[Congressional Record Volume 153, Number 124 (Tuesday, July 31, 2007)]
[Senate]
[Pages S10346-S10353]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SMALL BUSINESS TAX RELIEF ACT OF 2007
The ACTING PRESIDENT pro tempore. Under the previous order, the
Senate will proceed to consideration of H.R. 976, which the clerk will
report.
The legislative clerk read as follows:
A bill (H.R. 976) to amend the Internal Revenue Code of
1986 to provide tax relief for small businesses, and for
other purposes.
Amendment No. 2530
Mr. BAUCUS. I call up my amendment at the desk.
The ACTING PRESIDENT pro tempore. The clerk will report.
The legislative clerk read as follows:
The Senator from Montana [Mr. Baucus], for himself, Mr.
Grassley, Mr. Rockefeller, and Mr. Hatch, proposes an
amendment numbered 2530.
Mr. BAUCUS. I ask unanimous consent that reading of the amendment be
dispensed with.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
(The amendment is printed in today's Record under ``Text of
Amendments.'')
Mr. BAUCUS. Mr. President, the Senate now has before it the
reauthorization of the Children's Health Insurance Program, otherwise
known as CHIP. Pending is a substitute amendment that reflects the bill
reported by the Finance Committee by a vote of 17 to 4, a strong
bipartisan vote.
The bipartisan package Finance Committee colleagues and I crafted
will give millions more American children the healthy start they need
to lead a long, productive life.
Behind me is a photo of Abigale. Who is Abigale? Abigale is from
Missoula, MT. At the time the photo was taken she was 4 years old.
Abigale has two siblings, and they live with their mother and father.
All three of the children participate in the Montana Children's Health
Insurance Program. When Abigale was 2\1/2\ years old, she fell down,
split her head open and had to have nine stitches. Her medical care was
covered by the Children's Health Insurance Program. That same year her
6-year-old brother broke his arm twice and CHIP paid for the surgery,
the hospital stay, and all of the medical care he received.
Fawn, Abigale's mother, is thankful to have CHIP not only for the
emergency care it provides but also it helps immunize children against
childhood diseases and allows them to get the checkups they need for
school each year.
Not having health insurance clearly affects a child's life. Uninsured
kids do not go to the doctor. They do not have checkups. They remain
undiagnosed for serious childhood conditions such as asthma and
diabetes. They do not have vaccinations, and they put themselves and
their schoolmates at risk for serious illnesses. Kids without health
insurance do not have eye exams and are less likely to get glasses, and
often cannot see the chalkboard at school. They are not diagnosed with
learning disabilities, and they struggle through their classes. Kids
who do not have insurance do not see the dentist. They do not get their
cavities filled. They do not get braces, and they risk serious illness
due to poor dental health. Adequate health care creates a critical
foundation for a healthy life.
No one wants innocent children to suffer. Investing in children's
health is the compassionate choice, but it is more than that. Insuring
our children is a smart economic investment in our Nation's future.
Why? Because it is the only choice, if we wish to imbue future
generations with strong minds and healthy bodies. It is quite simple.
Health insurance has a direct effect on a child's performance at
school. Healthy children are more likely to go to school, and they are
more likely to do well in school. Then they are more likely to become
productive members of the workforce.
Children with health insurance are less likely to receive expensive
emergency room care. Parents of children with health insurance are less
likely to miss days at work to care for their sick children. When
America insures our children, we are all better off, we all benefit.
Health insurance is especially important to the success of minority
populations. African-American, Hispanic, and Native American children
are all less likely to have health insurance. They are more likely to
be poor. Providing affordable coverage is one of the best ways to
reduce the gap for these kids.
CHIP has already helped to narrow racial and ethnic disparities in
access to care among low-income children. But we can do better. We can
continue to narrow that gap.
Health insurance is also a key ingredient to alleviating child
poverty. Low-income families without insurance often get stuck in a
bitter cycle of medical debt. Parents struggling to make ends meet
should not have to choose between buying asthma inhalers for their
children and putting dinner on the table.
So I hope my fellow Senators will make the right choice, the only
choice. I hope they will join me in making our children's future, and
America's future, a brighter one.
I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Vermont.
Mr. SANDERS. Mr. President, this debate is not just about extending
health care to our children. It is about our national priorities. It is
about who we are as a nation. It is about which side we are on.
For the last 6 years, we have had a President who has insisted, as
one of his major priorities, on more and more tax breaks for the very
wealthiest people in our country. People who are worth millions of
dollars and people who are worth billions of dollars have,
collectively, received hundreds and hundreds of billions of dollars in
tax breaks. But when it comes to those people most in need, those
people who are most vulnerable, including the children of our country--
the kids who are 2 or 3 years of age--who have health care needs, this
President, tragically and embarrassingly, has not been there. If you
are wealthy and powerful, he is there. If you are a child and
vulnerable, AWOL--he is not listening. In fact, he has been in
opposition.
It is no secret to the American people that our current health care
system is disintegrating. Today, 46 million Americans, including over 9
million children, have no health insurance whatsoever, and tens of
millions more are underinsured, with high premiums and copayments.
Costs are soaring every single year, and small businesses in my State
of Vermont and throughout this country are no longer, in many cases,
able to offer any health insurance. Throughout the country today
workers are being asked to pay a higher and higher percentage of the
cost of their health insurance, and many of them cannot afford to do
that because health insurance premiums have been rising four times
faster than workers' earnings since the year 2000.
In the midst of all of that--more and more uninsured, costs soaring--
we end up spending twice as much per capita
[[Page S10347]]
on health care as any other country and remain--we remain--the only
Nation in the industrialized world that does not guarantee health care
to all our people as a right of citizenship. Today, we are debating
about whether we should expand the SCHIP program to 3 million more
children. But all over the industrialized world, every child in those
countries has health care as a right of citizenship.
