[Congressional Record Volume 149, Number 21 (Wednesday, February 5, 2003)]
[Senate]
[Pages S1989-S1993]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  By Mr. ROCKEFELLER (for himself, Mr. Chafee, Mr. Kennedy, Ms. Snowe, 
Mr. Baucus, Mr. Grassley Mr. Corzine, Mr. Warner, Mrs. Clinton, Ms. 
Collins, Mr. Bingaman, Mr. McCain, Mr. Bayh, Mr. DeWine, Mrs. 
Hutchison, Mrs. Lincoln, Mr. Hatch, Mr. Lautenberg, and Ms. Mikulski):
  S. 312. A bill to amend title XXI of the Social Security Act to 
extend the availability of allotments for fiscal years 1998 through 
2001 under the State Children's Health Insurance Program; to the 
Committee on Finance.
  Mr. ROCKEFELLER. Mr. President, I rise today to introduce a bill that 
would promote the health and well- being of America's children by 
restoring funds to the Children's Health Insurance Program, known as 
CHIP. CHIP has been an unqualified success, helping millions of 
children. The program has the potential to help millions more. However, 
it is only as effective as we make it.
  In 1997, I was joined by Senator Chafee in introducing the Children's 
Health Insurance Program as part of the Balanced Budget Act. At that 
time, 10 million children were uninsured. Today, 4.6 million have 
coverage; this includes over 21,000 children in the State of West 
Virginia. I believe the families touched by this program would agree it 
serves its purpose well.
  Unfortunately, this purpose may be seriously undermined. On September 
30, 2002, $1.2 billion in unspent CHIP funds reverted back to the 
national treasury because of a budget compromise. On September 30, 
2003, an additional $1.5 billion will be returned to

[[Page S1990]]

the treasury. This combined $2.7 billion loss will serve a huge blow to 
the program. As a result of it, States may be forced to stop accepting 
new children and may have to cut current participants from their rolls. 
In the meanwhile, money intended for the care of children will be spent 
on other initiatives. Healthy kids will go without preventative care, 
and sick kids will go without treatment or medicine.
  However, such a tragedy is preventable. Today, I am joined by 
Senators Chafee, Kennedy, Snowe, and others in introducing a bill that 
would restore full CHIP funding over 2 years and allow the program to 
continue its enormously important work without cutting the benefits of 
a single child.
  I am pleased to tell you that our legislation enjoys bicameral, 
bipartisan support and is endorsed by the National Governors 
Association, NGA. Though it is not a permanent solution to the problems 
faced by CHIP, this proposal would go far in addressing them. Most 
notably, it would provide real relief to States struggling to cover 
beneficiaries under Medicaid and would allow them to offer the care 
that every child needs and deserves.
  In order to achieve this, we must provide States with the resources 
they need. Today, we have introduced a bill which will do just that. 
However, this body must make its enactment a priority. The children we 
serve deserve nothing less.
  I ask unanimous consent that the text of this bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 312

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. EXTENSION OF AVAILABILITY OF SCHIP ALLOTMENTS FOR 
                   FISCAL YEARS 1998 THROUGH 2001.

       (a) Extending Availability of SCHIP Allotments for Fiscal 
     Years 1998 Through 2001.--
       (1) Retained and redistributed allotments for fiscal years 
     1998 and 1999.--Paragraphs (2)(A)(i) and (2)(A)(ii) of 
     section 2104(g) of the Social Security Act (42 U.S.C. 
     1397dd(g)) are each amended by striking ``fiscal year 2002'' 
     and inserting ``fiscal year 2004''.
       (2) Extension and revision of retained and redistributed 
     allotments for fiscal year 2000.--
       (A) Permitting and extending retention of portion of fiscal 
     year 2000 allotment.--Paragraph (2) of such section 2104(g) 
     is amended--
       (i) in the heading, by striking ``and 1999'' and inserting 
     ``through 2000''; and
       (ii) by adding at the end of subparagraph (A) the 
     following:
       ``(iii) Fiscal year 2000 allotment.--Of the amounts 
     allotted to a State pursuant to this section for fiscal year 
     2000 that were not expended by the State by the end of fiscal 
     year 2002, 50 percent of that amount shall remain available 
     for expenditure by the State through the end of fiscal year 
     2004.''.
       (B) Redistributed allotments.--Paragraph (1) of such 
     section 2104(g) is amended--
       (i) in subparagraph (A), by inserting ``or for fiscal year 
     2000 by the end of fiscal year 2002,'' after ``fiscal year 
     2001,'';
       (ii) in subparagraph (A), by striking ``1998 or 1999'' and 
     inserting ``1998, 1999, or 2000'';
       (iii) in subparagraph (A)(i)--

