[Congressional Record Volume 149, Number 137 (Wednesday, October 1, 2003)]
[Senate]
[Pages S12281-S12282]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. GRASSLEY (for himself and Mr. Baucus):
  S. 1693. A bill to amend section 35 of the Internal Revenue Code of 
1986 to allow individuals receiving unemployment compensation to be 
eligible for a refundable, advanceable credit for health insurance 
costs; to the Committee on Finance.
  Mr. GRASSLEY. Mr. President, today I am pleased to introduce, along 
with Senator Baucus, an extension of a bipartisan policy to help reduce 
the number of people living without health insurance today.
  In simplist terms, our bill extends the 65 percent credit offered to 
people eligible for trade adjustment assistance, and to certain PBGC 
beneficiaries, to those workers eligible for unemployment insurance.
  Is it perfect policy? No. Does it ``solve'' the problem of the 
uninsured? it does not.
  But it's an important step in the right direction. I do not subscribe 
to the view that ``incrementalism'' when it comes to covering the 
uninsured, is dead.
  With census figures showing the number of Americans living without 
health insurance increasing, even small steps are steps in the right 
direction.
  Incrementalism has made a difference. For example, the few million 
people we covered with this tax credit in last year's trade promotion 
authority bill made a difference. The S-CHIP program made a difference. 
I believe Medical Savings Accounts and the small group market reforms 
we made in HIPAA all have made a difference in controlling what would 
otherwise be a much larger number of people without health insurance.
  This year, Congress, in a bipartisan way, put $50 billion into a 
reserve fund to address the rising number of uninsured. The year is 
more than almost over, and nothing has been done, or even discussed.
  I will not let a bipartisan consensus to spend $50 billion on 
improving access to health insurance lay there on the table. Iowans 
expect us to do get things done.
  And to get anything, even something small, done on a problem this 
big, it's got to be bipartisan. That's why I am glad to be building on 
my work with Senator Baucus and making this important, novel program 
available to more Americans.
  I am looking forward to exploring still more options in the Finance 
Committee on reducing the uninsured in the weeks and months ahead.
  Mr. BAUCUS. Mr. President, I rise today to introduce the Health Care 
Tax Credit Expansion Act of 2003.
  According to the most recent census figures, more than 41 million 
Americans lack health insurance coverage. More than the population of 
23 States, plus the District of Columbia. As premiums sky rocket and 
the unemployment rate remains high--despite signs of economic 
recovery--I worry that this number may grow even higher.
  For America's uninsured, the consequences of going without health 
coverage can be devastating.
  Put plainly, uninsured Americans are less healthy than those with 
health insurance. They delay seeking medical care or go without 
treatment altogether that could prevent and detect crippling illnesses. 
Illnesses like diabetes, heart disease, and cancer. The uninsured are 
far less likely to receive health services if they are injured or 
become ill. They don't fill prescriptions that their doctors recommend.
  These factors take an enormous personal toll on the lives of the 
uninsured. They are sicker and less productive. Their children are less 
likely to survive past infancy. And they must struggle with the 
knowledge that a serious injury or illness in their family might push 
them to the brink of financial ruin.
  And there is also the impact on the rest of the U.S. economy that 
must be taken into account. Because when the uninsured become so sick 
that they must finally seek emergency treatment, there is often no one 
to pay for it. No insurance company. No government program.
  So who absorbs the cost of uncompensated medical care? We all do. In 
the form of higher health care costs. Higher and higher premiums at a 
time when the cost of health care is already rising out of control.