Despite the over $2 trillion--$2 trillion--we now spend on health
care--money which, to a significant degree, goes to enrich the
insurance companies and the drug companies--our health status measures,
including infant mortality and life expectancy, rank among the lowest
of developed countries. We spend twice as much as other countries per
person on health care--with over 9 million children who have no health
insurance--and yet health status measures are lower than many of our
allies around the world.
There is no question but that in the face of rising costs and a
broken health care system, we need to make fundamental changes in the
way we do health care in this country. We need to develop a cost-
effective national health care program which guarantees health care to
all our people, and study after study suggests we can do that without
spending any more than we currently spend on our wasteful and
bureaucratic nonsystem. That is what we have to do, and that is what I
will fight for as long as I am in the Senate.
Today, we are discussing, despite what some may say, what is, in
fact, a modest proposal--a modest proposal. We are discussing an
expansion of the SCHIP program, which would expand health care to some
3 million more children. Over 9 million American children today are
uninsured, and all we are doing today is saying: Let's expand health
insurance to one-third of those children. If this bill were passed in 5
minutes, two-thirds of the uninsured children would remain uninsured,
and in the United States of America we can do a lot better than that.
As Chairman Baucus has said, as Senator Olympia Snowe said last
night, investing in the health insurance of our children is a good
investment. It is cost effective. Today throughout this country there
are children who are unseen by medical professionals. They are
developing illnesses which are undetected. Those illnesses become worse
as they get older. They end up in the hospital. It costs significant
sums of money to treat these young people, as they age, in hospitals,
when we could have eased their suffering and saved money by getting to
their illnesses when they were young, if they had the opportunity to
see a doctor.
As Chairman Baucus also mentioned, there is the issue of dental care
in this country. In my own State of Vermont and throughout this
country, there are millions and millions of young people who simply
cannot gain access to a dentist who have teeth rotting in their mouths
in the United States of America, in the year 2007. That is not
acceptable to me, and I hope it is not acceptable to my colleagues in
the Senate.
Given this sorry state of affairs regarding health care in this
country in general, and the needs of our kids in particular, I find it
ironic we are having any debate about increasing health insurance
coverage for children under the SCHIP program.
Let me be very clear, in terms of providing health insurance to our
kids, I would go--and will go--a lot further than this legislation. I
have, in fact, recently introduced S. 1564, the All Healthy Children
Act of 2007, which would provide health insurance to every child in
America. That is where I think we should be going.
Some people, including the President of the United States, are
saying: My goodness, this bill will cost $35 billion over a 5-year
period; we can't afford that.
But I find it ironic that many of those same people, including the
President of the United States, believe, among other things--among many
other things--that we can afford to repeal entirely the estate tax,
which would benefit only the top three-tenths of 1 percent of the
American people. The very richest people in this country would, if the
President had his way, receive $1 trillion in tax breaks over 20 years.
That is $1 trillion in tax breaks over 20 years going to the wealthiest
three-tenths of 1 percent of the American people. That we can afford.
But when it comes to spending $35 billion over a 5-year period for the
children of our country, we do not have the money.
I find it ironic, if we repealed the inheritance tax, one family, the
Walton family who owns Wal-Mart, would receive $32 billion in tax
breaks. Yet we are trying to insure 3 million children today for $35
billion. So $32 billion for one family; $35 billion for 3 million
children.
To my mind, what this debate is about is getting our priorities right
as a nation. I am getting a little bit tired of hearing many of my
colleagues, and hearing this President, talk about family values, when
we have almost 10 million children in this country uninsured. If you
are interested in family values, you are interested in the future of
this country, you are interested in the children of this country.
This is a modest proposal. It is a first-step proposal, and it should
be passed and passed immediately.
Thank you very much.
The ACTING PRESIDENT pro tempore. The Senator from Montana.
Mr. BAUCUS. Mr. President, I might ask how much time the Senator from
New Jersey would like to consume. I very much appreciate and admire him
and thank the Senator from New Jersey for speaking on this amendment.
It would be helpful to know how long he would be speaking. He can have
whatever time he wishes.
Mr. MENENDEZ. Mr. President, I would say between 15 and 20 minutes.
Mr. BAUCUS. Mr. President, I ask unanimous consent that the Senator
from New Jersey be recognized to speak for 20 minutes.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Mr. BAUCUS. I thank the Chair.
The ACTING PRESIDENT pro tempore. The Senator from New Jersey.
Mr. MENENDEZ. Mr. President, I thank my colleague, the distinguished
chairman of the Finance Committee, not only for making the time
available but, more importantly, for his leadership on this critical
issue of insuring the Nation's children. There is no stronger voice in
the Senate on this issue. I am incredibly proud to have worked with
Senator Baucus, someone who is keenly interested in this program. I
appreciate what he has done in bringing a solid bill to the floor.
I rise today on behalf of our Nation's children and working families.
I am reminded every day when I come to the Senate that it is my
privilege--privilege--to represent these individuals in the Senate, and
with every vote I cast in this great Chamber, I try to always ensure I
am protecting and serving our hard-working families.
This week, we are considering a bill to reauthorize our children's
health program--a program that affects millions of families across the
country. This week, every vote--every vote--we cast will have a direct
impact on the health and well-being of our Nation's children and their
families.
I cannot overstate how important and how successful this program has
been. It currently provides health care to 6.6 million children.
Sometimes I think it is important to remember exactly what it means to
provide health care for children. It is the immunization shot before
school begins. It is a well-child doctor visit that catches early signs
of cancer. It is the emergency care coverage after a car accident. It
is the new eyeglass prescription to finally see the blackboard. It is
an x ray for a broken ankle and a prescription medication for a strep
throat. It is about ensuring the well-being of that child so they can
fulfill their God-given potential.
Proper coverage can be the difference between life and death, between
health and sickness, and between compassion and heartlessness.
In the next few days, we have choices to make, and I hope each of my
colleagues ask themselves one question before they cast their vote: Is
this good for our Nation's children? Because that should be the only
question and the only goal.
