[Congressional Record Volume 153, Number 124 (Tuesday, July 31, 2007)]
[Senate]
[Pages S10401-S10408]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SMALL BUSINESS TAX RELIEF ACT OF 2007--Continued
Ms. KLOBUCHAR. Mr. President, I am here today to talk about health
care. Today, 45 million Americans are living without access to
affordable health care. In a nation of such tremendous wealth and
opportunity, with such a strong belief in science and research and
medical advancement--we certainly have that in our State, the State of
Minnesota--one wonders how so many of our fellow citizens can be
burdened with the daily worry of what to do should a health disaster
strike themselves or a loved one.
Health insurance premiums have skyrocketed into orbits unreachable by
an increasing number of middle-class families. We have seen this in our
State, where we actually have a fairly high level of people covered.
But health care premiums for the middle class are so many times out of
reach. We have seen nearly a 100-percent increase in the last few years
in our State.
The foundations of employer-based health insurance are buckling under
enormous cost pressures. The result is that ever more Americans are
squeezed by health care costs and face awful decisions about delaying
or forgoing needed medical treatment and care.
I, in fact, woke up this morning trying to decide when my daughter
would get her braces because of the health insurance policy we got that
makes you wait 2 years to get that kind of care. Well, we are lucky to
be able to even have that insurance because so many kids in this
country do not have it.
In fact, nearly 9 million of the uninsured in America are children.
Kids without access to health care are at an enormous disadvantage as
they grow up and start to make their life in this world. Children
without health coverage are less likely to get basic preventive care,
less likely to see a doctor regularly, and less likely to perform well
in school. Children without health coverage are also more likely to
show up at the hospital sicker and more likely to develop costly
chronic diseases.
Currently covering 6 million children, the Children's Health
Insurance Program succeeded in improving their lives by giving them
access to the health care services they need. It is a successful
program that deserves to reach even more children. This is important
because, first of all, it is the decent thing to do for America's
children who, through no fault of their own, are growing up in families
that cannot otherwise get affordable health insurance. But this is also
important because it is something that is good for all of us.
That is because insuring our children is a smart investment. It is a
smart investment to make sure America's children get preventive medical
care. It is a smart investment to help America's children grow up as
healthy as they can be. It is a smart investment to have America's
children in school focused on learning rather than distracted by a
sickness or an injury that has gone untreated. It is a smart investment
to have America's children get medical care through a sensible system
of health insurance rather than having them end up in a hospital
emergency room as their health care provider of last resort, increasing
the bill for the rest of us.
I have seen the direct impact at the local level. For 8 years, I was
the county attorney. As county attorney, my office represented the
largest safety net hospital in Minnesota. That is the Hennepin County
Medical Center in Minneapolis. It is one of the Nation's premier public
teaching and research hospitals. It has a nationally recognized level 1
trauma center with the largest emergency room in our State.
The hospital serves patients regardless of their ability to pay. As a
result, in 2006, the Hennepin County Medical Center's level of
uncompensated care added up to $38 million--almost double what it was
in the year 2000. That is because the emergency room was these people's
doctor. People say: Well, they do not have insurance. They cannot get a
doctor. Well, they have a doctor. It is the emergency room. The
taxpayers are paying for it, and it is the most expensive place to get
health care. It is the clinic of last resort for the uninsured, whether
it is for minor illnesses or for more serious conditions that went
untreated or could have been prevented.
Both in the short run and over the long term, expanding health
insurance coverage offers a better deal for our Nation's health and for
our continued prosperity. The people of my State
[[Page S10402]]
have recognized this for a long time. Back in 1992, the leaders in my
State voted to establish MinnesotaCare to provide children and their
families with a new opportunity to secure health coverage.
The initiative was created with bipartisan support in our State
legislature, and it was signed into law by Republican Governor Arne
Carlson.
Within a decade--and thanks to the Children's Health Insurance
Program--MinnesotaCare had grown to cover more than 150,000 Minnesotans
and helped to make my State No. 1 in the Nation for the percentage of
residents with health coverage.
But we are now losing the high ground we worked so hard to gain, as a
growing number of Minnesotans, especially children, go without health
coverage. Uncompensated health care costs for Minnesota's urban and
rural hospitals have jumped substantially in recent years. Much of this
increase in uncompensated care is due to a decline in health care
coverage in our State.
For example, between 2001 and 2004, the proportion of Minnesotans who
had health coverage through their employers declined from more than 68
percent to less than 63 percent. During the same period, the proportion
of Minnesota children covered through their parents' employer also
declined from roughly 77 percent to 69 percent.
Not surprisingly, the number of Minnesota children lacking health
coverage increased significantly. Today, an estimated 82,000 Minnesota
children are without health coverage.
At the time when thousands of Minnesotans are losing coverage from
their employers, or they are being priced out of the insurance market
by ever-higher premiums, MinnesotaCare's funding has also been scaled
back.
In Congress, we have the opportunity to do something about this--
starting with the reauthorization of the Children's Health Insurance
Program.
Recently, the Senate Finance Committee approved bipartisan
legislation to reauthorize the Children's Health Insurance Program.
Although I believe it could be even stronger, this compromise
legislation authorizes $35 billion over 5 years to expand the
Children's Health Insurance Program and extend quality health insurance
to an additional 3.2 million children who currently lack coverage.
This legislation provides much needed funding for States to maintain
and expand their programs and ensure that States that have suffered
Federal funding shortfalls, including Minnesota, will now experience a
stable level of Federal dollars.
