[Congressional Record Volume 150, Number 66 (Wednesday, May 12, 2004)]
[House]
[Pages H2899-H2906]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   NATIONAL COVER THE UNINSURED WEEK

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 7, 2003, the gentlewoman from Wisconsin (Ms. Baldwin) is 
recognized for 60 minutes as the designee of the minority leader.


                             General Leave

  Ms. BALDWIN. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks and to include extraneous material on the subject of this 
Special Order.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Wisconsin?
  There was no objection.
  Ms. BALDWIN. Mr. Speaker, I rise today in the midst of National Cover 
the Uninsured Week to draw attention to the 43.6 million Americans who 
do not have health insurance and the millions more who are 
underinsured.

[[Page H2900]]

                              {time}  2130

  Ms. BALDWIN. Mr. Speaker, our Nation is in the midst of an escalating 
health care crisis. As health care costs soar, it becomes increasingly 
difficult for Americans to obtain comprehensive and affordable health 
care. Our current health care system is failing not only the 43.6 
million Americans who are uninsured, but also the millions more who do 
not receive comprehensive health care. We can no longer turn our backs 
while millions more lose access to health care. The lack of 
comprehensive and affordable health care affects every single 
congressional district in every State.
  To highlight this issue this evening and its real impact that 
Americans are experiencing, I have invited my colleagues to join me in 
sharing letters and thoughts, but letters particularly from our 
constituents who have had difficulty obtaining and affording 
comprehensive health care. I think it is really important that their 
voices are heard in this debate.
  I would like to begin with just a few letters from my district in 
Wisconsin that express real people's difficulties in dealing with the 
ever-rising cost of health care.
  Jen, from Oregon, Wisconsin, starts, ``Please help. I cannot find 
affordable health insurance. My husband works for a small employer that 
cannot afford to provide medical insurance. We have a tiny 2-bedroom 
home, a car payment and a 2-month-old baby. We choose to live very 
modestly in order to provide the margin to pay for health insurance, 
but the cheapest premium I could find was $200 per month with a $3,350 
deductible, and there are no maternity benefits. The amount is 
heartbreaking. There is no money to pay for clothes, let alone 
emergencies. If I worked full time for the health insurance, there 
would not be enough to pay for day care and somebody else would be 
raising my baby.
  ``It simply is not right that people in our society lack medical 
coverage when every other First World country provides for all of their 
citizens. Plus, how many people are underinsured? Also, our businesses 
are starting to go bankrupt just trying to maintain their health care 
benefits.
  ``Something has to change. Would you please help all of us as soon as 
possible?''
  Next is from David, from Cross Plains, Wisconsin. David writes, ``My 
wife and I have been self-employed for over 18 years, and have paid 
thousands of dollars for health insurance premiums. As of a few months 
ago, we had to drop out and are now without health insurance. The cost 
is completely out of reach. In fact, it is nuts. Now that I am 50 years 
old, it is not a matter of if I will have health problems, it is when.
  ``Tammy, we will lose everything we have worked for. So much for the 
American dream. We now look forward to dying broke and homeless. I 
still work 60 hours a week at my print shop and can only hope that I 
drop dead in front of my press some night so I will not be a burden to 
society.''
  Emily from Stoughton, Wisconsin writes, ``I am writing to you to 
express my utter frustration at the status of the United States health 
care system. It is my opinion that it is rapidly failing, and many, 
many people are finding themselves paying staggering monthly premiums 
and getting substantially fewer benefits every year.
  ``My husband runs a small business, less than 10 employees, and our 
family is being financially penalized for offering group health 
insurance to seven workers, two of which have had some significant 
health care needs in the last year. These two employees, just by 
getting illnesses not in their control, have jacked up our monthly 
premium by a staggering amount. It seems to us that offering health 
insurance is an ethical responsibility of ours as employers, yet our 
family still must pay a ridiculously escalating sum monthly just 
because of these two employees with unexpected health problems. In 
addition, I am routinely getting surprised upon regular visits to 
dentists, eye doctors, et cetera, to find we have no coverage at all 
from our HMO when only 1 year ago we had full coverage for these 
services.
  ``Thanks for letting me vent. I feel powerless and at times 
hopeless.''
  Before I continue with some additional letters from my congressional 
district, I am delighted to be joined this evening by one of my 
colleagues, the gentleman from Ohio (Mr. Brown), a member of the 
Committee on Energy and Commerce, a tireless advocate for health care.
  Mr. BROWN of Ohio. Mr. Speaker, the gentlewoman from Wisconsin has 
fought as hard as anybody in this body for universal health care for 
people who play by the rules, pay their taxes, most of whom have jobs 
and simply have been left out of this system, left out because this 
Congress, this President, do not seem to care.
  We had 40 million people uninsured 3 years ago; today that number is 
44 million. Of those people who do have insurance, many of them are 
underinsured. Many do not have a decent drug benefit. Many seniors do 
not have a good drug benefit, and this Congress has either done nothing 
or moved backwards as they have tried to privatize Medicare and tried 
medical savings accounts and other kinds of Rube Goldberg ways to try 
to provide health insurance, when in fact most of what they are trying 
to do is enrich the drug companies and the insurance companies.
  We are also joined by the gentleman from Ohio (Mr. Strickland) and 
the gentleman from New Jersey (Mr. Pallone). My State of Ohio has 1.2 
million people without health insurance, and 85 percent of those who 
lose their jobs also lose their health insurance. In Ohio, as much of 
the Great Lakes States, particularly Wisconsin, Michigan, Pennsylvania, 
Minnesota, those States have suffered dramatically because of high 
unemployment, because of large numbers of job layoffs. In Ohio, we have 
lost one-sixth of our manufacturing jobs since President Bush took 
office. We lose 200 jobs every day, and about 170 of those people lose 
their health insurance, yet this Congress sits on its thumbs and does 
nothing about it.
  But these are numbers, and I want to share some stories of people to 
put life situations to these numbers so people really see what this 
means.
  Joseph from North Ridgeville writes, ``Something has to be done about 
health care. We are going in the wrong direction. I cannot even think 
about retirement because of the cost of health insurance in Ohio. I am 
in Local 546, and a lot of us feel the same way. I am not sure how long 
I am going to have a job, to make matters worse. Sorry to complain.''
  Mr. Speaker, he writes, ``Sorry to complain.'' This is a gentleman 
who works hard, plays by the rules, pays his taxes. He does not have 
the health insurance he needs. His employer, it sounds like, is doing 
the best they can, and Joseph says sorry to complain. If people are 
playing by the rules, this society needs to do better. Joseph also does 
not want to be a burden on society.
  Judith from Medina writes, ``We are currently without any health care 
coverage because the company where my husband works raised the monthly 
premium so high we could not afford it. It was either health care or 
food. So many people are finding themselves in this predicament now 
that something must be done on a national level.
  ``Surely Congress can come up with some kind of help for those of us 
in this situation before it is too late and before something tragic 
happens to us. We could lose our home and be out on the street if a 
catastrophic disease hit one of us. Please, please make this a 
priority. So many need help. What will the insurance companies do when 
so few can afford their coverage that most cancel? What will happen to 
the health care system in this country then? Please give this top 
priority. I believe it is vital to this Nation. Thank you.'' That 
letter was from Judith of Medina, Ohio.
  Again, this family plays by the rules. They are working hard, and our 
government simply has not stepped up and fulfilled its obligation to 
them to make health care a right, not just a privilege.
  Thomas from Cuyahoga Falls in my district writes, ``Representative 
Brown, I have a question. I have a full-time job, a wife and children. 
My employer does not offer health care benefits. I cannot afford to 
purchase coverage on my own. What can I do? Please let me know what the 
government is trying to do to remedy this problem. I am sure I am not 
the only one dealing with this. Thank you very much for your time.''

