[Congressional Record Volume 149, Number 39 (Tuesday, March 11, 2003)]
[House]
[Pages H1726-H1733]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    HEALTH CARE CRISIS IN OUR NATION

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 7, 2003, the gentlewoman from California (Ms. Solis) is 
recognized for 60 minutes as the designee of the minority leader.
  Ms. SOLIS. Madam Speaker, tonight I am very pleased to be here to 
speak about health care and the crisis that we face here in our Nation 
and particularly about the crisis that is affecting the Hispanic 
population and other minority groups.
  I am delighted that I have been joined tonight by three colleagues 
that will speak about some of the situations and problems that they 
face in their own States. First I would like to, as chairwoman of the 
Congressional Hispanic Caucus Health Task Force, recognize the 
gentlewoman from the Virgin Islands (Mrs. Christensen), who is our 
representative for the Virgin Islands. She is chair of the Hispanic 
brain trust for the Black Caucus.
  I yield to the gentlewoman from the Virgin Islands.
  Mrs. CHRISTENSEN. Madam Speaker, I want to begin by commending the 
leadership of the Hispanic Caucus, past and present, my colleague and 
current Chair, the gentleman from Texas (Mr. Rodriguez), and my health 
counterpart, the gentlewoman from California (Ms. Solis), for the 
leadership they provide for all Americans and for the effective 
representation they provide to people of Hispanic descent. All people 
of color face unacceptable barriers to health care, but Hispanics and 
Latinos face the additional burden of language. Anti-immigrant 
sentiment places further roadblocks in their way to health services. 
Because of the leadership of the Hispanic Caucus in collaboration with 
advocacy groups, attention is being brought to these issues and the 
barriers are beginning to come down, but there is still much to be 
done.
  Madam Speaker, the racial disparities in health care so ably 
documented by the Institutes of Medicine report and other reviews 
continue to show that if you are a minority American, you are likely to 
receive a diminished quality of care even if you have the same income 
and educational status. As we recognize the plight of the uninsured 
this week and the reverberating impact not just on families but on 
entire communities including those with

[[Page H1727]]

insurance, it is important to point out that Hispanics have the highest 
uninsured rate among all racial or ethnic groups. Studies show that 
they are at high risk and lack basic access to medical care because of 
their high uninsured rates. That is why Hispanic Americans are joining 
other Americans from all backgrounds and parts of this country to rally 
during this April's Minority Health Month for universal insurance 
coverage and access to health care. Like other Americans of color and 
those living in the rural areas of our country, they are at increased 
risk.
  Hispanics are twice as likely as Anglo Americans to have diabetes, 
twice as likely to have AIDS. Latino children are prone to have asthma, 
yet less likely to receive care. Too many still use emergency rooms too 
late in the stages of their illnesses because they lack a regular 
source of care. We must take steps to turn this around if we are to 
reach our ultimate goal of wellness for this country.
  Further, many of Puerto Rican or Dominican descent comprise a large 
part of my district in the U.S. Virgin Islands. With their fellow 
Americans in the U.S. territories, they live under a system that caps 
Medicaid funding to our hospitals and clinics, leaving a heavy burden 
of care on municipalities that can afford it least and leaving many 
residents without access to care. Wherever this or a similar lack of 
access to care exists, there is also an effect on those with insurance 
and a direct and adverse impact on the ability of hospitals there to 
maintain quality health care services for everyone. Uncompensated care 
affects us all. We must take steps to turn this around if we are to 
reach our ultimate goals, as I said, for wellness in this country.
  And so, Madam Speaker, the minority caucuses of this Congress will 
host a rally on April 29 on Capitol Hill to bring the attention of our 
fellow Americans and the Congress to the urgent need for universal 
access to health care, because this country can no longer afford for so 
many of its citizens to go without a means to pay for the quality 
health care that they deserve.

