[Congressional Record Volume 153, Number 113 (Monday, July 16, 2007)]
[House]
[Pages H7841-H7849]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CHILDREN'S HEALTH INSURANCE
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 18, 2007, the gentlewoman from Pennsylvania (Ms. Schwartz) is
recognized for 60 minutes.
Ms. SCHWARTZ. Mr. Speaker, I am very pleased this evening to
introduce the subject of children's health insurance and what has
really been a remarkably successful Federal-State, public-private
initiative that has really helped to make sure that middle class
working families across this country have been able to get health
insurance for 6 million of their children. So it has really been
helping families all across this country be able to do what they want
to do as responsible parents, and that is to be able to help pay for
health insurance. Every State does it a little bit differently. That is
what we are going to talk about this evening; we are going to talk
about how important it has been for 10 years in this country to help
children in America get the health care they need and they deserve, and
it helps them get off to the right kind of start. So I want to talk
more about that and I will be joined by some of my colleagues. But
because one of my colleagues is going to be taking over in the chair, I
am going to give him a few minutes just to talk about the subject. He
is a colleague of mine from Pennsylvania. And I will say in
Pennsylvania we are very, very proud of having been one of the first
States well before the Federal level to start a children's health
insurance program. In fact, we called it CHIP, then the SCHIP program
started. In 1992 is when we started it in Pennsylvania, and I was
instrumental in creating the Children's Health Insurance Program in
Pennsylvania. It has been incredibly successful. 130,000 children have
health insurance in Pennsylvania.
{time} 2200
So a colleague of mine, who has also worked in health care for a good
long time and knows about the experience of the Children's Health
Insurance Program from the other part of Pennsylvania, in the western
part of the State, my colleague, a freshman who's done a wonderful job
already, Jason Altmire, Congressman Altmire is going to say a few
words, and then we'll continue for the hour.
Mr. ALTMIRE. Mr. Speaker, she is correct. In the State of
Pennsylvania, she did a fantastic job in the State legislature in
crafting Pennsylvania's plan with regard to children's health
insurance. And Pennsylvania, I think, has one of the best, if not the
best plans, the model for the entire country on this issue.
And we're going to be joined tonight by some other people who know a
lot about health care and especially know a lot about the children's
health insurance programs.
We're going to be joined by Mr. Pallone, who's the chairman of the
Health Subcommittee right here in the House of Representatives for the
Energy and Commerce Committee which has jurisdiction over this issue,
and there's no one in this Congress who has worked harder on this issue
over the years and has more experience with crafting this. He was
involved in putting this together 10 years ago and now, as chairman,
has certainly had a lot to say about it.
And we're going to be joined by our colleague from Connecticut, Mr.
Murphy, Chris Murphy, who was instrumental in his State legislature on
these issues. So we really do have some folks here tonight to talk
about this issue who have experience, who have detailed knowledge on
this issue.
And what could possibly be more important on the domestic front than
health care?
And I'm sure my colleagues would agree, as I travel around my
district, I'm sure they have the same experience in their district.
That's the issue that comes up more often than any other issue because
it affects everybody. It is an issue that, no matter whether you're
rich or poor, live in an urban setting, rural setting, you have issues
with your health care costs.
Small businesses can no longer afford to offer health insurance in
many cases. Large employers are having the same issue.
We have 45 million uninsured in this country, people who lack any
health insurance at all, tens of millions more that live in fear of
losing their health coverage or are underinsured, don't have adequate
coverage to cover their needs.
[[Page H7842]]
And 9 million of that 45, Mr. Speaker, are children. And,
unfortunately, 6 million of those 9 million children are eligible to
participate in the SCHIP program. And the SCHIP program has worked.
We're at a 10-year point of reauthorization. And over the past 10 years
the number of uninsured children in this country has decreased by 25
percent, while the number of uninsured Americans has increased. This is
a program that has worked.
And we talk a lot in this House and a lot during these discussions
about the differences between what the President wants to do on the
budget level and what this Congress wants to do in a variety of issues.
But there is no issue on which there is a starker contrast of opinion
than this SCHIP program.
We, as Democrats, want to expand the program in a way that makes
sense. It's fiscally responsible, but it's going to pick up many of
those 6.2 million children who lack health insurance. We want to find a
way to cover those kids.
What could possibly be more important in this country than finding a
way to give health insurance to children who live in families that
don't have health insurance? I can't think of any more important task.
The President, on the other hand, offered up a budget that actually
decreased the number of children that are going to be covered under
this program by 1 million. His 5-year budget would have knocked a
million children who currently qualify for the program, would have
knocked them off the rolls and they would no longer qualify.
And I know my colleagues are going to talk about some of the
President's comments recently about what his views are on the program,
and I will leave it to them to have that discussion, as I do appreciate
the Speaker's indulgence as I have to take the chair following my
remarks here.
But I did want to take a moment to just emphasize how important this
issue is and to talk about the difference of opinion that exists, not
just with Republicans and Democrats, but especially with the
administration, Mr. Speaker, and this Congress. There is a stark
contrast of opinion, and we're going to have that discussion tonight.
And I thank the gentlewoman from Pennsylvania for her time and all of
our colleagues here for their leadership on this important issue.
Ms. SCHWARTZ. I thank the Congressman, and I appreciate that he has
other duties to contend with, so he'll be a part of this conversation
in a way. But thank you for taking the time to come to the floor and
for your help on this.
And I think for many of us, and I know you've just come off the
campaign trail this last year, and even those of us who were not
campaigning every minute but certainly out and about talking to people,
we do hear from everyday families about how hard it is to be able to
buy health insurance for kids.
I mean, I remember a story, and maybe my colleagues I'm hoping will
share some as well. When I was actually out and about once, and it was
actually a church group. And afterwards a woman came up to me and said,
you know, I haven't always shared this, but my husband, it was actually
a fairly well-to-do area. But she said, my husband was laid off last
year and it was a really, really tough time for us as a family. And one
of the things that affected us is that we didn't have health insurance.
But because of the CHIP program in Pennsylvania, SCHIP as we know it
federally, she said, I was able to make sure that my kids had health
insurance and they got the health care that I know that they needed and
deserved and that we wanted to help make sure they got.
And as someone who, and Congressman Altmire referred to this, in
Pennsylvania I'm known as the mother of CHIP. People do come up to me
and say, well, we don't always get thanked as elected officials, but do
thank me, whether it's stories where someone came up and said my
granddaughter who had some health issues, daughter was working hard
trying to get a degree and just didn't have health coverage. She said,
my granddaughter would not have health coverage without CHIP.