[[Page H2901]]

  All these letters suggest, first of all, great hardship that people 
face, great risk people face if they get a catastrophic illness, and 
they underscore the point that we are the only Nation in the world, as 
wealthy as we are as a country, we are the only Nation in the world 
that does not provide health care to all of its citizens. We are the 
only Nation in the world that allows drug companies to charge whatever 
they want to charge.
  Our government's response is more tax cuts for the richest people in 
the country. President Bush's tax program gives a person making $1 
million a $123,000 tax cut, yet they cannot provide insurance to Thomas 
of Cuyahoga Falls, Judith of Medina, Joseph of North Ridgeville, and 
all of the people that the gentlewoman from Wisconsin (Ms. Baldwin) 
mentioned in Wisconsin.
  We give huge tax breaks to the wealthiest people, we spend $1.5 
billion in Iraq setting up a health care system there, and my friends 
on the other side of the aisle and the President simply turn their 
backs on these people who are playing by the rules. These are people 
who work and have full-time jobs that are trying to raise their family, 
and we do not help.
  What we ought to do is four things. First of all, we should extend 
unemployment benefits to the 1 million workers in this country and the 
50,000 workers in the districts of the gentleman from Ohio (Mr. 
Strickland) and my district who have lost their unemployment. They are 
working, they have lost their jobs and they are trying to find jobs, 
and their unemployment insurance expired.
  Second, we should do the Medicare buy-in bill to allow people 55 to 
64 who do not have insurance for whatever reason, to allow them to buy 
into Medicare.
  Third, we need to work on the children's health insurance program. 
There are 8.5 million children in this country who do not have health 
insurance. In most cases, their parents have jobs at companies like 
Wal-Mart and places like McDonald's and places that do not do health 
insurance, even though the companies are making billions of dollars, in 
the case of Wal-Mart.
  And then last, fourth, we need to pass the legislation we introduced 
today to give small businesses incentives to insure their employees.
  Those three bills, the unemployment extension we have pushed and 
pushed and pushed. The majority and the President have stopped it dead 
in its tracks. The other three bills were introduced today by the 
gentleman from Texas (Mr. Sandlin), the gentleman from California (Mr. 
Stark), the gentleman from New Jersey (Mr. Pallone), myself, and a 
whole host of others. We should move quickly on those bills as the 
number of unemployed workers in this country who have lost their jobs 
is way too high and too many people who have lost their jobs have lost 
their health insurance.
  It is discouraging, but worse than that, it is outrageous that we as 
a country, as rich as we are, simply will not take care of those who 
play by the rules, pay their taxes, contribute to their communities, 
and we do not do anything about their health insurance.
  Ms. BALDWIN. Mr. Speaker, I thank the gentleman for sharing his 
constituent's words as well as his own to this critical debate. I must 
note that the gentleman points out that we are the only industrialized 
Nation in the world that does not offer health care to all of its 
citizens.
  I was listening to the Special Order which occurred the hour before 
this, where Members from the majority were talking about nations with 
universal health care plans and berating them for rationing care. I 
cannot imagine how anyone believes that a system where 43.6 million 
people are uninsured, and many more underinsured, we are clearly 
rationing care here in this country and need to step up to the plate 
and address that.
  I am delighted to be joined by another one of my colleagues whose 
work on the issue of health care I admire so greatly. The gentleman 
from New Jersey (Mr. Pallone) is also a member of the Committee on 
Energy and Commerce. Day and night, the gentleman works on the issue of 
health care.
  Mr. Speaker, I yield to the gentleman from New Jersey (Mr. Pallone).
  Mr. PALLONE. Mr. Speaker, I thank the gentlewoman from Wisconsin (Ms. 
Baldwin). I know that both of us are involved with the Democrats' 
health care task force. One of the things that we work on is trying to 
come up with some solutions in dealing with the problem of the 
uninsured. As was pointed out, the number of the uninsured continues to 
go up. The gentleman from Ohio (Mr. Brown) said it was 40 million a few 
years ago, now it is up to 44, 45 million. The number continues to 
grow.
  I do not like to criticize the Republican side of the aisle 
unnecessarily, but I am amazed by the fact that our two colleagues who 
were here earlier were so convinced that other countries do not have 
the solution. Statements were made about how national health insurance 
does not work, yet the reality is, as my colleague from Wisconsin 
mentioned, in fact it does work.

