[Congressional Record Volume 148, Number 101 (Tuesday, July 23, 2002)]
[House]
[Pages H5092-H5093]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   HEALTH CARE IN LOS ANGELES COUNTY

  The SPEAKER pro tempore. Pursuant to the order of the House of 
January 23, 2002, the gentlewoman from California (Ms. Solis) is 
recognized during morning hour debates for 5 minutes.
  Ms. SOLIS. Mr. Speaker, I rise today to talk about an urgent issue 
facing the people that I represent in Los Angeles, California, in the 
great county of Los Angeles: nearly 3 million people in Los Angeles 
lack adequate health care insurance. At least 215,000 of those people 
live in communities that I represent in the San Gabriel Valley in east 
Los Angeles.
  Unfortunately, individuals without health insurance are more likely 
to have serious health problems and put off getting needed care. In 
L.A. County, our system of public hospitals and county clinics works 
together to provide health care to those who cannot afford health care 
because they are either uninsured or underinsured. Clinics offer vital 
services that provide prenatal care, asthma treatment, diabetes 
screening, and HIV prevention.
  Without these vital clinics, thousands of uninsured patients would 
have no health care or safety net for their families. Unfortunately, in 
L.A. County's health care system, we are now faced with major budget 
cuts that are threatening to close dozens of our health clinics.
  The crisis is a result of a combination of factors: an increase in 
the number of uninsured patients, declining State revenues, and Federal 
payments that simply do not match our need. L.A. County has the highest 
proportion in the Nation of indigent patients relying on the county 
health care system, with more than 600,000 people a year waiting to 
receive some kind of treatment at our county facilities.
  I am very concerned about the county's budget cuts because they will 
have a devastating impact on those people that reside in my community. 
Clinics, for example, in the city of Alhambra and in Azusa are 
scheduled to be closed in the future.
  Alhambra Health Center receives over 22,000 visits a year. In the 
city of Azusa, the health care center receives over 21,000 visits a 
year. These are families struggling with high unemployment rates. In 
fact, in my district alone in the city of South El Monte, we have one 
of the highest unemployment rates in the country: 11 percent.
  Where will the young mother who needs to have her baby's hearing 
checked go? What should we tell the working father who needs a place to 
get his diabetes treatment screened? Who will take care of the elderly 
woman who has problems with arthritis? Since L.A. County's health care 
system is so large, any downturn will have a ripple effect throughout 
California and the rest of the country.
  It is time for the Federal Government to step up to the plate and do 
its part to help the residents of L.A. County. Both the Congress and 
the administration must continue to work together. The Center for 
Medicaid and Medicare services here in Washington, also known as CMS, 
can help L.A. County with the Federal program known as the Medicaid 
Upper Payment Limit. Payments under the Upper Payment Limit, also known 
as the UPL, help safety net hospitals like L.A. County by providing 
over $120 million each year.
  Unfortunately, CMS decided this past January that they would change 
the

[[Page H5093]]

rules on UPL. This change would devastate California. We could 
potentially lose up to $300 million in Medicaid funding this year. CMS 
says the change in UPL is necessary because States were abusing the 
Upper Payment Limit by using these monies for nonhealth-related 
purposes. But this is not the case in California. Those monies were 
used in the health care delivery system, and it is simply unreasonable 
to punish California, to punish our uninsured patients, for the 
mistakes that other States have made.
  I want to remind my colleagues that now is the time to work together 
in a bipartisan fashion, and I hope we can agree that these important 
Upper Payment Limits need to continue at an agreed-upon rate. It is 
simply unfair to play politics with people's lives and health care 
services. We in Congress have an important role to play in Federal 
health care efforts.
  Right now, funding for another Federal program, known as the 
Disproportionate Share Hospital program, or DSH, is also scheduled to 
be cut. Cuts in the DSH program will cost California $183 million, and 
L.A. County can potentially get a hit of $37 million. That would ruin 
our safety net.
  Fortunately, the support for stopping the DSH cliff is bipartisan. 
Many in this Congress are working together to ensure that hospitals 
that serve indigent patients get the help they need in our communities 
immediately. I know our Republican and Democratic leadership have 
pledged to stop what they call the ``DSH cliff.'' I urge my colleagues 
to work together to resolve this matter. Patients in our county are 
counting on us here in the Congress to take care of this problem.
  I also want to bring to Members' attention another issue that is of 
great concern to us in L.A. County, and we call this ``the waiver.'' It 
is known here in Washington as the Medicaid 1115 waiver. This waiver 
allows L.A. County to operate our health care system in a unique way 
that is designed to serve patients better and saves the Federal 
Government money.
  I would ask that we also renew our efforts to provide full support 
for DSH funding.
  Mr. Speaker, as Los Angeles County faces new realities in our health 
care system, including a rising uninsured rate, the County has begun to 
renegotiate its waiver with the federal government.
  I hope that my colleagues at CMS will look favorably at the County's 
efforts to renegotiate the waiver. The County is taking serious steps 
to reconfigure its health care system, but we can't do it alone. We 
need the partnership of the federal government. Without it I fear we 
will force thousands of Los Angelinos who depend on our emergency care 
services to forgo urgently needed health care.
  We can't afford to sit idly by while patients in Los Angeles County 
face a health care crisis, we simply must do more.

                          ____________________