[Congressional Record Volume 148, Number 86 (Tuesday, June 25, 2002)]
[Senate]
[Pages S6026-S6028]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BAUCUS (for himself, and Mr. Smith of Oregon):
  S. 2679. A bill to amend the Internal Revenue Code of 1986 to provide 
for a tax credit for offering employer-based health insurance coverage, 
to provide for the establishment of health plan purchasing alliances, 
and for other purposes; to the Committee on Finance.
  Mr. BAUCUS. Mr. President, I rise today to introduce the ``Health 
Insurance Access Act'' of 2002.
  This bill addresses one of the most serious problems facing the 
United States. The problem of the uninsured.
  According to recent census data, 38 million Americans lack health 
insurance coverage. More than the population of twenty-three States. 
Plus the District of Columbia. And lack of coverage is an even greater 
problem in rural areas. In Montana, one in five citizens goes without 
health insurance. As premiums sky-rocket, I'm worried that this number 
may grow even higher.
  For America's uninsured, the consequences of going without health 
coverage can be devastating.
  Put plainly, uninsured Americans are less healthy than those with 
health insurance. They delay seeking medical care or go without 
treatment altogether that could prevent and detect crippling illnesses. 
Illnesses like diabetes, heart disease, and cancer. The uninsured are 
far less likely to receive health services if they are injured or 
become ill.
  These factors take an enormous personal toll on the lives of the 
uninsured. They are sicker and less productive in the workplace. Their 
children are less likely to survive past infancy. And they must 
struggle with the knowledge that a serious injury or illness in their 
family might push them to the brink of financial ruin.
  I just recently saw a statistic that women with breast cancer who 
lack health insurance are 49 percent more likely to die than women who 
have insurance. Unfortunately, this statistic is just one of countless 
other statistics about the effects that lack of health insurance has on 
peoples' health and their lives.
  But these personal struggles are not the only affect of America's 
uninsured problem. Because when the uninsured become so sick that they 
must finally seek emergency treatment, there is no one to pay for it. 
No insurance company. No government program.
  So who absorbs the cost of this uncompensated medical care? We all 
do. In the form of higher health care costs. Higher and higher premiums 
at a time when the cost of health care is already rising out of 
control.
  The situation is becoming critical. And I believe the time for 
talking has ended. It is time for us to examine solutions instead of 
talking about the problem.
  That is why I have joined with Senator Gordon Smith to introduce this 
important piece of legislation. Our bill would lift millions of 
Americans out of the ranks of the uninsured. It would give millions of 
families the peace of mind that comes from knowing they will receive 
the care they need, when they need it. And it would lighten the load of 
uncompensated care on our over-burdened health care system.
  Our bill attacks the problem of the uninsured on several fronts. As 
you know, the 38 million uninsured Americans are a diverse mix of 
people. Some work for small employers, who simply can't afford the high 
cost of health insurance. Others have pre-existing health conditions. 
These conditions translate into unaffordable, even astronomical, health 
care insurance premiums.
  Some uninsured Americans fall just beyond the eligibility levels for 
public programs like Medicaid. And many are near-elderly individuals, 
too young to qualify for Medicare, yet old enough that any health 
condition at all means expensive premiums or high deductibles. In fact, 
the fastest growing segment of the uninsured today is the near-elderly 
population.
  Our bill addresses each of these populations.
  The first part of our bill would target uninsured Americans who work 
for small businesses. It would give a tax credit of up to 50 percent to 
small firms, those with 50 or fewer employees, for the cost of health 
insurance premiums for their employees. The credit is not limited only 
to employers who do not currently provide health benefits. It is 
available to all qualified small employers. The credit will give small 
employers the extra resources they need to extend, or continue to 
offer, health benefits to millions of hard-working Americans and their 
families.
  One thing I heard from my constituents traveling around the State, in 
addition to grief over increasing premiums, is that the health 
insurance options available to individuals and small employers are 
limited. If they could pool their resources together, even across State 
lines, they might be able to reduce their costs as a group.
  In response to these concerns, the second part of our bill would 
provide funding to states, private employer groups, and associations to 
create purchasing pools. These purchasing pools, or alliances, as we 
call them in this bill, would provide small employers with affordable 
health coverage options, which would, accordingly, allow them to take 
maximum advantage of their tax credits.

