[Congressional Record Volume 147, Number 112 (Friday, August 3, 2001)]
[Extensions of Remarks]
[Page E1535]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


            TRANSITIONAL MEDICAL ASSISTANCE IMPROVEMENT ACT

                                 ______
                                 

                          HON. SANDER M. LEVIN

                              of michigan

                    in the house of representatives

                        Thursday, August 2, 2001

  Mr. LEVIN. Mr. Speaker, today I am pleased to join with my colleagues 
Michael Castle and Henry Waxman in introducing the Transitional Medical 
Assistance Improvement Act. I am also pleased to partner with Senators 
Lincoln Chafee and John Breaux, who have introduced identical 
legislation in the other body. This bill is a critical next step toward 
making welfare reform work for families and for states. Improving 
access to health insurance for people leaving welfare is also a 
necessary component of any plan to reduce the number of uninsured 
people in the U.S.
  When we passed the 1996 welfare reform bill, we agreed on a 
bipartisan basis that people who left welfare for work should not lose 
health insurance coverage. Unless Congress acts, the program which 
keeps that promise, the Transitional Medical Assistance program (TMA), 
will expire at the end of 2002. The TMA Improvement Act would 
permanently authorize this critical program and fix some of the 
problems that have kept it from living up to its potential.
  We made the commitment to providing health insurance for people who 
leave welfare for work both because it was the fair thing to do and 
because health insurance is a critical work support. According to the 
Welfare-to-Work Partnership, which represents over 20,000 businesses 
that have hired former recipients, access to health insurance is one of 
the five most important things that keeps employees on the job. 
However, it can be difficult for some employers--especially smaller 
ones--to offer medical benefits to employees and their dependents. For 
example, while 74 percent of all The Partnership's members offer health 
benefits to their new workers, only 56 percent of the smallest 
employers--those with 50 employees or fewer--are able to do so. And 
health insurance sometimes isn't offered to part-time employees, or 
doesn't become effective for up to a year. Even when an employer does 
offer health care benefits, employees may not participate if they can't 
afford the premiums.
  TMA fills the gap for former welfare recipients who aren't offered 
insurance or can't afford the coverage they're offered. Unfortunately, 
certain technical problems with the program have made it difficult for 
states to administer and even more difficult for eligible workers to 
access. Here are a few of the major problems the TMA Improvement Act 
would solve.

  Our bill would give states the option of offering up to a year of 
continuous TMA coverage, without burdensome reporting requirements and 
excessive paperwork. Current law requires beneficiaries to re-apply for 
coverage every three months and have states redetermine their 
eligibility for benefits. The redetermination forms are often long, 
complicated, and difficult to fill out, requiring time and energy that 
a working parent in a new job may not have. The process also creates a 
significant burden for primary care providers by forcing them to re-
verify insurance coverage each time they see a TMA patient, which makes 
them reluctant to serve this population.
  Our bill would allow states to offer a second year of TMA coverage to 
workers who were still poor and uninsured. The Urban Institute 
estimates that 50% of people leaving welfare are uninsured a year after 
leaving the rolls On average, those workers earn $7 an hour and cannot 
afford to purchase private insurance. A few states are already trying 
to offer these workers a second year of Medicaid coverage, but current 
law makes doing so administratively complex.
  Our bill would allow states to provide transitional health coverage 
to people who find work quickly. Ironically, current law restricts TMA 
coverage to those who have been receiving assistance for at least 3 
months. This means that some of the most motivated people leaving 
welfare, those that find work the most quickly, are deprived of health 
coverage. I applaud my home state of Michigan for using state funds to 
cover this group, but I believe the federal government should be doing 
its part.
  Our bill would make it easier for employers, community groups, 
schools, and health clinics to help us enroll working parents in health 
insurance programs. A recent survey of employers of welfare recipients 
found that 79% would be willing to help a new employee access 
information on these programs if they knew he or she were eligible. 
Many were even willing to help the employee enroll. Our bill would 
ensure that nonwelfare office sites were able to accept applications 
for TMA, greatly expanding access for working parents who are unable to 
go to welfare offices during business hours.
  Tens of thousands of former welfare recipients have gone to work 
since 1996, exactly as we asked. I hope that my colleagues will join me 
in supporting the TMA Improvement Act, which will ensure that Congress 
keeps its promise of transitional health insurance for these hard-
working parents and their children.

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