[Congressional Record Volume 149, Number 57 (Wednesday, April 9, 2003)]
[Senate]
[Pages S5083-S5084]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. GRAHAM of Florida (for himself, Mr. Chafee, Mr. McCain, 
        Mr. Daschle, Mr. Jeffords, Mr. Bingaman, Mrs. Lincoln, Ms. 
        Collins, Mr. Kennedy, Mrs. Landrieu, Mrs. Boxer, Mr. Kerry, and 
        Mr. Nelson of Florida):
  S. 845. A bill to amend title XIX and XXI of the Social Security Act 
to provide States with the option to cover certain legal immigrants 
under the medicaid and State children's health insurance programs; to 
the Committee on Finance.
  Mr. GRAHAM of Florida. Mr. President, I rise today with my friend and 
colleague from Rhode Island, Mr. Chafee, and a bipartisan group of co-
sponsors to introduce the Immigrant Children's Health Improvement Act 
of 2003.
  This legislation will give states the option to provide Medicaid and 
State Children's Health Insurance Program, CHIP, coverage to legal 
immigrant children and pregnant women during their first five years in 
this country.
  Medicaid and CHIP are vital components of our nation's health care 
safety net. They provide coverage to over 40 million non-elderly, low-
income Americans, most of them children. These programs have helped 
dramatically reduce infant mortality, and they have provided health 
care financing for millions of poor children whose families cannot 
afford the high cost of private health insurance.
  However, for many low-income families that are eligible for Medicaid 
and CHIP, these safety net programs are little more than a mirage in a 
desert--an illusion to those who need them most. The Personal 
Responsibility and Work Opportunity Reconciliation Act of 1996, 
commonly known as the welfare reform law, arbitrarily barred states 
from using federal funds to provide health coverage to low-income legal 
immigrants during their first five years in the United States. While 
the goal of welfare reform was to encourage self-sufficiency in adults, 
the legislation unintentionally punished children.
  Prior to 1996, Medicaid coverage was available to qualified children, 
parents,

[[Page S5084]]

seniors, and people with disabilities in both citizen and legal 
immigrant families alike. After passage of the 1996 welfare reform law, 
many low-income and working legal immigrant families were left without 
a viable option for health insurance coverage.
  In fact, while the percentage of our nation's children with health 
insurance has risen in recent years, the percentage of children in 
immigrant families with health insurance has fallen. According to the 
Kaiser Commission on Medicaid and the Uninsured, in 2000, half of low-
income children in such families were uninsured.
  Florida is home to over half a million uninsured children, many of 
whom are legal immigrants. Take the Sardinas family of Miami.
  The Sardinas family immigrated to the United States from Cuba in 
2001. Mr. Sardinas works in a factory assembling airplanes while Mrs. 
Sardinas maintains a low-wage job. The family's four children--Swani, 
17; Sinai, 13; Samuel, 8; and Sentia, 5--have been on a State waiting 
list for health insurance for almost two years. Sentia has allergies 
and Swani suffers from asthma. Mrs. Sardinas worries about not having 
access to regular check-ups for her children, but she has no choice. 
She does not know what the family will do if Sentia has a severe 
allergic reaction or Swani is hospitalized after an asthma attack.
  The Immigrant Children's Health Improvement Act eliminates the 
arbitrary designation of August 22, 1996, as a cutoff date for allowing 
children to get health care. More than 155,000 children like Swani, 
Sinai, Samuel, and Sentia will have access to health coverage each 
year, allowing them to receive preventive services, have their chronic 
conditions properly diagnosed and treated, and receive timely care for 
acute conditions.
  States have asked for this option. In its 2003 Winter Policy Report, 
the National Governors Association endorsed this common-sense policy 
proposal. The National Council of State Legislators has also endorsed 
this bill.