                              {time}  2145

  I am not saying that we are advocating that. I would love to see 
national health insurance. I know that is not realistic politically, we 
are not going to get it; but to suggest that somehow these other 
countries, whatever country you mention, France, Great Britain, Canada, 
Italy, all of Western Europe, every developed country really, other 
than the United States, has some form of national health insurance.
  The one thing I would stress, too, is I think when people talk about 
national health insurance, they get the impression that somehow that 
means that the government is going to run the hospitals or salary the 
doctors or something like that. That is not what national health 
insurance is all about. National health insurance just means that 
everybody has health insurance. People can have thousands of different 
policies, but it would be wonderful if we could say that everybody has 
health insurance. We are not saying, I am not saying certainly that the 
government would run the system, but they would at least guarantee that 
everybody has some form of health insurance. But that is not going to 
happen, that is not going to happen in the near future, so I do not 
want to really stress that today.
  I also heard my colleagues on the Republican side talk about 
community clinics or community health centers. The amazing thing about 
the Republicans is that they are in the majority and they act as if 
they are running for office and if they get in, they are going to 
implement these policies. They neglect to point out that they are in 
the majority, that the President is a Republican, the other body, the 
Senate, is majority Republican, there is a significant Republican 
majority here. So if they think these policies are so wonderful, why do 
they not pass them? The reason is because they do not have a consensus. 
In other words, they cannot get all the Republicans or a majority of 
their own party to agree on these three bills that they brought up 
today.
  They have characterized this week as Cover the Uninsured Week. They 
basically have three bills that are on the House floor. One deals with 
associated health plans; the other Republican bill is the health 
savings account legislation; finally, the medical malpractice 
legislation. Every one of these things has already been passed in this 
House in pretty much the same form last year. Again, they are in the 
majority. I think these bills are terrible. I refuse to vote for any of 
them, but if they think they are so wonderful, then what is the the big 
holdup? Pass it here, send it over to the other Republican body, send 
it to the Republican President, it becomes law. That is the way we 
operate.
  The problem is these proposals do not actually help the uninsured. 
They are bad proposals that will probably result in more people being 
uninsured, and that is why they cannot get most of the Republicans or 
enough Republicans to pass them. There is a certain amount of disbelief 
on my part when I listen to what they say.
  The other thing is they talked about the community clinics. I have to 
go back to that. Again, if you believe that community clinics or health 
centers are a way of dealing with people who do not have health 
insurance, I do not. I think they serve an important role. I would 
rather see everybody have health insurance; but certainly if everyone 
does not, as my Republican colleagues mentioned, somebody could go

[[Page H2902]]

to a community health clinic or health center. These places are grossly 
underfunded. A few weeks ago when we had our break around Easter and 
Passover, I had a gathering, a forum at a community health center in 
Asbury Park which is in my district. They are so grossly underfunded. 
They try to accommodate everybody, but they cannot.
  One of the things that was particularly egregious was dental care. We 
know how there is no dental care, and there are long lines. They do not 
even have the dental clinic there. It is at another location. There 
were long lines of people that cannot get in. The Republicans are in 
the majority. If they think community health clinics are the answer, 
why do they not just appropriate money so that they can accommodate 
more people or we can have more of them? I do not want to just totally 
discredit them, but when I hear these statements, and I hear this 
banter about how this is Cover the Uninsured Week, the bottom line is 
it is just a ruse.
  I want to just talk about each of these bills that they say is going 
to address the problems of the uninsured. They claim that the 
associated health plan legislation, which I think was voted on today, 
that that is going to lower rates and provide greater access to 
insurance. The reality is that the associated health plan legislation 
would result in less health care access and dramatic increases in 
premiums for State insurance-based employers. Associated health plans 
would fragment and destabilize the small group market resulting in 
higher premiums for many small businesses. The Republican legislation 
would allow employers to cherry-pick, attracting younger, healthier 
individuals to join associated health plans while leaving older, sicker 
individuals in the traditional insurance market which results in 
increased premiums for the remaining pool.
  One of the things that everyone knows about health insurance is that 
the more people you have in the pool and the more varied they are, 
young or old or sick or healthy, then the more it works. I do not want 
to get into all the details of that, but that is just the reality of 
insurance. What this associated health plan does, is break the pool and 
there is cherry-picking of the younger and healthier and leaving the 
others outside. So it just does not work. It makes the situation worse.
  The second thing they mentioned is the Republican health savings 
account legislation. I think that is up tomorrow. That creates a tax-
favored saving provision with no income limitations. The main reason 
Republicans want to pass this bill is to create a new tax shelter for 
the healthy and wealthy while at the same time threatening higher 
health insurance premiums for everyone else. Under this bill, basically 
you get a tax credit that would allow you to set aside up to $2,000 
tax-free in a new health savings account to supposedly help pay for 
health insurance, but unfortunately it is practically impossible for 
someone who is uninsured, who inherently does not have a lot of money, 
to be able to take advantage of the program because they would have an 
extremely difficult time saving $2,000 a year for health care. Again, 
it is not practical.
  The last one, and I do not want to spend a lot of time on it, was the 
medical liability reform. I agree that we need to address the rising 
cost of medical liability insurance, but what does it have to do with 
the uninsured? How is passing that going to do anything? The 
nonpartisan Congressional Budget Office concluded, and I quote, ``that 
even a very large reduction in malpractice costs would have a 
relatively small effect on total health plan premiums.'' It is not 
going to help the uninsured. It is not even going to reduce costs in 
any significant way for the patient. It is addressed to the physicians. 
That is certainly a good cause but it is not going to help the cost for 
the patient or result in any more people being insured. I later want to 
talk maybe a little bit about some of the Democratic proposals. I know 
that my colleague from Ohio did that.
  Ms. BALDWIN. I too share the gentleman's passion for creating a 
system where everybody in this country has health insurance. I guess I 
agree that the short-term prospects are dim, especially given this 
administration, this majority. But I do have some hopefulness, because 
frankly I think that the voices of 44 million Americans cannot be 
silenced and ultimately will lead to that political change that we are 
seeking. Along that line, I would like to share the words of a few more 
of my constituents. I want to share the words of Roger from Waunakee, 
Wisconsin. He writes:

  ``I'm a baby boomer that was rejected for health care. The 
explanation was vague, so I'm taking efforts to address it and resolve 
it but I'm frustrated with the realization of flaws in our health care 
system. At 54 years old, I'm healthy enough to exercise year round and 
race competitively in triathlons but not risk-free enough for the 
insurance companies. My wife is also healthy but she has so many riders 
on her coverage that her policy is almost worthless. An issue that may 
haunt us is what I call use it or lose it. Our main problem appears to 
be that we once had insurance and used it to stay healthy. Our claims 
were very small, much smaller than our annual fees but the insurance 
companies are using the knowledge that we learned about staying healthy 
as a logic to reject us. I normally don't like to see government 
getting into private matters, but health insurance does not appear to 
be a private matter anymore. We could easily pay out of pocket for the 
health costs we've incurred. We just wanted protection for potential 
major losses but now we're being rejected because of that.''
  Aside from frustration with the higher cost of health care, thousands 
of other constituents write to me about the trouble they have finding 
an insurer to cover them.
  Susan from Baraboo, Wisconsin, writes:
  ``I am writing you today regarding health coverage for single people 
with no children. As of this time, I feel that I am left out of the 
loop in regards to this topic. I am 42 and last September I was 
diagnosed with breast cancer. In January of this year, the company I 
worked for informed us that they would be closing down. I was laid off 
in December while I was out due to my cancer treatment. I have been 
searching for health care elsewhere because my COBRA will be going up. 
I am on unemployment, and I am barely able to pay the $244.76 for 
coverage now. I cannot get insurance because of the breast cancer. The 
health insurance risk-sharing plan, HIRSP, the Wisconsin State program, 
is too expensive for me to get coverage since they want 4 months of 
premium up front and they only cover some things. What are single 
people supposed to do? We do not qualify for any government assistance 
because we are single. I cannot go without insurance. There are no 
programs to help us out. So when you are working on health care in the 
House, please remember that there are other single people out there 
also in my shoes. I am at a crossroads because I have no avenue for 
assistance when it comes to health care. Come November, I will be 
unable to get coverage when I need it at this point in my life.''
  Florita of Madison, Wisconsin, writes:
  ``I am a divorced parent and am having difficulty obtaining health 
care coverage for my young adult son. My son, now 19, was dropped from 
my group HMO and this was based on his age and not being a full-time 
student. His employer offers a health care plan but there is a 1-year 
waiting period. When I tried to apply for individual coverage for him 
through my current HMO, my son was rejected because they needed more 
detailed information on his health status. When I telephoned them and 
discussed his recent diagnosis of high cholesterol and the medication 
prescribed to control it, I learned that this alone would make him 
ineligible for coverage. I learned from other insurers that he would 
have been rejected in that he had high blood pressure, migraines, 
obesity, et cetera. In other words, the HMOs deny applicants for the 
conditions that are quite common for a large segment of the population. 
This entire situation frustrates me. The government provides free 
health care for prisoners, but law-abiding, hardworking citizens are 
either denied health care coverage by the major HMOs, often for 
ridiculous reasons, or are drained financially if lucky enough to find 
individual coverage due to the high deductibles and premiums, coupled 
with dental, prescription and

[[Page H2903]]

optical costs that are not even covered in these plans. Health care has 
become a for-profit business at the expense of people's health. All 
citizens, regardless of their income, should not be denied full health 
care.''
  At this point I would like to yield again to the gentleman from New 
Jersey to share some of the remarks from his constituents.
  Mr. PALLONE. I want to thank the gentlewoman again. I actually do 
have two letters that I wanted to bring to your attention. By way of 
background, though, I did want to say, obviously many of us do believe 
as I do that we should have national health insurance. One of the 
letters actually addresses that. I would like to read it now. But I 
would also point out that there are ways of dealing with the uninsured 
in a more piecemeal fashion to expand options for the uninsured that 
would cover a great deal of those 44 million Americans. And so whether 
or not you agree, as I do, that we should have national health 
insurance or you want to look at this in a more piecemeal fashion, 
either way certainly would be better than what the Republican majority 
is proposing because I think that their solutions really are no 
solution at all. But I did want to read this one letter. I am not going 
to mention the names of my constituents because I did not get 
permission, so I am just going to read some sections. This is from a 
gentleman who is an advocate of national health insurance. He writes a 
very good letter.
  He says:
  ``I ask that you give some thought for national health insurance to 
cover every American citizen. We as a Nation are ranked 37th out of 191 
countries as far as medical health care. Our country is considered one 
of the wealthiest in the world. That being the case, why shouldn't 
every American citizen have medical, dental, and prescription drug 
coverage? A recent study by the prestigious Institute of Medicine said 
18,000 Americans die each year because they don't have health 
insurance. Myself, I wonder how many die because they don't have 
adequate health coverage because they can't afford the better coverage. 
Some can't afford to pay for their medication, glasses and other needs. 
I find it disgraceful that should you fall very ill or need extended 
health care or have to be treated for a terminal illness, all personal 
property and assets you work hard for all your life will be taken away 
from you and your loved ones. No other industrialized nation rations 
out health care to the degree as the United States does.''
  The letter goes on, but I think that last point is particularly apt, 
given what our Republican colleagues said earlier this evening and I 
will read that section again from this letter: ``No other 
industrialized nation rations out health care to the degree as the 
United States does.'' For those Republicans that say that other 
countries are rationing health care, we do it more than anybody else 
because we have so many uninsured.
  The second letter that I have I think is particularly significant 
because this person is a small business owner.