[[Page S6027]]

  For individuals with high cost health conditions, our bill would 
spend $50 million annually to support state high risk pools. These 
pools serve a dual purpose. They offer high-risk individuals a place to 
purchase affordable health coverage. And, by isolating the costs of 
high-risk individuals, they help lower premiums for those who are not 
considered high risk or high cost.
  Fourth, our bill would also allow states to expand health insurance 
coverage to the parents of children who are eligible for Medicaid and 
the Children's Health Insurance Program, or CHIP. This will reach an 
estimated four million low-income parents who do not currently meet 
eligibility levels for health insurance coverage under public programs. 
It will also help us cover even more kids under CHIP, kids who are 
eligible for coverage but not currently enrolled.
  Finally, our bill would allow uninsured Americans between the ages of 
62 and 65 to buy into Medicare. Under current law, Americans in this 
age group are stuck in a bind: not old enough to qualify for Medicare, 
but unable to afford the high cost of private health insurance options 
because of their age or health condition. This predicament explains why 
they represent the fastest-growing group of uninsured. Our bill would 
offer the near-elderly a more affordable, quality health care package 
to tide them over until they reach 65.
  All told, these efforts would expand access to health insurance 
coverage to 10 million Americans who are currently uninsured. It's not 
a panacea. But it's a start.
  I commend Senator Smith for his hard work on this issue. I believe 
our bipartisan efforts prove that covering the uninsured is not a 
Democratic issue. It's not a Republican issue. And it's not a Montana 
or an Oregon issue. It's an American issue.
  I hope my colleagues will join this fight by helping us pass this 
legislation, and taking a solid step towards providing quality, 
affordable health insurance to all Americans.
  Mr. SMITH of Oregon. Mr. President, I would like to thank my 
colleague from Montana for his leadership on the issue of the 
uninsured, and rise today in support of the Baucus-Smith Health 
Insurance Access Act. This bill will go a long way toward mending some 
of the holes in our nation's health care safety net.
  And make no mistake, the safety net is torn. Currently 40 million 
Americans, that's one in six,--live, work, and go to school among us 
without health insurance. That means that nationally, 17 percent of 
Americans do not have any health insurance. They are our friends, our 
neighbors, our children, our parents.
  And the problem is getting worse, not better. In 2001, two million 
Americans lost their health insurance, that's the largest one year 
increase in almost a decade.
  Many, more than 35 million of these uninsured Americans, are in low-
income working families. Many people who work in small businesses are 
not offered health insurance, and those who are often cannot afford the 
skyrocketing premiums.
  This is particularly true if an individual or a member of their 
family happen to have some kind of pre-existing or chronic condition 
that can make a simple policy totally unaffordable. Even relatively 
healthy Americans find that when they get older, they may be unable to 
afford health care premiums after they retire, but before they become 
eligible for Medicare.
  Some people say that insurance is irrelevant, that the uninsured can 
still get good care at public clinics and in emergency rooms. While it 
is true that public clinics do provide high quality care to millions of 
Americans, this is not the same as having health insurance with a 
regular source of care.
  Not having a regular source of care leads to needless delays in 
seeking care. According to a recent report by the Institute of 
Medicine, an estimated 18,000 people die every year because they don't 
have health insurance, and don't get the care they need in a timely 
fashion. Eighteen thousand deaths a year. Millions more people suffer 
unnecessarily due to delays in care.
  Millions of Americans are falling through the cracks in our health 
care system, and it is our moral obligation to help them get the care 
they need by providing access to affordable health insurance.
  The Health Insurance Access Act of 2002 provides a number of 
solutions to the growing crisis of the uninsured.
  It helps small businesses, which are often unable to offer affordable 
health insurance to their employees. Under this legislation, small 
businesses would get a significant tax break to subsidize their 
purchase of health insurance. The tax break is indexed to the size of a 
business, so the smallest employers get the most help if they choose to 
offer their employees health insurance. This is important because 
smaller businesses are much less likely to offer their employees health 
coverage.
  In order to avoid punishing small employers who are already doing the 
right thing, our tax credit is available to all qualified small 
employers, regardless of whether they currently offer health insurance 
to their employees.