I am proud of my home State of New Jersey for always keeping this
goal in its mind. Our program, New Jersey FamilyCare, currently covers
over 126,000 children and 80,000 parents. These are working families
who don't qualify for Medicaid but can't afford
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private coverage, and they don't get health care at their job. They
work at some of the toughest jobs our State has to offer. They get up
every day, 5 days a week--sometimes more--to try to make ends meet for
their families, but they don't have health insurance. These are
families who, without the children's health program, would yet be
another American family cast into the ocean of the uninsured. This
program saves them from that fate.
Let me take a moment to humanize what we are talking about, because
we talk about these programs in the abstract. They are about lives;
they are about people. Elizabeth Geronikos relied on the children's
health program for her necessary allergy and asthma medication when her
father suddenly lost his job. Jonathan Hale, who discovered a cyst in
his brain, was able to get medical attention that his family would not
otherwise have been able to afford because of the children's health
insurance program. The Cannon family no longer has to worry about their
son Jason, who now has a constant supply of asthma medication and has
suffered no serious asthma attacks since being on the Children's Health
Insurance Program. This is truly a life-changing, if not a lifesaving,
program.
But there are also stories of children who were not so lucky. Devante
Johnson, who depended on Medicaid for his cancer treatment, died, not
for failed chemotherapy, but because his paperwork was never processed.
He was 14 years old. Deamonte Driver died because he did not receive
treatment for an abscessed tooth--something that, if treated early,
would clearly not have been fatal. He was 12 years old. These stories
are heartbreaking not only because a child's life was lost but also
because it could have been prevented.
We must ensure that no more children go without treatment they need
and that no more lives are lost. Our job as Senators is to protect
these children. What greater honor and responsibility do we have but
protecting our children? As a father, I can't imagine the anguish I
would feel if I could not provide health care for my son and daughter.
Thus, as a Senator, I feel it is our obligation to provide health care
for every single child. I strongly believe we have a responsibility to
ensure that no child in America goes to bed at night without proper
health care and treatment, and that is why this reauthorization is so
crucial.
Under this bill, over the next 5 years we would be able to continue
covering the 6.6 million children currently enrolled, and we would be
able to reach out and cover an additional 3.2 million children. So the
answer to the question, Is this good for the Nation's children, is
clearly yes, especially for those 3.2 million children waiting to
receive care. That answer is a resounding ``yes.'' There are even more
whom we must work to cover.
I want to ask my colleagues who say they may not support this bill,
Where are the values we talk about in this institution? Where are the
family values voices that so often are heard in this Chamber? Now is
not the time to be silent. Now is when families need you most. Now is
the time to stand by your values and stand up to protect our future
generation.
To these colleagues, I wish to take a moment to answer some questions
about New Jersey's effort to reach out and enroll more children. Over
the past few weeks, New Jersey has received a lot of attention for
covering children up to 350 percent of the Federal poverty level. In
our regard, we think we are doing the right thing, and the statistics
prove we are right. I can understand that some might think these
families have enough money to afford private insurance, but for New
Jersey families, that is simply not the case. New Jersey families face
higher living costs, and they get less return on their Federal dollar,
so we cannot set a policy that suggests that one size fits all.
I did some of the math which I want to share with my colleagues. At
the top end, a working New Jersey family, their family budget, shows
they have about $4,428 in income. Housing in New Jersey is incredibly
expensive, about $1,500 a month. Food for that family is $547;
transportation to get to work, or if they happen to have a car to pay
for their commutes back and forth, with the high gas prices, $820;
child care, if they are not in school, and health insurance. I looked
up under the Bureau of Banking and Insurance what is the average health
insurance coverage for a family a month--a month. The statistic on the
Web site is $2,065. So that puts this family, if they have to be forced
to purchase health insurance, in the negative $1,200 a month. That
means they can't make ends meet. This doesn't take into account any
unforeseen circumstance on the family budget. So it doesn't end up
adding up. That is why this program is so important.
That is why, when New Jersey enrolls children up to 350 percent of
the Federal poverty level, they do it because without this coverage, we
would have thousands more children more without health insurance.
Purchasing a private plan, no matter what tax incentives you give--I
hear some of our colleagues talk about giving a $5,000 maximum credit
per family. Well, that is great. That buys us 2\1/2\ months of
insurance. What do we do for the rest of the year for that family? Do
we roll the dice on their health care? I don't think so--not when we as
an institution have some of the best health care in the Nation.
I am grateful to the Finance Committee for recognizing what we
already knew on a bipartisan basis: The one-size-fits-all approach
doesn't work. Remember, our objective is to cover more children, not
less. I can't believe I even need to mention what I am about to say,
but in light of some of the comments I have heard over the past few
weeks about the President saying: Well, let them go to the emergency
room, I think it might be necessary to look at what happens to children
without health insurance and how they suffer serious consequences.
Research has shown that uninsured children not only miss regular
checkups and visits to the doctors for less serious conditions that
ultimately become far more serious in their personal health and far
more consequential and far more expensive, but they also receive less
than lower quality care. In fact, uninsured children admitted to a
hospital due to injuries were twice--twice--as likely to die while in
the hospital as their insured counterparts, and that is simply
unacceptable.
There is no morality if upon hearing this, every Member of this
Chamber does not do everything in his or her power to cover more
children. It is, I believe, a moral obligation. I often hear about the
value of life and I cherish it as well. Now is the time to honor the
value of the lives of these children.
Another way New Jersey has been successful in covering more children
is because we also cover low-income and working parents. In New Jersey,
we have found a strong correlation between enrollment of parents and
enrollment of children. After the State implemented its parent
expansion in 2000, not only did it experience rapid enrollment of
parents, but it also saw a significant increase in the enrollment of
children, which is our goal. In 2002, the State stopped enrolling
parents, and what happened? As parent enrollment began to fall,
children's enrollment began to level off. Once the State began
reenrolling parents in 2005, children's coverage began to rise again.
There is clear evidence that by allowing those States that choose to do
so to cover parents, you increase the number of children who have
health coverage, achieving our ultimate goal of covering more children
and, by the way, we end up covering more Americans.