So these are the stories we hear all the time. And I think probably
my colleagues will share it. We're going to talk tonight about some of
the numbers they already referred to, the 6 million children who have
had access to health care, private health care in a lot of situations
across the States, the money that we've been able to work with the
States where they've put in their own dollars that have made a
difference in helping a lot of American families who didn't think that
we'd be there to help them who have been able to get health insurance
for the kids. But this is a place where we are making a difference in
people's lives.
One last story, and then I am going to turn it over to my colleagues.
I was talking to a group of school counselors, and some of them, one of
them said, stood up and said that she had a child come to her, a
teacher came to her and said they had a child in the class who never
raised his hand. He's in third grade. Never raised his hand. Never
participated in discussions. And she finally broke through to found out
what was going on. Turns out he had never had any dental care, and he
literally was afraid to open his mouth. It hurt. He had some
discomfort. He was embarrassed about the way his teeth looked. And when
he got children's health insurance coverage, he got to a dentist, she
said he was a different kid. And that would have been a child who would
have been a dropout, would have been a troublemaker in school because
he just wasn't going to be able to participate.
So she said, health care's important because of health care, but it's
also important because of education. If kids are not well, if they
don't get the preventative care they need, if they don't get the
eyeglasses, if they don't get treated when they're sick, I know it
makes a difference to the teachers in my school to be able to teach
those kids.
So on every level, and again we're going to talk about big numbers
here. The President wants to do $5 billion which will barely be enough
to sustain this program. It sounds like big numbers to families
listening, but the fact is that we need to make that commitment. And I
think we, as Democrats, have said we are going to make a commitment to
make sure that the Children's Health Insurance Program continues, that
it continues in the dynamic way that it has working with the States.
But we're going to even do more. We're going to be a little bold, even
in these tough budget times, and we're going to make sure that more
children who are now on waiting lists in some States are able to get
the health coverage that they deserve. And this is something we can do,
we should do. It's about having the political will to make it happen.
We're going to protect health care for seniors; we're going to do it
for kids. And that's what our discussion is about tonight.
And I'm going to close, and I know you mentioned this as well, the
previous speaker talked about the fact that the President, and I'm a
little, I have to say, this is very disturbing to many of us because
our Republican colleagues helped make this program happen. It was a
bipartisan effort. This wasn't something that one side or the other
sort of pushed without anyone else caring about it. But the fact is
that 193 House Republicans, 10 years ago, voted to make this happen. It
was a bipartisan effort; 153 House Democrats. This was a joint effort.
We said we wanted to make this happen. We all stand up from time to
time and we are really, really proud of this.
So when the President last week said, you know, he just doesn't think
this is important, that, in fact, we ought to be doing something else.
We ought to be helping families buy private health insurance by getting
them some tax deductions. They can't afford it? Well, I don't know what
he means.
He actually went on to say that kids can get health care in this
country. They can go to the emergency room.
That's really just stunning, given what we know about the high cost
of going to emergency rooms, the fact that that is not the best place
for primary care. It certainly is not the best place for children who
might just need a well-child checkup. So it's absolutely going in the
wrong direction on the health care. It's why we wanted to stand up
tonight and talk about this. That's why we will continue to until we
actually get it done. And I think that the commitment that we have made
is to make it happen.
[[Page H7843]]
And I'm joined tonight by two colleagues, one, Mr. Pallone from New
Jersey, who has not only been a leader on upgrading the Children's
Health Insurance Program, but continues to work out all the details of
how to make this happen. And I'm sure he's one of the people who
thought we were going to have bipartisan cooperation, and we still hope
we will, but is really working on some of the details of how we can and
we should do this.
One of the reasons we reauthorize programs is that we want to see
what worked best and what didn't; we want to see what changes have to
be made given our experience. He is going to talk about some of that
work.
And my colleague from Connecticut, who as a State legislator was
involved in working on the State level to make this happen and to work
in a special way to make Connecticut, make it work for children in
Connecticut, and feels a special connection to the Children's Health
Insurance Program there.
So gentlemen, I would ask you to share your stories and your help on
this. Maybe we'll start with Mr. Pallone, and if you would help us just
sort of by giving us maybe some of the facts and figures or some of the
stories that you hear from your colleagues as well.
Mr. PALLONE. I'd be very pleased to do that. And if I could, maybe
I'll talk; first of all, let me thank you for doing this hour tonight
and for everyone who's joining you, because it is really important. And
maybe I'll talk about three things, and then I'll turn it back; and
that is, one, how we came about with the SCHIP program because I think
that relates to the whole bipartisan nature of it, which is what you
stressed and is so important. And then maybe I can talk a little bit
about the preventative nature of it because you talked about the
emergency room and the President's comments about using the emergency
room. And then I'll give you my one story.
I'm glad you're here, in part because last week we had some of my
Republican colleagues, including some on the Health Subcommittee that I
chair, who were talking about this program as if it was an entitlement,
as if it was almost socialism, you know, sort of raising the specter
that we wanted the government to run the health care system. And
nothing could be further from the truth. I mean, first of all, you know
they neglected to mention that this was bipartisan. And remember, when
we're talking 10 years ago, this was the Gingrich Congress. This was
the Republican majority that hadn't been the majority for very long. I
mean, they were on the crest of this conservative right wing wave and
in the midst of that were willing to adopt this bipartisan measure.
And the reason was because, in fact it wasn't an entitlement; it
wasn't government control. It was just a practical solution to the
problems that we faced at the time and still face. I mean, we all know
that if people are very poor and likely not working, then they're
eligible for Medicaid. And we have a lot of kids, and we have a lot of
adults and, you know, people who find themselves because they're not
working and their income is very low, having to use the Medicaid
program, which is a very legitimate program and covers a lot of people
very successfully.
But what we found 10 years ago was that there were a lot of other
people who, because they were working, for the most part, were above
the Medicaid guidelines. Their income was too high. But what were they
making? Maybe 20,000 a year, 30,000, in some cases maybe 40,000 a year
and they still had kids. And because they were working in jobs where
there wasn't a health insurance option available to them, the employer
just didn't offer it, or when they went out in the private market, you
know, the costs were so prohibitive for them to buy insurance on the
private market, which, you know, in New Jersey you might be paying
$12,000 if you want to go out and buy insurance on the private market
for a family of four, today that they simply couldn't get health
insurance.
And so there wasn't any ideology involved here. In fact, it was a
block grant. It was set up as a block grant which, I don't know if you
guys remember because you haven't been here as long as me, but that was
like the Republican mantra at the time; that everything should be block
granted, all Federal Government programs should be block granted; this
shouldn't be an entitlement. And that's what we did. We said, okay,
fine. You want to make it a block grant. You know, President Clinton
was the President, so we had a divided Congress, and we said, that's
fine. Send the money to the States. We'll set up certain guidelines
that, you know, you had to be up to 200 percent of poverty. And then if
the States wanted to, they could go get waivers and go to 300 percent
or higher.