As a State-Federal partnership, Children's Health Insurance Program
has granted States the ability to tailor their programs to meet the
needs of their residents. Some States increased eligibility levels for
children. Other States allowed pregnant women to be covered under the
program.
With MinnesotaCare, my State was an early leader in covering children
from working families who had incomes above the Federal poverty level
but still could not afford health insurance. In 2001, Minnesota was
granted a waiver to extend the coverage to parents with incomes up to
twice the Federal poverty line.
I would like to make one point clear. In no way is Minnesota covering
parents at the expense of children. When the Children's Health
Insurance Program was established in 1997, Minnesota already had one of
the highest levels of covering children. So why did Minnesota include
low-income working parents? The reason is simple. Ample research shows
that when parents have coverage, children also get coverage, and they
are more likely to actually receive medical care.
I have to point out the Bush administration agrees--or at least at
one time it did. Here is a quote from Health and Human Services
Secretary Tommy Thompson in June of 2001, when his Department approved
Minnesota's waiver. He said:
I am thrilled today to extend the promise of health care
insurance to parents. We know there is a greater likelihood
that kids will stay insured if their parents also have
coverage.
Agreeing with Secretary Thompson was Mark McClellan, the
Administrator for the Centers for Medicare and Medicaid Services.
Testifying in 2006 before the Finance Committee about the virtues of
parent coverage, he said:
Extending coverage to parents and caregivers may also
increase the likelihood that their children remain enrolled
in SCHIP.
So as recently as last year, top officials in the Bush administration
were on record affirming the strong evidence of the role of parental
coverage in the health care and well-being of children. Now the
President and his allies have backtracked and would prefer to take
coverage away from American families, including 34,000 parents in
Minnesota alone.
I will tell my colleagues what seems odd to me. Both the President
and the Vice President were recently in hospitals, and they were
covered. That is good. But why would they want to deny millions of kids
in this country the same right? Why would they want to deny 34,000
parents in Minnesota the same right?
As Congressional Budget Office Director Peter Orszag stated during a
Finance Committee markup of this bill:
When you remove parents from health coverage, you end up
removing kids too.
It doesn't make sense. Our goal must be to secure health care access
for more--not fewer--Americans.
The White House is living in the past instead of looking to the
future. Leaders at the State level, including many Republican
Governors, have already moved well beyond the President's constricted
position and are committed to trying to expand health coverage to their
residents.
Minnesota's Republican Governor, Gov. Tim Pawlenty, currently the
chair of the National Governors Association, recently signed a letter
to congressional leadership asking them to reauthorize the Children's
Health Insurance Program. I have this letter in front of me and I wish
to quote from it:
The Nation's governors call on Congress and the
administration to reauthorize the State Children's Health
Insurance Program prior to September 30, 2007.
They talk about how the authorization is critical for the safety net.
Then they go on to say:
While we have not taken a position on the actual overall
funding amount or the sources of revenue used as offsets, we
are encouraged by the Senate Finance Committee's efforts to
move a bipartisan reauthorization bill that provides
increased funding and reflects the general philosophy that
State flexibility and options and incentives for States are
preferable to mandates.
Not only did Gov. Tim Pawlenty sign this, I know the Governor of the
Presiding Officer's home State of Ohio signed it. I also see that
Governor Schwarzenegger of California signed this. There are dozens and
dozens of signatures of the Nation's Governors.
I ask unanimous consent to have printed in the Record this letter
from the National Governors Association, Gov. Tim Pawlenty, Chair.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Washington, DC, July 24, 2007.
Hon. Harry Reid,
Majority Leader, U.S. Senate, Washington, DC
Hon. Mitch McConnell,
Minority Leader, U.S. Senate, Washington, DC
Hon. Nancy Pelosi,
Speaker, U.S. House of Representatives, Washington, DC
Hon. John Boehner,
Minority Leader, U.S. House of Representatives, Washington,
DC
Dear Senator Reid, Senator McConnell, Speaker Pelosi and
Representative Boehner: The nation's governors call on
Congress and the Administration to reauthorize the State
Children's Health Insurance Program (SCHIP) prior to
September 30, 2007. The authorization for this critical
safety net program will soon expire and urgent action is
needed to ensure its continued success for the next five
years. For many reasons, defaulting to a series of temporary
extensions of the program would be untenable for states and
the millions of children who rely upon the program.
While we have not taken a position on the actual overall
funding amount or the sources of revenue used as offsets, we
are encouraged by the Senate Finance Committee's efforts to
move a bipartisan reauthorization bill that provides
increased funding and reflects the general philosophy that
state flexibility and options and incentives for states are
preferable to mandates. Our recently enacted policy on SCHIP
and a series of letters we have sent since February outline
our positions on these issues in more detail.
We look forward to working with all of you to ensure that a
sensible bipartisan SCHIP reauthorization can be signed into
law in a timely and certain manner.
Sincerely,
Governor Tim Pawlenty; Governor James H. Douglas, Chair,
Health and Human Services Committee; Governor Edward G.
Rendell; Governor Jon S. Corzine, Vice Chair, Health
and Human Services Committee; Governor Janet
Napolitano, Arizona; Governor Ruth
[[Page S10403]]
Ann Minner, Delaware; Governor M. Jodi Rell,
Connecticut; Governor Mike Beebe, Arkansas; Governor M.
