[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.
____________________