                              {time}  2045

  Insured and uninsured alike, we are all in the sinking ship of a 
failing health care system in this country. The time to become 
proactive on the health issue that affects Hispanic Americans, African 
Americans, other minority Americans, rural Americans, and, indeed, all 
Americans, is now. Access for us, for those of us of color, is access 
for all.
  I want to thank the gentlewoman from California (Ms. Solis) for 
yielding to me. I want to thank my colleagues for inviting me to join 
them in calling attention to these important issues.
  Ms. SOLIS. Madam Speaker, I thank the gentlewoman, who in her own 
right is a leading physician and who has actually done so much to help 
further the cause for universal health care, access for everyone and 
also for HIV and AIDS prevention, and also for those many chronic 
illnesses that many of us face.
  Madam Speaker, I would like to yield to the gentleman from Washington 
(Mr. McDermott).
  Mr. McDERMOTT. Madam Speaker, I thank the gentlewoman for yielding. I 
appreciate the opportunity to talk here today on an issue which I think 
is very timely and very important.
  Today I dropped in H.R. 1200, which is a bill that I have dropped in 
for 12 years, providing universal health care insurance for the entire 
country. We are all one family. We are not this group or that group or 
another group or whatever. We are all together in this. We ought to 
have a plan that covers everybody, no matter where you live, no matter 
what color your skin is, no matter what ethnic background you come 
from, what kind of money you have or anything. It should be a system 
that covers everyone.
  Now, today I just took this out of my wallet. I am covered because I 
have got this piece of plastic in my wallet. If I get in an accident or 
get sick and they haul me in the emergency room, they will find out I 
got this piece of plastic and I am covered. I can go for preventive 
care. I can go for all kinds of things. But if you do not have this 
piece of plastic, you will have to wait until you are really sick, 
because you cannot afford to pay for it; and you go into the emergency 
room, you get health care, but in the most inefficient way possible and 
the most inhumane way possible, at the end, when you should have been 
having preventive care before.
  Now, this country, for reasons which totally escape me, cannot accept 
that it is a right for everyone to have health coverage. In Germany, we 
say, you know, what could the Germans know? In 1883 they put in a 
universal health care system. If you go to work tomorrow in Germany, 
you will have insurance tomorrow. They take in Turkish workers, they 
take in Kurds, they take in Bosnians. All these people come into their 
country, and they give them health care coverage from the very first 
day.
  The United States has lots of people who come into this country to 
work. They come here to pick our vegetables, to work in the fields, to 
do the hard labor in this country. The fact is that of the 42 million 
people in this country who do not have insurance, 72 percent of them 
work full-time. They are not lazy. They are pulling their weight. They 
are doing what you have to do in a society to feed their family. But 
they do not have health insurance, and it is wrong. I think that the 
members of the Hispanic Caucus are absolutely correct in bringing this 
up, that everybody in this country should be covered.
  The fact that Hispanics are in fact the least insured in this country 
is a travesty. If they were not doing the work they do in this country, 
we could not have the standard of living we have.
  Ms. SOLIS. Madam Speaker, I appreciate the gentleman's remarks this 
evening.
  Madam Speaker, it gives me a great deal of pleasure to recognize the 
distinguished gentleman from Texas (Mr. Rodriguez), the chairman of the 
Congressional Hispanic Caucus.
  Mr. RODRIGUEZ. Madam Speaker, I thank the gentlewoman for yielding.
  Madam Speaker, I rise tonight to talk a little bit about health care, 
and I want to personally first of all thank the gentlewoman from 
California (Ms. Solis) for her leadership in the area of health.
  On behalf of the Congressional Hispanic Caucus, the gentlewoman from 
California (Ms. Solis) is the chairwoman of the Task Force on Health. 
She has brought to it a great deal of energy. Now she sits on the 
Committee on Energy and Commerce also, so we have high expectations for 
the gentlewoman from California (Ms. Solis) and we want to thank her 
for what she has done, not only for her constituents back in 
California, but throughout the Nation, and her efforts in the area of 
health care. Under her leadership and passion the Health Care Task 
Force will be at the forefront of issues ranging from chronic diseases 
to the issues that we are here to discuss tonight, which is the 
uninsured.
  The 2000 census revealed what many of us already knew back home, and 
that is that the Hispanic community has grown by leaps and bounds over 
the past decade. Hispanics are now the fastest growing community in the 
United States and make up close to 13 percent of the U.S. population. 
So I want to take this opportunity to say that of that part of the 
population, we have one of the largest numbers of uninsured.
  Serving the uninsured must be a top priority for our Nation. 
Currently we have data to show that 33.2 percent, and it has been 
growing now with the individuals that have lost their jobs, of Hispanic 
individuals are uninsured, compared to the non-Hispanic whites who are 
uninsured at about 10 percent.
  Let me tell you, these are people that are hard working individuals, 
that are out there working and making $20,000, $30,000, yet find 
themselves, if they are working for a small company, they are not going 
to have access to insurance. Unless they are working for a government, 
State, local or Federal, unless they are working for a major 
corporation, they will not have access to insurance.
  So it is important for us to look at providing access to that 
insurance that their children and they need. While 19 percent of all 
Hispanics depend on Medicare and 35 percent of all Hispanic children 
depend on what we call the State Children's Health Insurance Program, 
which is CHIP, for their health care, still many of our needy families 
are not receiving the services that they deserve.
  Despite the rhetoric of the administration, we leave millions of 
children

[[Page H1728]]

behind by President Bush calling for a $2.1 billion cut in this 
critical program for children, which is the only health care that a lot 
of these children receive. These are families that are working, trying 
to make ends meet. They are not poor enough to qualify for Medicaid, 
and they find themselves just making too much money, $20,000, $30,000, 
that they do not have access to health care, which is unfortunate.
  It is unfortunate for too many working Americans that continue to 
lack this access to health insurance. Hispanics especially fall into 
this category. Over 33 percent of the Hispanics are uninsured, as I 
indicated earlier.
  When it comes to health care, despite the promises, the Bush budget 
leaves our community behind. The Bush budget gives no money to these 
vital Federal health care programs for Hispanic communities. The Bush 
budget insufficiently funds the Community Health Centers, which have 
been out there making a difference, that millions of uninsured low and 
moderate income individuals rely on for their health care needs. The 
Community Health Centers have been there in responding to our 
communities' needs, and we need to make sure they continue to get the 
resources needed.
  The Bush budget also cuts funding to the Office of Minority Health 
that focuses on health concerns which disproportionately affect 
minority communities.
  The Bush budget also cuts into the future of Hispanic communities by 
eliminating funding for health career opportunities that aim to 
increase the number of minority health care providers.
  We need to ensure linguistically and culturally appropriate health 
care by providing minorities an opportunity to go into the health care 
profession. At the present time we understand and recognize that we 
have a large number of individuals that could qualify and could enter 
the profession. A lot of times a little assistance in these programs 
that allow that opportunity to get into nursing, that allow them to get 
into some of the other health professions, as well as the medical 
profession, is important. So every effort needs to be made to continue.
  I want to also talk a little bit about diabetes and HIV/AIDS. In 
diabetes among the Hispanic community, the risk for diabetes is twice 
that of the non-Hispanic whites. Nearly 11 percent of Hispanics have 
been diagnosed with diabetes as compared to 7 percent of non-Hispanics.

