[Congressional Record Volume 151, Number 86 (Friday, June 24, 2005)]
[Extensions of Remarks]
[Pages E1339-E1340]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       INTRODUCTION OF THE MEDIKIDS HEALTH INSURANCE ACT OF 2005

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                        Thursday, June 23, 2005

  Mr. STARK. Mr. Speaker, it is with great pride that I join my 
colleagues in the House today to introduce the MediKids Health 
Insurance Act of 2005. This bill is also being introduced in the Senate 
by my good friend, Jay Rockefeller.
  Mr. Speaker, this year we are honoring the 40th anniversary of 
Medicare, our nation's health insurance program for the elderly and 
people with disabilities. At the time we created Medicare, our nation's 
seniors were more likely to be living in poverty than any other age 
group. Most were unable to afford needed medical services and unable to 
find health insurance in the market even if they could afford it. 
Today, as a result of Medicare's success, seniors are much less likely 
to be shackled by the bonds of poverty.
  Now it is our nation's children who are most likely to be poor. Kids 
in America are nearly twice as vulnerable to poverty as adults. This 
travesty is not only morally reprehensible, it also denotes grave 
consequences for the future of our country. Poor children are often 
malnourished and have difficulty succeeding in school. Untreated 
illnesses only worsen the chance for success. The future of our country 
rests in our ability to provide our children with the basic conditions 
to thrive and become healthy, educated, and productive adults. 
Guaranteeing continuous health coverage is a critical component of 
realizing this potential.
  The MediKids Health Insurance Act of 2005 assures that every child in 
the United States has health insurance by 2012. Modeled after 
Medicare--with benefits appropriate to children, simplified cost 
sharing, and comprehensive prescription drug coverage--MediKids covers 
America's kids from birth until age 23.
  MediKids assures that families will always have access to affordable 
health insurance for their children. Parents retain the choice to 
enroll their kids in private plans or government programs such as 
Medicaid or S-CHIP. However, if a lapse in other insurance coverage 
occurs, MediKids automatically fills in the gap. MediKids is the 
ultimate safety net, available nationwide, with maximum simplicity, 
stability, and flexibility.
  Many children's advocates and health care professionals who care for 
children are united in their support for MediKids, including: the 
American Academy of Pediatrics, the Children's Defense Fund, the 
American Academy of Family Physicians, the American Academy of Child 
and Adolescent Psychiatry, the American Nurses Association, Consumers' 
Union, FamiliesUSA, the March of Dimes, the National Association of 
Children's Hospitals, the National Association of Community Health 
Centers, National Association of Public Hospitals and Health Systems, 
and the National Health Law Program. I am submitting a sampling of 
letters from these groups along with my statement.
  I can think of no better use of Congress' time than to provide health 
insurance to every child. While some are fixated on flag burning, Terri 
Schiavo and banning gay marriages, my colleagues and I are offering 
solutions to real problems facing American families. Providing a 
simple, stable, and flexible health insurance option will afford 
millions of parents the peace of mind of knowing that their children 
will be cared for when they are sick. Our nation's priorities should be 
centered on creating a bright future for our children, and MediKids 
helps to achieve this goal.
  I look forward to working with my colleagues and the many endorsing 
organizations to enact the MediKids Health Insurance Act of 2005.

          MediKids Health Insurance Act of 2005--Bill Summary

       The MediKids Health Insurance Act provides health insurance 
     for all children in the United States regardless of family 
     income level by 2012. The program is modeled after Medicare, 
     but the benefits are improved and targeted toward children.
       MediKids is the ultimate safety net, with maximum 
     simplicity, stability, and flexibility for families. Parents 
     may choose to enroll their children in private plans or 
     government programs such as Medicaid or S-CHIP. However, if a 
     lapse in other insurance coverage occurs, MediKids 
     automatically picks up the children's health insurance. 
     MediKids follows children across state lines when families 
     move, and fills the gaps when families climbing out of 
     poverty become ineligible for means-tested programs.


                       ENROLLMENT AND ELIGIBILITY

       Every child born after 2007 is automatically enrolled in 
     MediKids. Older children are enrolled over a 5-year phase-in 
     as described below. Children who immigrate to the U.S. are 
     enrolled when they receive their immigration cards. Materials 
     describing the program's benefits, along with a MediKids 
     insurance care, are issued to the parent( s) or legal 
     guardian(s) of each child. Once enrolled, children remain 
     enrolled in MediKids until they reach the age of 23. There 
     are no re-determination hoops to jump through because 
     MediKids is not means tested.


                                PHASE-IN

       Year 1 = the child has not attained age 6; Year 2 = the 
     child has not attained age 11; Year 3 = the child has not 
     attained age 16; Year 4 = the child has not attained age 21; 
     Year 5 = the child has not attained age 23.


                                BENEFITS

       The benefit package is based on the Medicare and the 
     Medicaid Early and Periodic Screening, Diagnosis, and 
     Treatment (EPSDT) benefits for children, with simplified cost 
     sharing mechanisms and comprehensive prescription drug 
     coverage. The benefits will be reviewed annually and updated 
     by the Secretary of Health and Human Services to reflect age-
     appropriate benefits as needed with input from the pediatric 
     community.

[[Page E1340]]

                   PREMIUMS, DEDUCTIBLES, AND COPAYS

       MediKids assures that families will always have access to 
     affordable health insurance for their children. Families 
     below 150 percent of poverty pay no premiums or cost sharing. 
     Families between 150 percent and 300 percent of poverty pay 
     reduced premiums and cost sharing. Parents above 300 percent 
     of poverty are responsible for a small premium equal to one 
     fourth of the average annual cost per child. Premiums are 
     collected at the time of income tax filing. Premiums are not 
     assessed during periods of equivalent alternative coverage. 
     Families will never pay more than 5% of their adjusted gross 
     income (AGI) for premiums.
       Cost sharing is similar to the largest plans available to 
     Members of Congress. There is no cost sharing for preventive 
     and well childcare for any children. A refundable tax credit 
     is provided for cost sharing above 5% of AGI.


                               FINANCING

       Initial funding to be determined by Congress. In future 
     years, the Secretary of Treasury would develop a package of 
     progressive, gradual tax changes to fund the program, as the 
     numbers of enrollees grows.


                                 STATES

       Medicaid and S-CHIP are not altered by MediKids. States can 
     choose to maintain these programs. To the extent that the 
     states save money from the enrollment of children into 
     MediKids, states are required to maintain current funding 
     levels in other programs and services directed toward the 
     Medicaid population. This can include expanding eligibility 
     or offering additional services. For example, states could 
     expand eligibility for parents and single individuals, 
     increase payment rates to providers, or enhance quality 
     initiatives in nursing homes.


                        SUPPORTING ORGANIZATIONS

       American Academy of Child and Adolescent Psychiatry 
     (AACAP); American Academy of Family Physicians; American 
     Academy of Pediatrics; Children's Defense Fund; Consumers' 
     Union; Families USA; March of Dimes; National Association of 
     Children's Hospitals; National Association of Community 
     Health Centers; National Association of Public Hospitals and 
     Health Systems; National Health Law Program.
       Contact Deborah Veres at 225-4021 or 
     [email protected] if you have any questions.

                          ____________________