[Congressional Record Volume 148, Number 127 (Wednesday, October 2, 2002)]
[Senate]
[Pages S9825-S9828]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               MOTHERS AND NEWBORNS HEALTH INSURANCE ACT

  Mr. BINGAMAN. Madam President, I rise with the purpose of making a 
unanimous consent request, which I will make at the end of my remarks, 
the remarks of my colleague from Missouri, and the remarks of my 
colleague from Arkansas. The unanimous consent request will be to take 
up and pass S. 1724, the Mothers and Newborns Health Insurance Act of 
2001. This bill was reported by the Senate Finance Committee. This 
legislation, introduced by Senator Bond and Senator Breaux, would give 
States the option of covering pregnant women in the State Children's 
Health Insurance Program--the CHIP program--for the full range of pre 
and postpartum care.
  This legislation, which as I indicated, was passed by the Finance 
Committee, was passed by unanimous consent. It was included in S. 1016, 
which was the Start Healthy, Stay Healthy Act of 2001, which I 
introduced earlier with Senators Lugar, McCain, Corzine, Lincoln, 
Chafee, Miller, and Landrieu. It provides continuous health care for 
children throughout the first and the most fragile year of their life.
  According to the Centers for Disease Control, the U.S. is 21st in the 
world in infant mortality. We are 26th in the world in maternal 
mortality. For a nation as wealthy as ours, this is an unacceptable 
circumstance.
  The sad thing is that we know exactly how to fix this problem. 
Numerous studies over the years indicate that prenatal care reduces 
infant mortality and maternal mortality and reduces the number of low-
birthweight babies. According to the American Medical Association:

       Babies born to women who do not receive prenatal care are 4 
     times more likely to die before their first birthday.

  Current law creates some unintended consequences that this bill tries 
to correct. Under the Children's Health Insurance Program, women under 
the age of 19--that is, until they complete their 18th year--are 
covered for pregnancy-related services, but once they reach the age of 
19, they are no longer covered. This legislation will eliminate that 
problem by allowing States to cover pregnant women through CHIP, 
regardless of their age.
  This also eliminates the unfortunate separation between pregnant 
women and infants that has been created as a result of the CHIP 
program, as it currently is administered.
  This is, of course, contrary to longstanding Federal and medical 
policy through programs such as Medicaid and the WIC Program. There is 
a report by the Council of Economic Advisors entitled ``The First Three 
Years: Investments That Pay.'' That report states:

       Poor habits or inefficient health care during pregnancy can 
     inhibit a child's growth, development, and well-being. Many 
     of these effects last a lifetime. . . .

  The Washington Business Group on Health has found in its report 
entitled ``Business, Babies, and the Bottom Line'' that more than $6 in 
neonatal intensive care costs could be saved for every single dollar 
spent on prenatal care and low-birthweight babies.
  Furthermore, the Agency for Health Care Research and Quality report 
has found that 4 of the top 10 most expensive conditions in the 
hospital are related to the care of infants with complications, such as 
respiratory distress, prematurity, heart defects, and lack of oxygen. 
All of these conditions can be improved--not totally eliminated but 
improved--through quality prenatal care.
  Some might argue this legislation is unnecessary because the 
administration is proceeding with a regulation that goes into effect 
today, in fact, to allow States to cover some prenatal care through 
CHIP by allowing the insurance of the unborn child.
  I want to take a few minutes to talk about the administration's plan 
to cover the fetus and not to cover women through pregnancy.
  Leaving the woman out of this equation is completely contrary to the 
clinical guidelines of the American College of Obstetricians and 
Gynecologists and the American Academy of Pediatrics, which say the 
woman and the unborn child need to be treated together. You cannot 
perform fetal surgery without thinking about the consequences for the 
mother. You cannot prescribe unlimited prescription drugs to a pregnant 
woman without considering the consequences to the development of the 
fetus.
  Moreover, if you only are covering the fetus, as this rule would, 
this eliminates important aspects of coverage for women during all the 
stages of birth; that is pregnancy, delivery, and postpartum care.
  This is exactly what the administration rule proposes to do. 
According to today's published rule, pregnant women would not be 
covered during their pregnancy for cancer, medical emergencies, broken 
bones, or mental illness. Even lifesaving surgery for a mother would 
appear to be denied coverage.
  Further, during delivery, coverage for epidurals is a State option 
and is justified only if the health of the child is affected. On the 
other hand, anesthesia is covered for C-sections. The rule would 
wrongly push women and providers toward providing C-sections to ensure 
coverage.
  Finally, during the postpartum period, women would be denied all 
health coverage from the moment the child is born. Important care and 
treatment that includes, but is not limited to, the treatment for 
hemorrhage, infection, episiotomy repair, C-section repair, family 
planning counseling, treatment of complications after delivery, and 
postpartum depression would not be covered under the rule proposed by 
the administration.
  I repeat, our country ranks 26th in the world in maternal mortality. 
We need to do better than this. We can do better than this for our 
Nation's mothers. However, let there be no mistake, this bill is also 
about children's health. Senator Bond's bill is appropriately named the 
Mothers and Newborns Health Insurance Act for a reason. We all know the 
importance of an infant's first year of life. Senator Bond's 
legislation, as amended by the Finance Committee, provides 12-month 
continuous coverage for children after they are born. Again, the United 
States ranks 21st in the world in infant mortality, and this provision 
will help solve that problem.
  In sharp contrast, the rule that has been issued today provides an 
option for 12 months continuous enrollment to States, but makes the 
time retroactive to the period in the womb. Therefore, if 9 months of 
pregnancy are covered, the child would lose coverage in the third month 
after birth. Potentially lost would be a number of important well-baby 
visits, immunizations, and access to the pediatric caregiver.
  This legislation, which was introduced by Senator Bond, has a large 
number of bipartisan cosponsors, including Senators Daschle and Lott. 
It should be passed into law as soon as possible. It did pass the 
Finance Committee unanimously.
  Finally, Secretary Thompson is in very strong support of the passage 
of S. 724, and he has said so publicly. Also in a letter to me that is 
dated April 12 of this year, he wrote:


[[Page S9826]]


       Prenatal care for women and their babies is a crucial part 
     of medical care. These services can be a vital, lifelong 
     determinant of health, and we should do everything we can to 
     make this care available for all pregnant women. It is one of 
     the most important investments we can make for the long-term 
     good health of our Nation. . . .I also support legislation to 
     expand CHIP to cover pregnant women.

  That is exactly what we have. In addition, Secretary Thompson was 
quoted in the Washington Post on September 28 as saying in relation to 
today's ``unborn child'' coverage rule:

       There is no abortion issue as far as I'm concerned.

  If this is the case, then we should pass this legislation immediately 
to ensure States have the option of covering pregnant women with the 
full range of care. It is a much simpler and better way to go, both for 
the health of mothers and the health of children. It is also free from 
the very real problem in this Congress of abortion politics.
  Once again, this legislation has strong bipartisan support. I will, 
after my colleagues speak, ask to propound a unanimous consent request.
  I ask unanimous consent that the letter from Secretary Thompson be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:
                                       The Secretary of Health and


                                               Human Services,

                                   Washington, DC, April 12, 2002.
     Hon. Jeff Bingaman,
     U.S. Senate,
     Washington, DC.
       Dear Senator Bingaman: Thank you for sharing your views on 
     our new proposal to expand health care coverage for low-
     income pregnant women under the State Children's Health 
     Insurance Program (SCHIP). I believe it is not only 
     appropriate, but indeed, medically necessary that our 
     approach to child health care include the prenatal stage.
       Prenatal care for women and their babies is a crucial part 
     of medical care. These services can be a vital, life-long 
     determinant of health, and we should do everything we can to 
     make this care available for all pregnant women. It is one of 
     the most important investments we can make for the long-term 
     good health of our nation.
       Our regulation would enable states to make use of funding 
     already available under SCHIP to provide prenatal care for 
     more low-income pregnant women and their babies. The proposed 
     regulation, published in the Federal Register March 5, would 
     clarify the definition of ``child'' under the SCHIP program. 
     At present, SCHIP allows states to provide health care 
     coverage to targeted low-income children under age 19. States 
     may further limit their coverage to age groups within that 
     range. The new regulation would clarify that states may 
     include coverage for children from conception to age 19, 
     enabling SCHIP coverage to include prenatal and delivery care 
     to ensure the birth of healthy infants.
       Although Medicaid currently provides coverage for prenatal 
     care for some women with low incomes, implementing this new 
     regulation will allow states to offer such coverage to 
     additional women. States would not be required to go through 
     the section 1115 waiver process to expand coverage for 
     prenatal care.
       By explicitly recognizing in our SCHIP regulations the 
     health needs of children before birth, we can help states 
     provide vital prenatal health care. I believe our approach is 
     entirely appropriate to serve these health purposes. It has 
     been an option for states in their Medicaid programs in the 
     past and it should be made an option for states in their 
     SCHIP program now. As I testified recently at a hearing held 
     by the Health Subcommittee of the House Energy and Commerce 
     Committee, I also support legislation to expand SCHIP to 
     cover pregnant women. However, because legislation has not 
     moved and because of the importance of prenatal care, I felt 
     it was important to take this action.
       I know we share the same commitment to achieving the goal 
     of expanding health insurance coverage in order to reduce the 
     number of uninsured.
       A similar letter is being sent to the cosigners of your 
     letter. Please feel free to call me if you have any questions 
     or concerns.
           Sincerely,
                                                Tommy G. Thompson.