                              {time}  2200

  And as we know, one of the Democratic bills that we introduced today 
and that we wanted to have considered as an alternative to the 
Republican bill is the Small Business Health Insurance Act which 
creates a 50 percent tax credit to help small businesses with the costs 
of health care, which I think would be very significant; but again I 
would point out that under the rules of the House with the Republican 
majority, we were not allowed today to bring up this bill, which is 
what we wanted to do. We did not have that option.
  But in any case I will say this is from Christine, I will not give 
her full name, one of my constituents. And again I am not going to read 
the whole letter but I will read some parts of it.
  She says: ``Dear Congressman Pallone: I am writing to you to make you 
aware of the desperate situation in which my husband and I find 
ourselves. Included in this letter you will find a copy of a newspaper 
article from the Star Ledger.'' Let me explain that this newspaper 
article in the Star Ledger, which is the largest newspaper in the State 
of New Jersey, basically talks about the State License Beverage 
Association which had a health plan to cover member restaurants and 
taverns but essentially went belly up. I do not know all the details, 
but if people read the Star Ledger article, it simply stopped paying 
out benefits because it did not have the money to do so, which I think 
highlights again how difficult it is for small businesses to provide 
coverage even through their trade association.
  But let me go on about what Christine says. She says: ``This is most 
upsetting to us, as my husband was released from the hospital, after 
suffering a heart attack and subsequent angioplasty the day before we 
read this article'' in the Star Ledger. ``I cannot imagine what his 
bills will be.
  ``For a year prior to reading this'' Star Ledger ``article, we have 
been trying to find out why our doctor bills and hospital bills are not 
being paid. We receive letters and telephone calls from collection 
agencies. We never got a straight answer from the New Jersey License 
Beverage Association. We are told to resubmit the bills. Our premiums 
of $868 per month were paid in full, without exception. We also pay a 
$500 deductible per person, per year. That amount is for the most basic 
coverage; no dental or eye care. In addition, our plan is a 70/30 plan, 
which means we pay a co-pay each visit plus 30 percent of the rest of 
the bill.'' We can see that this is not really the best of plans, but 
this is all they had. When we are seeing cardiac specialists, this 30 
percent can be hundreds of dollars. Being restaurant owners, we know 
this amount of money is more than many people who work for large 
corporations pay, but we know it is what we have to pay to take care of 
ourselves.
  ``In addition to being without health coverage through New Jersey 
License Beverage Association, we now have to try to find a new health 
coverage plan. This task will not be an easy one. My husband and I are 
both in our 50s and have a number of health problems or, as they say, 
`preexisting conditions.' Health insurance plans do not like to see 
these words. They are reluctant to take on customers who may cost them 
money right away.
  ``Please look into this matter. Where did our money go, if not to pay 
our doctor bills? How can we possibly be held responsible for over a 
year's worth of doctor bills when we have paid our premiums?'' And they 
go on.
  And, again, the problem is real. The problem faces these 44 million 
uninsured Americans every day. And what we have proposed as Democrats 
here today, and I know my colleague from Ohio went into it a little 
bit, were three pieces of legislation which, again, are not going to 
cover all those 44 million uninsured but probably would cover the 
majority of them. And one of them, as I said, was the bill called the 
Small Business Health Insurance Act, which creates a 50 percent tax 
credit to help small businesses with the costs of health care, but I 
wanted to mention the other two. The second one is the Family Care Act, 
which essentially expands Medicaid and S-CHIP to provide affordable 
coverage to about 7.5 million working parents.
  What we found a few years ago when we studied the 40 million 
uninsured was that the biggest group of uninsured were kids, and the 
second largest were the near elderly, those between 55 and 65 that were 
not eligible for Medicare, and then the third, of course, were the 
parents of the kids. So we tried through, as I call it, piecemeal 
legislation to address those problems. And then we did pass it. It was 
a Democratic initiative, but we did get enough Republicans; so we 
passed the Family Care or the S-CHIP, which gave money back to the 
States to provide for health insurance for kids. What this bill does 
that was introduced today, this Democratic initiative, the Family Care 
Act, basically expands Medicaid and S-CHIP to provide coverage for the 
parents of those kids, the 7.5 million people.
  And then the third piece of legislation is the Medicare Early Access 
Act that provides coverage to 3.5 million people who are over the age 
of 55, but not yet eligible for Medicare, by allowing them to purchase 
Medicare coverage. These are the second largest group of uninsured, the 
near elderly. What happens is that when someone gets, say, 10 years 
prior to that, 65, when they are eligible for Medicare, they are often 
in a situation where they may be a spouse of a husband who may have 
died because he is older. I am

[[Page H2904]]

assuming the woman is still alive, but it could be either way. Then the 
other thing is that a lot of people at the age of 55 will sometimes 
lose their job or they will be in a position where they have an early 
retirement and they may think they have health care coverage, and then 
they do not have it or they lose it. So that is definitely a very 
vulnerable group, and they could be added to the Medicare program by 
simply paying a premium. It was estimated, I think, a few years ago, 
when President Clinton was in office, that it would be something like 
$350. I guess it was probably a month, I would imagine, $350 a month. 
Some people may not have been able to afford that, but it would have 
been an option.
  So these are ways, as I said, that we can expand health coverage and 
cover the majority of the uninsured without having to go to the 
national health insurance. Again, although I would like to see national 
health insurance, the Democrats have a consensus that this is a way to 
address the problem through this, as I call, piecemeal legislation that 
would provide significant coverage for most of the uninsured.

