[Congressional Record Volume 153, Number 125 (Wednesday, August 1, 2007)]
[House]
[Pages H9471-H9503]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
[[Page H9471]]
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House of Representatives
CHILDREN'S HEALTH AND MEDICARE PROTECTION ACT OF 2007--Continued
Mr. STARK. Mr. Speaker, at this time, I'm pleased to recognize the
gentleman from North Dakota (Mr. Pomeroy) for 1 minute. Pending that, I
would note that, as a former insurance commissioner, he understands
that the endorsement of the National Association of Insurance
Commissions is necessary to prevent fraud in the Medicare Advantage
program.
Mr. POMEROY. I cannot get out of my mind a picture that appeared in a
newspaper a few months ago of a young boy with a toothache. The
horrible story running alongside this picture was that this young
fellow later contracted a brain infection from the tooth infection, and
he later died. Because his family couldn't afford the tooth extraction,
this young fellow lost his life. We don't have any more urgent national
priority than making sure our children have access to the health care
they need.
There is another feature of this bill as well. It's rural health
care. If we don't pass this bill, there are very steep cuts slated for
doctors of hospitals practicing in our rural areas.
It's hard keeping essential health services available for kids, for
seniors, for everyone else in these rural areas. We have got to stop
these cuts, help our kids, keep rural medicine thriving. Pass this
bill.
Mr. BARTON of Texas. Mr. Speaker, I yield 2 minutes to the
distinguished Member from New Jersey, Congressman Garrett.
Mr. GARRETT of New Jersey. Mr. Speaker, throughout this debate, we
have heard a vote against this bill is a vote against the children, a
vote against the poor, a vote against those who need the help most; and
had this legislation merely reauthorized the current law, the arguments
might have had an element of truth to them. But with this unconstrained
growth in a welfare entitlement bill that this expansion has become,
what we do know is that this bill now undermines the health care of
millions of uninsured children and insured children and does so at the
expense of American seniors.
Supporters of this bill would say that by no means is this a back
door to a mandatory, socialized, government-run health care system. I
say, not the back door, but, as Paul Ryan might say, it's a front-door
approach to a socialized, government-run health care system. Also, it
opens the windows and the garage door as well.
This bill does not set a cap on the annual income levels of the
families it covers, it does not include an asset test to ensure that
millionaires are not eligible, and it expands the program to cover
childless adults.
It is entirely conceivable, and, actually, it probably will occur,
that the States can enroll as many people in this program as local
politics will make expedient. A benchmark figure that has been bandied
about is 300 percent. They want to enroll families up to 300 percent
above the poverty level.
Just what would that system look like? According to the Census
Bureau, and I just got these numbers a little while ago, of the 300
million or so people in this country, 48.3 percent, or roughly 145
million people, live at or below the 300 percent of the Federal poverty
level. So we're now considering a new entitlement program for nearly
half of the entire population of this country. And if you add to that
number the 44 million people who are currently enrolled in Medicare,
what does that mean? That means, with this bill, almost two-thirds of
the entire population of this country will be on a government-run,
socialized health care system, two-thirds paid for by one-third.
Mr. Speaker, make no mistake about it. This proposal is a large step
towards a single-payer, Washington-run State health care system.
Mr. DINGELL. Mr. Speaker, before I call up the next speaker, I would
like to point out that this bill will save 12 million kids from losing
their health insurance and that it will prevent New Jersey from having
a $200 billion shortfall in their SCHIP program.
At this time, I yield 2 minutes to the distinguished gentlewoman from
California (Ms. Solis).
Ms. SOLIS. Mr. Speaker, today I rise very proudly in strong support
of H.R. 3162, the CHAMP Act.
As policymakers, we have an obligation to make sure that children who
are in the program do not lose their coverage and that those who are
eligible for coverage but are not enrolled receive that care.
Millions of low-income children and seniors are depending on us to
pass a bill so they can receive health care. The CHAMP Act will provide
health care to 11 million poor children, reduce health care disparities
in communities of color, and protect senior citizens who rightfully
need access to their physicians.