  Twenty-two States are already providing health coverage for legal 
immigrants through State-funded replacement programs. However, severe 
budget shortfalls may prevent such states from being able to continue 
these important programs in the future. Our bill provides immediate 
fiscal relief for these States by allowing them to draw down federal 
matching funds. It also gives states that are not currently providing 
health coverage to legal immigrant children and pregnant women the 
flexibility to do so.
  Legal immigrants pay taxes, serve in the military, and have the same 
social obligations as United States citizens. Legal immigrant children 
are, as much as citizen children, the next generation of Americans. It 
is important that all children, both citizen children and legal 
immigrant children alike, start off on the right foot towards full 
civil participation.
  Our bill is supported by Senators McCain, Daschle, Jeffords, 
Bingaman, Lincoln, Collins, Kennedy, Feinstein, Corzine, Levin, 
Sarbanes, Dodd, Landrieu, Boxer, Kerry, and Bill Nelson.
  Representatives Lincoln Diaz-Balart of Florida and Henry Waxman of 
California have also introduced bipartisan companion legislation in the 
House.
  We call upon Congress and the President to act this year and pass 
this important bill.
  Mr. KENNEDY. Mr. President, it is a privilege to join Senator Graham 
and Senator Chafee in introducing the Immigrant Children's Health 
Insurance Act, which will benefit tens of thousands of immigrant 
children and families across the Nation.
  The 1996 welfare reform legislation disqualified legal, taxpaying 
immigrants from major Federal assistance programs, including health 
coverage through Medicaid and the State Children's Health Insurance 
Program. As a result, many of these individuals and families go without 
needed care or rely on hospital emergency rooms for their care.
  This bill will enable States to provide health insurance coverage for 
legal immigrant children and pregnant women under Medicaid and SCHIP. 
This is an important step in alleviating the health disparities that 
exist for immigrant children. Research shows that children of immigrant 
are twice as likely to be uninsured as children of U.S. citizens. They 
are more than three times as likely not to have regular care, and more 
than twice as likely to be in fair or poor health. Enacting this 
legislation will help to eliminate these inequalities.
  This bill will also help to reduce the number of uninsured in our 
country. Today, there are 42 million uninsured, and 10 million are 
children. Most of the uninsured are earning incomes below or near the 
poverty line, and can't afford the high cost of private insurance. The 
1996 legislation barring legal immigrants from federally funded health 
care has contributed to the increase in the number of uninsured. The 
Congressional Budget Office estimates that this bill will cover an 
additional 155,000 children and 06,000 pregnant women this year alone.
  Throughout our history, immigrants have made important contributions 
to our country. They work hard, pay taxes, and play by the rules. In 
fact, immigrants and their children make significant contributions to 
our long-term economic well-being by adding an estimated $10 billion 
annually to our economy. However, they are disproportionately employed 
in low-wage, low-benefit jobs, and are more likely to be uninsured. 
This bill will enable legal immigrant families to receive the services 
they are paying for as taxpayers. It is a matter of basic fairness.
  The bill makes good economic sense, as well. Twenty-six states and 
the District of Columbia already use their own State funds to provide 
medical coverage for legal immigrants, but continuing these programs is 
becoming increasingly difficult as state budget constraints worsen. In 
fact, Massachusetts, which currently provides health coverage at State 
expense, is proposing to eliminate Medicaid for adult immigrants. 
Allowing States to use Federal funds to support their health care 
initiatives will provide needed fiscal relief, and ensure that these 
children receive a health start.
  Both good nutrition and adequate health care are fundamental for 
health child development. Last year, with President Bush's support, 
Congress restored food stamp benefits to legal immigrants in the farm 
bill. It is long past time for Congress to guarantee that legal 
immigrants also have access to health care.
  America has a proud tradition of welcoming immigrants, and we must 
live up to our history and heritage as a nation of immigrants. 
Restoring these health benefits will ensure that children in immigrant 
families have the same opportunities for good health as every other 
child in the Nation. The Immigrant Children's Health Insurance Act is a 
needed step to achieve this goal, and I urge my colleagues to support 
this important legislation.
                                 ______