  The PRESIDING OFFICER. The Senator from Missouri.
  Mr. BOND. I thank the Chair.
  Madam President, I thank my colleague from New Mexico. I apologized 
to him earlier today. We tried to get him in the lineup so we could 
move on this important measure, and we did not get it done.
  I rise today in very strong support of the request he is going to 
make because I share with him and my other colleagues on the floor the 
fact that S. 724, the Mothers and Newborns Health Insurance Act of 
2001, is vitally important for the health care of children and pregnant 
women in America.
  As one who spent a good deal of time concerned about the care of 
children, particularly health care in the very earliest years, I 
believe this is one of the most important steps we can take. I was one 
of the original sponsors of S. 724. The legislation's simple goal is to 
make sure more pregnant women and more children are covered by health 
insurance so they get a good start for the child and have access to 
health care services they need to make sure they are healthy.
  This simply gives the States the option and flexibility to cover low-
income pregnant women in the States Children Health Insurance Program, 
or S-CHIP, as I call it, for the full range of prenatal, delivery, and 
postpartum care. This bill would complement the administration's final 
rule that allows States to expand S-CHIP coverage to fetuses by 
covering additional vital health care services for the pregnant mother 
the rule would not cover.
  Under current law, S-CHIP currently permits States to cover eligible 
babies once they are born, but coverage is not available to women when 
they are pregnant. This creates the perverse situation in which a State 
can provide health care for a child the day she is born, but cannot 
provide the critical prenatal care, both to the child and the mother's 
health, during the prior 9-month period. It just absolutely makes no 
sense. Prenatal care is essential for both the mother's health and the 
baby's health. No health care program that ignores this fact can fully 
address the issue of children's health care.
  This bill will eliminate the illogical disconnect that currently 
exists between pregnant women and babies in the S-CHIP program.
  This bill, as I believe has already been indicated by my colleague, 
has strong bipartisan support in the Senate and the House. It has the 
endorsement of the National Governors' Association and 25 other 
national organizations, including the March of Dimes, the American 
Academy of Pediatrics, American Public Health Association, National 
Association of Children's Hospitals, American College of Obstetricians 
and Gynecologists, and the Catholic Health Association. One normally 
speaks of the usual suspects backing a bill. In this case, the usual 
strong proponents are backing the bill. I can think of no stronger 
group to have behind this measure. I also note, the Secretary of Health 
and Human Services, Secretary Thompson, strongly supports passage of 
the legislation.
  The need is great. On any given day, almost 9 million children and 
400,000 pregnant women do not have health insurance coverage. For many 
of these women and children, they or their families simply cannot 
afford insurance. Many others are actually eligible for a public 
program like Medicaid or S-CHIP, but they do not know they are eligible 
and are not signed up.
  Lack of health insurance can lead to numerous health problems, both 
for children and for pregnant women.
  A pregnant mother without health coverage is much less likely to 
receive the health care services she needs to ensure the child is 
healthy, happy, and fully able to learn and grow. All women need 
prenatal care. Young and old, first baby or fifth, all mothers benefit 
from regular care during pregnancy.
  Studies have shown that an uninsured pregnant woman is much less 
likely to get critical prenatal care that reduces the risk of health 
problems for both the woman and the child. Babies whose mothers receive 
no prenatal care or late prenatal care are at risk for many of the 
health problems, including birth defects, premature births, and low 
birth rate, a tragedy that we ought to devote every effort to 
eliminate.
  We know prenatal care improves both birth outcomes and can save 
money. According to the National Center for Health Statistics, infants 
born to mothers who receive no prenatal care or late prenatal care are 
nearly twice as likely to be low birth weight, and low birth weight in 
pre-term births is one of the most expensive reasons for a hospital 
stay in the United States, with hospital charges averaging $50,000, an 
especially serious issue for families without health insurance.
  A report by the IOM entitled ``Health Is A Family Matter'' notes:

       Infants of uninsured women are more likely to die than are 
     those of insured women.