  In the area of AIDS, funding for HIV/AIDS must also address the 
change in infectious rates. Hispanics have a rate of new infections 
four times that of non-Hispanics, despite the fact we have made some 
gains in the area of AIDS. Despite the fact that the number that are 
getting it and that are suffering serious illnesses are decreasing, the 
number for Hispanics is growing disproportionately.
  So we ask as we look at those issues, such as diabetes that hit 
Hispanics disproportionately and such as AIDS that now affect those 
poor communities throughout this country, as well as African Americans, 
it is time to focus attention to the needs of these populations. I 
would ask the Bush administration to seriously reconsider their budget 
when it comes to health.
  The Bush administration also has continued to deny legal permanent 
residents, and I will say that once again legal permanent residents' 
access to vital programs such as the Temporary Assistance for Needy 
Families, TANF, and the States' Children's Health Insurance Program, 
such as CHIP. These are individuals that are here legally, these are 
individuals that have not broken the law, yet we have denied them the 
right to have access.
  One of the proposals that we have serious concerns with this 
administration on is the proposal that he has taken in hand, and that 
is that the Medicaid proposal has been one that addresses the needs of 
the most needy in this country, those that are indigent.
  He has taken the Medicaid, and then he has taken the CHIP program, 
which is the program that addresses the children of the working 
families of this country, and has taken that program.
  Thirdly, he has also gone after the disproportional share, the money 
that goes to hospitals that provide the indigent care, that provide for 
those in need.
  So those three programs impact the most needy of this country, yet 
those are the three programs that this administration has chosen to 
bundle up into one block grant, and his proposal is to send it to the 
States, with the understanding that as the future goes on there is 
going to be a cap on it, and in those States where we have 
disproportional numbers, such as Texas and other States, that we will 
continue to have a difficulty in that area.
  I want to continue to go ahead and address a couple of issues, but I 
wanted to take this opportunity to thank our task force chairman from 
the Hispanic Caucus, the gentlewoman from California (Ms. Solis), on 
her efforts, and I want to continue to join her here and thank her very 
much for what she has been doing.
  Ms. SOLIS. Madam Speaker, I thank the gentleman from Texas (Chairman 
Rodriguez), our illustrious chair of the Hispanic caucus. I thank him 
for appointing me as the woman who will be now in charge of the issues 
regarding Hispanics and health care this term. I am very privileged to 
be in this position, and I know that we have a long charge ahead of us.
  Madam Speaker, tonight, today as Chair of the Congressional Hispanic 
Caucus Health Task Force, I wanted to call attention to the health 
status of Latinos throughout the United States.
  When we talk tonight about Latino health care, it is important to 
note that Latinos are the fastest growing minority group in the 
country, in the United States. So the issues we face confront the 
health care field throughout the country, whether you live in east Los 
Angeles, in my district in California, or if you live in Atlanta, 
Georgia, or in Birmingham, Alabama, where we are seeing a large number 
of Hispanics now residing in that area. I had the privilege, Madam 
Speaker, of being there this weekend and walking with other members of 
our caucus to celebrate a civil rights memorial for 28 years of 
suffrage that has gone on in the South. The issues are no different 
there than they are in other parts of the country with respect to those 
that are uninsured. African Americans and Latinos still face the same 
kinds of problems.
  This week, however, Madam Chairman, we are celebrating this week as 
Cover the Uninsured Week, a national effort that is going on right now, 
that is being celebrated across the country, to recognize those people 
who are under-insured and uninsured.
  I would be remiss if I did not point to this chart here tonight, to 
point out that 41 million Americans do not have health care insurance 
in our country. It is unfortunate that about 30 percent of those 
individuals are Hispanic.
  Let me point that out on this section of the pie chart, 30 percent. 
Forty-seven percent of non-white/Hispanic, 47 percent. Thirty percent 
Hispanic, 16 percent black or African American, and 5 percent Asian and 
South Pacific Islander also fall into that category.
  Madam Speaker, by the year 2020, it is projected that one in five 
children will be Hispanic. Yet Latino children have the highest 
uninsured rates in the U.S. child population.

                              {time}  2100

  And unfortunately, the number of Latino uninsured has been on the 
rise over the past decade.
  I would like to point out the next chart that I have. Here we see 
also the rising numbers of those individuals that are Latino, that are 
working, 43 percent; those that are in the private sector, 2 percent; 
18 percent Latino, Medicaid; and others that receive some type of 
coverage; and then those that are in the uninsured category: Latinos, 
37 percent, to 14 percent who are Anglo, or white. Madam Speaker, 73 
percent of the Anglo population has insurance; 43 percent on this chart 
here indicates people that are working, working Latino family members 
are uninsured. It is a crime. It is a crime that this is the situation 
here in our country.
  The next chart unfortunately does not provide us with many more good 
indicators. The number of Latinos uninsured has been on the rise over 
the past decade; and all we have to do is start looking at 1990, where 
7.0 percent, the number of uninsured Hispanics, has increased 7.0 
percent in 1990, a decade ago. When we look to the year 2000, it is now 
not quite doubled, but almost

[[Page H1729]]