Michael Rounds, South Dakota; Governor John Baldacci,
Maine; Governor Martin O'Malley, Maryland; Governor Rod
Blagojevich, Illinois; Governor Christine O. Gregoire,
Washington; Governor Deval Patrick, Massachusetts;
Governor Jennifer M. Granholm, Michigan; Governor Brian
Schweitzer, Montana; Governor Kathleen Babineaux
Blanco, Louisiana; Governor Bill Ritter, Colorado;
Governor Brad Henry, Oklahoma; Governor Benigno Fitial,
Northern Mariana Islands; Governor Felix Perez Camacho,
Guam; Governor Eliot Spitzer, New York; Governor Jim
Doyle, Wisconsin; Governor Chester J. Culver, Iowa;
Governor Jon M. Huntsman, Jr., Utah; Governor Kathleen
Sebelius, Kansas; Governor Timothy M. Kaine, Virginia;
Governor Ted Strickland, Ohio; Governor Don Carcieri,
Rhode Island; Governor John Lynch, New Hamsphire;
Governor Ernie Fletcher, Kentucky; Governor Sony
Perdue, Georgia; Governor Bill Richardson, New Mexico;
Governor Arnold Schwarzenegger, California; Governor
Dave Heineman, Nebraska; Governor Michael F. Easley,
North Carolina; Governor Jim Gibbons, Nevada; Governor
Linda Lingle, Hawaii; Governor Theodore Kulongoski,
Oregon; Governor Phil Bredesen, Tennessee; Governor
Sarah Palin, Alaska; Governor Dave Freudenthal,
Wyoming; Governor John Hoeven, North Dakota.
Ms. KLOBUCHAR. Mr. President, here is one more indicator of broad-
based support for this insurance. A few days ago, a group of law
enforcement leaders in my State came together to express their support
for expanding the Children's Health Insurance Program. They included
Minneapolis Police Chief Tim Dolan, my former colleague Dakota County
Attorney Jim Backstrom, and Hennepin County Sheriff Rich Stanek, who
also happens to be a former Republican State legislator. They believe
that investing in health insurance for kids and their families is one
of the best things we can do to fight crime and ensure safe, prosperous
communities.
The time to act is now. In a few months, the Children's Health
Insurance Program will expire. If that happens, our children will
suffer. The President should reconsider his threat to veto. My Senate
colleagues who say they are against this bipartisan compromise
legislation should reconsider their opposition.
I thank the Finance Committee for its efforts to bring this bill to
the floor and to expand this important and successful initiative. It is
not only good for American kids, it is good for our families and for
our local communities, and it is good for all of us, because it
improves our Nation's health and prosperity.
Mr. President, I yield the floor.
The PRESIDING OFFICER. The junior Senator from Tennessee is
recognized.
Mr. CORKER. Mr. President, I rise this evening at this late hour to
again talk about the SCHIP bill before us, but even talk a little
further about health care for all Americans. I don't think there is
anybody in this body who believes that at some point we are not going
to extend children's health care coverage. I think everybody in this
body realizes what we are doing right now is talking about how, in
fact, that is going to be done. Even if the President were to veto this
bill, I think all of us realize that again, in some form or fashion, we
are going to come back together and we are going to make sure the
children of America benefit from the SCHIP program that has been in
place now since 1997. I think as we look at the issues we are dealing
with on this SCHIP bill, as we look at the many issues we are dealing
with involving Medicaid and Medicare, I know of no other moment for us
to more fully be able to debate the future of health care in our
country in general.
I think all of us know, as the Senator from Minnesota said and many
Senators before her have said, there are 45 million Americans today who
at some point in time during the year did not have health insurance. In
my own State of Tennessee, we have 800,000 people in the State who do
not have health insurance. The toll is enormous. I think all of us can
tell a story about a friend or a neighbor or somebody we have seen in
our cities as we go back into the States who does not have health care
coverage and the insecurities they feel. We are having one of the most
dynamic growths in markets in U.S. history, and yet so many people in
America feel insecure. I am convinced one of the main reasons is
because so many people feel insecure about their health care coverage.
I know that throughout the campaign, in the 95 counties of our State
that I visited, I met so many Tennesseans who were concerned about the
financial health of their family because they did not have health
insurance, and about whether their husbands who might have had seizures
would be able to get the proper care they might need. So I believe it
is a moral obligation for us here in the Senate and for those in the
Congress to deal with this issue in a much broader way even than as we
are talking about during this SCHIP debate. I also believe as this
Presidential race unfolds, almost every Presidential candidate will
have to face Americans and talk about how they plan to deal with the
fact that Americans today do not have the health insurance coverage
they need.
That is why today I rise to join the Senator from North Carolina,
Senator Burr, with Senate bill 1886, which is the Every American
Insured Health Act. Americans want to control their own destiny. They
don't like the fact that an employer might decide what kind of coverage
they have, or if they have coverage at all. They don't like the fact
that some bureaucrat in Washington may decide that they have coverage
or not. Americans like to know they have their destiny in their own
hands. There is something about American psyches that is grounded in
that particular issue.
So what we propose through the Every American Insured Health Act is
that every individual in America--every individual in America--who is
not now covered by some existing governmental program would receive a
$2,160 tax credit, and every family would receive $5,400. This is very
different than many proposals in the past where we talked about a tax
deduction. One of the things I think we all know we can talk about
which are niceties--things that are decent--are health savings
accounts. We can talk about other things that sort of nibble at the
edges, if you will, as they relate to health care, but the only thing
that allows people to own their own health insurance is the money to
pay for it. So we, through what is called a refundable tax credit in
this bill, caused that to be the case.
Unlike the other bills that are being discussed today, and unlike so
many other health care acts we discussed, this actually is revenue
neutral. This is one of those things that allows every American to be
covered with health insurance, yet does not pile on a deficit, if you
will, for the children of our future to have to deal with. It is
absolutely revenue neutral.