  Ms. BALDWIN. Mr. Speaker, I thank the gentleman for his comments.
  I have several additional letters from constituents that really, I 
think, emphasize the crisis that we are in right now, and their voices 
are so powerful in this debate. This is ultimately what is going to 
make the difference in this debate, what will ultimately bring us to 
pass effective legislation, not just things with feel-good titles to 
them. And their voices are very powerful in this debate.
  One letter, Norm from Mazomanie, Wisconsin, Norm writes: ``I had 
short-term coverage through COBRA, but that was cut short when my last 
employer reorganized. With that change came a loss of coverage, without 
notice. For some this would be a case of purchasing private coverage. 
For me it was a crisis as my medical records include treatment for skin 
cancer, angioplasty with two stents in my heart, and one episode of a 
transient ischemic attack (ministroke). I was lucky in all three cases 
as early detection and proper treatment left me able to work without 
limit and able to carry on life normally. However, it also made me 
uninsurable. I am grateful for living in Wisconsin as I was able to 
secure coverage through the Wisconsin Health Insurance Risk Sharing 
Plan. The coverage is expensive and has a high deductible. It is, in 
fact, best described as an asset insurance rather than health 
insurance.
  ``My bottom line is that if one can get the insurance, many can ill 
afford it. And if they can afford it, it commands such a large portion 
of the budget for a retiree or unemployed person that it is often a 
choice of insurance or having access to other normal things as well.
  ``Would there have been any value in saying we have a medical 
coverage crisis in this country and it's not only for the homeless or 
indigent. It has arrived for the common man. There is no place to turn. 
We can fund billions to defeat Iraq and will spend billions more to 
repair that country. We give aid to half the world and spend billions 
on one questionable project or another. Yet we cannot seem to find a 
way to provide decent, affordable health care to those of us who have 
faithfully paid large portions of our income to the tax system. It is 
time for Congress to get off their figurative and collective behinds 
and address this issue.'' And that is what Norm writes.
  Niki from Madison, Wisconsin says: ``I'm fighting a battle right now 
just to get coverage. After a layoff 6 years ago, I had a year of COBRA 
and then found an agent and got insurance rather easily with a company 
the agent represented. That company'' was bought by another company and 
now the new company ``has decided to get out of the medical insurance 
business. My agent recommended switching companies and that's where the 
sledding has gotten tough.
  One company ``turned me down for a jammed little finger and removal 
of a benign growth and again on appeal, despite a letter from my doctor 
saying I have been a perfectly healthy person all my life with no 
predisposition to anything uninsurable,'' a second company asked `` 
`Have you ever been turned down for insurance?' Well, yes, just last 
week, for a jammed little finger and removal of a benign growth.'' That 
company ``gave me no specific reason for also turning me down. I have 
to make a request in writing to them for that information and then they 
won't send the information to me, only to the health provider of my 
choice.
  ``What really irks me is the years and years that I have never made a 
claim.''
  Along with these individuals, there are millions of Americans who are 
fortunate enough to find an insurer willing to cover them at an 
affordable price. But oftentimes the coverage turns out to be 
inadequate, and necessary medical procedures and treatments simply are 
not covered.
  Jean from Stoughton, Wisconsin writes: ``Please continue the fight 
for coverage for mental health with medical coverage. We know all too 
well the devastating sadness that we have endured having an immediate 
family member with a severe eating disorder complexed with Type I 
diabetes. We have fought with the insurance company for 3 years with 
little success. Twenty visits for mental health is all that is included 
with most medical plans, and this does nothing to address a severe 
eating disorder and very possible death being a fact at all times for 
our family. It takes no rocket scientist to understand that being put 
in the hospital every 3 weeks in intensive care for the last 3 years is 
not saving any money for the insurance company, and yet the company 
will not budge. They would rather let a patient die than to open up the 
door and give mental health access to get better and become healthy.''
  Barbara from Madison, Wisconsin writes: ``In August, 1997, both my 
husband and my college-age child required major medical care. One had a 
disease of the kidneys and one suffered severe clinical depression. 
Both patients required emergency visits and extended treatment. Both 
patients were compliant and followed their doctor's treatment 
instructions. Both patients were covered under the same family policy, 
which had been in effect for over 25 years.
  ``But our insurance company paid his expenses at a rate twice as high 
as it paid hers, because he had kidney stones and her severe depression 
was `mental illness.'
  ``My husband underwent three outpatient treatments to dissolve the 
stones, as well as the required X-rays, tests, and office visits. When 
these treatments failed, he underwent surgery to remove the kidney 
stones. He was not expected to remain in extreme pain for the next 
several months until the new calendar year came in order to have 
insurance coverage. He was not told that he had used up all of his 
allotted benefits.
  ``My daughter required an emergency room visit as the result of a 
depressive self-harm episode.

                              {time}  2215

  Since this was not a psychiatric visit, the insurance paid 75 percent 
of the cost to treat her. But when she required psychiatric 
hospitalization to prevent any more self-harm, the insurance paid only 
44 percent. And since she has been faithful about seeing her 
psychiatrist regularly, her insurance would not pay anything towards 
future psychiatric visits because she had used up her allotted number 
of visits for the year. She was expected to wait several months for 
psychiatric care to be covered, even though she was in extreme 
emotional pain, since she had used her allotted number of psychiatric 
visits for that year. Even though she was dangerously suicidal, the 
insurance company would not cover her psychiatric treatment. Of course, 
if she had harmed herself and survived, the medical bills would have 
been covered. Needless to say, we are not willing to take a risk with 
our daughter's life, so we accumulated an exorbitant amount of medical 
bills.
  ``Was my husband's health of more value than my child's? Of course 
not. But our insurance company paid his expenses at a rate twice as 
high as hers. Justice demands parity in insurance.''
  Mr. Speaker, as Cover the Uninsured Week comes to a close, I am very 
grateful to know that I have colleagues here fighting tirelessly for a 
better answer to our health care crisis in this country.
  Before I close, I yield additional time to the gentleman from New 
Jersey (Mr. Pallone).