Insured children are more likely to receive cost-effective,
preventative services and are healthier, which leads to greater success
in school and later on in life.
Although programs such as SCHIP and Medicaid have decreased the
number of uninsured children, the lack of funding over the last 10
years and outreach efforts have left millions of children who are
eligible from receiving this care.
More than 80 percent of uninsured African American and 70 percent of
uninsured Latino children are eligible currently for public coverage
but are not currently enrolled. In my district alone, 18,000 children
go uninsured. The bill ensures that these children will receive that
health care coverage.
Some would argue that this bill is a vote on immigration. I'm sorry,
but
[[Page H9472]]
they are absolutely wrong. The bill restores State's options to provide
the coverage that they need; and the bill ensures that citizens who
have lost their birth certificates and other identification are not
immediately denied care, like the more than 11,000 children in Virginia
and 14,000 children in Kansas who have lost their coverage.
The bill helps one-third of Asian and Pacific Islander American
seniors who live in linguistic isolation understand health care.
The bill does not provide services, and I underscore, does not
provide services to undocumented immigrants. Those who say that are
blatantly wrong.
I urge support of the bill. Let's move on. Let's do the right thing
for our children. Vote for the CHAMP Act.
Mr. BARTON of Texas. Mr. Speaker, could I inquire as to how much time
I still control?
The SPEAKER pro tempore. The gentleman from Texas controls 10\1/2\
minutes of time.
Mr. BARTON of Texas. Mr. Speaker, I yield myself such time as I may
consume.
(Mr. BARTON of Texas asked and was given permission to revise and
extend his remarks.)
Mr. BARTON of Texas. Mr. Speaker, I want to recapitulate the debate
as I see it today and start off, as I've already said, with what the
Republicans are for.
We are for reauthorization of the SCHIP program. This program has
been in existence for 10 years. It is a block grant program between the
Federal Government and the States where we spend approximately $5
billion each year to help States provide health care and health
insurance for low-income and near-low-income children in their States.
Some States have received waivers to provide health insurance for
adults and for children that are not really in the low income.
We, on the Republican side, support reauthorization of the
straightforward SCHIP program.
{time} 1615
We believe that SCHIP should be for children. A Republican
substitute, which was not made in order at the Rules Committee last
evening, would limit SCHIP to children; that is, individuals in this
country that are under 19 years of age or under.
We believe that SCHIP should be for low-income and near low-income
children. The Republican substitute, again, allowed SCHIP eligibility
for up to 200 percent of poverty. We believe that SCHIP should be for
citizens of the United States and legal residents of the United States
who have been here at least 5 years.
We believe that SCHIP should be funded without cutting senior
citizens' health care, so the Republican substitute had no cuts in
Medicare for our senior citizens. We also believe that we should fund
SCHIP without tax increases. The Republican substitute had no tax
increases to fund our SCHIP reauthorization.
The problems with the pending bill before us have become almost too
numerous to mention. But just to go through some of them, first of all,
the pending bill changes SCHIP from a block grant program for a limited
duration of time to an open-ended entitlement. It has authorized such
sums, and there is no time limit on the bill before us.
It removes the limitation on income at the Federal level. If a State
chose to certify that millionaires were eligible for SCHIP, as far as
we can tell, there is no restriction on covering millionaires, if a
State chooses to make that certification.
There are tax increases in the Democratic-sponsored bill. There is a
tobacco tax increase that CBO scores at least $52 billion. And there is
a cut in Medicare that CBO scores over a 10-year period at $157
billion.
While there is disagreement among my friends on the majority side
about this requirement, there are sections of the pending bill that
removes the requirement that was put in place several years ago that
States have to certify the citizenship of eligible citizens for SCHIP.
Of the 465-page bill that was produced in the Energy and Commerce
Committee last week, three-fourths of that bill does not deal with
children. The Democratic bill is not just about the children. According
to the CBO score that we just received today, the pending bill before
us in the SCHIP program, by expanding eligibility requirements, would
add an additional 1.1 million children, and by adding enrollment within
existing eligibility, another 1 million.