       (I) by striking ``or'' at the end of subclause (I),
       (II) by striking the period at the end of subclause (II) 
     and inserting ``; or''; and
       (III) by adding at the end the following new subclause:
       ``(III) the fiscal year 2000 allotment, the amount 
     specified in subparagraph (C)(i) (less the total of the 
     amounts under clause (ii) for such fiscal year), multiplied 
     by the ratio of the amount specified in subparagraph (C)(ii) 
     for the State to the amount specified in subparagraph 
     (C)(iii).'';

       (iv) in subparagraph (A)(ii), by striking ``or 1999'' and 
     inserting ``, 1999, or 2000'';
       (v) in subparagraph (B), by striking ``with respect to 
     fiscal year 1998 or 1999'';
       (vi) in subparagraph (B)(ii)--

       (I) by inserting ``with respect to fiscal year 1998, 1999, 
     or 2000,'' after ``subsection (e),''; and
       (II) by striking ``2002'' and inserting ``2004''; and

       (vii) by adding at the end the following new subparagraph:
       ``(C) Amounts used in computing redistributions for fiscal 
     year 2000.--For purposes of subparagraph (A)(i)(III)--
       ``(i) the amount specified in this clause is the amount 
     specified in paragraph (2)(B)(i)(I) for fiscal year 2000, 
     less the total amount remaining available pursuant to 
     paragraph (2)(A)(iii);
       ``(ii) the amount specified in this clause for a State is 
     the amount by which the State's expenditures under this title 
     in fiscal years 2000, 2001, and 2002 exceed the State's 
     allotment for fiscal year 2000 under subsection (b); and
       ``(iii) the amount specified in this clause is the sum, for 
     all States entitled to a redistribution under subparagraph 
     (A) from the allotments for fiscal year 2000, of the amounts 
     specified in clause (ii).''.
       (C) Conforming amendments.--Such section 2104(g) is further 
     amended--
       (i) in its heading, by striking ``and 1999'' and inserting 
     ``, 1999, and 2000''; and
       (ii) in paragraph (3)--

       (I) by striking ``or fiscal year 1999'' and inserting ``, 
     fiscal year 1999, or fiscal year 2000''; and
       (II) by striking ``or November 30, 2001'' and inserting 
     ``November 30, 2001, or November 30, 2002'', respectively.

       (3) Extension and revision of retained and redistributed 
     allotments for fiscal year 2001.--
       (A) Permitting and extending retention of portion of fiscal 
     year 2001 allotment.--Paragraph (2) of such section 2104(g), 
     as amended in paragraph (2)(A)(ii), is further amended--
       (i) in the heading, by striking ``2000'' and inserting 
     ``2001''; and
       (ii) by adding at the end of subparagraph (A) the 
     following:
       ``(iv) Fiscal year 2001 allotment.--Of the amounts allotted 
     to a State pursuant to this section for fiscal year 2001 that 
     were not expended by the State by the end of fiscal year 
     2003, 50 percent of that amount shall remain available for 
     expenditure by the State through the end of fiscal year 
     2005.''.
       (B) Redistributed allotments.--Paragraph (1) of such 
     section 2104(g), as amended in paragraph (2)(B), is further 
     amended--
       (i) in subparagraph (A), by inserting ``or for fiscal year 
     2001 by the end of fiscal year 2003,'' after ``fiscal year 
     2002,'';
       (ii) in subparagraph (A), by striking ``1999, or 2000'' and 
     inserting ``1999, 2000, or 2001'';
       (iii) in subparagraph (A)(i)--

