[Congressional Record Volume 150, Number 100 (Monday, July 19, 2004)]
[Senate]
[Pages S8424-S8425]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. GRAHAM of Florida:
  S. 2685. A bill to amend titles XIX and XXI of the Social Security 
Act to provide States with the option to cover certain legal immigrants 
under the Medicaid and State children's health insurance programs; to 
the Committee on Finance.
  Mr. GRAHAM. Mr. President, I am introducing the Immigrant Children's 
Health Improvement Act today.
  This legislation would allow States the option to once again provide 
Medicaid and State Children's Health Insurance Program (SCHIP) coverage 
to legal immigrant children and pregnant women.
  Traditionally, Medicaid and SCHIP have served as vital components of 
our nation's health care safety net. These programs have provided 
coverage to over 50 million non-elderly, low-income Americans, most of 
them children, and have helped to dramatically reduce infant mortality 
and provide health care for millions of poor children whose families 
cannot afford the high cost of private health insurance.
  However, for many low-income families that are income eligible for 
Medicaid and SCHIP, these safety programs are today little more than a 
mirage--an illusion to those who need them most. The 1996 welfare 
reform law arbitrarily barred states from using Federal funds to 
provide health coverage to low-income legal immigrants during their 
first 5 years in the United States.
  While the goal of welfare reform was to encourage self-sufficiency in 
adults, the legislation unfortunately has punished children. Today, 
half of all legal immigrant children from families making less than 200 
percent of the Federal Poverty Level are uninsured. That's over two and 
a half times the uninsured rate for children who are United States 
citizens.
  In the long term, ignoring the health care needs of legal immigrant 
children

[[Page S8425]]

and pregnant women will prove more costly than providing care today. 
Children and pregnant women who do not have access to preventive care 
often use the emergency room as a first resort--an expensive treatment 
for conditions that could have been treated at a fraction of the cost 
or possibly even prevented.
  The American Journal of Obstetrics and Gynecology in 2000 estimated 
that $1 spent on prenatal care for immigrant women saved $3 in short-
term postnatal costs and $5 in longer-term costs. By spending on 
prevention today, we can reduce health care costs in the future.

  Another result of the 1996 legislation was to push the costs of care 
to the States. The 20 states with the highest number of legal 
immigrants all used to have state-financed health care programs for 
legal immigrant children or pregnant women. States put these programs 
in place because they recognized the enormous toll the 1996 rules have 
taken on state budgets, when states have to provide preventable 
emergency-room care to thousands of uninsured legal immigrants.
  But due to the recent State budget crisis, some of these states 
cannot now afford programs that are exclusively state-financed. In my 
home state of Florida, for example, new enrollment in the program has 
been frozen.
  This amendment allows states the option to use Medicaid and SCHIP 
funding to cover legal immigrant children and pregnant women. Over the 
last 6 years, Senator Chafee and I, along with our colleagues in the 
House and Senate, have worked to restore this option and we've come 
very close to achieving our goal.
  Last year, a 3-year restoration provision was included in the Senate-
passed Medicare prescription drug bill, with 65 Members supporting it. 
Over 400 national, state, and local organizations have supported this 
legislation, including the National Governors Association, the National 
Conference of State Legislatures, the American Academy of Pediatrics, 
and numerous immigrant, ethnic, labor, health and faith-based 
organizations.
  Despite this support, Congress has yet to enact legislation that 
restores health benefits to legal immigrant families.
  Why?
  Some Members argued it didn't belong on a Medicare bill but instead 
on a welfare reauthorization bill. That was one of the reasons it was 
dropped from the Medicare bill. But the same argument has been made 
when it was discussed in the context of welfare--that it is not a 
welfare issue, it's a health care issue.
  Well, while this volleyball match continues, legal immigrant families 
in this country continue to work hard and pay taxes, while being denied 
the benefits of the system they are paying into. Meanwhile, States 
continue to provide as much care as they can from strapped state 
budgets. We need to send a clear message about our concern for 
uninsured children and we need to stop pretending that our federal 
penny-pinching is cost free to the states or to taxpayers.
  Mr. President, legal immigrants pay taxes, serve in the military, and 
have the same social obligations as United States citizens. Legal 
immigrant children are, as much as citizen children, the next 
generation of Americans. It is important that all children start off on 
the right foot towards good health. This provision can help them do 
just that.
  This legislation is offset by a custom user fee extension included in 
the President's budget.
  I hope that we will begin consideration of this important measure 
before the August recess. The health and lives of many children is at 
stake, and there is simply no reason to delay any further.
                                 ______