  In one region of West Virginia, the fetal death rate dropped 35.4 to 
7 for

[[Page S9827]]

1,000 live births after the introduction of the prenatal care for the 
uninsured. Let me reemphasize that--35 fetal deaths for 1,000 live 
births. When they gave insurance and prenatal care, it dropped to 7, a 
reduction of 80 percent.
  In addition to ensuring better health outcomes, research and State 
experience suggest that covering pregnant women is a highly successful 
outreach mechanism for enrolling children. I thank Senator Bingaman 
from New Mexico for his leadership in the Finance Committee on this 
vital health care issue. This bill passed the Finance Committee in the 
beginning of August by unanimous consent, with additional language to 
provide children continuous coverage through the first and most 
critical year of life. I commend him for that provision. It makes a 
strong bill even stronger.
  The studies have shown time and again that babies born to mothers 
receiving late or no prenatal care are more likely to face 
complications which result in hospitalization, expensive medical 
treatment, and ultimately increased costs to public programs. We must 
close the gap in coverage between pregnant mothers and their children 
to improve the health of both and to address more fully the issue of 
children's health care.
  It can be said this is a sound matter of economics, to reduce the 
costs, but none of us would deny that the far greater benefits are the 
benefits of healthy children. Numbers cannot be put on them. In this 
instance, this is a saving: Less money to care for needy children. But 
the most important benefit is less needy children, less harm to the 
children, less serious conditions for the children, and better 
families, better citizens in the future.
  This is crucial legislation. I urge all of my colleagues to join in 
support so we can pass this bill. I thank the Senator from New Mexico 
for his leadership, and I hope we will be able to get this bill done 
before we leave.
  I yield the floor.
  Mrs. LINCOLN. Madam President, today I proudly rise with my Senate 
colleagues from New Mexico and Missouri, Senator Bingaman and Senator 
Bond, to speak about the importance of passing S. 724, the Mothers and 
Newborns Health Insurance Act.
  I say to both Senators, I am extremely proud of the enthusiasm and 
compassion with which they come to this issue, neither one of them 
having experienced pregnancy themselves, but more importantly I am 
proud of the fact they have recognized the importance of this issue for 
mothers and children across our great Nation.
  As Senator Bond has mentioned, we must pass this bill as soon as 
possible, and certainly before we adjourn this Senate.
  This bipartisan legislation, which we passed unanimously in the 
Finance Committee this summer, gives States the option of covering 
pregnant women in the State children's health insurance program, their 
CHIP program. Most importantly, the bill allows coverage for postpartum 
care and treatment of any complications that might arise for women due 
to pregnancy.
  It is absolutely inexcusable the numbers that Senator Bingaman 
presents to us about infant mortality and maternal mortality of women 
in this great country of ours, at a time when we are ahead of every 
other nation in every other arena and yet we look at those numbers. To 
me, I am ashamed of that. I am ashamed we have not taken the course of 
action that could help us prove to the rest of the world that we truly 
do value life in this country, and that we want to do all we possibly 
can to ensure the healthy delivery of children in this country, as well 
as the health of their mothers.
  Myself having given birth to twins 6 years ago, I can personally 
attest to the importance of prenatal care. Because I did have good 
prenatal care, I was able to work up until several weeks before I 
delivered my children. I was blessed with two healthy boys and a 
relatively trouble-free pregnancy and delivery. Both the boys and I 
were able to come from the hospital within 2 days to a healthy 
beginning for our entire family.
  Not only is prenatal care essential for quality of life, it is also 
cost-effective. If we do not want to do it because we value families 
and the importance that children play in our future, we should at least 
want to do it because it is cost-effective. For every dollar we spend 
on prenatal care, we still save more than $6 in neonatal intensive care 
costs; not to mention the cost to the woman who is giving birth.
  It comes as no surprise that preterm births are one of the most 
expensive reasons for a hospital stay in the United States.
  If S. 724 was law and all States elected the option, some 41,000 
uninsured pregnant women could be covered. Arkansas currently covers 
pregnant women up to the minimum Federal requirement of 133 percent of 
poverty. If the State chose to implement this option, it could raise 
eligibility levels under S-CHIP to as much as 200 percent of poverty 
and receive an enhanced Federal payment for doing so. We in Arkansas 
could receive extra dollars enhanced payment for doing the right thing, 
both economically and for our families and our children.
  This policy simply makes sense. It seeks to improve health care for 
low-income mothers and their babies while reducing costs for everyone, 
particularly the taxpayer. No wonder it has the support of Senator 
Daschle and Senator Lott. Let's not delay any longer. Let's pass this 
legislation today.
  There is no excuse for us not passing this legislation today, 
tomorrow, or certainly before we adjourn the Senate.
  Some might wonder why this legislation is needed since the 
administration has just announced a final regulation on providing CHIP 
coverage of unborn children. The reason is simple. The administration's 
regulation covers the fetus but not the woman. It is beyond me that 
anyone could imagine when a child who was being carried by a pregnant 
woman, that in some way these two were separable. They are not.
  This is completely contrary to the clinical standards of care 
established by the American College of Obstetricians and Gynecologists 
and the American Academy of Pediatrics. Why on Earth would we want a 
policy that fails to cover the health issues that may arise for a woman 
during her pregnancy--issues such as diabetes and hypertension?
  What happens to that young mother who is pregnant and all of a sudden 
has a reaction to diabetes or hypertension, who is in an automobile 
accident and goes to the hospital?
  This covers the medical care for the unborn child but not for the 
mother who is carrying that child? It makes no sense. Mother and baby 
are undeniably connected during pregnancy. They must be treated 
together.
  Why would we want a policy that fails to cover post partum care, the 
60 days of care following delivery, which can often involve serious 
clinical complications for the mother? This care is covered by Medicaid 
and most private insurance. Why wouldn't we cover it under S-CHIP if we 
are going to cover the unborn child? What if the new mother has a 
hemorrhage, an infection? She may need some episiotomy repair or have 
post partum depression. The administration's regulation would not cover 
such services because, in their words, they are not services for an 
eligible child. But what about the mother carrying that child?
  The March of Dimes mission is to improve the health of babies 
worldwide; it has expressed serious concern and opposition to the 
President's regulation. This regulation is needlessly controversial and 
will therefore prevent many States from even taking up the option. Why 
further complicate and politicize an issue that is so important to the 
health of poor mothers and their babies?
  Even Secretary Tommy Thompson has indicated publicly his support for 
S. 724 as a way to expand prenatal care to low-income women. On behalf 
of our Nation's mothers, fathers, and their babies, we in the Senate 
have the serious obligation to pass this legislation as soon as 
possible. It is unconscionable that we have waited this long to pass a 
bill that would drastically improve the lives of our most vulnerable 
citizens. It is beyond me why we would even wait or what opposition 
there might be to this sensible legislation.
  I urge my colleagues, as we continue to muddle through all of what we 
are trying to accomplish in the final days, to help us ground ourselves 
in some of the issues that can actually make an enormous difference, 
not only economically but, more importantly, that will