The SCHIP bill that the Democrats are putting before us, according to
the CBO, adds 2.1 million children in the SCHIP categories, so that all
the other money and all the other things that they are doing, it is not
about the children. It is about a lot of other things.
So, I have great respect for the people that are trying to
reauthorize SCHIP. I know that at some time this fall, some time in
September or maybe in October, we will have a bipartisan effort to
reauthorize and send to the President an SCHIP bill that he will sign.
But this is not that bill. This bill won't come up in the Senate. This
bill won't come up in conference between the House and the Senate in
all probability. This bill will be voted on one time, and that is
sometime this evening. And then it will just sit there.
So I would rather, as Chairman Dingell and I talked about back in
November, the day after the election when I called to congratulate him
on becoming the new chairman of the Energy and Commerce Committee, I
would have rather we spent this spring working on a bipartisan basis to
come to an agreement on what we could agree on and bring before this
body a bipartisan bill on SCHIP. That has not happened.
This bill was presented to the Energy and Commerce Committee at 11:36
last Tuesday evening and the markup was scheduled the next day at 10
a.m. It was presented to the Rules Committee this morning at 12:30 a.m.
It was reported out of the Rules Committee at approximately 2:30 a.m.
this morning with no amendments and with self-executing changes that
nobody had seen, until we had time to look at it this morning.
There have been no amendments on either side; not just on our side,
but on their side. So the only people that really know what is in the
bill, and the only people that really have input into the bill, are
those people on the majority side that are working behind the scenes in
the dark of night to craft this bill.
Mr. Speaker, I hope we vote ``no'' on the bill. I hope we vote
``yes'' on the motion to recommit. I hope eventually we will get in a
bipartisan mode, work with our friends on the other side of the body,
work with the President of the United States, and send to the President
some time this fall a bipartisan SCHIP reauthorization bill that is
just about the children.
Mr. Speaker, today the Democratic majority will make claims that they
support reauthorizing the SCHIP program and, by implication, that
Republicans do not. I, for one, fully support reauthorizing the State
Children's Health Insurance Program. I also believe we should ensure
that the program is covering the population it was intended to serve,
and that's low-income children who don't have health insurance. It
isn't for adults or for bureaucrats who think adults should pretend to
be children. It isn't for men and women making $100,000 salaries. And
it shouldn't be an incentive to pull families out of private health
insurance coverage and into a public welfare program.
States have used the gaping loopholes in the current SCHIP program to
expand coverage to include adults and people with the kinds of salaries
that are still a dream to most working people. Our friends on the
majority think those are blessings, not problems, and that explains why
they've written legislation that makes the list of blessings longer
instead of shorter. Their bill is the first giant leap towards
government-run, universal health care since Hillarycare collapsed under
the weight of its own bureaucracy and deception. More bureaucracy?
They're for it. More welfare? They're for it. Rationing health care?
They're for it. A blank check? They're for it. In reality, the check
isn't exactly blank. The CBO indicates that the cost of this Democratic
welfare bill will top $200 billion, and that's only for Federal
taxpayers. The States' share of SCHIP will cost the state taxpayers
another $300 billion.
The majority would spend hundreds of billions of dollars saying that
they are trying to cover low-income children who don't have insurance.
That's not what CBO says. According to the Congressional Budget Office,
of the newly eligible individuals, 60 percent already had private
health insurance coverage.
Democrats say they are not raising the eligibility levels for SCHIP
in this bill. They fail to mention that they allow states to determine
income and they also do away with the block-
[[Page H9473]]
grant nature of the program by providing states swollen Federal
matching funds, even for families making above $200,000 a year. Now,
some will say I've got it all wrong, but if I'm wrong and they're
right, show me. I challenge my friends on the majority to point to the
place in the bill where that would be prohibited. Further evidence that
this bill is not about low-income children is that their bill actually
allows for bonus payments to states if they eliminate asset tests. It
looks like they do want welfare for the rich, and the richer, the
better. I ask, should a millionaire's child be on SCHIP or Medicaid? I
don't think the American people believe so, but the majority's bill
encourages it.