[[Page H2905]]

  Mr. PALLONE. Mr. Speaker, I want to thank my colleague for not only 
doing this special order, but also for having all those letters and 
comments from her constituents, because I think that is the best way to 
show what the problem is. It needs to be personalized, because it is 
real.
  This is not just some abstract theory we are operating under here. 
These are real people who are suffering and talk to us and approach us. 
Many of them are not in a position to write a letter, because maybe 
they are not articulate enough. But they tell you when they see you on 
the street or they see you at a function that they are having 
tremendous problems. And they are fearful. They either have no 
insurance or they are fearful they will not have insurance or they are 
under-insured.
  I just want to spend a few minutes talking a little more about these 
three bills that we Democrats introduced today that I think will go far 
towards providing insurance for the majority of those 44 million 
uninsured Americans.
  The one I mentioned before is the Small Business Health Insurance 
Promotion Act. This addresses small businesses trying to provide 
insurance for their employees.
  I will not again get into all of it, but basically what it does is to 
provide a tax credit to help defray the costs of health insurance and 
encourage more employers to offer health insurance. It is available to 
any small employer who has 2 to 50 employees who provides coverage 
through a qualified pooling arrangement and who offers coverage to all 
employees. It is available to any self-employed individual who gets 
coverage through a qualified pooling arrangement. The tax credit, as I 
said before, is equal to 50 percent of the employer's cost of health 
insurance coverage.
  Small businesses and self-employed individuals receive the tax credit 
for 4 years at least, and participating employers who increase the 
number of employees to over 50 after qualifying for credit continue to 
receive the credit for another 4 years.
  The bill provides additional economic stimulus even to small 
employers who currently offer coverage, so it is something that those 
who offer coverage can take advantage of, so they do not get into a 
situation where they have to drop the coverage.
  The second bill I mentioned is the one with the near-elderly. 
Actually, when I described it before, I made it sound as if you were 
going to have to pay all the costs of the premium. In reality, that is 
not the case. There is actually a subsidy in the bill. But I would like 
to describe it a little bit.
  It again applies to those from 55 to 64. Starting in January 2005, 
individuals in that age bracket who have no insurance under another 
public or group health plan are eligible to purchase Medicare as their 
health insurance. They receive the full range of Medicare benefits and 
they are not required to exhaust employer-based COBRA before choosing 
the Medicare buy-in.
  The way it works is the premium is set by the Centers for Medicare 
and Medicaid Services, and enrollees receive a 75 percent refundable 
advanceable tax credit to offset the premiums. So, basically the 
participants are only personally responsible for a 25 percent share of 
the monthly premiums.
  The third bill I am not going to get into, because I see one of our 
colleagues has arrived, but it is the one for the parents of the kids 
who now receive funding and coverage for their kids under the SCHIP 
program.

  Ms. BALDWIN. Mr. Speaker, I would like to now yield time to my 
colleague the gentleman from Rhode Island. The gentleman has 
distinguished himself on this issue since he joined us here in 
Congress.
  I yield to the gentleman from Rhode Island (Mr. Langevin).
  Mr. LANGEVIN. Mr. Speaker, I want to thank the gentlewoman from 
Wisconsin (Ms. Baldwin) and others for their leadership in organizing 
this special order, especially also the gentleman from New Jersey (Mr. 
Pallone). The two of you deserve a great deal of credit, and I thank 
you for your leadership.
  America's health care delivery system, Mr. Speaker, is incredibly 
flawed and in crisis. As premiums for employer-sponsored insurance 
rapidly rise, employers are struggling to maintain the same level of 
benefits or are offering less coverage and fewer options, and in some 
cases they are being forced to drop coverage altogether.
  Even worse, the number of small businesses offering health insurance 
to their employees is rapidly declining. Existing public programs meant 
to reach those without access to private insurance are strained and 
still do not reach everyone. The challenges of the current system are 
affecting the health security of every American. Meanwhile, as we 
learned this week, the number of uninsured Americans is rising.
  Mr. Speaker, we depend on coverage from a very haphazard system. If 
you do not qualify for a public program and do not work for an employer 
who is able to offer comprehensive benefits, you do not have access to 
affordable group coverage.
  I find it staggering that over 30 percent of uninsured Americans are 
working and making more than $50,000 per year. Most of these 
individuals who make too much money to qualify for Medicaid are willing 
to contribute a fair share of their own income to a health insurance 
plan, if only they had access to a reasonably priced private plan.
  The fastest growing segment of the uninsured population is young 
adults. There are 8 million 18 to 24-year-old Americans without health 
insurance. We need to find a way to pull these people into the system, 
which is breaking under the strain of rising costs and an aging 
population.
  Like my other colleagues here tonight, I am going to read a letter 
that I received earlier this year from a young man in my home State of 
Rhode Island.
  Mr. Speaker, it reads: ``I am a 28-year-old resident of Warwick. The 
cost of medical care is astronomical. I do not have a job which gives 
me coverage, so I was forced to pay over $400 a month to Blue Cross for 
my health coverage. Well, I am no longer able to afford that incredible 
price and they have dropped me. I then applied to the Department of 
Human Services in Buttonwoods for medical assistance, and I was 
rejected. They said my medical condition was not severe enough to 
warrant assistance.
  ``My medication and medical bills are far too expensive for me to 
afford more much longer. I live with my family and they have been 
giving me help, but it is an extreme strain. I have just recently 
gotten a job delivering papers, but that will not be much help.
  ``Are there any Federal programs which could help? Are there any 
State programs? There seems to be no information out there for people 
such as myself who are in desperate need of medical coverage. I can 
afford maybe $100 to $200 per month for coverage, but I do not know of 
any private companies in Rhode Island that provide that.
  ``I have heard of the Neighborhood Health Plan of Rhode Island and 
Right Aide, but they seemed designed for families and I was told 
initially I probably wouldn't qualify. What about singles such as 
myself?
  ``Do you or does anyone on my staff know how to help? Can you direct 
me to any government or private agencies, and can you tell me of any 
private health insurance companies in Rhode Island, aside from Blue 
Cross, that provide reasonably affordable health coverage? I have 
looked on the net, but most of what I see are scams and junk web sites.
  ``Also, I am a registered Democrat and I am aware of your work on 
health care, but I think that the U.S. Congress and our State could do 
a much better job at getting the uninsured more help and more 
information. Thank you.''
  Mr. Speaker, my constituent sees the value of health coverage and has 
expressed a willingness to contribute a fair amount of his salary 
towards the cost of his medical care. Yet, because he does not fit into 
one of the categories I described earlier, there are no affordable 
options available to him.
  Mr. Speaker, this is morally and economically wrong. We must begin a 
meaningful dialogue about how to reach those who have been left out of 
our health care system.
  I am presently at work on a health care proposal that will assure a 
system that can include people like my constituent. The plan that I am 
proposing, that I am working on, uses the Federal