       (I) by striking ``or'' at the end of subclause (II),
       (II) by striking the period at the end of subclause (III) 
     and inserting ``; or''; and
       (III) by adding at the end the following new subclause:
       ``(IV) the fiscal year 2001 allotment, the amount specified 
     in subparagraph (D)(i) (less the total of the amounts under 
     clause (ii) for such fiscal year), multiplied by the ratio of 
     the amount specified in subparagraph (D)(ii) for the State to 
     the amount specified in subparagraph (D)(iii).'';

       (iv) in subparagraph (A)(ii), by striking ``or 2000'' and 
     inserting ``2000, or 2001'';
       (v) in subparagraph (B)--

       (I) by striking ``and'' at the end of clause (ii);
       (II) by redesignating clause (iii) as clause (iv); and
       (III) by inserting after clause (ii) the following new 
     clause:

       ``(iii) notwithstanding subsection (e), with respect to 
     fiscal year 2001, shall remain available for expenditure by 
     the State through the end of fiscal year 2005; and''; and
       (vi) by adding at the end the following new subparagraph:
       ``(D) Amounts used in computing redistributions for fiscal 
     year 2001.--For purposes of subparagraph (A)(i)(IV)--
       ``(i) the amount specified in this clause is the amount 
     specified in paragraph (2)(B)(i)(I) for fiscal year 2001, 
     less the total amount remaining available pursuant to 
     paragraph (2)(A)(iv);
       ``(ii) the amount specified in this clause for a State is 
     the amount by which the State's expenditures under this title 
     in fiscal years 2001, 2002, and 2003 exceed the State's 
     allotment for fiscal year 2001 under subsection (b); and
       ``(iii) the amount specified in this clause is the sum, for 
     all States entitled to a redistribution under subparagraph 
     (A) from the allotments for fiscal year 2001, of the amounts 
     specified in clause (ii).''.
       (C) Conforming amendments.--Such section 2104(g) is further 
     amended--
       (i) in its heading, by striking ``and 2000'' and inserting 
     ``2000, and 2001''; and
       (ii) in paragraph (3)--

       (I) by striking ``or fiscal year 2000'' and inserting 
     ``fiscal year 2000, or fiscal year 2001''; and
       (II) by striking ``or November 30, 2002,'' and inserting 
     ``November 30, 2002, or November 30, 2003,'', respectively.

       (4) Effective date.--This subsection, and the amendments 
     made by this subsection, shall be effective as if this 
     subsection had been enacted on September 30, 2002, and 
     amounts under title XXI of the Social Security Act (42 U.S.C. 
     1397aa et seq.) from allotments for fiscal years 1998 through 
     2000 are available for expenditure on and after October 1, 
     2002, under the amendments made by this subsection as if this 
     subsection had been enacted on September 30, 2002.
       (b) Authority for Qualifying States To Use Portion of SCHIP 
     Funds for Medicaid Expenditures.--Section 2105 of the Social 
     Security Act (42 U.S.C. 1397ee) is amended by adding at the 
     end the following:
       ``(g) Authority for Qualifying States To Use Certain Funds 
     for Medicaid Expenditures.--
       ``(1) State option.--
       ``(A) In general.--Notwithstanding any other provision of 
     law, with respect to allotments for fiscal years 1998, 1999, 
     2000, 2001, for fiscal years in which such allotments are 
     available under subsections (e) and (g) of section 2104, a 
     qualifying State (as defined in paragraph (2)) may elect to 
     use not more than 20 percent of such allotments (instead