[[Page S12282]]

  The situation is becoming critical. And I believe the time for 
talking has ended. It is time for us to examine solutions instead of 
talking about the problem.
  That is why I have joined with my colleague, chairman of the Senate 
Finance Committee, Senator Chuck Grassley, to introduce this important 
piece of legislation.
  Our bill would provide health care assistance to the unemployed--one 
specific category of those without health insurance. And one where we 
believe there is agreement to move forward.
  More specifically, this bill would expand the 65 percent refundable, 
advanceable tax credit that is currently provided under the Trade 
Adjustment Assistance program to workers receiving unemployment 
benefits.
  By building on the structure that Congress put in place last year 
under the Trade Act, we make it more likely that unemployed workers can 
receive benefits in a timely manner. Without significant implementation 
and start-up time.
  And by building on the historic agreement that we reached last year, 
we are more likely to have support for the structure and approach.
  Let me be clear. This bill is not a major overhaul of the U.S. health 
care system that several Democratic Presidential candidates have 
outlined. It was not intended and does not seek to cover everyone in 
this country without health insurance.
  Rather the proposal would use the money set aside in this year's 
budget for the uninsured--$50 billion--on a targeted policy that I 
believe both sides can agree on. It is a practical, principled, 
incremental solution.


                          Why the unemployed?

  According to the Labor Department, since February 2001, 2.6 million 
jobs have been lost. And with those jobs, an awful lot of health 
insurance has been lost, too.
  Despite assertions by economists that the recession has ended and the 
economy is experiencing signs of improvement, the unemployment rate has 
remained stubbornly high--6.4 percent in June. In fact, we are hearing 
more and more talk of the same ``jobless recovery'' that we heard about 
following the recession in the early 1990s.
  It is true that employment does not immediately improve when an 
economy emerges from recession. We read repeatedly that even if growth 
surges and business investment begins to take off tomorrow, the ranks 
of the unemployed may not thin for months.
  Unfortunately, for many, many families, this means more weeks, if not 
months, of endless job searches. And a longer period of time without 
health coverage.
  An estimated 46 percent of unemployed adults lack health insurance, 
or about 4 million unemployed workers. Less than one in three 
unemployed adults receives health coverage through their spouse or 
other family member.
  And while 65 percent may qualify for COBRA continuation coverage, 
only 7 percent can afford to enroll. That is not surprising. Premiums 
for this coverage average almost $700 a month for family coverage and 
$250 for individual coverage. A very high price, given the average 
$1,100 monthly UI check.
  Last year, when we debated the economic recovery package, both 
Republicans and Democrats proposed to expand health coverage for 
unemployed workers. There was almost universal agreement that this 
population deserved help and attention. So I think it's a good place 
for us to start from this year.


                           Why a tax credit?

  There's been a lot of debate about the best way to expand health 
insurance coverage to the uninsured. Most Democrats favor expanding 
public programs like Medicaid and CHIP, and harnessing the power of the 
group insurance market to provide affordable coverage options.
  Most Republicans, however, favor a more market-based approach that 
gives the uninsured tax breaks and allows them to use the individual 
insurance market.
  But, after years of logjams and disagreements, we were able to come 
together last year when we created the TAA tax credit. The TAA tax 
credit merges a market-based tax credit with the affordability of the 
group insurance market. This proposal simply builds on that progress. 
With the structures now in place to implement the TAA credit, a new tax 
credit for the unemployed can easily be incorporated into the new 
system.


                                Caveats

  I realize that the TAA tax credit is not a perfect model. And we may 
need to make some adjustments as full implementation kicks in this 
summer. For example, we need to ensure that the groups we intended to 
cover actually have access to coverage.
  In particular, all workers who had health insurance coverage for 3 
months before they lost their jobs should be assured of coverage they 
qualify for under TAA. I support making the technical change that would 
provide that assurance.
  I am also willing to consider other improvements, like additional 
help for low income workers.
  But I do not think these adjustments should deter us from moving 
forward with an expansion of the tax credit. Millions of unemployed 
workers and their families need our help. And they need it now.
  All told, expanding the TAA tax credit to the unemployed would 
provide health insurance coverage for 1.4 million Americans a month who 
are currently unemployed and uninsured. It's not a panacea. But it's a 
start.
  I hope my colleagues will join this fight by helping us pass this 
legislation, and taking a solid step toward providing quality, 
affordable health insurance to all Americans.
                                 ______