Yesterday, on the floor some members spoke about how this bill would
pay for services for illegal immigrants. With no true way to refute
that assertion the majority, in the managers' amendment that was
released after midnight this morning, added a new section that states
that no Federal funding can go towards paying for care for illegal
immigrants. That was a nice restatement of current law, but it does not
change the fact that this bill eliminates the requirement that States
verify a person's citizenship before they are enrolled. If we don't
verify citizenship, this new section is meaningless. The bill even
eliminates the 5-year waiting period that legal immigrants must wait
before being enrolled in Medicaid, effectively inviting more illegal
immigration.
During the morning session, member after member of the majority rose
to say that this bill is about children. I ask my colleagues to show me
where in this bill limits this Children's Health Program to children.
They can't, because the bill will continue the discredited practice of
siphoning off money from children's health care to buy health care for
adults. We had amendments filed at the Rules Committee to ensure that
SCHIP dollars go toward children, not adults, but these amendments were
banned.
The majority also says this isn't kids versus senior citizens, but
Democrats pay for their enormous expansion by cutting $200 billion from
Medicare. The Democratic bill makes a particular target of the senior
citizens who picked Medicare Advantage, and takes over $150 billion
away from them. That means more than 8 million of our seniors will have
their choice in health care coverage sharply restricted. This bill
disproportionately harms rural and low-income Medicare beneficiaries in
particular since it cuts payments in these areas so drastically that
plans will be driven out of these markets.
The draconian cuts that the Democrats expect the Medicare Advantage
program to take will obliterate the benefit. Again, no wonder the
Democrats kept this bill away from the public eye. It is hard to
explain to seniors why you are cutting their benefits.
These plans are an important option for low-income and minority
beneficiaries--57 percent of enrolled beneficiaries have incomes less
than $30,000. These plans can reduce cost-sharing relative to
traditional Medicare. These plans also offer better access to care--
more than 80 percent of plans provide coverage for hospital stays
beyond the traditional Medicare benefit, and more than 75 percent cover
routine eye and hearing tests. Over 98 percent of beneficiaries can
enroll in a plan offering preventive dental benefits.
These are our most vulnerable seniors. Yes, the Democrats would cut
their benefits to pay for the higher income children and adults. They
made this decision with no legislative hearings and developing the bill
behind closed doors. My friends on the majority claim that they have
had seven hearings on this. I would like to set the record straight
that the Energy and Commerce Committee held one hearing on SCHIP back
in February to discuss the general program, and did not discuss
anything that is incorporated in this bill. They did not even invite
the people who administer SCHIP at the Department of Health and Human
Services to testify.
This bill was written in secret, delivered at midnight, and then
rewritten from 1 to 3 a.m. this morning.
We have had little time to examine this bill, and we have found
glaring weaknesses, I urge all members to be very cautious about what
you are voting for because the rhetoric of the authors of the bill
doesn't match the substance. The majority adjourned the Full Committee
markup without disposing of a single amendment or reporting the bill.
The rules Committee allowed no amendments in order. We have had more
Committee process in this Congress on bills naming post offices.
It should come as no surprise that the majority wants to ram this
through with no public process provided and no changes allowed. They
don't want people to know what's in it, and they certainly don't want
people to change it. They claim that they have to do this because the
program will expire. They have had 8 months to reauthorize the program
since the day that Chairman Dingell and I agreed that SCHIP was to be a
high priority in the Energy and Commerce Committee. Where have the
Democrats been? They claim that this is of the highest priority, but
yet they sat on it until they could create an artificial crisis and
then blame Republicans for daring to read their bill. I question why
they would treat the reauthorization of SCHIP as a last-minute concern.
I feel it's important to note that SCHIP is only part of the
Democrats' bill, which also is laden with attacks on Medicare and
Medicaid. The legislation pits children against the elderly. It was
brought here today out of the night, when no one was looking.