To further prove this point, former Congressional Budget Office
Director Peter Orszag recently stated that:
Restricting eligibility to parents does have an effect on
take up among children, in part because when you pick up the
parent you are more likely to pick up the child.
Thus, if we stop covering parents under the Children's Health
Insurance Program, as some in the Congress and the White House want to
do, you end up covering fewer children.
In fact, Peter Orszag said:
For every three of four parents you lose, you lose 1 or 2
kids.
Based on this, in New Jersey, if we were forced to disenroll all of
our parents, over 40,000 children would lose their coverage. This
doesn't help us achieve our goal of covering more children.
So again, we have to ask: Is covering parents of eligible children
good for our Nation's children? The answer is clearly yes.
As I said at the beginning of my statement, I fully support the
legislation we are considering today. Senator
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Baucus has done an excellent job. I appreciate the bipartisan vote of
the committee. I am proud of the reauthorization bill because of what
it prioritizes, but also because I know how hard it was to reach this
compromise. This is a bipartisan bill that Members of both sides of the
aisle support. I know it has taken long nights and serious conversation
and many difficult decisions to reach where we are today. I appreciate
again Senator Baucus's incredible efforts, the members of the
committee, as well as Majority Leader Reid, for their efforts on behalf
of the program.
That being said, I simply want to say that if I had my druthers, I
would have sought to achieve a greater height. I understand that so
would many of the Members who actually created the compromise. I would
have liked to have seen, as I did as a member of the Senate Budget
Committee, $50 billion provided. I worked hard to make sure we had that
in the budget resolution. I know that is the funding that will be
necessary to reach out to the 6 million eligible but uninsured children
in America, and it is the funding these children deserve.
Another area of major concern is the lack of language to provide
health care for legal immigrant children and pregnant women in the
Children's Health Insurance Program. I am a proud cosponsor of the
bipartisan Legal Immigrant Children's Health Improvement Act, also
known as ICHIA, which would have repealed the morally objectionable law
that prohibits new legal immigrants from accessing Medicaid and CHIP
until they have lived in the United States for 5 years. I think we
should have the flexibility for States to make that decision.
I am proud that in my home State of New Jersey, they have taken it
upon themselves to use 100 percent of State funds to cover over 8,000
legal immigrant pregnant women and children at a cost of over $22
million. The State has temporarily fixed the problem, but I had hoped
Congress would do the same. How can you tell a 7-year-old child with an
ear infection he has to wait 5 years to see the doctor? How can you
tell a child who may have the incipiency of some incredibly terrible
disease you have to wait 5 years to go see the doctor? It seems to me
we can't bar these families from accessing our health care supply
simply because they haven't lived here long enough. During the
immigration debate, our colleagues emphasized the difference between
those who are here legally and those who are not. So it is appalling to
me that a legal immigrant child--one whose family waited their time to
come to this country, came here legally, obeyed the law, are working,
paying taxes--is still subject to the lash of those people who, even
for a child who is here legally, seem to punish. It seems to me that is
simply wrong.
Let me close by addressing the President's veto threat. He is
basically opposed to this bill because he says it covers too many
children and families. I don't know how more outrageous and
unacceptable a statement can be. I find it embarrassing that some in
Washington--those who have the best health care coverage in the world--
would propose to cut America's neediest families--neediest families who
work hard every day, because if you are poor, you are on Medicaid.
These are families who get up and work hard, don't have enough to pay
insurance, don't have coverage through work, and can't afford it. Yet
the President of the United States, who has the best coverage in the
world, and the Vice President of the United States, whom we saw
recently in the hospital--happy that everything went well for him--have
no worries. They have no worries every night--and for them to say these
children are less worthy than them. If the President had his way, over
110,000 New Jerseyans would lose their coverage, and tens of thousands
more across the Nation would lose their coverage. I find that morally
reprehensible.
I find it ironic that the President doesn't want to cover parents
with this program, considering the fact that since 2001, it was his
administration that granted 24 waivers for adult coverage in 15 States,
including my home State of New Jersey. In fact, when a waiver was
issued in 2003 to New Jersey, the administrator of CMS, the Federal
agency that supervises the program, said:
New Jersey is setting an example of how Federal waivers can
help them cut into the numbers of citizens with no health
coverage.
Tom Scully, Administrator of CMS, the Federal agency overseeing this
program, said we are setting an example.
In 2004, President Bush made a promise to insure all of the Nation's
children, but his latest proposal would only serve to cut children and
increase the number of uninsured. Rather than adding to the ranks of
the uninsured, we should be working together to expand access to even
more children and families. Mr. President, it is time to make good on
your word.
It is time to make good on your promise. It is time to cover all
children. At the end of the day, this bill is about low-income and
working families getting much needed care. This is about our Nation's
children having access to a doctor for preventive care and receiving
treatments for more serious conditions. This is about the health and
safety of current and future generations.
There is only one question left to be asked: Is this good for our
Nation's children? The answer is yes.
Let me close with a great Republican I admire, Abraham Lincoln. He
said:
A child is a person who is going to carry on what you have
started. He [and I add she] is going to sit where you are
sitting, and when you are gone, attend to those things which
you think are important. You may adopt all the policies you
please, but how they are carried out depends on him. He will
assume control of your cities, states, and nations. All your
books are going to be judged, praised, or condemned by him.
The fate of humanity is in his hands. So it might be well to
pay him some attention.
I ask my colleagues to now pay attention to our children and support
this important bill. It is important our children. It is for our
families. It is in pursuit of our values, and it is for the well-being
of our country.
I yield the floor and yield back the remainder of my time.
(Ms. KLOBUCHAR assumed the Chair.)
Mr. BAUCUS. Madam President, I highly compliment the Senator from New
Jersey. He is a tireless advocate to make this legislation even better
than it was, especially on behalf of parents. There are other groups in
his State that are very deserving. I thank him publicly. He has talked
to me many times very earnestly, with a real desire to make sure the
people in his State are adequately taken care of. I thank the Senator
for his tireless advocacy.