Let me tell my colleagues how it works. A lot of people, such as we
here in the Senate, receive our health insurance through our employer--
the Federal Government. A lot of people receive health insurance
through the employer they work for back in our home States. Let me give
a little example. For an individual in Tennessee who might make $40,000
and receive a $5,000 health benefit, whereas now that is not taxable,
in the future, if this bill were to be enacted, they would have to
actually pay tax on that and their tax bill would be about $1,250.
Under the provisions of this act, what we would propose is that every
individual would receive $2,160, so they could pay their tax bill, and
then have money left over to deal with whatever other health issues
they might have.
The most important aspect of this, though, is it means that so many
Americans today--Tennesseans, Ohioans, Minnesotans--who don't have
health insurance, through this proposal would actually have the money,
the money timed in a fashion to actually allow them to purchase health
insurance. This would mean that virtually everybody in America, through
this plan, would have the opportunity to own their own health insurance
plan and they themselves would decide who the carrier would be. This
would do something that was discussed by Dr. Coburn from Oklahoma. It
would do away with what we call cost shifting.
Obviously, the 45 million citizens, as the Senator from Minnesota
mentioned, get health care; they just happen to get it at the emergency
room. Who pays for that? Well, all of those
[[Page S10404]]
people who go out and buy private health plans or employers who buy
those, actually pay for that, because all of those costs are shifted to
the other plans. What the Every American Insured Health Act would do is
do away totally with cost shifting, because everybody in America would
own their own plan and those plans would be paying for their health
coverage.
This obviously includes a few other attributes. It includes reforms
for States so that States can set up pools, so that individuals today
who don't have access to other pools of insurance at lesser expensive
rates, it allows the States to set up pools so that individuals can buy
their insurance through those pools. It also incentivizes States to set
up high-risk pools. There are obviously many people, by the grace of
God, by the genes they are created from, who have health issues that
some of us don't have to deal with, so their health care costs are
higher, if you will, than other Americans. This would provide
incentives for States to set up high-risk pools so that those people
could benefit from the opportunity of being grouped with others.
One other attribute and incentive of this is it causes States to
actually set up a plan--a plan in their State--that has of the cost 6
percent of the median income of the population of that State, so that
you create a basic plan that certainly almost everyone--everyone in
their State certainly, by virtue of the plan we are laying out, would
obviously be able to afford. This obviously, as I mentioned, would
reduce the cost to people around our country who are trying to do the
right thing by their employees. It obviously gives people the
opportunity--every American--to determine their own destiny as it
relates to health care.
I know this bill is not perfect; no bill is. I want to say in closing
that the reason I have joined Senator Burr and others to offer this
bill is I do believe this country continues and continues and continues
to have a debate about the fringes, if you will. We talk about
children. We talk about other populations. We offer in many ways what I
think is empty rhetoric around the issue of health care. This is a
solution. It may not be a perfect solution. But I ask my colleagues to
please join the debate about health care in a way that ensures that
every American has access to health care.
We are very fortunate in this body. We have health care. All of us
know of people who truly are concerned about the next day and the next
day and the next day, about how they are going to survive because a
loved one in their family has health care issues that are not covered.
So I ask my colleagues, please, don't turn away from this plan. Join
the debate and let's make sure that this body puts forth an act, a
bill, a solution, if you will, to make sure that every American--every
American--has the same benefit we here in the Senate have.
Mr. President, I yield the floor.
The PRESIDING OFFICER (Mr. Whitehouse). The Senator from Ohio is
recognized.
Mr. BROWN. Mr. President, the Children's Health Insurance Program is
a success story. It was created in 1996 during my second term in the
House of Representatives under a Republican-controlled Congress and
signed into law by President Clinton. It was exactly what voters sent
people to Washington to do. It was bipartisan, with a Democratic
President working with a Republican Congress, with wide support within
Congress from large numbers of both Democrats and Republicans.
Since then, the program has reduced the number of uninsured children
in working families by one-third; 6.6 million children are covered
nationally. More than 218,000 children are covered in my State of Ohio,
from Galion to Gallipolis, from Mansfield to Middletown, from Xenia to
Zanesville. These children now get care in their doctors' offices but
not, as the President suggests, in the emergency rooms. Their care is
delivered when it is needed, not when it is too late. They go to their
family physician with an ear infection, and they get an antibiotic that
may cost $50 or $75 or $100. The child gets sent home with his or her
mother or father, and the child is cured instead of the ear ache
getting so bad for a child whose parent has no insurance, and the
parent waiting and hoping it gets better. The child goes to the
emergency room at the cost of several hundred dollars, and the child
may have a permanent hearing loss as a result, with what that does to
the child's future in school and to the child's future later in getting
a job.
These children under the CHIP program have good, reliable health
coverage. The Children's Health Insurance Program, in short, works. It
works for our Ohio children, our Ohio parents, and for Ohio
communities. But it does not work as well as it could.
Today we have the opportunity to make the Children's Health Insurance
Program what it should be. Sadly, we all know millions of American
children--far too many children in Dayton and Columbus and Toledo and
Cleveland and Akron and Canton and Youngstown and Cincinnati--remain
without health insurance, even though the law states they are eligible
for it.
Eleven years ago, in 1996, Congress made a promise to America's
children. Right now, today, this week, in the Senate and in the House,
we have the opportunity to live up to that promise. We can pass this
bill to provide health insurance to 3.2 million more children, children
who have missed out on our promise--not their fault, ours--so far.
This is a bipartisan effort and bill, just like the original was a
decade ago. That is because this legislation is about children, not
politics. This bill is about helping children.