there, 11.2 percent. It has increasingly gone up. It is not to say that 
these people are not working, because they are. I fail to see the 
reason that they are not being provided with some attempted coverage 
for those that are uninsured.
  In fact, 37 percent of nonelderly Latinos are uninsured, more than 
double the rate of whites. The large majority of uninsured Latinos come 
from working families, approximately 87 percent; but less than half of 
all Latinos have employer-based health coverage. That is to say that 
where they work, at their place of employment, they do not have any 
type of insurance coverage for their needs, to meet their needs.
  So let us be clear tonight, I say to my colleagues. There are women 
and men who are working and paying taxes, they play by the rules, but 
they are not getting any health coverage. This goes far beyond just the 
Latino community. There are many working men and women, African 
American, Anglo women that I met, even today when I was out visiting 
folks in my district, who told me about their plight with not having 
adequate health coverage, or being underinsured. This is a real issue, 
I say to my colleagues, that we need to address.
  Unfortunately, nearly one-third of all Latinos work for an employer 
who does not offer any health care insurance at all. The lack of 
insurance in our country is devastating to families, particularly 
Latino families. Among the uninsured, Latino adults in fair to poor 
health, 20 percent are women, 40 percent are men; and they have not 
visited a doctor in the past year. Can we imagine that, not being able 
to see a doctor in more than a year?
  We know that the uninsured receive less preventive care and are 
diagnosed later for diseases and tend to receive less medical care for 
their illnesses. Uninsured children are 70 percent more likely than 
other children not to have received medical care for common conditions 
like ear infections, 30 percent are less likely to receive medical 
attention when they are injured, and nearly 40 percent of uninsured 
adults report skipping a recommended medical test or treatment in the 
past year.
  Having health insurance would reduce death rates for the uninsured by 
10 to 15 percent. How many lives can we save if we provide them with 
some attempted coverage?
  There is a consensus that health insurance is a necessity. So how can 
we increase access to health insurance? Certainly, we need to make sure 
that children are enrolled in successful programs like the gentleman 
from Texas stated earlier, like the State Children's Health Insurance 
Program, known as SCHIP, and in California known as Healthy Families. 
And we must make sure that all of our vulnerable populations are 
enrolled in Medicaid in that safety net program, and that these 
programs make health care access a reality.
  Madam Speaker, we also need to focus on innovative private and public 
approaches to covering the uninsured. When I was in the State 
legislature in California, I authored a bill to launch a body of 
research on how to provide universal health care coverage, and I was 
proud to be the sponsor of Senate bill 480. The researchers have come 
up with several proposals for universal health coverage, and many are 
being implemented now as we speak in Sacramento. Unfortunately, due to 
severe budget cuts, not only in the State of California but across the 
board, many of these programs that we have instituted in the past are 
now on the chopping block. One of the reasons is because of this whole 
new attempt to try to block-grant Medicaid. Our State is now being 
devastated with cutbacks in the budget. In California, which is almost 
a continent in and of itself, we are crying out for assistance now 
because our budget is woefully low in terms of providing coverage for 
the very needy, for the working poor, and for children.
  Medicaid in California is known as MediCal. It is called MediCal. Our 
medical program offers dental services, physical therapy, and diabetes 
management. I was a proud offerer of reforms to provide treatment and 
management for diabetes. Lord knows the African American community and 
the Latino community suffer very high rates of diabetes. If it is not 
treated appropriately in a preventive matter, it can become a very 
acute problem that will come to haunt us and continues to haunt us if 
we do not come up with the incentive and money to go into those 
measures. I say we need to put money up front into programs like that 
to combat chronic illnesses like obesity, diabetes treatment, and 
asthma. These are the things that we need to be addressing and putting 
our money where our mouth is when we talk about providing assistance to 
the uninsured.
  Medicaid is an incredibly important program, and it covers now 
approximately 40 percent coverage for Latinos; but without this help, I 
fear what will happen to our communities, not only Latinos, the people 
that I represent in my district, but poor people, working people, 
people who actually have jobs that will go without this kind of 
coverage.
  Unfortunately, this administration has proposed what I said earlier, 
the Medicaid reforms known as block grants. What they are telling us is 
that they will give States money to be able to get more flexibility to 
provide coverage for different illnesses; but in the long run, in 10 
years, they are going to cut that money back, and what it means is less 
people will be served. The elderly will be out. The young people, the 
children will be hurt.
  I am here to tell my colleagues that we need to do more than that. We 
need to reverse that trend and ask this administration to step up to 
the plate and forget the rhetoric and really talk about making some 
very meaningful reforms in Medicaid and providing the coverage that is 
so very much needed in States like mine in California where we do not 
get a refund in our dollars. We are known as one of those States where 
we are a donor State. We give more money than we get back. I am here to 
say it is time that California and other States in the southwest like 
Texas, Washington State, and other parts of the country receive their 
fair share of dollars where we need it. Our seniors are crying out for 
reform; our children need it. Their voices are not heard often enough, 
and we know that. That is why we are here tonight, to speak on their 
behalf as well.
  These proposals, as I see them, that the administration is proposing 
will be devastating; and instead, we should be looking at proposals 
that increase the Federal support to Medicaid by increasing Federal 
Medicaid or medical assistance known as FMAP. This bipartisan bill that 
has been introduced, known as H.R. 1816, will provide States the fiscal 
relief they need to improve health care access to vulnerable 
populations. To improve Latinos' access to Medicaid, we must lift the 
ban on health care access for legal immigrants and pregnant women and 
their children. I say, and I underscore, legal, people who are here 
legitimately who are having children here and are playing by the rules 
and paying taxes as they work, whether they are a nanny, whether they 
are a housekeeper, whether they are there in a restaurant serving us, 
or whether they are out in the fields picking our fruits and vegetables 
that we had here tonight, I say to my colleagues.
  It is time to pass the bipartisan Legal Immigrant Child's Health 
Improvement Act. This bill would lift a 5-year ban currently in place 
on States receiving Federal support for health care services for 
lawfully present immigrant children and pregnant women who entered the 
United States after August 22, 1996.
  This simply makes sense from a humanitarian and medical point of 
view, and it will save the public health system money, thousands and 
thousands of dollars. I can tell my colleagues that firsthand as a 
Representative in Los Angeles County where we have one of the largest 
health care, public health hospitals right now that sees so many 
individuals having to wait 8 hours just to be seen by one doctor, 
whether it is for a throat infection, an ear infection, or for being a 
victim of a drive-by shooting. It is unheard of, the kind of medical 
access that people have to attempt to receive, knowing fully that we 
are all paying for this standard of health care. Yet, it is unequal in 
areas that I represent. We have to change that. We have to work hard to 
make sure that it is equal for everybody, whether one lives in Texas, 
in the Rio Grande, whether one lives in Boston, Massachusetts, or 
whether one lives here in Washington, D.C.