[[Page S1991]]

     of for expenditures under this title) for payments for such 
     fiscal year under title XIX in accordance with subparagraph 
     (B).
       ``(B) Payments to states.--
       ``(i) In general.--In the case of a qualifying State that 
     has elected the option described in subparagraph (A), subject 
     to the total amount of funds described with respect to the 
     State in subparagraph (A), the Secretary shall pay the State 
     an amount each quarter equal to the additional amount that 
     would have been paid to the State under title XIX for 
     expenditures of the State for the fiscal year described in 
     clause (ii) if the enhanced FMAP (as determined under 
     subsection (b)) had been substituted for the Federal medical 
     assistance percentage (as defined in section 1905(b)) of such 
     expenditures.
       ``(ii) Expenditures described.--For purposes of clause (i), 
     the expenditures described in this clause are expenditures 
     for such fiscal years for providing medical assistance under 
     title XIX to individuals who have not attained age 19 and 
     whose family income exceeds 150 percent of the poverty line.
       ``(iii) No impact on determination of budget neutrality for 
     waivers.--In the case of a qualifying State that uses amounts 
     paid under this subsection for expenditures described in 
     clause (ii) that are incurred under a waiver approved for the 
     State, any budget neutrality determinations with respect to 
     such waiver shall be determined without regard to such 
     amounts paid.
       ``(2) Qualifying state.--In this subsection, the term 
     `qualifying State' means a State that--
       ``(A) as of April 15, 1997, has an income eligibility 
     standard with respect to any 1 or more categories of children 
     (other than infants) who are eligible for medical assistance 
     under section 1902(a)(10)(A) or under a waiver under section 
     1115 implemented on January 1, 1994, that is up to 185 
     percent of the poverty line or above; and
       ``(B) satisfies the requirements described in paragraph 
     (3).
       ``(3) Requirements.--The requirements described in this 
     paragraph are the following:
       ``(A) SCHIP income eligibility.--The State has a State 
     child health plan that (whether implemented under title XIX 
     or this title)--
       ``(i) as of January 1, 2001, has an income eligibility 
     standard that is at least 200 percent of the poverty line or 
     has an income eligibility standard that exceeds 200 percent 
     of the poverty line under a waiver under section 1115 that is 
     based on a child's lack of health insurance;
       ``(ii) subject to subparagraph (B), does not limit the 
     acceptance of applications for children; and
       ``(iii) provides benefits to all children in the State who 
     apply for and meet eligibility standards on a statewide 
     basis.
       ``(B) No waiting list imposed.--With respect to children 
     whose family income is at or below 200 percent of the poverty 
     line, the State does not impose any numerical limitation, 
     waiting list, or similar limitation on the eligibility of 
     such children for child health assistance under such State 
     plan.
       ``(C) Additional requirements.--The State has implemented 
     at least 3 of the following policies and procedures (relating 
     to coverage of children under title XIX and this title):
       ``(i) Uniform, simplified application form.--With respect 
     to children who are eligible for medical assistance under 
     section 1902(a)(10)(A), the State uses the same uniform, 
     simplified application form (including, if applicable, 
     permitting application other than in person) for purposes of 
     establishing eligibility for benefits under title XIX and 
     this title.
       ``(ii) Elimination of asset test.--The State does not apply 
     any asset test for eligibility under section 1902(l) or this 
     title with respect to children.
       ``(iii) Adoption of 12-month continuous enrollment.--The 
     State provides that eligibility shall not be regularly 
     redetermined more often than once every year under this title 
     or for children described in section 1902(a)(10)(A).
       ``(iv) Same verification and redetermination policies; 
     automatic reassessment of eligibility.--With respect to 
     children who are eligible for medical assistance under 
     section 1902(a)(10)(A), the State provides for initial 
     eligibility determinations and redeterminations of 
     eligibility using the same verification policies (including 
     with respect to face-to-face interviews), forms, and 
     frequency as the State uses for such purposes under this 
     title, and, as part of such redeterminations, provides for 
     the automatic reassessment of the eligibility of such 
     children for assistance under title XIX and this title.