Let me tell a story about how the Children's Health Insurance Program
has helped one family in Ohio. Seth Novak is a 3-year-old boy who lives
in Lebanon, OH, in Warren County, outside Cincinnati, the southwestern
part of the State. This is a picture of Seth. His dad is self-employed.
He helps churches with their construction projects.
The family buys private health insurance for $444 a month that covers
the parents and Seth's two older siblings. But Seth has Down Syndrome
and other health problems. In addition, in an attempt to get health
insurance for her son, Seth's mom checked with six different insurance
companies. She was quoted rates from $1,200 to $1,800 per month for
private insurance--just for Seth, not for Mr. and Mrs. Novak or the two
older children.
The Novaks are a hard-working family, but they simply cannot afford
$14,400 a year for a policy covering only one of their children, not to
mention their own insurance, another $444. They cannot afford a policy
of $14,000 a year for one of their children, which would cover only
part of the cost, frankly, for only some of the care Seth needs.
Just this week, the Novak family learned that Seth's eligibility for
Medicaid/SCHIP has been denied effective August 31. That is why we have
work to do. Where will Seth go for medical care? What if something
happens?
There is hope for Seth, though. In Ohio, Governor Strickland and
legislative leadership--again, in Ohio, it is a bipartisan effort--by
increasing eligibility for the Children's Health Insurance Program to
children up to 300 percent of the Federal poverty level. As Assistant
Majority Leader Durbin pointed out about an hour and a half ago, these
are not people living in the lap of luxury when you say 300 percent of
the poverty level. These are middle-class families with significant
health problems, who simply cannot afford, on their middle-class
salaries and wages, their health insurance.
In January, the legislature and the Governor, understanding the
plight that families like Seth's find themselves in, when the new
eligibility for the program goes into effect, the Novaks of Lebanon,
OH, will be able to restore his health insurance and still pay their
bills and take care of their family.
Ohio's leaders have taken care of Seth and thousands like him. They
need Congress and the President this week to do the same.
I have a picture of another Ohio family--a success story--who can
attest to how the Children's Health Insurance Program helped them. This
is Latonya Shoulders of Kent, OH, and her son Phillip Grant, Jr.
In 1996, Latonya was a pregnant, full-time student at Kent State
University, my wife's alma mater. She didn't have health insurance or
the resources to afford medical care. She enrolled in Ohio's Medicaid
Program about halfway through her pregnancy. Her son had Medicaid/SCHIP
coverage until he
[[Page S10405]]
was 5 years old. That is when she finished her bachelor's degree and
got a job as a nurse with insurance benefits.
The Children's Health Insurance Program was there for Phillip in the
first years of his life. The program provided for him in several
medical emergencies. At 2 years old, he was bitten by another child at
daycare and developed acute cellulitis. He spent 2 days in the
hospital. When he was about 4, he cut his arm and had a recurrence of
cellulitis. This required two surgeries, both inpatient and outpatient
treatment.
As any parent knows, raising children means all too many visits to
the hospital. These hospital stays could have devastated this family's
finances and so much that went with it, right when Latonya was working
so hard to get her nursing degree and to get ahead. Latonya is proud
that she no longer needs Medicaid/Children's Health Insurance Program
coverage for her son.
As I said, she is now a nurse and has health insurance. The program
helped Latonya when she and Phillip needed it. Today she is a
productive taxpaying citizen, and he is a healthy boy. The goal now is
to let other families experience the same benefit.
President Bush came to Cleveland recently--about 25, 20 miles from my
home--and told an audience of Ohioans:
People have access to health care in America. After all,
you just go to an emergency room.
The President doesn't seem to realize that is exactly the problem. We
all know emergency care is much more expensive than a scheduled visit
to a doctor or a clinic. When people go to emergency rooms and
hospitals, they end up with large costs which insurance companies bear
and then raise their premiums, or the hospital eats the cost. It is a
huge burden on hospitals, especially hospitals in places such as rural
Appalachia, in southeast Ohio, and places such as Zanesville and Morgan
County and Athens and Gallia County and Lawrence County. It is a burden
on hospitals such as Metro in Cleveland, which serves our community so
well, or Akron General or the Summa or Lorain's community health
center. These hard-working families cannot afford health insurance for
children, much less if the child has a serious health issue.
I want to make sure children like Seth Novak and Phillip Grant
receive the care they need. This is a picture of Seth playing on a
slide. I want him to be strong and healthy so he can continue playing
and getting his exercise and enjoying his childhood, with health
insurance; or this picture of Phillip with his mother at her
graduation. I want him to grow up healthy so he can pursue a bachelor's
degree just like his mom did. I want every child in Ohio to thrive and
develop to his or her full potential.
Ohio families should be able to take care of their bills without
worrying about whether they will get their most basic health care needs
met. Every eligible child should be able to benefit from the Children's
Health Insurance Program--every eligible child in this country. That
requires the additional $35 billion that this bill authorizes. That is
about how many weeks in Iraq? We spend $2.5 billion a week in Iraq, and
here we are asking for $35 billion over 5 years. That requires that
additional $35 billion.
I want our President to see past relying on emergency rooms, thinking
that is the best option to provide the basic medical care that our low-
income families need, and instead, to provide it through an insurance
program so a mother can take her child to a family practitioner and get
the kind of preventive care that my friend from Oklahoma, Senator
Coburn, talked about. Even though he doesn't agree with this
legislation, he talked about getting the care that these children need
that only health insurance--not emergency room treatment--will get
them.
This bill is about children, not about politics. It needs to pass.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
(Mr. BROWN assumed the Chair.)