  Another problem small businesses face in purchasing health insurance 
for their employees is finding an affordable policy with real benefits 
for their employees. By definition, small businesses are too small to 
provide a stable risk pool. This drives up the cost of premiums.
  The Baucus-Smith Health Insurance Access Act of 2002 offers employers 
some relief to this problem by providing funding for purchasing 
alliances, which lower premiums by sharing risk. This will provide new, 
more affordable options for millions of Americans, who have until now 
had limited health insurance choices.
  Our bill also provides grants to states to help fund high risk pools 
for people who have very limited health insurance options. It seems 
ironic to me that many of the people who need health insurance most, 
people with an expensive medical condition--are often unable to obtain 
insurance.
  For many people who have extensive health care needs and medical 
expenses, obtaining coverage in the individual insurance market is not 
a viable option. If they can find a policy to cover their illness--
often they cannot--they may not be able to afford the premium.
  However, in many cases, many of these individuals may not be able to 
buy health insurance at any cost, because insurers often turn down high 
risk individuals for coverage because of an existing or previous 
illness.
  High-risk insurance pools attempt to fill this gap in the insurance 
market. Oregon has had a high risk insurance pool for people who were 
unable to obtain health insurance because of health conditions for the 
past 15 years. Since its inception, more than 24,000 Oregonians have 
bought health care coverage through this high risk insurance pool, 
24,000 people who would otherwise have had no health care coverage.
  Operating a high risk pool in Oregon has had its costs, costs which 
are increasing every year. Our legislation will help States assist 
people who are trying to do the right thing afford health insurance 
coverage that would otherwise be out of reach.
  While much of the policy discussion about the uninsured focuses on 
children, low income parents are substantially more likely than their 
children to be uninsured. The Health Insurance Access Act of 2002 would 
also allow states to offer Medicaid and SCHIP benefits to parents of 
low income eligible children.
  Encouraging States to offer Medicaid or SCHIP coverage to parents 
will significantly expand access to care for low income parents, and 
their children, because parents are more likely to enroll their kids in 
Medicaid or SCHIP when the family is eligible, rather than just certain 
family members.
  Finally, the Health Insurance Access Act of 2002 would address 
another hole in the insurance market: the near elderly. The near 
elderly, Americans aged 62-64, often do not have employer sponsored 
health insurance, because they have retired from the labor force, but 
are not yet eligible for Medicare.
  At the same time, insurance coverage is particularly critical for 
near-elderly Americans, as the risk of serious illness rises with age, 
and the prevalence of chronic disease is higher among this population. 
In addition, because many of the near-elderly have pre-existing 
conditions, private insurers often deny them coverage or charge 
unaffordable premiums.
  Allowing all Americans aged 62-64 to buy into the Medicare program 
would create a strong risk pool that would

[[Page S6028]]

stabilize premiums, making them affordable to many who would otherwise 
have been unable to afford coverage. Researchers estimate that almost 
40% of eligible Americans 62-64 would buy into Medicare if allowed to 
do so.
  The number of uninsured people in America is an outrage. If 18,000 
Americans died in terrorist incidents each year, there would be 
widespread outrage. Yet, tens of thousands of uninsured Americans are 
at risk of dying each year from cancers diagnosed too late, or stroke 
from uncontrolled high blood pressure. These can be slow, painful 
deaths. They are preventable deaths. We can help prevent these deaths. 
We should help prevent these deaths.
  I urge you to join me and my colleague from Montana to support the 
Health Insurance Access Act of 2002. This legislation will touch 
millions of lives by making quality, affordable health insurance 
accessible to individuals and families who are living at risk.
  It is the right thing to do. It is the right time to do it.
                                 ______