I inquire of the Senator from Arkansas, roughly how much time does
she wish to consume?
Mrs. LINCOLN. I hope I can have somewhere between 15 and 20 minutes.
Mr. BAUCUS. I ask unanimous consent that the Senator from Arkansas be
recognized to speak for 20 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
The Senator from Arkansas is recognized.
Mrs. LINCOLN. Madam President, I thank Chairman Baucus for his
tireless effort here in really portraying what I think is a tremendous
priority for so many of us in the Senate and certainly in the Finance
Committee.
As a mother of twin boys--and I know our Presiding Officer is a
mother of a daughter who is a year older than my boys--I know all too
well of the importance of reliable health insurance coverage for
children. My husband and I have experienced the sleepless nights
looking after a sick child. But we also have the comfort of knowing
that when dawn comes, we have the opportunity, through health
insurance, to seek out health care through a pediatrician or, if it
should be worse, to be able to go to the emergency room and know we are
covered, to know we can seek that health care for our children when
they need it the most, with the confidence that with that health
insurance we can continue to care for their needs.
In situations such as these, health insurance coverage is critical
not only to the lifelong health of a child but also to a family's peace
of mind. I think that is what we are about here today--our ability as
Senators to be able to step outside the box of being a Senator and
really think about what it means to be a hard-working American, to be a
parent, and to not just think of what it means to us and our families
as Federal employees and what we have access to in health care but
translating that to the needs of all hard-working
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Americans and to understand how important it is to them and to their
children too.
We have to, in this debate, step outside and put ourselves in the
shoes of the hard-working Americans who need health insurance for their
children. That peace of mind should not only belong to those families
who can afford private health insurance; it should also belong to
working families who are struggling to make ends meet in today's world,
who are the strength of the fabric of this Nation, those hard-working
families who are going to jobs day in and day out--and sometimes more
than one job--to keep the needs of their families, as was listed by the
Senator from New Jersey, to make sure their families stay whole.
Coming to the bottom of that list and recognizing how expensive
health care costs are for their children, we need to make sure the
fabric of this Nation stays strong. We do so by not only supporting
those working families and their children but by establishing
priorities in this country. That is why I rise to speak on behalf of
the State Children's Health Insurance Program, or SCHIP, a Federal-
State partnership which today provides much needed health care coverage
for more than 6 million children across this great country.
In conjunction with Medicaid, CHIP has been tremendously successful
in reducing the number of uninsured children in my State and across our
country. Since the program's inception 10 years ago, the number of
children without health care coverage has dropped by one-third. That is
something we can be proud of and that we can build on.
During that time, I am proud that Arkansas has become a national
leader in reducing its number of uninsured children from over 20
percent in 1997 to 10 percent today. Now, nearly 65,000 of Arkansas'
children currently receive coverage through CHIP or, as we know it in
Arkansas, ARKids First.
Despite this success, an estimated 9 million children remain
uninsured, nearly two-thirds of whom are already eligible for CHIP or
for Medicaid nationwide--9 million children, Madam President. Those
children belong to parents just like us. Their parents care for them
just as we try to care for our children--yet not having the comfort of
knowing their health care needs could be and should be covered.
I am certainly proud that the Senate Finance Committee has recently
taken steps to reach more of these children, and I do wish to commend
Chairman Baucus and Senators Grassley, Rockefeller, and Hatch, as well
as their staffs, for their incredible dedication, the vision and
leadership they have shown on this issue, their tireless energy
in sticking with coming together to bring about a compromise--a much
needed compromise--and the extraordinary effort they have put forth
particularly over the past few months, which has made renewal of CHIP
much more of a reality for America's families.
The CHIP reauthorization package that was overwhelmingly approved in
our Finance Committee--by a vote of 17 to 4--applies the lessons of the
past 10 years and builds upon the success of the program by giving
States more of the tools they need while preserving their flexibility
to strengthen their program and ultimately cover more children. In
doing so, it would provide an additional $35 billion over 5 years that
will allow States to preserve coverage for the children who are
currently enrolled, while reaching an additional 3.2 million uninsured
low-income children.
This proposal would also provide much needed funding to States for
outreach and enrollment efforts to reach many of those who are
currently uninsured and yet eligible. It also takes steps to ensure
that they get a healthy start by providing care for pregnant women and
establishing pediatric quality measures to improve the level and
efficiency of the care they do receive. How important that is as we
have begun in this country to look at the quality measures of health
care, particularly for our elderly. Why is it not equally important to
look at the quality measures for the pediatric care that goes to our
children?
I have long supported improving access to health care coverage for
pregnant women, not only because it is vital to the health of mothers
and infants, but it also often reduces future health care costs. What
an incredible return on our money--to see expectant mothers going full-
term to deliver a child that has a much greater opportunity to perform,
to be healthy, and to be less costly later in life due to health care
needs. In fact, it was reported in 2005 that the socioeconomic costs--
medical, educational, and lost productivity--associated with preterm
birth in the United States was at least $26.2 billion. Every year, more
than 500,000 infants are born prematurely, an increasing number that
now affects nearly one out of every eight babies.
This is of particular concern to me because, in recent reports, more
than 13 percent of births in our State of Arkansas were premature,
ranking it among the States with the highest incidence of preterm
babies. So many of us have been faced with those choices. I know when I
served in the House of Representatives and my husband and I were so
excited to receive the news that we were expecting twins, I also
received the news that at my age, and certainly the work environment I
was in and all of the pressures, I was also at risk for a premature
delivery. I had the wonderful opportunity to make a decision that I
would not run for reelection and that I could minimize my job in order
to do everything within my power to bring those children into this
world in a safe manner.
I look across this great country, and not all working mothers have
that opportunity. They don't have those choices to be able to step
aside and do everything they possibly can with the health care they
receive to bring their babies into this world in the healthiest
fashion. One thing we can do is to provide them the prenatal care they
need and the advice and consultation to be able to do what they can to
ensure those babies are delivered after a full term.