Mr. WHITEHOUSE. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. WHITEHOUSE. Mr. President, I speak today in support of the
Children's Health Insurance Program. I want to first applaud the
Finance Committee for its bipartisan 17-to-4 vote to approve this bill.
I thank Senators Baucus, Rockefeller, Grassley, and Hatch, Majority
Leader Reid, and also the staff of the Finance Committee for all their
hard work through the very difficult negotiations that made it possible
to bring this critical measure so strongly to the floor.
I also recognize Rhode Island's role in this piece of legislation,
going all the way back to the distinguished Senator John Chafee, one of
the early bipartisan sponsors of the bill. Now on the floor today, my
senior Senator, Jack Reed, has been one of the most powerful and
outstanding advocates for this program in this institution. I am proud
to join him in supporting this bill and in this fight.
I am proud also to represent a State with one of the lowest rates of
uninsured adults and children in the Nation. There is a reason. Rhode
Island has worked over the past 15 years to achieve this success,
beginning with the RIteCare program in 1993. In 2001, the creation of
this Children's Health Insurance Program allowed Rhode Island to
further reduce the number of uninsured children in the State. I am
proud to have been part of Gov. Bruce Sundlun's team when he started
the original RIteCare program in 1993.
As health care costs skyrocket, and the number of people in this
country who lack health insurance approaches the staggering number of
50 million, we in Congress have an obligation to strengthen initiatives
like RIteCare that make health care more accessible.
For years, the Children's Health Insurance Program has given millions
of uninsured American families access to health care for their kids.
And pretty much everyone has thought this was a good thing. But now,
setting aside reason, and driven by ideology, President Bush has
threatened to lift his veto pen for only the fourth time in his
Presidency to take that security and peace of mind away from these
children and from their worried moms and dads, from families similar to
the ones the Senator from Ohio highlighted in his eloquent remarks a
moment ago.
The President claims the $35 billion improvement over 5 years is too
expensive. The President would prefer only the $5 billion he included
in his budget. But that funding level would result in 1 million
American children losing their health insurance. We certainly cannot
look to President Bush for leadership.
How ironic, after all we have heard from this administration praising
the State Children's Health Insurance Program and even taking credit
for expanding coverage, for encouraging State flexibility, and for
spurring innovation at the State level.
Listen to what they used to say. In the administration's plan
outlining the President's second term, their fact sheet boasted:
The year before President Bush took office, some 3.3
million low-income children were enrolled in SCHIP. By 2003,
that number had risen to 5.8 million, a 75 percent increase.
Over that same period, by working cooperatively with State
Governors, the Department of Health and Human Services
increased the number of low-income adults on Medicaid by 6.8
million.
That was then, this is now.
After that, the administration went on to lament the fact that
``millions of children who are eligible for SCHIP or Medicaid coverage
are not yet enrolled. Billions in Federal dollars available to the
States to insure these children remain unspent because these children
haven't been signed up.''
Then, at the 2004 Republican National Convention, President Bush
promised this:
In a new term, we will lead an aggressive effort to enroll
millions of poor children who are eligible but not signed up
for the Government's health insurance programs. We will not
allow a lack of attention or information to stand between
these children and the health care they need.
But now the same Bush administration, the same President, is
aggressively planning to deny health insurance to poor children. How
does this make any sense?
The President's rationale for this new parsimony was revealed before
an audience in Cleveland on July 10. Here is the President's approach
to health
[[Page S10406]]
insurance for America. You just pointed this out, Mr. President:
I mean, people have access to health care in America; after
all, you just go to an emergency room.
Well, that is a thoughtful approach. Once again, we cannot look to
our President for any leadership on this issue.
The administration has also expressed its opposition to the cigarette
tax that will fund the increases in children's health insurance,
calling it--get this--among the most regressive revenue-raising
measures one could propose. That is from a letter from Secretary
Leavitt to Chairman Baucus and Senator Grassley.
The irony department is open late in the Bush administration. In
evaluating their crocodile tears about regressive tax measures,
consider that this Nation will spend $233 billion in 2008 on the Bush
tax cuts, 30 percent of which will go to the top 1 percent of income
earners. From 2008 through 2011, the period we are talking about for
children's health care, those tax cuts will cost Americans, in lost
revenue and interest on the debt, nearly $1 trillion, 22 percent of
which will go to people who earn more than $1 million a year.
This chart illustrates just how the cost of tax cuts for the top 1
percent of Americans compares to the cost of expanding health care for
children in this country. We are spending vastly more each year on tax
cuts for the Nation's highest income earners than we are fighting for
in children's health care.
Here it is, $2.1 billion for children's health care in 2008, $70
billion for the richest 1 percent; $5 billion in fiscal year 2009 for
children's health care, $72 billion for the richest 1 percent; and in
2010, gosh, we go all the way to $7.9 billion for children's health
care with only $82 billion for the richest 1 percent.
The Congressional Budget Office estimates that in just this year
alone--just this year alone--we are paying an extra $46 billion in
interest, not paying back the debt, just in interest, on the Bush tax
cuts--$46 billion just in 1 year. And the whole thing we are arguing
about here is $35 billion over 5 years for children's health care. It
is truly mind-boggling.
But it doesn't end there. The President has also threatened to veto
the bill based on its coverage of adults. This is a policy that the
administration has previously, explicitly, repeatedly approved. This is
a sudden ideological U-turn of stunning and deeply hypocritical
proportions.
