[Congressional Record Volume 147, Number 59 (Thursday, May 3, 2001)]
[Extensions of Remarks]
[Pages E721-E722]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       INTRODUCTION OF THE MEDIKIDS HEALTH INSURANCE ACT OF 2001

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                         Thursday, May 3, 2001

  Mr. STARK. Mr. Speaker, I join my colleagues Representatives Charlie 
Rangel, George Miller, Jim McDermott, John Conyers, Barney Frank, 
Sherrod Brown, John Tierney, Sheila Jackson-Lee, Dennis Kucinich, 
William Coyne, Karen Thurman, and John LaFalce today to introduce the 
MediKids Health Insurance Act of 2001, which would provide universal 
health for our nation's children through a new Medicare-like national 
program with benefits tailored toward children. Senator Rockefeller is 
introducing a companion bill in the Senate.
  Children are the least expensive segment of our population to insure, 
and maintaining their health is integral to the future of our society. 
We can not allow children to go without basic health care because they 
are uninsured. They will be more likely to require both avoidable 
hospitalizations and emergency care. In addition, lack of health care 
as a child can lead to the need for more intensive and unnecessarily 
costly care later in life. Providing health care coverage to children 
impacts much more than just their health--it impacts their ability to 
learn, their ability to thrive, and their ability to become productive 
members of our society.
  In the past several years, we have achieved a remarkable consensus to 
address the millions of children without health insurance in America. 
The result has been the expansion of Medicaid and the implementation of 
S-CHIP. But, despite these efforts, there are still over 10 million 
uninsured children. Clearly, much more can and should be done to 
guarantee the coverage of all children in the United States. It is 
unconscionable for our society to allow children to go without health 
care coverage because the are stuck in the gap between being eligible 
for public programs like Medicaid and their parents' being able to 
afford reliable coverage.
  MediKids will provide health insurance for all children in the United 
States regardless of family income. The program is modeled after 
Medicare, but the benefits are tailored toward children. MediKids is 
financed like the Medicare Part B program with families paying a 
premium of 25% of the value of the program and the rest financed 
through general revenues. Premiums for MediKids would be collected each 
year when their parents' file their taxes. There is also a generous 
low-income subsidy for families phasing out at 300% of poverty.
  Parents who have other coverage for their children--employer 
sponsored, individual marketplace, S-CHIP, Medicaid or whatever, could 
maintain that coverage. But, if something happens and that coverage is 
no longer available, their children could always rely on MediKids for 
coverage. If the family moves, MediKids follows the children across 
state lines. And, no longer would kids get caught with no health 
insurance coverage if their parents are climbing out of welfare.
  Enrollment in MediKids is simple with no complicated paperwork or re-
determination hoops to jump through. When children are born or 
immigrate to this country, the parents are automatically given a 
MediKids insurance card and information on the benefits. For those 
children who are already born, the bill authorizes presumptive 
eligibility and enrollment at outstationed sites such as 
Disproportionate Share Hospitals and Federally Qualified Health Centers 
to simplify outreach efforts. Once the program is fully phased in no 
outreach will be needed because enrollment into the program will be 
automatic.
  Our legislation is supported by both children's advocates and the 
doctors who care for children. Groups that support the legislation 
include: the American Academy of Pediatrics, the Children's Defense 
Fund, the American Academy of Child and Adolescent Psychiatry, 
Consumers Union, Families USA, the March of Dimes, the National 
Association of Community Health Centers, the National Association of 
Public Hospitals and Health Systems, the National Health Law Program, 
and NETWORK: a Catholic Social Justice Lobby. These providers and 
children's advocacy groups are united around the concept that children 
deserve access to continuous health insurance. MediKids meets that 
goal.
  It's time we make this investment in the future of America by 
guaranteeing to all children

[[Page E722]]

the health coverage they need to make a healthy start in life. In a 
country awash in surplus, there is no excuse for any of our children to 
grow up without health care coverage. A small investment in our 
children's health will go much further than a huge tax break for those 
who are already well off. I look forward to working with my colleagues 
and supporting organizations for the passage of the MediKids Health 
Insurance Act of 2001.
  Below is a short summary of the legislation:

                               ENROLLMENT

       Every child born after 2002 is automatically enrolled in 
     MediKids, and those children already born are enrolled over a 
     5-year phase-in as described below. Children who immigrate to 
     this country are enrolled when they receive their immigration 
     card. Materials describing the program's benefits, along with 
     the MediKids insurance card, are issued to the parent(s) or 
     legal guardian(s) of each child. Once enrolled, children 
     remain enrolled in MediKids until they reach the age of 23.
       Parents may choose to enroll their children in private 
     plans or government programs such as Medicaid or SCHIP. 
     During periods of equivalent alternative coverage, the 
     MediKids premium is waived. However, if a lapse in other 
     coverage occurs, MediKids automatically covers the children's 
     health insurance needs (and a premium will be owed for those 
     months).


                                PHASE-IN

       Year 1 (2003)=the child has not attained age 6
       Year 2 (2004)=the child has not attained age 11
       Year 3 (2005)=the child has not attained age 16
       Year 4 (2006)=the child has not attained age 21
       Year 5 (2007)=the child has not attained age 23


                                BENEFITS

       The benefit package is based on the Medicare and the 
     Medicaid Early and Periodic Screening, Diagnosis, and 
     Treatment (EPSDT) benefits for children, and includes 
     prescription drugs. The benefits will be reviewed annually 
     and updated by the Secretary of Health and Human Services to 
     reflect age-appropriate benefits as needed with input fro the 
     pediatric community.


                   PREMIUMS, DEDUCTIBLES, AND COPAYS

       Families up to 150 percent of poverty pay no premiums or 
     copays. Families between 150 percent and 300 percent of 
     poverty pay a graduated premium up to 5 percent of their 
     income and receive a graduated refundable tax credit for cost 
     sharing. Parents above 300 percent of poverty are responsible 
     for a small premium, one-fourth of the annual average cost 
     per child. Premiums are collected at income tax filing. There 
     is no cost sharing for preventive and well childcare for any 
     children.


                               FINANCING

       Congress would need to determine initial funding. In future 
     years, the Secretary of Treasury would develop a package of 
     progressive, gradual tax changes to fund the program, as the 
     number of enrollees grows.


                                 STATES

       Medicaid and S-CHIP are not altered by MediKids. These 
     programs remain the safety net for children until MediKids is 
     fully implemented and appropriately modified to best serve 
     our nation's children. Once MediKids is fully operational, 
     Congress can revisit the role of these programs in covering 
     children.
       To the extent the states save money from the enrollment of 
     children into MediKids, states are required to maintain those 
     funding levels in other programs and services directed at the 
     Medicaid and S-CHIP populations. This can include expanding 
     eligibility for Medicaid or offering additional services. For 
     example, states could expand eligibility for parents and 
     single individuals, increase payment rates to providers, or 
     enhance quality in nursing homes.

     

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