[Congressional Record Volume 149, Number 162 (Monday, November 10, 2003)]
[Senate]
[Pages S14335-S14336]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE (for herself and Mr. Kennedy):
  S. 1843. A bill to amend titles XIX and XXI of the Social Security 
Act to provide for FamilyCare coverage for parents of enrolled 
children, and for other purposes; to the Committee on Finance.
  Ms. SNOWE. Mr. President, I rise today to join my colleague, Senator 
Edward Kennedy of Massachusetts, in reintroducing the FamilyCare Act of 
2003, which has strong bipartisan support. First developed in 2001, 
FamilyCare extends health insurance coverage to more Americans by 
expanding eligibility for the Medicaid and State-Children's Health 
Insurance Program.
  Increasing access to the health insurance for the uninsured is as 
vexing an issue as Congress will consider, and no issue is as 
compelling. The diagnosis is clear--over 44 million Americans aren't 
getting the health care they need because they lack the money to pay 
for it. And as the most recent Census data shows, the number of 
Americans without health insurance is increasing--by 2 million in 2002 
alone.
  And yet, the number of uninsured Americans could be even higher. If 
it were not for Medicaid and S-CHIP, over a million more people would 
not have had health coverage in 2002. The percentage of children with 
private coverage fell from 66.7 percent in 2001 to 63.9 percent in 
2002; for adults, it slipped from 73.7 percent to 72.3 percent. 
Fortunately, at the same time, the number and percentage of children 
and non-elderly adults covered by public health insurance--primarily 
Medicaid or the State Children's Health Insurance Program (SCHIP)--
increased.
  The number of children who lost private health insurance coverage was 
offset from increased enrollment in public programs, which rose from 
23.6 percent in 2001 to 27.1 percent in 2002; and the percentage of 
non-elderly adults covered rose from 9.4 percent to 10.3 percent. Taken 
together, this means that about 2.5 million more children and 1.6 
million more non-elderly adults had health insurance coverage in 2002 
because Medicaid and SCHIP expanded during the economic downturn.

[[Page S14336]]

  We all know about the problem. The question now is, what is the best 
possible cure? And while we know that there is no one answer, I think 
we can all agree that the solutions are long overdue. I find it 
astonishing that here we are in the 21st century, in one of the 
wealthiest countries in the world, and still our citizens are going 
without basic coverage and care. We're talking about working families--
close to three-quarters of the nearly seven million lower-income, 
uninsured parents in America have jobs. They just don't have access to 
affordable coverage.
  Year after year Congress has debated this issue. Last Congress we 
invested $28 billion in a reserve fund to help increase the rolls of 
the insured in America. Then the President, in his fiscal year 2003 
budget, allocated $89 billion to help the uninsured. And finally, this 
Congress in its fiscal year 2004 budget established a $50 billion 
reserve fund. Yet, no action has been taken that actually extends 
coverage to the uninsured.
  Now is the time to act. The news that an additional 2 million 
Americans joined the ranks of the uninsured in 2002 should be a wake-up 
call. We must work together to find common ground so that we finally 
can take the steps necessary to help the millions of working Americans 
and their families who cannot afford health insurance coverage.