       ``(v) Outstationing enrollment staff.--The State provides 
     for the receipt and initial processing of applications for 
     benefits under this title and for children under title XIX at 
     facilities defined as disproportionate share hospitals under 
     section 1923(a)(1)(A) and Federally-qualified health centers 
     described in section 1905(l)(2)(B) consistent with section 
     1902(a)(55).''.
  Mr. CHAFFEE. Mr. President, I am pleased to join Senator Rockefeller 
and others today in introducing a bipartisan compromise proposal to 
extend expiring State Children's Health Insurance Program, SCHIP, 
funds. I am pleased that we recently secured the commitment of Budget 
Chairman Nickles to include funding in the fiscal year 2004 budget 
resolution for this important proposal, as well as the commitment of 
Finance Chairman Grassley to address this issue quickly in the Finance 
Committee.
  This legislation will allow States to continue using $1.2 billion in 
funds through fiscal year 2004 that were originally allocated for 
fiscal years 1998 and 1999, and that reverted to the Federal Treasury 
on September 30, 2002. This provision extends for one additional year 
the availability of $1.5 billion in SCHIP funds that are scheduled to 
expire by the end of fiscal year 2003. This legislation also applies a 
redistribution formula to the unspent fiscal year 2000 and 2001 
allotments, allowing 50 percent of each year's unspent money to be 
retained by states that have not used their entire allotment, with the 
remaining 50 percent of unspent money being redistributed to states 
that have spent all of the respective year's allotment.
  This compromise will prevent States from losing their unexpended 
SCHIP allotments and will allow other States, such as Rhode Island, to 
receive redistributed funds they need to continue providing health 
insurance to children. Without this compromise, the result could be a 
reduction of up to $2.7 billion for children's health programs 
throughout the United States. This would undermine the overwhelming 
success of state SCHIP programs in providing quality health coverage to 
millions of uninsured children. Starting this year, States would have 
no choice but to begin imposing severe enrollment cutbacks; eligible 
children who are not yet enrolled in the program would continue to go 
without health insurance.
  Preserving the expiring funds is essential to guaranteeing that 
nearly one million children will not lose their health insurance. The 
Office of Management and Budget recently projected that the number of 
children insured through SCHIP will fall by 900,000 between Fiscal 
Years 2003 and 2006 unless appropriate congressional action is taken to 
restore the expiring funds.
  At a time when our Nation's uninsured rate continues to climb above 
40 million, it makes little sense to take away Federal funding from 
States that are desperately trying to find and enroll needy children. 
This legislation is crucial to many States, including my state of Rhode 
Island. Without this remedy, Rhode Island is set to run out of SCHIP 
funds by fiscal year 2004. At 4.5 percent, Rhode Island currently has 
the lowest uninsured rate of any State in the Nation for children. This 
bill will enable Rhode Island to continue offering health coverage to 
this vulnerable population.
  I urge my colleagues to join Senator Rockefeller and me in supporting 
this important legislation. It is a crucial step toward ensuring that 
our Nation's children will have long-term access to quality health 
insurance.
  Mr. KENNEDY. Mr. President, it is a privilege to join my colleagues 
in introducing a bipartisan bill to extend the availability of the 
unused funds in the Children's Health Insurance Program, so that 
hundreds of thousands of children can retain their health coverage, and 
so that the CHIP program can continue to grow.
  We recently celebrated the fifth anniversary of the CHIP program. 
Over its relatively short life, the program has served children across 
America, providing health coverage for those who would be otherwise 
uninsured. Last year, over 4.5 million children received health 
insurance through CHIP or through Medicaid expansions under CHIP, 
including 105,000 children in Massachusetts. Health insurance provides 
children with a healthy start in life, and CHIP is important in 
providing that healthy start for millions of children in moderate-
income working families.
  Unfortunately, because of a technical provision in the law, $1.2 
billion in unspent CHIP funds reverted to the Treasury last October. 
Another $1.5 billion will revert to the Treasury this October if 
Congress fails to act. We know that 20 States are projected to run out 
of CHIP funds soon, including 5 States--Alaska, Arizona, Maryland, New 
Jersey, and Rhode Island--that are projected to run out of money as 
early as next year.
  It makes no sense to allow funds to revert to the Treasury when there 
is so much unmet need. Some States have not been able to use all their 
CHIP