[[Page H1730]]

  We also must fix Medicare in order to help Latino seniors who are 
struggling with high-cost prescription drugs. This goes far beyond the 
Latino community. There are many, many seniors who are crying out for 
reform, who want to see their prescription drugs, the cost for that 
medication reduced dramatically. I can tell my colleagues now there are 
people who have told me, why is it that I have to pay $300 for my 
medication to treat my diabetes or my thyroid gland? I cannot afford to 
go on vacations; I barely make my rent. Why is it that the Congress 
cannot come together and make these reforms feasible so that I can live 
an appropriate life, one that I feel I deserve? This is what seniors 
are telling me all the time. I look at them and I look in their eyes 
and I feel we have done them a disservice, because we have not been 
able to reach an agreement with the other Members on the other side of 
the aisle to see that we are truly, truly addressing the needs of our 
senior population.
  I say that fully knowing that my own parents are faced with that 
dilemma right now. They have one of those plastic cards that allows 
them to go see their HMO, Kaiser, Kaiser coverage; but they have to pay 
a copayment. If they have surgery, they have to pay another copayment. 
If they have to go in to get treatment for their thyroid, they have to 
pay another $200 or $300 every month, and my parents are on a fixed 
income. They no longer work. They are over 70 years old. I know there 
are millions of seniors that are in that same predicament, and they 
probably even have harsher, harsher illnesses than my own parents. And 
I pray that they will be able to make it as they see their daughter 
here try to get a resolution to provide an adequate prescription drug 
benefit for them, that is low cost, that does not discriminate against 
them, whether they are in an HMO program or if they are seeing their 
own fee-for-service doctor. There should be no discriminate treatment 
for either, and that is what I am going to work hard for, and I know 
that our Hispanic Caucus will do the same.
  I want to tell my colleagues that recently I have had a chance to 
visit with a lot of my seniors in my own district in Monterey Park and 
in my new cities that I represent in Covina and West Covina, which were 
previously represented by the gentleman from California (Mr. Dreier). I 
want to tell my colleagues that folks are telling me the same thing: we 
have to change. We have to change the rules of the game so that 
everyone receives a fair, level playing field when it comes to access 
to health care.
  Right now, because unemployment rates are so high, people are losing 
their jobs, they are losing their health care coverage. Today I saw a 
woman who I spoke to who runs her own business out of her own house. 
She told me that one of the opportunities that she had was to try to 
provide her own coverage for health care. It would cost her a minimum 
of $500 a month. That was entirely too much for her. What does that 
mean for her? That means that she is going to have to forego that. If 
she gets ill, God forbid. If she has to go to the doctor, God forbid. 
If she gets really sick or hit by a car or she becomes tremendously 
ill, she will have to go to a public emergency or trauma center, which 
is going to cost the public dollars, the taxpayers a lot more money. If 
we were just to put more money in to help the uninsured, we could save 
a whole lot in the long run.
  I am advocating for us to have that discussion here tonight, for us 
to talk about other options for providing assistance to the uninsured 
and the underinsured, because there are a whole lot of people out there 
who are working that make $15,000, $16,000 a year, they have four kids, 
they are beating themselves up because they want the best for their 
kids; but they cannot afford to even make a copayment to have adequate 
coverage. It is time that we start looking at providing assistance to 
the uninsured, because every tax dollar that they pay into when they 
see their check, their payroll check, it says a deduction, but where 
does that deduction go? Is it going into a health care trust fund for 
them? Is it going to be available for them when they need it? Is it 
going to be available for their children? Those are the questions that 
I ask here tonight.
  I would like to ask my colleague, the gentleman from Texas (Mr. 
Rodriquez), the chairman of the Hispanic Caucus, to please share with 
me what insights he might be able to shed on this issue.
  Mr. RODRIGUEZ. First of all, I want to thank the gentlewoman for 
allowing us to be here tonight, and I want to thank her for her 
leadership in the area of health. Also, as I was looking at the data 
that she had before us and the research and all of the studies, one of 
the things that was glaring was the fact that things are not getting 
any better; they are getting worse. As they get worse, we come up here 
and we get elected to respond to the problems that we are confronted 
with, we get elected to hopefully come up with some solutions to those 
problems. But it is unfortunate that some people are up here not to 
solve problems, but to see how they can leverage their political power 
in the process of not responding to the needs of our constituency in 
this country.
  So one of the things that is important, as the gentlewoman indicated, 
is, and the research shows, that of the ones that are uninsured, 87 
percent, especially the Hispanics, 87 percent of them are hard-working 
Americans. These are people that are not out there not working and 
being lazy; these are people that are making $20,000, $30,000, $40,000 
a year. Yet, if they work for a small company, they do not have access 
to insurance. Once again, unless they are working for the Federal 
Government or the State government or some form of government, they do 
not have access to insurance, or a major corporation.

                              {time}  2115

  And so these are hard working Americans that are trying to make ends 
meet. They make some money and because of that they do not qualify for 
the Medicaid for the indigent. And now we are trying to take away the 
only thing that they might qualify for, which is to ensure their 
children an access to health care. So in this country we would hope 
that as we move forward, we make every effort to make it affordable and 
accessible. What good is it that we have the best health care in the 
whole world, the best research, if it is not accessible and it is not 
affordable? It does not make any sense. So hopefully we will continue 
to work on that.
  I just wanted to also add that, additionally, we have only 43 percent 
that have employer based coverage compared to 73 percent for Anglos, 
which means that most Hispanics are working for even smaller companies 
and so they do not have any access.
  I wanted to share with the Congresswoman, I represent Starr County on 
the Mexican border. I have 11 counties. Starr County is a beautiful 
county, yet it has the distinction of being one of the poorest in the 
2000 Census. It is the poorest in the entire Nation. In Starr County we 
have close to 40 percent of those between the ages of 19 to 64 are 
without health insurance, 40 percent of the population. And the lack of 
insurance means restricted access to preventative care which can lead 
to costly emergency room visits, poor quality of life and even 
shortened lifespan. While we have a patchwork of Federal and State 
types of programs, we continue to have difficulty. And I know that 
there is a talk about the private sector coming in. Well, I represent 
rural America, too. I have 11 counties. I have a lot of what we call 
the ``brush country'' in Texas in San Saba, in Frio, La Salle, in 
Atascosa, Duval, Jim Wells also, those counties out there as well as 
Starr and now parts of Hidalgo, those counties are rural counties, a 
lot of them are rural counties and the ones that are rural counties 
have difficulty getting the private sector to come in. So despite the 
fact that we have had the private sector move into Medicare, they have 
not had the experience.
  I will share with you what happened to one of my counties that I used 
to represent that I do not now, in Wilson County, where the private 
sector was not making the profits that they wanted to see. They cannot 
get rid of the individuals if they are not making the profits, but what 
they can do is decide not to service the entire county. So they decided 
to get rid of most of the rural counties.
  So in rural America we are having a rough time. And if you work in 
rural America and live in rural America, most likely you are working 
for a