[[Page S9828]]

actually affect the lives of some of our most vulnerable constituents.
  I plead with my colleagues, let us pass this bill today or certainly 
before we adjourn.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Mexico.
  Mr. BINGAMAN. Madam President, I thank my colleague from Arkansas and 
also my colleague from Missouri for their eloquent statements in 
support of moving ahead and passing this legislation. The Senator from 
Arkansas speaks with more authority and conviction than any male Member 
of this body can muster in connection with this subject and this 
legislation. Of course, the Senator from Missouri is the prime sponsor 
of the very bill on which I am asking that we move ahead.
  I ask unanimous consent that the Senate proceed to the immediate 
consideration of Calendar No. 541, which is S. 724; that the committee 
substitute be agreed to, the bill be read the third time and passed; 
that the title amendment be agreed to, the motions to reconsider be 
laid upon the table, with no intervening action or debate; and that any 
statements related to the bill be placed in the Record at the 
appropriate place as if read.
  Mr. NICKLES. Reserving the right to object, I ask my colleague a 
couple of questions. I have not looked at this issue for some time.
  There is a committee substitute to S. 724?
  Mr. BINGAMAN. Madam President, yes, there is a committee substitute 
that is essentially the bill. It is the bill we passed through the 
Finance Committee by unanimous consent.
  Mr. NICKLES. Does the Senator remember how much that bill costs?
  Mr. BINGAMAN. Madam President, in answer to the question, the bill 
costs right at $600 million over a 5-year period, and the cost is fully 
offset in the legislation.
  Mr. NICKLES. Could my colleague tell me how it was offset?
  Mr. BINGAMAN. In response, the offset was the increased scrutiny on 
the Social Security payments which we discussed in the Finance 
Committee as an appropriate offset. I think all Members agree that 
would at least raise as much money as this bill will cost the Treasury.
  Mr. NICKLES. I appreciate that. I believe I heard one or two Senators 
say Secretary Thompson supports this bill. It is my understanding that 
that is not the case. Secretary Thompson may support the thrust of it. 
I understand he supports the regulation that goes into effect today and 
this bill somewhat counteracts the regulation that he is primarily 
responsible for promulgating. Is that correct?
  Mr. BINGAMAN. Madam President, I did not hear the second part of the 
question.
  On the question as to whether he actually supports passage of this 
bill, he issued a press release indicating he supports passage of S. 
724, the bill we are trying to move ahead right now. This was March 6, 
2002, in his testimony before the House Labor-HHS Appropriations 
Committee.
  Mr. NICKLES. It is my understanding that Secretary Thompson has 
promulgated a regulation which I believe he thinks satisfies a lot of 
the unmet health care needs of children, including unborn children, and 
he supports the regulation that he promulgated and is now effective, 
and does not support the legislation which goes far beyond the 
regulation he has promulgated.
  I am very particular on making sure we are accurate in our 
statements. I believe that is accurate. I have asked my staff to check 
with HHS. I have a note that says he supports the regulation but not 
the legislation. Maybe he did make a statement that was supportive in 
March, but he may well believe that was accomplished in the regulation. 
I have not talked to him personally. I am stating my belief.