As recently as last summer at a Finance Committee hearing on
children's health insurance, then CMS Administrator Mark McClellan said
the following:
Extending coverage to parents and caretaker relatives not
only serves to cover additional insured individuals, but it
may also increase the likelihood that they will take the
steps necessary to enroll their children. Extending coverage
to parents and caretakers may also increase the likelihood
that their children remain enrolled in SCHIP.
That was then, this is now.
This administration has approved waivers to cover parents in New
Mexico, Illinois, Oregon, New Jersey, Michigan, and Wisconsin. Fewer
than 2 months ago, on May 30 of this year, Leslie Norwalk, who was then
Acting Administrator of CMS, was ``pleased to inform'' Wisconsin that
its extension request for what they call BadgerCare--it is equivalent
to RIteCare in Rhode Island--had been approved through March 31, 2010.
BadgerCare covers roughly 67,000 parents. Again, this waiver was
approved by the Bush administration 8 weeks ago, and now he is
threatening a veto for care that covers adults.
Here is a copy of the letter that CMS Administrator Mark McClellan
sent to my home State of Rhode Island on January 13, 2006. It reads:
We are pleased to inform you that your amendment to the
RIteCare section 1115 demonstration, as modified by the
Special Terms and Conditions accompanying this award letter,
has been approved.
It also notes:
Rhode Island's request to renew title XXI, section 1115,
demonstration project, dated July 15, 2005, with additional
information . . . has also been approved.
Finally, it notes:
Individuals who, at the time of initial application, are
custodial parents or relative caretakers of children who are
eligible under the title XIX State plan or the title XXI
State plan . . .
Are in the demonstration population and, of course, ``we look forward
to continuing to work with you and your staff.'' Signed Mark B.
McClellan, M.D., Ph.D., the Administrator of CMS. This was January of
2006. This is the Bush administration. This is them signing off on
adults, custodial parents, or relative caretakers of children being in
the plan.
Yet now the President is shocked--shocked--that this program may
cover some adults. Who didn't send him the memo?
At the end of May, I spoke on the Senate floor about some of the
major problems facing health care in this country. I talked about the
lack of investment in quality improvements, the lack of a national
information technology infrastructure, and a reimbursement system that
pays doctors to perform procedures rather than to help patients get
well. I took these issues to the Senate floor because the structure of
our system is unsound, its underlying mechanism is broken, its signals
are misaligned.
But there are a few shining lights in the American health care
system, and the Children's Health Insurance Program is among the
brightest. This program respects State flexibility, it encourages
responsiveness to local needs, it fertilizes structural creativity in
the health care arena, it safeguards the vulnerable, it unites
families, and it invests in the future of our Nation.
The Children's Health Insurance Program means that children are more
likely to receive medical care for common conditions such as asthma or
ear infections. It means that children have higher school attendance
rates. It means that children have higher academic achievement. It
means that children have more contact with medical professionals and
receive more preventive care. It means that children stay out of
expensive urgent care settings, such as the emergency room.
We choose now in this bill and in this debate between providing our
Nation's children with health insurance and not providing our Nation's
children with health insurance. It is as simple as that. We choose now
whether every individual in this Nation, regardless of age, gender,
race, income, or health status deserves the stability and the safety
that health insurance provides. We choose for millions of American
families how much they have to worry, how much moms and dads have to
worry about the health care of their children.
It is my duty as a representative of the people of Rhode Island, and
it is our collective duty as representatives of a great Nation to stick
up for the most vulnerable members of our society and for programs that
protect those who cannot protect themselves. We must certainly not give
up in the face of an administration that willingly violates its own
principles in order to create an issue on which the President can
deliver a veto as a desperate political stunt in the last bleak
chapters of his collapsed Presidency--not at the cost of health care
for children. That would be truly pathetic.
I yield the floor.
The PRESIDING OFFICER. The Senator from Montana is recognized.
Mr. TESTER. Mr. President, I rise in strong support of the
reauthorization of the Children's Health Insurance Program. The
reauthorization of this highly successful 10-year-old program would
provide an additional $35 billion over the next 5 years to make sure
that more of America's neediest children have access to one of their
most basic needs--health care.
In fact, 6.6 million of our most vulnerable children--that is an
increase of 3.2 million children--will be covered by this bill. I
applaud the efforts of my senior Senator, Max Baucus, for leading the
charge to cover more children.
Reauthorizing the Children's Health Insurance Program is the right
thing to do. Because of Max Baucus and the good work of the Finance
Committee, almost 12,000 more children in Montana will have coverage
this year. Montanans know just how well this program works. As
president of the Montana Senate, I worked to increase the number of
children eligible for the Children's Health Insurance Program and
pushed through full State funding of the Children's Health Insurance
Program for Montana's children, expanding the enrollment from 10,900 to
13,900
[[Page S10407]]
children annually. As of this July, Montana's Children's Health
Insurance Program is providing insurance for 14,304 children per month
in the State of Montana.
It just makes sense. Only children who do not have private insurance
are eligible. I am going to repeat that because I have heard contrary
stuff on the floor. Only children who do not have private insurance are
eligible for this program. No one is double-dipping, no one who has
insurance can receive this coverage.
With this reauthorization of the Children's Health Insurance Program,
we as a country are investing in our most valuable resource--our
children. If children have regular checkups and receive the preventive
care they need, they are sick less and in school more, and they grow up
to be healthy, productive members of our society with less problems in
middle age and healthier in their elderly years.
Mr. President, it is tough out there. Millions of children lack
health insurance despite their parents' hard work and efforts to keep
their heads above water. Many families cannot afford health insurance
despite the fact that they have jobs. When it comes time for parents to
pay the bills, health insurance comes after rent, food, clothing,
utility bills, and gas for their car. Health insurance shouldn't be
treated as a luxury, and access to health care shouldn't be a fantasy.