[[Page H1731]]

small company. You are working for a small employer who does not have 
access to health insurance. That is why it is important for us to 
provide that alternative. That is why it is important for us to provide 
that access to health care that is so critical.
  I wanted to also share with the gentlewoman that it is unfortunate 
that there are no easy answers, but the reality is that we can come up 
with if the will was there, we could make something happen. But it is 
unfortunate that we have not come to grips with it and we are not close 
to answering the problems. But the election is coming up in 2 years, 
and people have talked about meeting the prescription drugs. I saw the 
ads lots of time calling to thank Congressman so-and-so for their 
legislation that they had passed. Well, I want to ask where are they 
now on that piece of legislation? Nowhere.
  And the same thing with the proposal on prescription drug coverage 
that this administration has put forward. It is embarrassing. It is a 
sham. The Bush administration in terms of their proposal on drug 
prescription, I am sick and tired of these types of responses when 
people are sincere. When they come to me when I go to churches they 
tell me, Mr. Rodriguez, I cannot afford to buy the prescription. I 
cannot afford it. I buy my husband's. I cannot buy mine. We go without 
food because we are on fixed incomes.

  We have got to do something about this. Once again, it does not make 
any sense for us to have all the remedies in the world when our own 
constituency who are working hard and trying to make ends meet do not 
have access to this.
  I wanted to take this opportunity if it is okay to talk a little bit 
about the Hispanic Health Improvement Act that the gentlewoman is a co-
author of that piece of legislation. I would like to use a little time 
on that.
  This week we will be introducing the Hispanic Health Improvement Act 
with Senator Bingaman and the gentlewoman from California (Ms. Solis) 
and members of the Hispanic Congressional Caucus. This will be landmark 
legislation and it is based on the previous Hispanic Health Act. I 
reintroduced it in the 106th Congress with existing legislation with 
Senator Bingaman, who has been a champion for us. And I want to 
personally thank him for his efforts in the area of health care because 
he has been there.
  In addition, we have taken some of the Federal regulations from the 
Hispanic Health Leadership Summit, as the gentlewoman will recall. We 
convened last August. The Hispanic Caucus convened in a group and 
incorporated many of the suggestions of the group. And we invited two 
Members from each side of the Congress, both Republican and Democrat, 
we invited them to San Antonio to come and talk about the needs of 
Hispanic health. We had a good representation from both Republicans and 
Democrats come forward and participate in our conference. And the 
legislation offers a variety of different strategies for expanding 
health care coverage, improving access, and that is important.
  If you have the decisions that respond to the problems that we are 
encountering but you do not provide the access, it does not do any 
good. And also we talk about affordability. It has got to be 
affordable, otherwise forget it. I do not care how good the response 
is. If the person does not have any money, it is not accessible. It is 
not affordable. They will not be able to live unless they get that 
accomplished.
  And then we also reduced and addressed the health disparities. We 
know that in certain communities such as the Hispanic communities and 
the African-American community that we have disparities such as 
diabetes, AIDS and varieties of others. So while we consider each 
provision in our bill, we look to improve it. And I am just going to 
highlight just a few things from the piece of legislation.
  In order to address the lack of health care coverage, the legislation 
provides $33 billion between fiscal year 2003 and 2010 for the 
expansion of the successful State Children's Health Insurance Program, 
SCHIP, and to cover the uninsured, low-income pregnant women and 
parents. So we are looking at those working parents and women that are 
expecting. In addition, it provides States the option to enroll legal 
immigrants. Once again, we are not talking about undocumented illegals. 
We are talking about legal residents, legal immigrants, pregnant women 
and children, access to both Medicare and SCHIP.
  In addition, the Congressional Hispanic Caucus considers the 
expansion of Medicaid and CHIP eligible to be critical legislative 
priorities for improving health, Hispanic health. The bill also seeks 
to address Hispanic health disparities and requires an annual report to 
Congress on Federal programs or responding to improving health status 
of Hispanic individuals with respect to both diabetes, cancer, as the 
gentlewoman has mentioned, asthma, HIV infection, AIDS, substance abuse 
and mental health. And the legislation provides $100 million for 
targeted diabetes prevention as well as education, school-based 
programs, and screening activities in the Hispanic communities. 
Similarly, the bill provides for targeted funds for programs that were 
aimed at preventing suicide.
  One of the things that we have noticed recently, and when I have 
first heard about the issue of suicide among young Hispanic young 
ladies, I was not aware of the seriousness of the situation and how bad 
it was, and so the issue of mental health in responding to the needs of 
young Latinos who are committing suicide. We really need to be 
conscious of that. This country has really not come forward when it 
comes to the mentally ill, whether Hispanic or non-Hispanic. The 
mentally ill really are not addressed and especially our young, the 
youths, when it comes to mental illness, we need to see what we can do 
for them much sooner for them and see how to address these needs. We 
are hoping to begin to address the issue of mental illness.