  I need to learn more about the bill. It has been months since we have 
looked at it. We have been doing a few other things. I object at this 
point. At this point I will further my contacts with those in the 
administration who know more about the regulation just promulgated. I 
compliment the Secretary on the regulation. I also wish to do a little 
more homework. I will check with the Secretary of Health and Human 
Services.
  I will check with the States. I believe this is an expansion of 
Medicaid which I know my State is struggling to pay. As a matter of 
fact, the State was reducing cases, in some cases in Medicaid because 
they do not have the budget. Our State Medicaid director told us, do 
not increase any new expansions on Medicaid because we cannot afford 
it.
  Correct me if I am wrong: I think pregnant women who have incomes 
less than 150 percent of poverty are now eligible for Medicaid and 
States have the option to take that up to 185 percent. Pregnant women 
with incomes of less than 185 percent of poverty are eligible for 
Medicaid, and I believe the legislation takes that up to 300 percent. 
It makes many more people eligible for Medicaid, which increases the 
costs to the States, which some States cannot afford.
  I object at this point and will check with a couple of other people 
who may have reservations, and perhaps those questions can be resolved, 
and I will get back to my friend and colleague from New Mexico.
  I object.
  The PRESIDING OFFICER. The objection is heard.
  Mr. BINGAMAN. Madam President, let me say for the information of my 
colleague, I appreciate his willingness to look into this matter. My 
strong impression--and not just impression, but information I have been 
given--is Secretary Thompson clearly supports the regulation which his 
Department issued today related to the fetus, the coverage of unborn 
children. However, he also supports passage of this bill to provide an 
option to States to cover pregnant women under the CHIP Program.
  It is also my information that this does not involve any expansion of 
Medicaid, that this is strictly a change in law that provides the 
option to States to cover pregnant women under the CHIP Program if they 
so choose. That is not, as I see it, an additional burden on any State.

  Mr. NICKLES. Will the Senator yield?
  Mr. BINGAMAN. Yes, I am glad to yield.
  Mr. NICKLES. Did the Senator say it is his belief that this bill does 
not increase Medicaid coverage for pregnant women up to 300 percent of 
poverty?
  Mr. BINGAMAN. That is certainly my understanding of the bill. I know 
of no provision in this bill that changes the Medicaid coverage that 
way.
  Mr. NICKLES. We will both do a little more homework and I will be 
happy to talk to my friends and colleagues, both from Arkansas and from 
New Mexico, and see where we go from there.
  Mr. BINGAMAN. Madam President, let me add one other item, since the 
Senator referred to it, about States not favoring this. My other 
information is that the National Governors Association has issued a 
policy or endorsement of this legislation and supports it.
  I appreciate the willingness of the Senator from Oklahoma to look 
into this further. I will get all the information we have to him. If he 
has any other information that we need to see, I am glad to look at it. 
I hope we can move ahead as soon as possible with this bill.
  I yield the floor. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. REED. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Miller). Without objection, it is so 
ordered.

                          ____________________