We must be focused on improving the overall quality of health care
for low-income children. We know there are more children eligible for
benefits than are currently enrolled. In order to find and provide
coverage for those children, States should be able to use the
information from food stamp programs, free and reduced lunches, and
other initiatives in place for low-income families. Up to now, these
programs could not share information, so those with the greatest need
would have to apply for each program separately.
This Children's Health Insurance Program before us increases funding
and outreach and enrollment efforts to find these uninsured kids. This
is especially critical in rural States--rural States such as Montana.
Rural children are more likely to be poor and less likely to have
access to employer-based health plans even though most of their parents
are employed. Nearly one-third of the kids in rural America rely upon
CHIP and Medicare. The need is clear: Without children's health
insurance, they would be uninsured.
There have been a lot of stories shared today on the floor. I want to
share another one, of a fellow Montanan. Duran ``Junior'' Caferro from
Helena, MT, is a boxer and has been fighting for 10 years. He is ranked
in the 125-pound weight class and will compete in the Olympic trials
next month in Houston, TX. Duran is also an enrolled member of the
Northern Cheyenne tribe. His father, who works with at-risk youth, does
not have health insurance and can't afford coverage for himself or his
son. Helena has an urban Indian health clinic but not an Indian Health
Service hospital, so Duran doesn't have access to emergency and
hospital services with his IHS health benefits.
CHIP has allowed him to have a choice in where he receives medical
care, and he recognizes the value of this coverage. When asked about
CHIP, he said the following:
It is important that I have Children's Health Insurance
Program because I don't have to be afraid to push myself when
I'm training or fighting. It gives me one less thing to worry
about.
If Duran wins this tournament in Houston this summer, he will be a
member of the U.S. Olympic boxing team. He will turn 19 soon and will
age-out of CHIP. He expects to become uninsured because he and his dad
are still struggling and can't afford to buy private health insurance.
Some may doubt the cost-effectiveness of this program, but this bill
not only helps low-income children, it also helps middle America. Why
is that the case? Because the coverage made available to low-income
kids lowers the number of emergency room visits of uninsured children.
Emergency room doctors no longer serve as primary care physicians for
the uninsured, and that lowers the cost of health care for the rest of
America--the middle class--who currently cover the cost of the
uninsured emergency room visits.
We all know that the middle class is feeling the pinch too. If we can
lower health costs for them and provide health care to more of our
kids, it is a win-win.
The way to ensure the continued strength of our country for future
generations is to improve the future of our most valuable asset--our
young people--and this bill which reauthorizes the Children's Health
Insurance Program does just that.
Once again, I thank the senior Senator from Montana, Max Baucus, and
the Finance Committee for championing this bill. They did some
outstanding work. Hopefully, we will continue that work on the floor
here tomorrow. We must pass this bill, and I urge my colleagues and the
President to support it.
Mrs. BOXER. Mr. President, I rise today to support the
reauthorization of the Children's Health Insurance Program--an
essential effort to ensure the health of our Nation's children.
For the past 10 years, the Children's Health Insurance Program has
helped provide health care for millions of children from working
families that do not qualify for Medicaid but can't afford private
insurance. These are the children of working families whose companies
do not offer health insurance to their employees.
As the cost of health insurance rises and an increasing number of
employers are unable or unwilling to provide health insurance to their
employees and their families, the number of families who do not have
health insurance has continued to rise.
While the number of the uninsured continues to rise, the percentage
of low-income children without health insurance has dropped more than
one-third since the creation of the Children's Health Insurance
Program.
Currently the Children's Health Insurance Program provides coverage
for 6.6 million children nationwide. This reauthorization would provide
health care coverage for an additional 3.2 million children who are
uninsured today. In California, an estimated 250,000 children will be
added.
The Children's Health Insurance Program has always enjoyed the
bipartisan support of our Congress, our Governors, and our President--
which is why I am shocked by the inadequacy of this administration's
plan to insure the children of our Nation's working families.
The President is spending $10 billion each month in Iraq but has
threatened to veto a bill that will provide 10 million children with
access to health care. Under the President's proposal, he is willing to
fund the Children's Health Insurance Program with an increase of $1
billion a year--the cost of 3 days in Iraq.
Under the administration's proposal, we end up counting how many
children will lose health insurance instead of how many we can enroll.
In the first year, the President's plan would eliminate health care
insurance for 200,000 children in California alone--and the number of
uninsured children would continue to climb.
This shortfall in funding would result in 800,000 children who are
currently enrolled to lose their coverage. I ask the President, what
does he propose these children do when they are sick?
If we fail to renew this program or if the President vetoes this bill
as he has threatened to do, it is the children who will pay the price.
There is not a man or woman in this Chamber who wouldn't do
everything within their power to ensure the health of their own
children--we should do no less for the children of our Nation.
The Members of this Congress have overwhelmingly expressed a
commitment to children's health. Earlier this year, we passed a budget
resolution which set aside $50 billion for the Children's Health
Insurance Program, reaffirming our commitment to the continued success
of this program.
We can still do more and we will, but this bill is a step forward in
the right direction.
I would like to thank Senators Baucus and Rockefeller, Senators
Grassley and Hatch and the members of the Finance Committee who worked
so tirelessly to bring this legislation forward in a bipartisan way,
and keep the focus of this bill where it should be--on the children.
Mr. President, I suggest the absence of a quorum.
[[Page S10408]]
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. TESTER. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
____________________