  And I want to lastly indicate that we seek in the bill to reduce 
health care disparities also by addressing the lack of providers who 
can provide culturally competent and linguistically appropriate care. 
That is so important. When you look at especially therapists that 
provide access to psychiatrists to Hispanics who when the doctor is 
unable to speak the language of the client, you know that the type of 
care is not going to be up to where it should be. When in describing 
the type of medication that is needed, having an understanding of the 
client in terms of culture is also extremely important; and we can cite 
some examples later on. But the bill also provides for increased 
funding for HRSA, health professions and the diversity programs.
  As you know, the President's budget for 2003 budget proposal 
eliminates virtually all funding for these types of programs. So you 
tell me that we are needing people in the area of health care in every 
forum, we need minority representation in those areas, and yet these 
programs that are so needed by our community are the same programs that 
this administration is choosing to cut.
  In addition to the promoting of diversity, these programs support the 
training of health professionals in the fields experiencing shortages, 
such as pharmacy, dentistry and allied health. They promote access to 
health care services in the medically underserved communities.
  I want to also mention that the Hispanic Caucus considers increased 
funding for those programs a high priority. As the Hispanic community 
continues to grow, the implementation of these provisions will take on 
even greater importance, so the consequences of inaction will be felt 
for many years. So we encourage both the Democrats and the Republicans 
and the administration to reconsider their budget when it comes to 
health because their budget is one that basically says we do not care. 
We are not here to respond to the problems that are confronted by their 
little proposal. The President's proposal is a sham and I know that 
people, even Republicans that look at it, ought to be ashamed of that 
and they are embarrassed because it really does not address the issues 
that confront our communities and address the issues of our 
constituency when they come and say, how can I have access to buy the 
prescription that I need for my husband or my wife? And the answer is 
that unless we come together on that and unless we address that need, 
the bill that is before us does not answer the problem, and the 
solution that is there is only a political solution that really does 
not address the problem that is out there.

[[Page H1732]]

  But the constituency back home will have an opportunity because the 
election will be coming up in 2 years. And I am hoping that as we go 
forward that we will make some inroads. And we have an opportunity 
because I know that both Democrats and Republicans are looking to get 
votes from the Hispanics. Well, you have a good opportunity. You start 
addressing the problems that confront our community, and I think our 
community will be willing to respond, I think, if that is the case. But 
if you give us lip service such as we are getting from this 
administration, then the results will be that you are not going to get 
our support and it is not going to happen because you are not there 
sincerely trying to address our problems.
  I know this is the gentlewoman's time. I want to thank the 
gentlewoman very much for taking the time to be out here tonight.
  Ms. SOLIS. I thank the gentleman from Texas (Mr. Rodriguez). It is a 
pleasure to be here tonight with him and other Members that came 
forward to speak on this very important issue.
  The gentleman touched on so many important areas that we do not even 
have time in our committees, and as a member of the Committee on Energy 
and Commerce, a new member, we did not even have sufficient time to 
debate this new proposal that the administration is putting forward.
  We had about 3 weeks ago Secretary Tommy Thompson come forward and 
talk about the aspect of trying to block grant Medicaid, and I talked 
about that earlier. What it means, block granting, is that we are 
racheting down health care. Fewer people get fewer health care. Not 
more care, fewer. And with the rising increase of population with the 
uninsured, it means less dollars, not only for Hispanics but for 
blacks, for Asian Americans, even for Anglos that right now are 
uninsured.

                              {time}  2130

  We have to do something. We have to take action.
  Rural America also has been neglected in this debate. We are not 
doing nearly enough to provide incentives for health care centers, 
public health care centers to be adequately funded, serving our at-risk 
populations out there and I mean in particular women and men over the 
age of 40 who are still toiling out there, whether they are working in 
the fields or working in rural America who have no benefit of health 
care access.
  We need to put funding there. We have to come up with formulas that 
are expanding and broadening support of the Federal Government to reach 
out to these rural communities.
  My colleague hit an important note that I want to touch on also, and 
that is, with respect to the shortage of health care professionals that 
exist, the opportunities for people to get into the medical profession 
and especially in the nursing profession. Many of our community 
colleges at this point in time do not find that they have adequate 
funding to offer the curriculum that costs a lot of money, but money 
that is invested and well-spent can provide a product that will mean so 
much for our society, and I am asking this administration to put more 
money into those areas, into those health career professions and create 
those career ladders and opportunities not only for Latinos who want to 
come back and serve in their community but for all underrepresented 
groups and particularly those people who live in rural America.
  I also want to touch on the aspect of mental health because in that 
whole discussion we forget about women and individuals who are 
afflicted by domestic violence, people that have the right under 
welfare reform, TANF legislation that provides them the ability to get 
help. Many of these individuals are being asked now to get off of 
welfare as we know it and to find jobs, but their illnesses have not 
been addressed. Some have mental illness. Some have substance abuse. 
Many are victims, at least 50 percent of the caseload can report that 
they have been victims of domestic violence.
  Why have we not done a better job of monitoring those individuals? 
They are going to go back into that cycle and there will be no remedy 
for them. We should put dollars up front for prevention in mental 
health care and that should be covered by any health insurance program, 
and that is not being adequately addressed.
  I know that the former Senator Paul Wellstone had a proposal that is 
being reintroduced under his name to try to provide that incentive for 
fully covering mental health care illnesses so that when we detect them 
we can get to those individuals that need that help to remedy and 
provide them from creating more harm to themselves, and I know that our 
caucus will be working hard to promote that.
  Lastly, I would just like to say that we have a long way to go in 
terms of health care. We talk about education as being a privilege and 
a right for everyone in America, but I do not think that we have talked 
enough about providing equal access to health care for Americans and 
people who reside in this country. Our country is so wealthy, we are 
one of the wealthiest countries in the world, and yet we forego 
providing assistance and immunization for children to combat TB, to 
fight HIV, infections that are now ongoing in communities like mine and 
like my colleague's.
  I ask this administration why, why is it that we could send billions 
of dollars across this country to fight a war and not use that same 
money to fight the wars that are here on our own Earth, on our own 
country to combat AIDS, to combat diseases, chronic illnesses in here 
and making an investment in the very families that are sending their 
young men and women abroad to fight a war.
  It is nonsense that we forego the kinds of opportunities that we have 
here at home to put that money where it will be well spent, that will 
reap profits and benefits for this country tenfold, in 10 years to 
come, instead of bankrupting our system right now.
  Those are the questions that I have. Those are the questions that my 
constituents have been asking me, and I hope that this administration 
will step up to the plate and begin to outline their plan to provide a 
recovery for health care for all Americans but particularly in this 
case tonight for the uninsured and for the Latino community.
  Mr. RODRIGUEZ. Mr. Speaker, I want to thank the gentlewoman once 
again and touch a little bit on a couple of things that she mentioned.
  On the mentally ill, there is no doubt that is one of the areas that 
we have not made the inroads that we should have. In this country, in a 
way, we have been negligent, not being responsive to our youth when it 
comes to the mentally ill. We have not provided the resources that are 
needed. We forgot all about Columbine and how that occurred, the fact 
that we really need to go and see what is happening. Youngsters, a lot 
of them were suffering from depression. We need to make sure we pay a 
little more attention to what is occurring in those areas and spend 
some time and look at the number of suicides of young people that is 
occurring.