  And while my colleagues and I are not claiming that the FamilyCare 
bill is the entire answer, we do believe it is a workable, 
uncomplicated proposal based on a proven approach that has the 
potential of reaching in the neighborhood of 13 million American 
children and their families. With so much at stake, we ought to be 
building on what works, and the S-CHIP program fits the bill. In just 
the six short years since this program passed under the leadership of 
Senators Kennedy, Hatch, Rockefeller and the late John Chafee, this 
federal-state partnership has extended coverage to over 5 million low-
income children.
  In my own home State of Maine under the ``Cub Care'' program, the 
number of children without health insurance has dropped dramatically. 
In 2003 alone, Maine extended health insurance coverage to more than 
12,800 low-income children. Unfortunately, roughly 16,600 or one in 
seventeen children are still without health insurance in Maine. We can 
and must do more.
  We should applaud states for taking the lead and helping to show us 
the answer to this crisis. But a massive national problem requires a 
national solution--and a good place to start is with the over four 
million children nationwide who are eligible for SCHIP benefits but 
remain unenrolled mostly because parents simply don't know the program 
exists.
  Our FamilyCare measure narrows that ``coverage gap'' while at the 
same time adding to the roles of the insured in America by covering the 
parents of low income children. Low-income Americans--those with 
incomes below 200 percent of the poverty level, or about $36,000 for a 
family of four--comprise 65 percent of the uninsured. We take this 
approach because the facts tell us it works. We know that states that 
covered parents through S-CHIP saw a 16 percent increase in the number 
of children enrolled in their program versus only 3 percent for states 
that enrolled only children. . .
  We also know from the Commonwealth Fund's May 2001 report that almost 
90 percent of low-income children who have insured parents themselves 
are insured as compared to just 348 percent of children with an 
uninsured parent . . . And we know that low-income children with 
insured parents are more than twice as likely to have health insurance 
as children with uninsured parents.
  That's because states can insure parents at the same time they insure 
the children--offering ``one-stop-shopping'' that also helps ensure 
that services hit their intended target and provides for family-based 
continuity of care. The FamilyCare bill adopts this proven approach and 
with so many pieces already in place we should be able to get moving on 
this because, frankly, if not now, when? And if not now, why? In these 
times of trouble, how could we face the American people and tell them 
we are unwilling to help address one of our nation's highest 
priorities? How could we explain that we reneged on our obligation to 
right this national wrong?
  That's why we want to work with our Committee leadership to see that 
FamilyCare is included to the greatest extent possible in any proposal 
that the Finance Committee considers when it develops its proposal to 
extend coverage to the uninsured. Because, like a letter mailed without 
an address, benefits that aren't delivered to our children are benefits 
that might as well not exist. The bottom line is, parental coverage 
ensures that children will be more likely to be enrolled in S-CHIP, and 
the FamilyCare Act of 2003 will help us provide insurance to as many as 
13 million parents and children.
  I look forward to working with my colleagues to see that this bill 
gets passed and I urge you all to support this bill.
  Mr. KENNEDY. Mr. President, it's a privilege to join Senator Snowe in 
introducing the Family Care Act to expand health coverage to millions 
of families. The Family Care Act builds on the success of the Child 
Health Insurance Program, by expanding it to cover the parents of low 
income children, so that the whole family is eligible for affordable 
coverage. This expansion is the next logical step toward the day when 
the basic right to health care will be a reality for every American.
  Parents across America get up every day, go to work, and play by the 
rules. But all their hard work does not buy them the health insurance 
they need to keep themselves and their loved ones healthy or to protect 
their family when serious illness strikes. They can't afford the 
coverage on their own, and their employers don't provide it. Family 
Care is a practical solution for millions of hardworking families, and 
it deserves to be a national priority.
  Six years ago, Congress passed bipartisan legislation to cover 
uninsured children in families whose income is too high for Medicaid 
but not high enough to afford private coverage. Today, the Children's 
Health Insurance Program brings quality health care to over 5 million 
children. But there are still millions of children who are uninsured, 
even though they are eligible for coverage, and even those who are 
insured cannot truly enjoy a healthy life when their parents are sick 
and can't afford the care they need.
  Our bill is an important step to build on the Children's Health 
Insurance Program. Over 80 percent of children who are uninsured or 
enrolled in Medicaid or CHIP have uninsured parents. Expanding CHIP to 
cover parents as well as children will make a huge difference to 
millions of working families.
  The legislation will also help sign up the large number of children 
who are already eligible for health coverage through CHIP or Medicaid, 
but who have never enrolled. The numbers are dramatic. Ninety-five 
percent of low-income uninsured children are eligible for Medicaid or 
CHIP. If we can enroll all of these children, we will be taking a giant 
step toward the day when every child has the opportunity for a healthy 
start in life.
  Our legislation makes it easier for families to register and stay 
covered. We also know that many families lose coverage because 
complicated applications and burdensome requirements make it hard to 
stay insured. Under our bill families will have a simple application 
and they won't have to enroll over and over again. When parents enroll, 
they will enroll their children, too.
  These are long-overdue steps to give many more Americans the health 
coverage they deserve. Family Care is a health care bill of rights for 
millions of hardworking parents and their children, and I urge its 
prompt consideration and adoption by the Congress.
                                 ______