[Congressional Record Volume 149, Number 64 (Thursday, May 1, 2003)]
[Senate]
[Pages S5643-S5644]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              IMMIGRANT CHILDREN'S HEALTH IMPROVEMENT ACT

  Mr. DASCHLE, Mr. President, I would like to bring a matter to the 
attention of my colleagues. This is a clear example of misplaced 
priorities in the President's budget.
  Last January, a number of Senators wrote to the President requesting 
that he include a provision in his budget to allow states to provide 
Medicaid and SCHIP health care coverage for women and children who are 
legal immigrants.
  Yesterday, Senator Graham received a letter in response to that 
request. The letter makes a number of claims that are, at best, 
disingenuous.
  Just to remind my colleagues of the history of this issue: the 1996 
welfare law banned legal immigrants from receiving Federal benefits 
under a number of programs, including Medicaid, for 5 years. The 
argument was made that people shouldn't come to this country if they 
are going to be a public charge.
  The reality is that many legal immigrants and their families, because 
of language barriers and other issues, agree to take some of the lowest 
paying jobs in this country. They don't come here to take welfare; they 
come because they want to make better lives for themselves and for 
their children. Most of these jobs, as we well know, do not provide 
health insurance for citizen families or immigrant families.
  Legal immigrants play an important role in our overall economy. They 
take low-paying jobs that businesses rely on. They pay taxes. Immigrant 
children are also required to register for the Selective Service when 
they turn 18. According to the American Immigrant Law Foundation, 
60,000 legal immigrants are on active duty in the U.S. Armed Forces.
  But now, as a result of this policy, when a woman becomes pregnant, 
or a child gets sick, they have no where to turn but to emergency care, 
which is the most expensive means of providing health care.
  A number of States have realized that this is not an efficient or 
acceptable means of addressing the health care needs of these families. 
Some 20 States now provide health care services to legal immigrants 
using their own funds. The result of the 1996 policy has not been the 
one desired by the authors of the language. Instead, it has resulted in 
transferring the burden of caring for these people to States and 
hospitals. Unfortunately, the severe fiscal crisis is forcing some 
States to reexamine their coverage.
  To respond to this situation, Senator Graham introduced S. 845, the 
Immigrant Children's Health Improvement Act, or ICHIA. It would allow 
States to use Federal Medicaid and SCHIP funding to provide coverage 
for pregnant women and children who are legal immigrants. This proposal 
has strong bipartisan support, not only in the Senate but also in the 
House. In fact, last year, it was adopted on a bipartisan basis in the 
Finance Committee during debate on a bill to reauthorize welfare 
programs.
  The administration's letter suggests that this proposal would somehow 
create a new burden on the States. In fact, the proposal gives States 
the option to provide this coverage, and allows them to use Federal 
resources to do so, thus giving them significant fiscal relief. No new 
burden would be imposed on the States. In addition, the National 
Governors Association and the National Conference of State Legislatures 
have made restoring these benefits a priority.
  The long-term economic and health consequences of inadequate health 
care services for pregnant women and children is well-established. The 
administration's letter tries to minimize the importance of this issue 
for immigrants, by talking about other, less effective health care 
proposals, such as the Medicaid block grant, and by pointing out that 
the fetuses of immigrants are covered by SCHIP.
  It is important to recognize, however, that more than 5 million 
children live in poor or ``near-poor'' non-citizen families. That is 
more than one-quarter of the total population of poor or

[[Page S5644]]

``near-poor'' children. Almost half of all low-income immigrant 
children are uninsured--and they are more than twice as likely to be 
uninsured as low-income citizen children with native-born parents.
  Most of these children will eventually become American citizens. By 
denying all but emergency health care, and especially by denying 
preventive care, we increase the risk that these children will suffer 
long-term health consequences--consequences that could reduce their 
ability to learn and develop and become productive, contributing 
citizens; consequences that increase the possibility these children 
will need more expensive health care later on.
  The administration claims credit for providing coverage for fetuses, 
presumably because when these children are born they will be citizens. 
But it is worth noting that the Medicaid/SCHIP ban is having an impact 
on citizen children living in immigrant families. As many as 85 percent 
of immigrant families have at least one child who is a citizen. 
Although many of these children are eligible for Medicaid and SCHIP, 
receipt among eligible citizen children of non-citizen parents is 
significantly below that for other poor children. Parents may be 
confused about their children's eligibility, or concerned that somehow 
claiming these benefits will affect the status of other family members.
  Finally, the letter suggests that, at a cost of $2.24 billion over 10 
years, providing this coverage is too expensive. It also reminds us 
that this issue must be considered in the context of competing 
priorities. That is precisely my point. Making sure that pregnant 
immigrant women, and their children, have access to health care, 
including preventive care, is an investment in the future workforce of 
this Nation. Denying them the care they need on an appropriate and 
timely basis could have dire consequences not only for these 
individuals, but for our businesses that will depend on a healthy 
population for their future workers.
  I believe providing health care for all of our citizens, including 
pregnant women and children who are immigrants, is vital for our future 
economic strength. It should be a much higher priority than providing a 
$1.2 trillion tax cut for the richest people in the country. It is the 
right thing to do.

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