By taking needed steps to improve access to care for pregnant women,
I am confident we can make strides to improve health outcomes for them
and for their children. If, in fact, we don't want to do it for the
sake of bringing healthy babies into this world, who are going to be
future leaders of this country, we should do it as an investment. The
long-term investment of a healthier child being born makes so much more
sense than the long-term cost of a premature delivery and the health
care needs that child would have for the rest of his or her life.
The Finance Committee proposal would also provide the Federal
authority and resources to invest in the development and testing of
quality measures for children's health care. Of the 146 medical schools
in this country, every one of them has a department in pediatrics. We
can make an incredible investment in quality measures that would give
us not only the outcome we want but also the cost savings in overall
health care we so much desire.
This provision would help ensure that States and other payers,
providers, and consumers have the clinical quality measures they need
to assess and improve the quality and performance of children's health
care services.
Additionally, the bill would allow some States to use income-
eligibility information from other Federal programs, such as school
lunch programs, to speed up the enrollment of eligible children into
CHIP or Medicaid. The Senator from New Mexico has done so much hard
work on making good common sense out of the mounds and mounds of
paperwork people already have to fill out, using the knowledge we
already have and those mounds of paperwork to get those children
enrolled in the program for which they already qualify. It would
simplify the administrative process for States and certainly reduce the
paperwork burdens on our families.
The bill would also provide greater access to much needed dental care
for lower income children and would ensure that children enrolled in
CHIP would have access to mental health care that is on par with the
level of medical and surgical care they are currently provided.
As we look at our children and their growth, understanding the
unbelievable essentials in dental care, not only so our children can
get the nutrition they need but they can pay attention in school, they
can get the education they need, which allows them to grow and be a
part of this incredible Nation
[[Page S10351]]
in a productive way, the success of CHIP over the past 10 years is
itself a great example of the things we can accomplish when we reach
out across the aisle, when we work in a bipartisan way, when we come
together on our priorities and put aside the partisan differences.
This bipartisan proposal we are considering today is another. We
should all agree that providing health care for our children is
certainly one area where partisan politics should be placed aside.
There is no room for partisan politics as we address our children.
After all, it is a moral issue, an investment in our Nation's most
precious resource--our children; an investment in a future of our
country, its leadership, and its productivity. Who can disagree with
that?
As we move forward together to reauthorize this successful program, I
am hopeful we can do so in the same bipartisan spirit that was
demonstrated in the creation of this program, the 10-year
implementation of this program, and in the recent reauthorization of
this program in the Finance Committee.
It is unfortunate the President and the Secretary of Health and Human
Services feel differently. In fact, their proposal to increase the CHIP
funding by only $5 billion over the next 5 years falls so short of the
funding needed to simply maintain coverage of those currently enrolled
in the program. To justify their proposal, the administration actually
claimed the number of uninsured children in our Nation was only 20
percent of the estimates calculated by the nonpartisan CBO.
Instead of forcing over a million children--a million children--to be
dropped from their current health insurance provider, shouldn't we all
agree that at the very least absolutely no child should lose coverage
as a result of reauthorization?
The President has been adamant about leaving no child behind when it
comes to their education, but shouldn't we apply this to their health
care as well? Shouldn't we recognize the reason, or a part of the
reason, our No Child Left Behind in education has been less productive
is because we failed to provide the resources--the much needed
resources--to implement good policies, basic policies? It is fine to
talk about these things, but if we don't put our money where our mouth
is, the health care doesn't get to the children who need it.
Moreover, shouldn't we all move forward in covering as many of the 9
million uninsured children we possibly can; finding the middle ground,
as we have done in the Finance Committee? I wholeheartedly believe so,
and that is why I rise in strong support of this legislation.
Some of my colleagues have raised concerns about our efforts to
expand this successful program. They have argued the $35 billion
compromise that was reached in the Finance Committee is too much money.
You know what. It is going to cost us something to cover more children.
Let us take a step back and get some perspective on how much money we
are actually talking about.
Our current proposal to reauthorize CHIP provides a total of $60
billion over 5 years--$25 billion in the baseline, with an increase of
$35 billion. In contrast, our operations in Iraq are now estimated to
cost taxpayers $10 billion per month. So for the amount of money,
nonbudgeted money, we now spend in Iraq every 6 months, we can cover an
estimated 10 million lower-income children with much needed health care
for 5 years--5 years. We are talking about money that is completely
offset--a program that is completely paid for.
How you spend your money--and this goes for families and for
Government--tends to reflect your values and your priorities. We all
have to look at where our priorities are in our own family, and we as
Senators and stewards of this land and this great country and its
resources have to set priorities as well, and they should reflect our
values--our values and our priorities. So I ask my colleagues today:
What could be a bigger priority than the well-being of our Nation's
most precious resource, our children?
Look at our families, the families who are the fabric of this
country. One of the things they need the most is time--time to be a
family, to sit down to dinner with their children, to be able to go to
a PTA meeting or a parent-teacher conference, to take a small vacation,
to care for an aging parent. They need time to do that. It is not easy
to find that time. If you are a single parent, perhaps a single mom,
but even if you are a working family, a lower income working family,
working two or three jobs to be able to hit that budget the Senator
from New Jersey talks about, to make sure you can hit all those issues
you have to deal with, whether it is rent or groceries or certainly any
type of health care you could access, it takes time--time away from our
families, the time needed to build strong families, to keep their
children whole and focused on the good values we want our children to
have.
Minimum wage was a great example. Minimum wage was much needed, with
over 10 years of not having seen that increase. What an important role
it plays in providing our families greater time to be a family. At a
time when more and more Americans are struggling to find affordable
health care, CHIP has allowed us to make coverage more accessible for
millions of children, coverage that is critical to the lifelong health
of a child and to a family's peace of mind. I urge each and every one
of my colleagues to explore your own conscience, not just thinking
about your family but thinking about the millions of American families
out there today who want nothing less for their children than what we
want for ours.