{time} 2215
And we will give the money to the States. They will match it, and we
will cover these kids.
Now, the second point I wanted to make is this is a preventative
measure, as you pointed out. For President Bush to say people can
always use the emergency, that's not the point. The point is we want
people to have health insurance so that they go to the doctor on a
regular basis, so they take preventative measures, and they don't get
so sick, particularly if they are kids, that they have to go to an
emergency room to get care. As you said, that is not the way to
operate. So we save money because through prevention, and everyone will
tell you, any doctor or medical professional will tell you, that the
most important thing for a person is to get health care in those first
4 or 5 years of their life. If they are properly cared for and they
have the type of preventative care and regular doctor care and dental
care that you mentioned in those formative years, then they are likely
to be healthy for the rest of their life because that is the most
important time. So it makes sense; right?
And then I will tell you my story. My story is that before this was
enacted, about maybe 11 years ago, I don't go there as much anymore,
but I used to go to a luncheon place that was like a diner, but not a
New Jersey, but more of a luncheonette, we used to call it then. It is
like an old-fashioned word, I guess. And there was a waitress there who
I knew for a long time, and she had young children. And she would
always say that her husband worked and she worked as a waitress but she
was never able to afford health insurance for her kids. She wasn't
eligible for Medicaid. She and her husband were both working. I don't
know how much they made. But she had tried repeatedly and asked me
about getting private insurance. I even gave her some ideas about how
whom to contact. And they couldn't afford it.
The day that we passed SCHIP, I went back there. I forget how long it
was going to be enacted, maybe a couple months from then, and the
President signed it. And I said, We are going to have this program now.
You can go sign up for it. I went back there whenever it went into
effect, and she had signed up her children, and it was the nicest thing
that could ever happen.
You know how we always say we want to do things for people but a lot
of times we are not able to? For me to be able to go back there and
have lunch and have her say, Well, now my kids are covered through this
program, it was such a wonderful thing.
And I think the gentleman from Pennsylvania said that right now there
are about 6.7 million kids that are covered by SCHIP. There are about 6
million that are eligible and not enrolled. And the reason they are not
enrolled, in part, is because the States have run out of money. Some of
them ran out of money in March of this year, and we had to do a
supplemental appropriation. So we are not talking about all this extra
money in a vacuum. We are talking about needing it in order to try to
cover as many of these kids as possible. And our reauthorization will
not only include more money but also ways of getting them enrolled. One
stop so that they sign up for one Federal program. They can get this so
that they don't get dropped. This is a streamlined application. These
are all the things that we are doing in addition to the dollars in
order to try to cover as many kids as possible.
I am staying but I will yield back to the gentlewoman.
Ms. SCHWARTZ. Mr. Speaker, I wanted to let my colleagues share their
stories too so maybe we could have a little conversation about it. But
I just want to say that certainly one of the points that have been
criticized by the other side is that families that make as
[[Page H7844]]
much as $40,000 for a family of four might be eligible or are eligible
for the Children's Health Insurance Program. Now, in Pennsylvania it is
a subsidy to buy private health insurance. So you either get a complete
subsidy or you might just get half of it or you can buy it at cost. In
fact, many parents are contributing.
But as you point out, for a family of four making $40,000 a year and
both parents might be working, by the time they pay their mortgage and
pay the baby-sitter and pay their utility costs and maybe fill up their
car with gasoline and pay the loan on the car and they pay their taxes,
there is not a lot of money left over to find the $12,000 that they
might have to find to purchase private health insurance. So you can
say, fine, go to the marketplace, but you need a little help to go to
the marketplace. And that is what this is about. And it has made such
an enormous difference, thinking you can put a smile on a parent's face
for doing the right thing. And good for you to go back and actually say
to a person we really did do something for you, and it made such a huge
difference.
I think the other point, and this is a lead in to our colleague from
Connecticut (Mr. Murphy) that the States have always done these
programs in different ways. They have written these programs in ways
that they think work best.
In 1992, 5 years before the Federal level when we were running it in
Pennsylvania, we knew that a lot of these working families wanted a
private health insurance card. Some States got very creative and
expanded Medicaid and called it cute names, and that made it
friendlier, and it is an issue just to tell people it exists. But we
actually worked very hard with the private sector to get the benefits
package right, to make sure that the cost was right. There were a lot
of rules and regulations about it. But the fact is at the end of the
day, people could walk in, families could walk into their physicians'
offices with a private health insurance card, and that made them feel
really proud that they were able to get some help so they could get
that private health insurance. But it has made an enormous difference
in Pennsylvania. And we have, as I say, about 130,000 children covered
on the number of uninsured. It just goes to show it can work. When we
work together, we can really make it work.
Mr. Murphy, if you want to add a bit about the experience in
Connecticut. We have been joined by another colleague of ours, Mr.
Allen from Maine, who also has a long history in being an advocate for
children's health insurance and making it happen. So thank you for
joining us.
I yield to Mr. Murphy.
Mr. MURPHY of Connecticut. Thank you, Representative Schwartz. I am
thrilled to be here with Representative Pallone and Representative
Allen, who have been advocating for this issue and many other issues
regarding health care equity for a very long time.
I come from the State of Connecticut, where I served, as you
mentioned, Representative Schwartz, in the State legislature for about
8 years, and I chaired the Health Committee there for the last 4 years.
And what we figured out was what Pennsylvania figured out a little bit
before us and what dozens of other State legislatures figured out over
the past few years, which is that by expanding our SCHIP program, and
we have got a cute name for that program in Connecticut, where we call
it the Husky program after the mascot of our University of Connecticut
sports teams, we figured out over time that not only was expanding
children's health care, and we actually make some adults, some of their
parents, eligible for that benefit as well, that not only was it the
right thing to do because, as you said and you are exactly right, in
the high cost of living in a State of Connecticut, $40,000 doesn't go
very far, and at a time we live in today where wages are remaining
pretty much stagnant and flat, and when we celebrate a year in which
the average health care premium increase stays at around 10 or 11 or 12
percent, you simply can't do much with an income hovering around
$40,000, $45,000 or $50,000. In Connecticut certainly that becomes a
problem. So what we figured out was that not only was it the right and
fair thing to do to go out and insure these thousands of children who
didn't have health care insurance before, but it was cost-effective
thing to do it. We have referenced that on the floor here today.
I give some credit to the President in his remarks that he at least
recognizes that we do have one single place that very ill children and
adults can go, the emergency room. But what he neglects to mention in
those remarks is that not only is it the most inhumane place to dump
the sick and the ill but it is also the most expensive place for those
patients to end up. We know that the care that children, and we are
talking about children today, end up getting in the emergency room is
amongst the most expensive care that you can get. And for just a few
cents on the dollar in that preventative care that in Connecticut the
Husky program provides and in Pennsylvania the CHIP program provides,
you cannot only get care that is the right to do and the moral thing to
do for those kids, but it, frankly, saves the health care system money
in the end. The cost of insuring kids is actually pretty low compared
to the cost of insuring you or me or other people out in the community.