  So I am hoping that we begin to address some of these issues, and I 
am hoping that the will will be there to make something happen.
  The gentlewoman also mentioned, I know, the issue of rural America. 
Rural America right now, and I represent 11 counties that I indicated 
already that are having a rough time getting access, and one of the 
reasons why we decided to privatize part of Medicare is because the 
whole argument was to try to reduce the costs. In fact, the other side 
argued that Medicare is a government-run program and this and that, 
that they could do it better. We have tried that experiment, and as my 
colleague well knows, that experiment has failed. In fact, right now, 
if a person is under Medicare+, they are costing the Federal Government 
more money than a straight Medicare, despite the fact they might be 
paying $300 additional money.
  So it is a gimmick to try to destroy the program. We know and people 
understood that if they provide access to our seniors, they are the 
ones that they are less likely to make a profit on because they are 
ill. The data that shows that a person on the average spends over 
$1,000 on prescription drug coverage when they are seniors. There is no 
insurance company that is going to be able to make the profits they 
would like to see from our most vulnerable in this country and our 
seniors, and we

[[Page H1733]]

should not be doing that. We need to see how we can make it affordable.
  What angers me, and I know what angers Americans, is that that same 
pharmaceutical company that sells those products that contributes to 
the politicians up here and contributes big bucks and puts those ads to 
thank those Congressmen for nothing basically because they did not 
accomplish a darn thing except the elections were coming up, those are 
the same companies that choose to sell those medicines in Canada and 
elsewhere for half the price, for one-third of the price.
  The sincereness of their efforts, it is a crime what they are 
committing, and it is sad that we have got to this point that those 
same products can be bought in Mexico and Canada for much less, and it 
is the same company, and it is unfortunate that the ones that are 
having to pay because they claim that they are doing that for research 
purposes, and yet who are they sticking it to? Our most vulnerable, our 
seniors, who buy a large percentage of the prescriptions.
  So I am hoping that we can come up with a realistic plan, and the 
people in this country, they are not stupid. They are going to see 
right through the President's proposal on prescription drugs. It helps 
a few at the expense of everyone else, because most people, at least 
the constituency of the Hispanic community, the only thing they have is 
Social Security. They do not have any other pension, and if they do, it 
is a small one. They do not have additional money to dish out $300 or 
more for additional coverage, and even though they get additional 
coverage, the private sector is not interested because if they do get 
sick they do not make a profit.
  We have all understood that, and that is why we need to come up to 
the plate. This is no way to treat our seniors after they have given of 
themselves. This is a time for us to reach out to them and provide 
whatever assistance that we can and to be able to make it also in a way 
that is accessible and affordable.
  So I wanted to once again thank my colleague for what she has done, 
and I want to also share that in health care somehow we have not come 
to grips because we do have a lot of Congressmen out here that 
basically feel that the Federal Government should have no role in 
health care, and apparently they feel that way and they feel that it 
should be just privatized. But we understand that people get ill and 
cost insurance companies, and we know that the insurance companies, as 
soon as a person gets a serious illness, will dump them if they have 
the opportunity, despite the laws that we have tried to pass.
  That was happening in the 1960s, when we established Medicare and 
Medicaid, and that is happening now, so the companies are there, and 
for good reason, they are there to make a profit and provide access to 
health care but they are there to make a profit. So a person does not 
have any problems while they are young and healthy, but as soon as they 
get ill and they need them, that is when they start having the 
difficulties. Anyone who has gotten ill understands that and recognizes 
that.
  So their main priority is to be there to make a profit and secondary 
is everything else, and that is why the Federal Government has a role 
and a responsibility. The health of this country depends on the quality 
of life for our constituency.
  Ms. SOLIS. Mr. Speaker, I thank the gentleman for being here this 
evening and sharing his thoughts and words.
  Again, I just want to underscore why we are celebrating here tonight, 
to talk about the real issue, and the real issue is that there is so 
many millions of Americans that are uninsured, 40 million, and we need 
to change that, and we need to do more here in the Congress and work 
together on both sides of the aisle to see that we come up with some 
remedies that can be taken care of this legislative session.
  I want to thank the gentleman from Texas (Mr. Rodriguez). I want to 
thank also other speakers that came here tonight representing the 
Congressional Black Caucus, the gentlewoman from the Virgin Islands 
(Mrs. Christensen), and also the gentleman from Washington (Mr. 
McDermott). I am very privileged.

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