[[Page S1992]]

funds within the allotted period in current law. Yet some of these same 
States will run short of funds in the very near future, forcing them to 
drop children from their programs. One of our Nation's most fundamental 
principles should be to give every child the opportunity to succeed in 
life. But that principle rings hollow if children must fact a lifetime 
of disability and illness because they did not have needed health care 
in their early years.
  That is why this bill we introduce today is so important. It enables 
States to maintain and expand their CHIP programs. It lets States keep 
a portion of their unspent funds that would otherwise expire. It 
reallocates the rest of the funds to States that have already used 
their original allocation to enroll children in their program and are 
ready, willing, and able to enroll even more children. This 
reallocation is vital to enrolling the highest possible number of 
children in CHIP. The retention and reallocation of these funds will 
prevent an unacceptable loss of coverage for the Nation's children.
  Our legislation moves us one step closer to fulfilling the promise 
that all children should have adequate health insurance coverage. I 
urge my colleagues to support this bipartisan legislation, so that we 
can give the Nation's children the healthy start they deserve.
  Ms. SNOWE. Mr. President, I am pleased to join with my colleagues 
today in introducing our legislation restoring funding for the State 
Children's Health Insurance Program, SCHIP. I would like to thank my 
colleagues for their willingness to work with me to secure the deal 
that has led to the introduction of this legislation and ultimately its 
signature into law. SCHIP is essential to ensuring continued health 
care coverage for America's children.
  During debate over the Omnibus appropriations bill, I worked with my 
colleagues to secure an agreement that will restore $2.7 billion in 
expired, or soon to expire, SCHIP funding. This compromise has the 
support of our Nation's governors and will ensure that this funding 
remains in the program and continues to provide children with access to 
the care that is vital to their healthy development.
  I especially appreciate the willingness of Majority Leader Frist, 
Finance Committee Chairman Grassley and Budget Committee Chairman 
Nickles to work with us during the omnibus debate to develop the 
agreement. Because of their commitment to finding a solution, we are 
able to move forward with this important policy, the first step being 
introduction of this bill.
  I believe the agreement that I was able to craft with my colleagues 
is the most appropriate way to restore the SCHIP funding. Because the 
budget resolution adopted by the House of Representatives does not 
include adequate budget authority to restore this funding, the floor 
amendment that I planned to offer to the omnibus appropriations bill 
would have been subject to a budget point of order in the House. Given 
that this point of order would have laid against the provision, the 
likelihood that the House would have stripped the provision during 
conference was great. In light of those circumstances, I believe that 
the agreement I negotiated is the most appropriate way to ensure that 
this funding is restored.
  The agreement that was struck would, in exchange for withdrawing the 
amendment that filed to the omnibus appropriations bill to restore 
SCHIP funding, provide the support of the Majority Leader and Chairmen 
Grassley and Nickels to make necessary changes to remove the budget 
hurdles that have prevented this legislation from being enacted.
  Specifically, Senator Nickles has provided his commitment to 
reallocate through the Fiscal Year 04 budget process additional budget 
authority for SCHIP in Fiscal Year 03 and Fiscal Year 04. I am 
confident that under Senator Nickles' leadership, the budget process 
will move smoothly and expeditiously and that we will be able to speed 
the adoption of this proposal in both the Senate and House and 
Representatives.
  Further, Chairman Grassley has agreed that as soon as the necessary 
budget adjustments are made he will move this bill through his 
committee. Again, under his strong leadership I am confident that we 
will get this done.