Kids are generally pretty healthy. They are cheap when they are
healthy, but they are very expensive when they are sick. So if you
don't get them that care upfront, and the reality is that a lot of
illnesses that may not present themselves to be major that may not
cause a parent, even without health care insurance, to drag that child
down to the emergency room, it may end up being something very serious.
And the barrier to getting that preventative care is often that $100 or
$200 doctor visit that stands in the way.
The last thing to say is to just reinforce the notion that both of
you have brought up here, which I am sure we will talk about, which is
that bipartisan spirit in which this bill was brought into being. I
wasn't here when the bill was passed, but my predecessor was. I was
preceded in this House by Representative Nancy Johnson, a Republican
who served here for a very long time. And she was very proud to come
back here as a Republican and talk about her role in the passage of
that bill. The problem was over time there were fewer and fewer people
like her in the Republican caucus who were proud to talk about insuring
children, standing up for kids. And you stand here now on the
Republican side of the aisle that looks and sounds very different,
unfortunately, than the group that stood up in 1995.
And, lastly, it is not just bipartisan within that House, but you
also have a wide range of ideological and advocacy groups that are
standing up for the reauthorization of SCHIP, and I will mention just
one and that is the United States Chamber of Commerce. Not a fan of big
government, if you have ever seen any of the propaganda coming from the
U.S. Chamber of Commerce. So when you listen to the President or
Republicans talk about the Democrats and children's health care being
yet another government program, listen to what their friends are
saying. Their friends in the U.S. Chamber of Commerce and the Business
Roundtable and all of the groups that are traditionally the main
cheerleaders against any minute expansion of government are standing up
for children's health care, are cheering on the Democratic effort to
reauthorize the SCHIP program, because they know what we know; that not
only is it the right thing to do but it is the cost-effective thing to
do. We figured that out in New Jersey and Pennsylvania and Connecticut
and Maine. And I hope that we will be able to return to that bipartisan
spirit again.
Ms. SCHWARTZ. If I may, I was very well aware of the fact that so
many different organizations were supportive and, again, outside some
of their own realm a little bit. So I asked my staff to produce a list.
And I have four pages of a closely typewritten list of all the groups.
It is the U.S. Chamber of Commerce and the Business Roundtable and it
is also the AFL-CIO, AFSCME, and SEIU. But it is groups that you would
think who are advocates for children: the March of Dimes and Families
USA and the Children's Defense Fund. But it also is all the senior
organizations: the AARP and the Center for Medicare Advocacy and the
Alliance for Retired Americans. And so many of the provider groups: AMA
and the Academy of Family Physicians and the Academy of Pediatricians.
But also America's Health Insurance Plans and the Pharmaceutical
Research and Manufacturers Association, PhRMA, who are saying this is
an important thing
[[Page H7845]]
to do as well, and the American Hospital Association. These are groups
where you might say, well, why do they care? Now, hospitals, maybe they
could get reimbursed for some of the uncompensated care that they
provide, but the fact is that all these groups recognize how important
it is. And we have the faith-based organizations: the National Council
of the Churches of Christ and the Catholic Health Insurance
Association. I mean all of them, all of them, have come together.
For the Record I will submit these four pages of the list of all of
the different folks who have actually said this is so important. It
works. It matters to people. It is helping Americans be healthier and
stronger and more productive. And what more important thing can we do
than that? I think that was said earlier.
But it is also doable. And we are taking a lot of fiscal
responsibility in this new Congress among the Budget Committee. And the
gentleman who is going to speak in just a minute is on the Budget
Committee, and we have argued in the Budget Committee about how
important it is to be smart about how we spend our money, to only spend
money we can account for. So we are working very hard in this Congress
to say we will not only maintain this program but we will expand it and
we will find the money to do that because it is important. And when we
are committed to doing something, we will find the money to do it, and
that is what we are going to do in this.
I was going to ask my colleague, and I know you have some remarks you
would like to make, but if you think about what happens if we don't
continue the SCHIP program, I mean that is one of the things that
people presume will, of course, continue. But, in fact, the President
just said today said that he might veto a reauthorization continuation,
just the maintenance of the Children's Health Insurance Program if it
is not constructed the way he likes, which is really shocking that 6
million children on October 1 may be without health coverage because of
his unwillingness to do this.
So knowing your history and your commitment to health care in general
but particularly to children's health care and the good work that your
State has done, if you would speak to that as well, I think it would be
very helpful for Americans to understand that we are at risk here, that
our children are at risk.
And I yield to my colleague Mr. Allen from Maine.
{time} 2230
Mr. ALLEN. I thank the gentlewoman from Pennsylvania for organizing
this event tonight and for yielding to me.
I was here in 1997 when the SCHIP program was passed, and it was
passed with very strong bipartisan support. People on both sides of the
aisle, and many of the same groups that you just mentioned, people on
both sides of the aisle believed, as virtually all Americans do, that
our children should get health care. They ought to be able not just to
go to an emergency room when they're seriously ill or have had an
accident, but they should be able to get preventive care so they can
grow up to be healthy children and healthy productive adults. That's
really, I think, a fairly basic proposition. And that's what drove us
back in 1997.
And now you were asking, what happens if this program doesn't
continue? Well, if it's not reauthorized, then 6 million children in
this country lose their health insurance. And if they lose their health
insurance, maybe some of them, when they're seriously injured, will go
to an emergency room, but most of them will lose the preventive care
that they get today.
The President put in his budget $5 billion over 5 years for an
increase in SCHIP, which would fund about one-third of the amount that
States are estimated to require over the next 5 years. In other words,
the President's position is that this is a program that should be cut
back. And that probably is why he made the veto threat, which he
basically said, look, people, children and adults, have access to an
emergency room; and one thing we want to be careful not to do is expand
health insurance if it's through a government program, which is
bizarre, because the SCHIP program is designed for people who cannot
afford to buy health insurance in the private market today. That's why
they don't have it.
What we're trying to do is continue this public/private partnership
because most States provide coverage through private plans. It's a
Federal/State partnership, with 70 percent of the money coming from the
Federal Government and about 30 percent coming from States. So States
are choosing to fund this program for the obvious reason that our kids
deserve to have health care coverage. Outside of the White House, this,
I think, is a broadly accepted proposition.
