[Congressional Record Volume 148, Number 133 (Thursday, October 10, 2002)]
[Senate]
[Pages S10367-S10368]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. CANTWELL (for herself and Mrs. Murray):
  S. 3092. A bill to amend title XXI of the Social Security Act to 
extend the availability of allotments to States for fiscal years 1998 
through 2000, and for other purposes; to the Committee on Finance.
  Ms. CANTWELL. Mr. President, I rise today to introduce the Children's 
Health Protection and Eligibility Act. I am delighted to be joined on 
this bill with my good friend, Senator Patty Murray. Senator Murray has 
been a champion for children's health issues throughout her career in 
the Senate. This important legislation addresses the allocation of 
budgeted but unspent SCHIP funds that are currently out of reach of 
states and, under current law, are scheduled to be returned to the 
federal treasury. This legislation also helps those States with the 
highest unemployment rates use more of their SCHIP dollars to provide 
health insurance coverage for low-income children.
  Washington State is in the middle of an economic crisis resulting 
from a downturn in both our aviation and high-tech sectors. With the 
jobless rate at 7.2 percent, we have one of the highest unemployment 
rates in the country, 202,000 Washingtonians are unable to find work. 
And over the last 12 months, our State has lost 50,000 jobs, and 60 
percent of those are in the high-paying manufacturing sector.
  In 2000, before the recession began, there were 780,000 uninsured 
people in Washington state, including 155,000 children. That number has 
surely grown as the economy has worsened and our population has risen. 
In fact, just last week the Census Bureau reported that the number of 
uninsured increased for the first time in two years. Sadly, there are 
41.2 million people nationwide without health insurance, 8.5 million of 
whom are children.
  The increasing number of uninsured isn't the only problem facing the 
health care system. In September, the Kaiser Family Foundation reported 
the largest increase in health insurance premium costs since 1990, 
while the Center for Studying Health System Change found that health 
care spending has returned to double-digit growth for the first time 
since that year.
  The lack of health insurance has very real consequences. We know that 
the uninsured are four times as likely as the insured to delay or 
forego needed care, and uninsured children are six times as likely as 
insured children to go without needed medical care. Health insurance 
matters for kids, and coverage today defrays costs tomorrow.
  Five years ago, Congress created a new $40 billion state grant 
program to provide health insurance to low-income, uninsured children 
who live in families that earn too much to qualify for Medicaid but not 
enough to afford private insurance. In most states, the State 
Children's Health Insurance Program, SCHIP, has been extremely 
successful. Nearly one million children

[[Page S10368]]

gained coverage each year through SCHIP and, by December 2001, 3.5 
million children were enrolled in the program.
  Unfortunately, however, not all States have been able to participate 
in this success, and perversely, these are the states that had taken 
bold initiatives by expanding their Medicaid programs to cover low-
income children at higher levels of poverty. Sadly, the recession and 
high unemployment means that the health insurance coverage we do have 
for children, pregnant women, and low-income individuals is in jeopardy 
due to State budget crises.
  Washington State has been a leader in providing health insurance to 
our constituents. We have long provided optional coverage to Medicaid 
populations and began covering children up to 200 percent of poverty in 
1994, three years before Congress passed SCHIP
  When SCHIP was enacted in 1997, most States were prohibited from 
using the new funding for already covered populations. This flaw made 
it difficult for Washington to access the money and essentially 
penalized the few States that had led the nation on expanding coverage 
for kids. This means that my State only receives the enhanced SCHIP 
matching dollars for covering kids between 200 and 250 percent of the 
Federal poverty level. Washington has been able to use less than four 
percent of the funding the Federal Government gave us for SCHIP.
  Today, Washington has the highest unemployment in the country, an 
enormous budget deficit, and may need to cut as many as 150,000 kids 
from the Medicaid roles. Because it is penalized by SCHIP rules and 
cannot use funds like other States, Washington State is sending $95 
million back to the Federal treasury or to other States. This defies 
common sense, and I do not believe that innovative States should be 
penalized for having expanded coverage to children before the enactment 
of SCHIP.
  This is why we are introducing the Children's Health Protection and 
Eligibility Act. This bill will give States the ability to use SCHIP 
funds more efficiently to prevent the loss of health care coverage for 
children. This bill targets expiring funds to States that otherwise may 
have to cut health care coverage for kids. States that have made a 
commitment to insuring children could use expiring SCHIP funds and a 
portion of current SCHIP funds on a short-term basis to maintain access 
to health care coverage for all low-income children in the State. The 
bill also ensures that all states that have demonstrated a commitment 
to providing health care coverage to children can access SCHIP funds in 
the same manner to support children's health care coverage.
  First, as my colleagues know, 1998 and 1999 State allotments 
``expired'' at the end of fiscal year 2002 and are scheduled to be 
returned to the federal treasury. Our bill allows states to keep their 
remaining 1998 and 1999 funds, and use these funds for the for the 
purposes of this legislation.
  Second, unused SCHIP dollars from the fiscal year 2000 allotment are 
due to be redistributed at the end of fiscal year 2002 among those 
States that have spent all of their SCHIP funds. Our bill would allow 
the retention and redistribution these funds as was done two years ago 
through the Medicare, Medicaid, and SCHIP Benefits Improvement and 
Protection Act, P.L. 106-554. However, under our bill, States that had 
an unemployment rate higher than six percent for two consecutive months 
in 2002 would be eligible to keep all of their unspent 2000 SCHIP 
allotment.
  Third, at State option, for certain Medicaid expenditures, qualifying 
States would receive the difference between their Medicaid federal 
matching assistance percentage, or FMAP, and their enhanced SCHIP 
matching rate. This temporary measure would be paid out of a State's 
current SCHIP allotment to ensure children's health care coverage does 
not erode as states face enormous budget deficits. States would be able 
to use any remaining funds from fiscal years 1998, 1999, and 2000 SCHIP 
allotments, plus ten percent of fiscal 2001, 2002, and 2003 allotments.
  Finally, our bill allows States that have expanded coverage to the 
highest eligibility levels allowed under SCHIP, and meet certain 
requirements, to receive the enhanced SCHIP match rate for any kids 
that had previously been covered above the mandatory level.
  Children are the leaders of tomorrow; they are the very future of our 
great nation. We owe them nothing less than the sum of our energies, 
our talents, and our efforts in providing them a foundation on which to 
build happy, healthy and productive lives. During this tough economic 
time, it is more important than ever to maintain existing health care 
coverage for children in order to hold down health care costs and to 
keep children healthy. I urge my colleagues to join us in support of 
this bill.
                                 ______