Let's set aside partisan influences and support this critical effort
to invest in the health care of our children, not only for the future
of our Nation but for the well-being of millions of American children
in working-class, lower income families. They are depending on us, the
stewards of this body, the stewards of this country, and it is time we
fulfill our commitment to them. I urge my colleagues to join me in
supporting legislation to expand health care coverage for children.
I have been proud to work with Chairman Baucus and Senator Grassley
and others in this effort, and I certainly commend them for their
leadership and good work. I look to this body to stand up and to show
who it is we are and what it is we are made of on behalf of America's
children.
I yield the floor.
Mr. WYDEN. Madam President, before she leaves the floor, let me thank
my seatmate on the Senate Finance Committee for a passionate and
eloquent address on behalf of this country's children. I commend her
for it.
Madam President, I ask unanimous consent that the time between now
and 12:30 be divided equally between the Senator from New Mexico, Mr.
Bingaman, and the Senator from New Jersey, Mr. Lautenberg.
The PRESIDING OFFICER. Without objection, it is so ordered.
The Senator from New Mexico is recognized.
Mr. BINGAMAN. Madam President, would the Chair please advise me when
half the time allotted to me has been used?
The PRESIDING OFFICER. Yes.
Mr. BINGAMAN. Madam President, I wish to congratulate the majority
leader for taking this time to bring the reauthorization of the
Children's Health Insurance Program to the Senate floor. Since this
program was created, through a bipartisan effort in 1997, the number of
uninsured Americans has grown by millions. At the same time, the
percentage of low-income children in the United States without health
care coverage has fallen by a third. So this is a remarkable
achievement, and this program is a large share of the reason for that
achievement.
The program is critically important to my home State of New Mexico.
It currently permits the State to cover over 14,000 low-income New
Mexicans and will play a critical role in ensuring that all low-income
New Mexicans have access to meaningful health care coverage. I strongly
support the reauthorization we have reported from the Finance
Committee. Of the many issues before the Senate, I believe
reauthorizing this legislation needs to be at the top of our list.
Unfortunately, there seems to be a huge gap between what the
administration would like to see done on this subject and what in fact
is needed. The President has proposed such a small sum of new funding
over the next 5 years, $1 billion per year of additional
[[Page S10352]]
funding, that if we were to accept that proposal, we would have a
significant reduction in the size of the program and the number of
children covered by the program.
Instead of reaching a larger percentage of the 9 million uninsured
children in our Nation, the President's proposal would not add to the
number of children covered. In fact, it would result in hundreds of
thousands, if not millions, of low-income children losing their
coverage.
I also wish to commend Senator Baucus, Senator Grassley, Senator
Rockefeller, and Senator Hatch, all four of these individuals, who
worked in a selfless and bipartisan way to come up with a proposal they
could embrace and they could bring to the full Senate. The
Congressional Budget Office estimates the $35 billion over 5 years
authorized in this legislation will fill in the shortfalls in funding
that have plagued the program for many years. It will allow us to
expand coverage to nearly 4 million additional low-income children.
Although I strongly support this bipartisan compromise, there are
several aspects of the legislation I hope we can still strengthen as we
move forward. First, of course, I would like to see greater funding
than the $35 billion over the next 5 years that is called for in this
legislation. If we could go to the full $50 billion we provided for in
the budget resolution, and that I believe the House is trying to enact,
we could expand coverage to an additional 5 million children who would
remain uninsured at the bill's current funding levels. So there are
ways we can improve this bill.
I am also disappointed in changes that were made to coverage for
adult populations in this program. I will not oppose the compromises
that were reached on the issue, but I firmly believe the
reauthorization program should not result in the narrowing of the
flexibility States have had through this program to cover uninsured
populations, including adults. In particular, let me discuss a little
of the rhetoric that has circulated around this subject.
Coverage of adults is very important to the efforts of my State and
other States in our efforts to cover low-income parents and childless
adults, but in fact, this program is overwhelmingly a program that is
focused on providing coverage to children. Less than 10 percent of the
coverage under the SCHIP program currently goes to adults. I believe
that has been somewhat taken out of context by many who have discussed
the issue.
We should also note States are relying on waivers in covering the
adults who are covered under the program. States are relying on
waivers, most of which were approved and authorized in this Bush
administration, to cover these populations. These are not Democratic-
proposed waivers, these are waivers a Republican administration has
approved. Tommy Thompson, our former Secretary of Health and Human
Services under President Bush, in his first term stated in 2005, upon
approving New Mexico's ability to cover adult populations:
This approval means health coverage for tens of thousands
of uninsured New Mexico residents--including many uninsured
parents whose children are already covered. By giving States
like New Mexico greater flexibility in the way they provide
health care to low-income citizens, we are helping millions
of people across the country to gain access to quality health
care.
Madam President, how much time remains for my half?
The PRESIDING OFFICER. The Senator has 5 minutes remaining.
Mr. BINGAMAN. Madam President, let me also go to one other issue
which I think is important to deal with, another shortfall in this
legislation, and that is the failure of the program to provide dental
coverage.
According to the Children's Dental Health Project, of the 4 million
children born each year in the United States, more than a quarter of
them will have cavities by the time they are toddlers, and more than
half will have cavities by the time they reach second grade. This is
concentrated in low-income rural children who suffer disproportionately
from these problems.
I believe strongly the Children's Health Insurance Program should be
expanded to cover dental care for children across this country, low-
income children. This is something we are not able to do as part of
this legislation, but I hope we can revisit this issue before final
action is taken.
A final issue I wanted to discuss relates to important improvements
in legislation I hope we can make for legal immigrant children and
legal pregnant women. Under current law, these individuals are
prohibited from receiving most CHIP or Medicaid coverage for the first
5 years they are resident in the United States on a legal basis. Very
often these children and these legal pregnant women, U.S. citizen
children I point out, will become eligible for CHIP and Medicaid. It is
counterproductive to prevent these legal immigrants from accessing
services at the time they become legal residents of our country.