I just want to say a few things about my State of Maine. Maine has
been very aggressive in using this particular program. We have one of
the lowest rates of uninsured children in the country. Only 7 percent
of our children do not have health insurance, and the national rate is
about 12 percent. But that, for us, we're a small State, but that's
about 19,000 children who do not have health insurance. And for those
families, for those parents, they know it makes a difference whether or
not their kids have health insurance. And they, I know because I've
talked to them, worry about whether they're going to get the kind of
coverage, the kind of vaccinations, the kind of preventive health care
that everyone hopes for their children, because that's really a
fundamental point here.
I don't think there is a parent in America that doesn't want their
children to have good health coverage, to get the health care they need
when they need it. And that is what this program attempts to do.
Because there are 6 million children in this country today who qualify
for the SCHIP program but are not signed up, for whatever reason. Some
States aren't being aggressive enough and the Federal Government
contribution is falling short.
There are another 3 million who don't qualify for SCHIP and still
don't have coverage. And all we're trying to do, as Democrats, is to
expand that coverage. Now, we can argue about how fast we expand it, we
can argue about how we pay for it, but the bottom line is this:
children in America deserve to have health care. And we know if they
have health insurance, whether the program is privately run or whether
the program is publicly run, or some combination, they are much more
likely to grow up into healthy, productive children and healthy,
productive adults. That's what we're fighting here today for.
I want to thank you, my colleague, the gentlewoman from Pennsylvania,
and all the rest of my friends here tonight for pushing this issue so
hard and so long. We will not fail. And I yield back.
Ms. SCHWARTZ. And I think this is where we can get a chance to have a
little bit of a conversation. There is a lot of feeling about it. I
think all of us feel that we should be working as hard as we possible
can to be getting this done, not be sort of saying, okay, I'm not
interested, we'll do something else.
There are a lot of priorities here. We stand up on the floor
frequently and say, okay, one of the most important things we can do is
this, one of the most important things we can do is that. But the fact
is if we aren't all parents, and many of us are, then we certainly have
nieces or nephews we love, or neighborhood children. All of us know
someone who has struggled through a moment when they couldn't provide
the essentials. This is not a frill. And I think that's what you were
saying, Mr. Allen, is this is not an, okay, if you can get to do it, go
do it. This is something that's really essential for every child in
America. And we're helping parents to be able to meet that essential
requirement for their children.
Some of you may know, my husband is a physician. And I was joking
with my staff that he cuts out articles from the New England Journal of
Medicine all the time for me to read. And mostly they're not so
readable for me, I have to admit, you know, they sort of need some
interpretation. But just in the last week's journal there is a
wonderful article talking about the imperative to continue the SCHIP
program. And I'll share it with my colleagues, I'll send it around to
everyone tomorrow, but really it made it very, very clear that this is
something that we need to do because of the medical imperative, the
health care imperative. And we know it is something that we can do.
[[Page H7846]]
So, it's something we're proud of and we should be and we want to do.
Mr. Pallone, you look like you're ready to jump in here.
Mr. PALLONE. You know, when you relate your own experiences, I can
relate so much to it myself.
I have to say, I was thinking back about 10 years ago when we first
started the program. Of course, my wife and I were just starting to
have kids. My oldest daughter now is 13, so she was three at the time.
And I guess I had my son at the time, he was only one. And we were
starting to realize at the time about the fact that, first of all, as
parents, the idea of kids not having health insurance, you know, young
kids at that age was really an awful thing. And that's why we got
involved. I say ``we'' because my wife got involved in the whole issue
as well. And to think about the fact that you have children and they
can't have health insurance or you have to take them to an emergency
room is just an awful thing.
I worry myself even now because a lot of times your health insurance
doesn't cover everything. Like I was faced with the orthodontist bill a
couple years ago. And I suddenly realized our insurance doesn't cover
orthodontistry. And that was upsetting, but to think of parents that
can't even take their kids to the doctor is just an awful thing.
One of the things that my wife would always say to me that she
observed was that many times government officials, and I don't want to
speak about ourselves because I don't want to be critical, but a lot of
times politicians don't think about kids because of the fact that they
don't vote. And I would almost kind of differ with the gentleman from
Maine when he says that, you know, one of the things that we found and
one of the reasons why States like Connecticut and New Jersey have
covered some of the parents is because they have noticed that a lot of
times the parents wouldn't enroll the kids unless they were eligible
themselves to be enrolled in the program. And I again go back to, this
is really a very practical thing. If some States have found that the
parents won't enroll the kids unless they're enrolled, they actually
allow the parents to enroll as an incentive to get the kids enrolled.
Because you can be cynical. I mean, you have to say that
unfortunately sometimes parents don't care or sometimes politicians
don't care. And the fact that we were able to do this and basically do
a kids' health initiative program and get the political support for it
in some ways was an amazing thing. You would say, well, gee, that's a
basic thing, why wouldn't that happen? But it wasn't that easy. And
we're going to have to continue to fight to expand it today.
I just wanted to answer your question, because I know that the
gentleman from Maine did, but you said, what would happen if we don't
reauthorize?
Well, I will just say, first of all, essentially this has happened in
some fashion in the last few years. States have run out of money
because there wasn't enough money as early as March in a given calendar
year. Georgia ran out of money this March. And my own State started to
run out of money by May. So we had to actually do a supplemental
appropriation. The world knows it as the ``Iraq supplemental,'' but
actually it was the supplemental that included the funding for Iraq,
and it included about $750 million for SCHIP because States, in fact,
were running out of money.
In my own State of New Jersey a couple of years had to cut back on
the program and actually lower the eligibility and eliminate parents
because of the fact that they started to run out of money. So we have
experience of what actually happens if we don't provide the additional
funds.
The other thing, too, is that until last year, every year for the
first 9 years of the program, the number of uninsured kids in the
country was going down. But last year, for the first time, the number
of uninsured kids went up. So this is a crisis. I mean, if we're going
to get to those extra kids, we really have to do something.
Ms. SCHWARTZ. And just on that note, if the gentleman would yield, we
do know that the number of uninsured for the first time in a long time
is going up again. So we're talking about 45 million Americans. And the
fact that, of those, 9 million are children who, again, through no
fault of their own, don't have access to health insurance.
And one of the reasons is that health insurance is expensive. And
even for businesses that want to provide health insurance for their
employees, sometimes they're faced, particularly small businesses, with
how do I actually pay that whole amount for family coverage? And they
just cover the employee. And so even here, where you're talking about
employers trying to do the responsible thing, but just looking at their
bottom line and saying I can't do anything about this, when the parent
is covered and the child is not is one situation where certainly CHIP
comes in and really can be very, very helpful.
