverty level.
  Approximately 35 children each day are diagnosed with juvenile 
diabetes, which can lead to blindness, heart attack, kidney failure and 
amputations. Type 2 diabetes is increasingly high among minority 
children.
  Before 1992, only 1 to 4% of children was diagnosed with Type 2 
diabetes or other forms of diabetes. Now, reports indicate that up to 
45% of children with newly diagnosed diabetes have Type 2 diabetes.


                        children's mental health

  Currently, there are 13.7 million children in this country with a 
diagnosable mental health disorder, yet less than 20% of these children 
receive the treatment they need. At least one in five children and 
adolescents has a diagnosable mental, emotional, or behavioral problem 
that can lead to school failure, substance abuse, violence or suicide.
  However, 75 to 80 percent of these children do not receive any 
services in the form of speciality treatment or some form of mental 
health intervention.
  The White House and the U.S. Surgeon General have recognized that 
mental health needs to be a national priority in this nation's debate 
about comprehensive health care.

  Suicide is the eighth leading cause of death in the United States, 
accounting for more than 1% of all deaths.

[[Page H8040]]

  The National Mental Health Association reports that most people who 
commit suicide have a mental or emotional disorder. The most common is 
depression.
  According to the 1999 Report of the U.S. Surgeon General, for young 
people 15-24 years old, suicide is the third leading cause of death 
behind intentional injury and homicide.
  Persons under the age of 25 accounted for 15% of all suicides in 
1997. Between 1980 and 1997, suicide rates for those 15-19 years old 
increased 11% and for those between the ages of 10-14, the suicide 
rates increased 99% since 1980.
  More teenagers died from suicide than from cancer, heart disease, 
AIDS, birth defects, strokes, influenza and chronic lung disease 
combined.
  Within every 1 hour and 57 minutes, a person under the age of 25 
completes suicide.
  Black male youth (ages 10-14) have shown the largest increase in 
suicide rates since 1980 compared to other youths groups by sex and 
ethnicity, increasing 276%.
  Almost 12 young people between the ages of 15-24 die every day by 
suicide.
  In a study of gay male and lesbian youth suicide, the U.S. Department 
of Health and Human Services found lesbian and gay youth are two to six 
times more likely to attempt suicide than other youth and account for 
up to 30 percent of all completed teen suicides.
  We must act to prevent states like Texas, California, and Louisiana 
from loosing millions of dollars in federal funds which have been 
provided to insure our nation's uninsured poor children.

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