[[Page H2906]]

Health Employee Benefit Plan as a model and would make a major step 
forward in achieving health care for all.
  Mr. Speaker, I look forward to working with my colleagues on this 
effort and other legislative initiatives that will extend the promise 
of health insurance for every American.
  Mr. Speaker, again I want to thank my colleagues for organizing this 
special order on such a critically important issue at this time.
  Ms. BALDWIN. Mr. Speaker, reclaiming my time, I thank the gentleman.
  Mr. Speaker, I want to thank all of my colleagues who this evening 
amplified the voices of their constituents. The crisis is dire. I know 
that we are rededicating ourselves as Democrats, but also as Members of 
this body who have constituents in dire need, to work towards the day 
where there is no need to have a Cover the Uninsured Week because we 
found solutions, workable solutions, to this problem.
  Again, I thank my colleagues who shared this hour.
  Ms. MILLENDER-McDONALD. Mr. Speaker, I rise this evening to speak for 
a few moments about the almost 44 million Americans, including 8.5 
million children, who are uninsured.
  Mr. Speaker, this week is Cover the Uninsured Week. As part of an 
intense effort to highlight the state of the uninsured in this country, 
more than 800 national and local organizations are working together and 
holding events, including health and enrollment fairs for uninsured 
Americans and health coverage seminars for small business owners.
  In a study released yesterday, the Kaiser Commission on Medicaid and 
the Uninsured estimates our Nation will spend $41 billion to care for 
the uninsured in 2004. Federal, State and local governments will bear 
as much as 85 percent of these costs according to the study.
  This study comes on the heels of new research from the Robert Wood 
Johnson Foundation, the national sponsor of Cover the Uninsured Week, 
which found that 20 million working adults in the U.S. are uninsured.
  In my home State of California, approximately 6.5 million State 
residents were uninsured for all or part of 2002. Mr. Speaker, the 
uninsured are not only the poor or unemployed. In California, 2.5 
million working residents are uninsured. That's 16 percent of the 
working population.
  According to the Kaiser Family Foundation, between 2000 and 2001, the 
number of the uninsured increased by 1.4 million, and low income 
Americans are the most likely to be uninsured.
  Mr. Speaker, earlier this Congress, I introduced legislation, H.R. 
1143, the Keep America Healthy Act. My bill amends title XIX of the 
Social Security Act (SSA) to permit States to expand Medicaid 
eligibility to uninsured, poor adults.
  The eligibility is expanded through the creation of a new optional 
Medicaid eligibility group for individuals between the ages of 21 and 
65 whose family income does not exceed a State-specified percentage of 
up to 200 percent of the applicable poverty line.
  I believe that Congress must take steps to insure the health of all 
Americans. In addition, the working poor should be confident that 
unfortunate incidents would not affect their ability to provide for 
their families. These citizens are left vulnerable by the lack of 
Federal health care assistance available to them, and my bill seeks to 
fill that gap.
  Mr. Speaker, we all are aware that there is a health care crisis in 
our Nation, and while there are no easy solutions, I ask my colleagues 
to support not only my legislation, but also the mission and goals of 
Cover the Insured Week.
  Mr. RODRIGUEZ. Mr. Speaker, I rise today in observance of Cover the 
Uninsured Week.
  Over 40 million people are walking the streets of America without the 
most basic of protections. A protection that you and I have, and one 
that has been afforded to our families. But for many working families, 
the prohibitive cost of health insurance puts it out of reach. And this 
can lead to tragic consequences. The uninsured are more likely to be in 
poor health, receive diagnoses too late, and use the emergency room for 
primary care.
  Research also shows that being uninsured has a financial cost too. 
After jobs loss, being uninsured and getting sick is the most common 
reason people file for bankruptcy.
  While the cost for solving the problem of the uninsured is high, the 
cost for ignoring this problem is even higher.
  In Texas, a huge budget deficit led to drastic cuts in the CHIP 
program and optional Medicaid benefits. While some restorations were 
made, those cuts will undo any gains that Texas has made in the fight 
to increase access to care.
  We must begin to thing of healthcare as an investment. It is an 
investment in our children, in our workforce and in creating a better 
quality of life that we all strive to achieve. Until we can guarantee 
coverage for all, then we must take measures to fill in the gaps.
  Earlier today we heard spirited debate about the merits of 
Association Health Plans and revisited the debate on medical 
malpractice reform. But the bills that we considered would do little to 
address the problem of the uninsured.
  In fact, the legislation could actually make people worse off as was 
the case with the Small Business Health Fairness Act, H.R. 4281. Under 
this plan, the CBO estimates that 80 percent of small businesses would 
see premium increases and as many as 100,000 of the sickest workers 
would lose coverage altogether. This is not the answer.
  Instead, I urge my colleagues to cosponsor three bills that if 
enacted could provide help to over half the uninsured.
  The Family Care Act will make it possible for the working parents of 
children who are enrolled in Medicaid or CHIP to also participate in 
the program. This bill will promote health for the entire family as 
people work their way up out of poverty.
  Second, The Medicare Early Access Act is designed to assist uninsured 
people who are 55 and over, but not yet eligible for Medicare. The bill 
would allow this pool to purchase Medicare for a premium and a tax 
credit to help defray the cost of the premium.
  Lastly, the Small Business health Insurance Promotion Act would 
provide tax credits to eligible small businesses, including the self-
employed, to help secure affordable health insurance.
  This week, Robert Wood Johnson Foundation released data showing that 
Texas has the highest rate of uninsured working adults at 27 percent. 
These are the folks that are out there working hard and paying taxes, 
but don't make enough to provide for their own benefits.
  We must begin to tackle this problem by creating programs that will 
help small businesses offer health insurance to employees.
  I would like to thank the Members who have worked tirelessly to 
promote and improve upon these bills, especially Representative Dingell 
and Representative Rangel. This three-pronged approach will help 
increase access to health insurance.
  Again, I urge my colleagues to cosponsor these bills. Let's provide 
an answer to covering the uninsured.

                          ____________________