There has been some discussion obviously about adults. And I think
this is intended for children. Some States have brought along the
parents because it does help with enrollment, and we think that's true
in Pennsylvania as well. But we also know that when the parents don't
have health insurance, and if they can't get timely health care, then
they don't have an ongoing relationship with a physician or a medical
group. And the children also learn from their parents. Their parents
are their models. And so if the parents are going for regular checkups
and their kids are going for regular checkups and it's part of what you
learn to do as a responsible person, that's a good package. It's what
we want adults do be doing as well.
So I know that there is some discussion about that, too, whether
States, now they're not allowed anymore to be able to sign up adults
alone, but they're usually signed up with their children as a family
coverage. And that's the way most people who buy insurance do it, too.
They buy insurance for their family. That's the way it's sold mostly.
So I think it's making sure that we actually allow people to sort of
use the marketplace the way it really works and not punish them for
that.
Mr. PALLONE. If I could point out one thing, too, because I know
there is some debate about this. The States don't get any more money
because they cover kids at a higher percentage of poverty or because
they cover the adults, and I think there has been some debate about
that. Remember, as I said before, this is a block grant, and the money
that goes to the States is dependent upon the number of children that
they have. So the fact of the matter is that if a State decides, like
Connecticut did, that they're going to cover the adults, they just have
to stretch out the Federal funds and contribute more State dollars to
pay for it. They don't get additional money. I know that this sounds
like such a bureaucratic comment, but some Members are worried, well,
is my State going to get more because they cover kids at a higher level
of poverty or another State covers adults. They don't. It's just a
question of usually they're providing more State dollars and having the
flexibility to include the parents so that they can cover the kids.
Mr. ALLEN. If the gentlewoman would yield, there are differences
among States and now aggressively they seek to use the money that comes
from the Federal Government. So there certainly are differences among
States in that respect.
But I just wanted to comment. It is absolutely true that most people
who buy insurance through a private plan will try to cover their kids
as well, except that today one of the trends in this country is that
the wheels are coming off this employer-based health care system and
increasingly, by about a million people a year over the last 4 or 5
years, the number of uninsured is going up. It's now about 46 million
people. And one of the reasons, and this is why I've done a plan for
small businesses, one of the reasons is the small business community is
simply not able to afford the kind of insurance they had in the past.
And what they're doing, they're tending not to cover family members,
which includes the children, and to require the employee to pay a
higher and higher percentage, which some employees simply can't do.
So what we're seeing here, at the same time as the President is
saying we don't want to expand this successful children's health care
program, we're watching the number of uninsured
[[Page H7847]]
steadily climb, both adults, and now children for the first time in a
long period of time, having the number of uninsured climb because the
private market, the employer-based market isn't working as well as it
did in the past.
We have a national health care crisis on our hands, and this is a
part of the solution. It ought to be the easiest part of the solution.
But here is the President's spokesman the other day saying this will
encourage many to drop private coverage purchased through their
employer or with their own resources to go on a government-subsidized
program. This is a program that is designed for people who don't have
health insurance. We know these children don't have health insurance.
We know how many there are. We know where they are. And we ought to be
able to do a better job than simply to raise this kind of ideological
objection. We ought to cover them first in the most practical, cost-
efficient way.
I yield back.
Mr. MURPHY of Connecticut. Mr. Allen, if you would yield. I guess I
come to the thinking, we wish we were in that position. I mean,
wouldn't it be lovely, wouldn't it be wonderful if we were in the
position in which the choice was between a government-sponsored program
and an employer-sponsored program or a privately available sponsored
program. It just isn't the reality. And anybody who spends time out in
their communities, in their social halls, in their churches and
synagogues listening to families will realize that, that there are just
more and more families largely, as Mr. Allen noted, that work for small
businesses and simply don't have the access to health care insurance
that they once did.
And I want to hit one more point, and I mentioned it the other night
when Mr. Pallone and I were down here talking about this. We also have
to disabuse people of this notion that we all aren't paying for those
kids and those parents who don't have health care insurance. If the
employer doesn't provide it, and then the HUSKY program in Connecticut,
the SCHIP programs go away, somebody is going to pay for that health
care. And we pay for it largely in two ways: one, all of the premiums
that we pay, as insured people, are higher because they are basically
subsidizing the care of people that don't have health care insurance,
because a doctor is going to have to treat, by law, someone that shows
up in an emergency room, and the hospital has to be compensated for
that.
{time} 2245
So private insurance normally pays about 120 percent, 110 percent of
what the average Medicare rate is. They are paying a 20 percent, 10
percent premium in order to subsidize the care of the uninsured. I
don't know if this is the case in all States, but in Connecticut, we
also have an uncompensated care pool, a taxpayer-funded pool, where tax
dollars go directly to hospitals and health care providers to help them
pay for the kids that walk in, 70,000 of them without health care
insurance in Connecticut that have no insurance.
So the idea that we are going to be spending any more money on this,
when really what you are doing is you are shifting money that we are
all spending in our private rates and through these taxpayer-subsidized
pools of money that go to hospitals, it is just shifting it to
preventive care. We have to sort of remind people that we are paying
every day for the uninsured that we have now. It is simply about
building a more cost effective and more humane way of paying for it.
Ms. SCHWARTZ. I think we should continue this discussion about what
is the smartest and most efficient way to do this. Again, what is
interesting about the way SCHIP, the children's health insurance
initiative, was set up is it said to each State, one, you don't have to
do it if you don't want to, if you don't have a problem, or you don't
think this is an issue. We were not even sure how it would all work
out. They also said, then you can create whatever initiative works for
you, what really works for you. It turns out every State has chosen to
do it.
Actually, we already had SCHIP in Pennsylvania for 5 years when the
Federal Government came in. Our governor was very nervous about taking
it. He wasn't sure he wanted to do this. He was concerned it would be a
new entitlement program and that he would be stuck with the bill at the
end of the day. I know States had legitimate worries about that, that
we actually tell them to do things and then don't give them any help in
doing it.
But this is one case where we said, no, you have to do it. You have
to structure the program. Here are some guidelines. Here is how we
think you should do it. Then we are going to pay a part of it, a good
part of it, but we are not paying all of it. You have to buy into it.
You have to want to do it, also. You have to structure this.
So every State did this. We learned from each other. That also was a
good thing, to look around and see what worked for other States and
what didn't. When our governor was saying, should we do it? He really
was very torn about it. Actually, he didn't decide to do it until
September 30, and that was the deadline that year. I was very anxious.
I was on the floor of the State senate many nights saying we ought to
do this. I was pushing him to do that.
Of course, we were able then to triple the number of children who
were covered because of the partnership we had with the Federal
Government. That is what this is about. It really is. This is a great
example of a very innovative way to create a partnership between the
Federal Government and the States, between insurers in some ways and
the States as well, in many cases, and between parents and families and
health care providers, and say, we are all going to help make this
happen.