Today there is a 5-year bar in place to them receiving Medicaid and
CHIP coverage. It exists even though the vast majority of these
immigrants are working or are in families with working parents and are
therefore paying Federal and State taxes. They contribute significantly
to the system, but they are barred from receiving the services they are
subsidizing. I highlight that legislation to remove this 5-year bar. I
want to highlight that this proposal to remove the 5-year bar has
bipartisan support. It has passed the Senate as part of the 2003
Medicare Modernization Act. I hope very much that before we complete
action and send the bill to the President, we can deal with this issue
here.
I urge each Member of the Senate to focus on what is the important
work that we can accomplish in the Senate, how we can help the lives of
children growing up in this country, and how we can make them more
productive citizens in the future. Expanding this health care coverage
to cover more children is obviously the first and best thing we can do.
I hope very much we can pass this bill, go to conference with the
House, and come up with a bill the President can be persuaded to sign.
Again, I congratulate the Finance Committee for the good work they
have done bringing the legislation to the full Senate.
I yield the floor.
The PRESIDING OFFICER. The Senator from New Jersey is recognized.
Mr. LAUTENBERG. Madam President, I also extend my commendations and
thanks to Senators Baucus and Grassley for producing this bill. This
bill is a long step forward. Although I think it is quite apparent that
we need even more than this generous attempt to meet our needs, the
fact is, it is a very good bill. But it is surprising to me that we
even have to debate this bill.
As we stand here, there are 9 million kids in the United States
without health insurance; 250,000 of them live in my State of New
Jersey. Every day that we wait to reauthorize and expand the Children's
Health Insurance Program we risk more children's illnesses and even
permit them to die because they have no health care.
In 2010 there are going to be more than 83 million children, from
newborns to 19-year-olds, growing up in America. We have an obligation
to make sure those boys and girls have health insurance so they can see
their doctor, get a prescription, or visit the hospital if they need
to. That is exactly what the CHIP, Children's Health Insurance Program,
helps them do. It will ensure that kids have insurance to get regular
checkups, to pay for emergencies, or to fight illnesses such as
diabetes and other illnesses that afflict children terribly in their
lives.
Children without insurance are twice as likely to die from injuries
while they stay in the hospital than children who have insurance, and
12 percent of children either delay getting care or do not get any care
at all because their families cannot pay for it. It is simply not
right. It is those children who need this program the most, but this
vital children's health program is set to expire on September 30, just
2 months from now.
The Children's Health Insurance Program is the only way that 6
million of America's children can afford health insurance. Their
parents are typically hard-working people, but they simply cannot
afford expensive private insurance, and they make too much money to
qualify for Medicaid.
For example, in New Jersey, our State program helps to keep 126,000
low-income children in good health. Considering how many kids the
program is keeping healthy in New Jersey
[[Page S10353]]
and across the Nation, we would expect that President Bush would keep
this program healthy, but he has not, and the long-term health of this
program hangs in the balance. The President's proposed budget for
fiscal year 2008 is $10 billion short of what we need to keep our
children healthy. Without more money, we cannot cover the young people
who currently get children's health insurance, and we cannot add any
new children, no matter how much they need it, to the ranks of the
insured.
By 2009, States will be facing more financial shortfalls. They will
be forced to cut coverage for our kids. It is unacceptable, so the
Senate is offering a better bipartisan plan. I am proud to support the
Children's Health Insurance Program Reauthorization Act, which Senators
Baucus and Grassley introduced and the Finance Committee approved. This
bipartisan bill will provide $35 billion in new funding. Most of us
would have preferred even higher levels of funding--$50 billion--and I
plan to support amendments to increase the funding amount. But there
cannot be any doubt that this bipartisan compromise that we have before
us is a crucial step forward in improving children's health. It would
maintain insurance for the 67 million children who are currently
covered, and it would insure more than 3 million new kids who do not
have any health insurance at all now.
It would also continue giving States flexibility in covering these
youngsters. We know the cost of living and the cost of health care
varies from State to State, and that must be a consideration in
coverage.
President Bush ran on a campaign pledge to get millions more kids on
health insurance. Instead of pledging to sign the bipartisan Senate
bill--it is incredible but true--President Bush is threatening to veto
it. A veto means putting millions of children at risk for illness and
disease. It means going back on the President's pledge, and it shows,
by his action more than his words, that the President's priorities are
not the same as America's.
President Bush's lopsided tax cuts are projected to cost $252 billion
in 2008 alone. We spend $3 billion a week on this war, and we have
supplementals in between there. We have already spent more than a half
trillion dollars on this war. When you think about it, this bill asks
for only $35 billion over 5 years, $7 billion a year, to provide for
children's health. It is roughly 2 months of keeping this war going.
In those 5 years we could keep millions of kids healthy and help them
become productive members of our American society.
Martin Luther King said:
Of all forms of injustice, inequality in health care is the
most shocking and inhumane.
To let millions of children go without health insurance is an
absolute injustice. To stand by while they get sick and cannot afford
care is both shocking and inhumane. We are the wealthiest country in
the world. We also should be the healthiest country in the world. But
we do not seem to be able to tie in these domestic needs with the
opportunity that faces us, despite the shortage of revenues because we
have become so generous with people who are billionaires, in terms of
their taxes. Those who make $1 million a year get tax cuts that are
substantial, so it does cut into our revenues. So, as I mentioned
before, does the war.
I hope all my colleagues will support this bipartisan Baucus-Grassley
bill.
Last, we plead with the President to keep his promise, not to veto it
but sign it, to do the best we can for our children and our country.
I yield the remainder of my time. I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The bill clerk proceeded to call the roll.
Mr. LAUTENBERG. Madam President, I ask unanimous consent the quorum
call be dispensed with.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. LAUTENBERG. I ask unanimous consent now we recess for the
caucuses.
____________________