  Finally, Majority Leader Frist has agreed to place the legislation on 
the Senate calendar as soon as it is reported from the Finance 
Committee.
  I might add that while I am aware that this agreement was forged in 
the Senate, the underlying policy contained in this bill was developed 
through a bipartisan, bicameral process led by Senators Grassley and 
Baucus last fall. I hope that the House of Representatives will work 
with us to make the necessary changes to the Fiscal Year 03 and Fiscal 
Year 04 budget allocations and to see this legislation enacted into law 
in a timely manner.
  How it works is this, once passed, our legislation will restore $2.7 
billion in SCHIP funding that has either reverted to the treasury or is 
scheduled to revert to HHS for redistribution. On October 1, 2002, $1.2 
billion reverted to the treasury in unspent SCHIP funding from 1998 and 
1999. If we do not recapture this funding, it will be lost to the 
program. Our agreement allows the states to reclaim this unspent money 
and provides until the end of Fiscal Year 04 to spend it on health 
insurance provided by SCHIP.
  The policy contained in this legislation also strikes a compromise 
between States that have spent all of their 2000 and 2001 allotments, 
and those that have not, by dividing the funding evenly between them. 
Those States that have not spent all of their allocations will be able 
to retain half of their funding, while the remaining States will 
receive additional allotments from the redistributed funding.
  It also rewards those States that used Medicaid to expand access to 
health care for low income children prior to the creation of SCHIP, by 
allowing them to access 20 percent of their SCHIP funding to serve this 
population. this compromise has the endorsement of the National 
Governors Association and children's health advocates from across the 
country.
  In my home State of Maine, where we are using SCHIP to insure over 
14,500 children, this proposal will allow the State to keep $13.24 
million in SCHIP funding and will provide until the end of Fiscal Year 
04 to spend it. In Maine, $13.24 million will help provide health care 
assistance to a lot of children, children who otherwise would not have 
access to immunizations, well-baby visits and yearly check-ups.
  While I agreed to forgo the appropriations process to enact this 
policy change, I certainly have not abandoned my effort to restore the 
funding. If in fact, the introduction of this legislation should 
demonstrate that I am more committed than ever to seeing the SCHIP 
funding restored. What's more, the Majority Leader and Chairs of the 
Finance and Budget Committees have provided their support to see this 
important legislation enacted into law. Adding their endorsement to 
this effort, which already has garnered strong bipartisan support, 
certainly will speed its passage.
  Again, I appreciate the support of my colleagues and look forward to 
working together to advance this critical policy.
  Mrs. CLINTON. Mr. President, today, we need to address the impending 
crisis that may leave thousands of children in New York and around the 
country without health insurance or access to health care.
  The State Children's Health Insurance Program, or SCHIP, has been 
remarkably successful in providing for the health of needy children 
whose parents would otherwise be unable to afford health insurance. New 
York has been on the frontlines of this effort, implementing its Child 
Health Plus program even before the Federal Government recognized the 
promise of CHIP and began committing Federal funds. Thanks to those 
Federal funds, New York has been able to expand its program. I'm proud 
to say that as of November 2002, we have been able to enroll 475,000 
children and thereby make a significant dent in the number of uninsured 
children in my State.
  Those accomplishments aside, we still have much work to do. Estimates 
of the number of SCHIP or Medicaid eligible children in New York who 
are not currently enrolled range from 200,000 to 400,000. As the 
economy continues to slip, and more hardworking Americans lose their 
jobs or their benefits, I fear that these numbers will only increase. 
Now more than ever, children across our Nation depend on SCHIP to