Mr. MURPHY of Connecticut. Just to add to that partnership, it is
also a partnership of health care professionals as well, because, to
tell the truth, in a lot of States, Connecticut being one of them, the
rate that we pay physicians for participating in the program is a
little bit below the level of sufficiency. So there are a lot of
physicians who want to do the right thing, who want to get compensated,
but are okay not getting compensated at the same levels that they do by
private HMOs.
It really becomes in the end, it really becomes a partnership of not
only the Federal Government and the State Government, but also the
provider community as well who has agreed to say, listen, because we
really care and we really want to take care of this constituency, we
are willing to do it for a little bit less than we would do otherwise.
That has been a great benefit to the Government, to be able to get away
with paying a little bit less, at least in Connecticut, than private
payers do. But it is a wonderful partnership of all constituency
groups.
Ms. SCHWARTZ. Again, the debate here is how much can we do? What can
we afford to do? What is the best way to do it? Mr. Pallone is working
on all those details. I know we bug him and give our him suggestions
about how to make this easier and streamline the bureaucracy and make
it work for both providers and for children and for the States. So we
are learning from that. I think that is pretty exciting.
But that is not the discussion that some are in. We were in that
discussion since January, actually. This is certainly something that
the President proposed. We wanted to push much further. But I just say
that is unfortunate. I think that is why we are so deeply disturbed.
I will say that the President is consistent here. I will add just a
note that when he was Governor, he was very reluctant to participate in
the Children's Health Insurance Program and actually worked quite
actively not to be engaged, not to have his State do it, and then tried
to keep the level of the family to be as poor as possible.
He did not want to go to 200 percent of poverty. He wanted to keep it
lower. He did not want to reach into the sort of the really working
folks in Texas who were struggling. You may want to comment on that.
But I think for so many of my constituents, and again I think, Mr.
Pallone, you pointed this out earlier, for very poor people in this
country, we do have health care coverage. But for the people who are
above that level, who say I don't know that there is anyone there to
help me, this is actually one way to say, that is right, we are going
to help you be able to get health insurance for your kids. You are
working. You are trying to do the right thing, and this is the way we
can help you do it.
[[Page H7848]]
So for the very people who are playing by the rules, trying to do it
right, struggling to make ends meet, to be able to help them get health
insurance for their kids makes such a world of difference to their
peace of mind and, of course, to the actual health of their kids.
Mr. PALLONE. I just think the President has been very inconsistent.
You talk about his experience as governor of Texas. But keep in mind
that for the last 6 or 7 years, he has actually been granting the
waivers. For example, right now the law says 200 percent of poverty, is
what the law says in terms of eligibility. But it allows for waivers,
and he has given waivers for so many States, I think as many as around
15 States, to go to 300 percent of poverty, to allow adults in some
cases. His administration had to approve all those.
So I was very surprised in the early part of this year when he said
that he wanted to keep it at 200 percent, he didn't want to cover any
of the adults, because he has allowed that flexibility during his
administration.
One of the things that the National Governors Association said
unanimously was that they wanted States to have the flexibility. Again,
I point out, this is a block grant. The States don't get any more money
because they cover adults or go to higher levels of poverty or lesser
levels. There is also flexibility, and some States don't count assets
in determining that 100 percent or the 300 percent.
I think it really makes sense, and the National Governors Association
said it makes sense to leave it to the States to have that flexibility,
and the President historically has been in favor of that kind of
flexibility. So I really don't understand where he is coming from.
The other thing I wanted to mention is we were talking about
alternatives. When I listened last week to our colleagues on the other
side of the aisle, some of them were saying, well, people can go to
community health centers. That was another thing that I heard. Well,
the President talked about emergency rooms and some of our colleagues
on the Republican said, well, they can go to community health centers.
Well, I am all in favor of expanding community health centers, but in
my district I think we have maybe four Federally sponsored, maybe 5,
community health centers. There is absolutely no way that the kids and
the parents are going to line up. They don't have the ability to handle
all the kids.
So what you said is true. They are going to end up being in an
emergency room. They are part of charity care whose responsibility is
on the rest of the taxpayers.
Then I heard another one of our Republican colleagues say, well, what
we really need is, and I wrote it down, competition in the marketplace.
And I was saying, what are we talking about here? Again, this is people
who are working, who can't afford health insurance. What competition?
They can't go out and buy it on the individual market.
So we hear a lot of inconsistencies. I don't want to be so critical
of our Republican colleagues, because I want them to join us on this.
But some of the statements that have been made by the President in the
last few days.
I would point out in the Senate, as you know, the Republicans and
Democrats came together and they are about to pass a bipartisan SCHIP
expansion. So the Republicans in the Senate hopefully can talk to the
President and the Republicans in the House and say, what are you doing?
We want to continue with this on a bipartisan basis.
Ms. SCHWARTZ. Again, our hour is concluding, but I think, in other
words, we certainly are very interested, I certainly am, in making sure
that the marketplace, the insurance marketplace, you are from
Connecticut, so I am sure you have an interest in this, that it works;
that in fact it is affordable, that we can figure out a way for
businesses to work together, to be able to get a market share, to be
able to maybe do some things on the individual marketplace so that in
fact it can be more affordable.
Some of the ideas that the President has about tax deductions, not as
substitutes, but for individual coverage, that's fine. We should be
doing that. But not say, okay, which are going to make sure that 6
million children who have had access to health care, and another 6
million who could, who are now eligible but are not signed up, we are
going to continue to deny them care, and we are going to do that by
scaring you into thinking somehow we are creating some new expanded
government program that is somehow just going to be evil.
That is sort of kind of what the President is saying, instead of
saying wait a minute, this is an initiative that works. It works in
every State. People are proud of it. Republicans and Democrats stand up
and praise it, doctors are happy about it, hospitals are happy about
it, parents are happy about it. I don't know how the kids feel when
they get their immunizations, how happy they are about it.
But the fact is we are doing the right thing and we are meeting a
priority that American families talk to us about all the time. And it
is not instead of doing something else. It is really just because it is
a high priority for us. It is always a question of priority, but we
really I think, certainly what I want to say, we are determined to get
this done, and we want to work in a bipartisan way to do it. We want to
do it in a fiscally responsible way. We want to continue to build on
the success of the Children's Health Insurance Program, and that is why
we are going to keep talking about it until we get it done and
hopefully be joined by not only our colleagues on the the other side,
but the President as well.
Mr. MURPHY of Connecticut. Let me just add some final thoughts to add
to the theme of inconsistency here. This is a President who has
presided over the largest expansion of a government paid for health
care program in my generation at least with the addition of the
prescription drug benefit to the Medicare program. But it was okay when
it resulted in a massive giveaway to the pharmaceutical industry.
But when we are asking to expand health care for kids who don't have,
as Mr. Pallone said, not only do they not vote, but they also don't
have political action committees and they also don't have lobbyists
patrolling the hallways here and within the administration. When it
comes to helping the most vulnerable, the most voiceless group of
individuals out there, this administration results in a deafening,
deafening silence.
So I am so glad we are down here talking about this tonight. I came
to Congress, gave up my seat working on a health care policy in the
Connecticut legislature because I figured out that this really had to
be a Federal fix, to try to do something for the millions of uninsured.
I frankly hope in a lot of places I think I am am going to depart
from the legacy of the person I replaced, but on this I hope to be able
to work with all of you to join back across the aisle and build that
bipartisan consensus to stand up for those voiceless, lobbyist-less
PAC-less constituents of ours, uninsured kids.
Ms. SCHWARTZ. We have an enormous opportunity here. We want to meet
that challenge and we want to do it right. So that is the challenge
over the next few months. My guess is we are going to continue to talk
about this for the weeks ahead, and certainly if we are lucky enough to
take some vacation this summer and see those cute kids on the beach on
the Jersey shore, and Connecticut has some nice beaches too, to look at
them and think which ones of those, because there are, who don't have
health insurance, whose parents may delay care that they should get,
not get an immunization, should not get care, maybe not even treat some
simple illness that ends up running through school or camp and
everybody gets sick.
But this is about giving kids the right healthy start. It is about
doing it in a cost-effective way, about being creative and innovative,
and meeting that challenge that American families have every day.
So I thank my colleagues for joining me this evening, and I look
forward to continuing to work with you. Thank you for your leadership,
Mr. Pallone, as well.
Mr. Speaker, I include for the Record the list of all groups who
support the SCHIP package.
All Groups Who Support SCHIP Package
seniors groups
AARP
Alliance for Retired Americans
[[Page H7849]]
American Association for International Aging
American Society on Aging
Association of Jewish Aging Services of North America
B'nai B'rith
National Academy of Elder Law Attorneys
National Association of Professional Geriatric Care
Managers
National Association of State Long-Term Care Ombudsman
Programs (NASOP)
National Association of RSVP Directors
National Association of Social
Workers
National Committee to Preserve Social Security and Medicare
National Council On Aging
National Indian Council on Aging
OWL, The Voice of Midlife and Older Women
American Association for Geriatric Psychiatry
Medicare Rights Center
National Committee to Preserve Social Security and Medicare
National Senior Citizens Law Center
provider groups
American Dental Association
American Hospital Association
American Medical Association
American Health Care Association
Federation of American Hospitals
National Association for Home Care & Hospice
National Association of Community Health Centers
PhRMA
labor unions
AFL-CIO
AFSCME Retiree Program
American Federation of Teachers
International Union, United Auto Workers
National Active and Retired Federal Employees Association
Service Employees International Union
American Federation of State, County and Municipal
Employees (AFSCME)
International Association of Machinists and Aerospace
Workers
International Union, United Auto Workers
United Steelworkers
children's groups
Academy of Pediatricians
Children's Defense Fund
Families USA
March of Dimes
National Association of Children's Hospitals and Related
Institutions
disability groups
AIDS Treatment Activists Coalition
AIDS Treatment Data Network
American Academy of HIV Medicine
American Association of People with Disabilities
American Association on Intellectual and Developmental
Disabilities
American Network of Community Options and Resources
Association of Assistive Technology Act Programs
Association of University Centers on Disabilities (AUCD)
Gay Men's Health Crisis
HIV Medicine Association
Council for Learning Disabilities
Easter Seals
NAADAC, the Association for Addiction Professionals
National Association of Councils on Developmental
Disabilities
National Association of People with AIDS
National Disability Rights Network
National Down Syndrome Society
The Arc of the United States
advocacy groups
Military Officers Association of America
Bazelon Center for Mental Health Law
Campaign for America's Future
Center for Medicare Advocacy, Inc.
Center on Budget and Policy Priorities
Consumer's Union
National Association of State Head Injury Administrators
National Health Law Program
National Organization of Social Security Claimants'
Representatives
National Respite Coalition
National Spinal Cord Injury Association
NETWORK: A National Catholic Social Justice Lobby
Project Inform
Protestants for the Common Good
The American Federation of Teachers
Title II Community AIDS National Network (TII CANN)
United Cerebral Palsy
United Spinal Association
USAction
state and local groups
AIDS Action Baltimore, Inc.
AIDS Drug Assistance Protocol Fund
AIDS Education Global Information System
AIDS Legal Council of Chicago
AIDS Resource Alliance, Inc.
AIDS/HIV Health Alternatives
Alliance for Family Education Care & Treatment
California Health Advocates
Center for Independence of the Disabled in New York
Champaign County Branch NAACP
Chicago Women's AIDS Project
Clinical Social Work Guild 49
Coleman Global Telecommunications, LLC
Community HIV/AIDS Mobilization Project (CHAMP)
Community Information Center
Desert AIDS Project
Douglas County AIDS Project
Family Service Association of Bucks County HIV/AIDS Program
Florida Legal Services
F.O.U.N.D., Inc.
Friends of The Poor International
Georgia Rural Urban Summit
Health Equity Project
Hemophilia Association of New York
Hep C Advocate Network, Inc. (HepCAN)
HIV/AIDS Law Project
HIVictorious, Inc.
IndependenceFirst
International Foundation for Alternative Research in AIDS,
Portland, OR
Kleine Editorial Services
La Fe Policy and Advocacy Center
L.A. Gay & Lesbian Center
Latinos for National Health Insurance
Living Hope Organization
Michigan Positive Action Coalition
NAMES Project Central New Jersey
NETWORTH/Positive Action
New Mexico Poz Coalition
New York AIDS Coalition
New York Legal Assistance Group
New York State Consumer Coalition on Part D
New Yorkers for Accessible Health Coverage
Northwest Health Law Advocates
Ohio AIDS Coalition
Pennsylvanians United for Single Payer Healthcare (PUSH)
Physicians for a National Health Program, NY Metro Chapter
Positive Opportunities, Inc.
Pueblo Family Physicians
Redwood AIDS Information Network and Services
Regional Addiction Prevention (RAP), Inc.
Regional AIDS Interfaith Network Colorado
Salt Lake Community Action Program
Search For A Cure
Selfhelp Community Services, Inc.
South Carolina Campaign to End AIDS (SC-C2EA)
Teamsters Retiree Club of Santa Clara County
Tennessee Justice Center
The Evangelical Catholic Diocese of the Northwest
The North American Old Catholic Church
The Richmond/Ermet AIDS Foundation
Topeka Independent Living Resource Center
Tia's Foundation
Triad Health Project
Twin States Network
Ursuline Sisters HIV/AIDS Ministry
West House, Inc.
West Oahu Hope For A Cure Foundation
Western
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