[[Page S1993]]

help them obtain the health care they need.
  I had hoped that the recent Senate passed omnibus appropriations bill 
would act to preserve SCHIP. Incredibly, just when the uninsured are 
increasing, SCHIP funding is being cut. Just when State budgets are 
disintegrating, $2.7 billion of previously allocated SCHIP money is 
flowing out of states and back to the Federal treasury. Indeed, the 
Office of Management and Budget projected earlier this year that the 
number of children insured through SCHIP will fall by 900,000 between 
Fiscal Years 2003 and 2006 unless appropriate congressional action is 
taken to restore the expiring funds.
  This is why I support the bill introduced by my colleagues, Senator 
Rockefeller and Senator Chafee. Their legislation would sustain SCHIP 
programs throughout the country, and save New York from losing $526 
million in unspent 1998/1999 funds. This bill extends the deadline for 
States set to return funds to the Federal treasury another two years. I 
also support the measure to redistribute the portion of unspent funds 
to States. This year, New York's annual allotment will not cover one-
half of the Federal share of its program expenditures. New York is 
counting on those redistributed funds to make up the shortfall.
  In the last Congress, I had supported measures to fix SCHIP so that 
States could continue to take care of their children. I was proud to 
co-sponor Senate bill 2860, also introduced by Senator Rockefeller. And 
in the waning days of the last session, we were very close to a 
solution. We had a good proposal supported by members of both parties, 
in both houses of Congress, to help States in their efforts to insure 
their children. Unfortunately, because of the objections of a few, we 
were unable to accomplish our goal before the session ended. Without 
changes in the SCHIP program, I fear that many children in New York and 
around the country will be left without adequate health care.
  Our support of SCHIP will make a critical difference in the health of 
our children, and that support must come now. Already, nearly $1.2 
billion in Federal funds have expired and reverted to the treasury on 
September 30. What's more, CMS is delaying redistribution of unspent 
2000 funds because it is unsure of what formula we in Congress will 
ultimately set. State governments are being forced to draft their 
budgets without knowing what Federal funds will be available. The time 
has come to fix this problem, and I strongly urge my colleagues to 
support this bill.
  Additionally, in the long term, we must make a commitment to 
strengthen SCHIP which has already proven so effective in insuring so 
many of our Nation's children. The initial formula that set each 
State's annual allotment has left many States with money that they will 
never spend, while short-changing States that have a higher burden of 
uninsured children. While the redistribution of funds has helped 
mitigate this inequity somewhat, we need to improve the primary 
allocation formula to more accurately account for each State's 
uninsured populations.
  Looking further ahead, as SCHIP enrollment increases, more States 
will exhaust their yearly allotments, as New York does now. This will 
mean smaller amounts of unspent funds to be distributed to a larger 
pool of States. Without significant changes, the long-term health of 
the program is in jeopardy. I look forward to working with my 
colleagues in the future to address these fundamental issues, but until 
then, I urge all of my colleagues to support this bill.
  Mr. McCAIN. Mr. President, I am pleased to join Senators Rockefeller, 
Chafee and a bipartisan group of my colleagues in introducing a bill to 
restore funding which was previously allocated to the State Children's 
Health Insurance Program, SCHIP.
  Established in 1997 as part of the Balanced Budget Act, SCHIP was 
developed as a means for states to provide basic health coverage for 
uninsured children of low income families, who are not eligible for 
coverage under Medicaid. Through the Fedeal-State matching program, 
SCHIP has provided coverage for millions of uninsured children. In 
fiscal year 2001, 4.4 million children were enrolled in SCHIP. Today 
every State in the country, five territories, and the District of 
Columbia are using SCHIP to develop innovative programs to expand 
health coverage to even more children.
  In my home State of Arizona, our SCHIP program, KidsCare, was 
developed to provide low income children with medical, dental, and 
vision coverage. KidsCare has successfully enrolled almost 50,000 
uninsured children and is anticipating reaching 60,000 by fiscal year 
2004. When Arizona found that children are more likely to received 
health care if their parents also have access, and the flexibility of 
SCHIP enabled Arizona to expand its program. Last October Arizona began 
covering not just children, but also their parents. Arizona now 
provides health coverage to almost 8,000 uninsured parents. Although a 
substantial number of eligible children and parents still need 
coverage, I believe this relatively young program is nothing short of a 
success.
  Due to Congressional inaction, approximately $2.7 billion of unspent 
SCHIP funding reverted to the Treasury at the end of last year. The 
bill we are introducing today would return that money to SCHIP, 
ensuring that funds are allocated to States that need more funding to 
continue existing programs, while allowing other States to develop new 
and innovative programs to help our Nation's children get access to 
health care.
  The number of uninsured Americans reached 41 million in 2001 and 
continues to rise. However SCHIP is successfully reducing those numbers 
for one of the most vulnerable populations in our Nation, our children. 
I hope the Senate will act expeditiously on this important legislation 
to return the funds that belong in SCHIP and to ensure that we are 
expanding, not reducing, the number of children covered through this 
innovative program.
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