I urge Members to vote against this bad bill so we can reauthorize
this program in a responsible, transparent, and open way that the
powerful Democrat leadership promised to conduct the business of the
Nation.
PRELIMINARY CBO ESTIMATE OF CHANGES SCHIP AND MEDICAID ENROLLMENT OF CHILDREN UNDER H.R. 3162, THE CHILDREN'S HEALTH AND MEDICARE PROTECTION ACT
[All figures are average monthly enrollment, in millions of individuals. Components may not sum to totals because of rounding.]
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SCHIPa Medicaidb SCHIP/Medicaid total
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Enrollees Reduction Reduction Enrollees Reduction Reduction Reduction Reduction
moved to in the in other Total moved to in the in other Total in the in other Total
SCHIP uninsured coveragec SCHIP uninsured coveragec uninsured coveragec
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FISCAL YEAR 2012:
CBO's baseline projections................................... ........... ........... ........... 3.3 ........... ........... ........... ....... ........... ........... 28.3
Effect of providing funding to maintain current SCHIP 0.6 0.8 0.5 1.9 -0.6 n.a. n.a. -0.6 0.8 0.5 1.3
programs................................................
Effect of additional SCHIP funding and other provisions:
Additional enrollment within existing eligibility n.a. 0.6 0.4 1.1 n.a. 3.1 0.8 3.9 3.8 1.2 5.0
groupsd.............................................
Expansion of SCHIP and Medicaid eligibility to new n.a. 0.5 0.5 1.0 n.a. 0 0.2 0.2 0.5 0.7 1.2
populations.........................................
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Subtotal............................................. n.a. 1.1 0.9 2.1 n.a. 3.1 1.0 4.1 4.2 1.9 6.2
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Total proposed changes................................... 0.6 1.9 1.5 4.0 -0.6 3.1 1.0 3.5 5.0 2.4 7.5
Estimated enrollment under proposal.......................... ........... ........... ........... 7.3 ........... ........... ........... 28.4 ........... ........... 35.8
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Note: These estimates are based on the bill as ordered reported by the Committee on Ways and Means on July 27, 2007, and modified by the amendments in the legislative language RULES--005,
(dated August 1,2007, at 12:25 AM)
a The figures in this table include the program's adult enrollees, who account for less than 10 percent of total SCHIP enrollment.
b The figures in this table do not include children who receive Medicaid because they are disabled. The figures for ``additional enrollment within existing eligibility groups'' include about
120,000 adults who would gain eligibility under section 801 of the bill.
c ``Other coverage'' is largely private coverage, but also includes about 200,000 legal immigrant children who now receive coverage under state-funded programs.
d For simplicity of display, the Medicaid figures in this line include the additional children enrolled as a side effect of expansions of SCHIP eligibility.
n.a. = not applicable
I reserve the balance of my time.
The SPEAKER pro tempore. The gentleman from Texas has 4 minutes
remaining.
Mr. BARTON of Texas. Mr. Speaker, I would ask unanimous consent that
my 4 minutes be controlled by Mr. McCrery of Louisiana.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
The SPEAKER pro tempore. The gentleman from Louisiana (Mr. McCrery)
now controls 49 minutes, the gentleman from Michigan (Mr. Dingell)
controls 27.5 minutes, and the gentleman from California (Mr. Stark)
controls 29.5 minutes.
Mr. DINGELL. Mr. Speaker, I will defer to my good friend from
Louisiana (Mr. McCrery).
Mr. McCRERY. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, as my colleague, the ranking member of the Energy and
Commerce Committee, said earlier this afternoon, we in the minority
want to reauthorize the Children's Health Insurance Program. Our motion
to recommit, which we will offer later today, will do that.
[[Page H9474]]
SCHIP should be about a bipartisan program. We think it should focus
on low-income children. That was the concept when both parties agreed
to create this program back in 1997. But the bill that is on the floor
today loses sight of that focus, and, therefore, we cannot support it.
We could support it with significant changes. Unfortunately, the
Rules Committee did not allow us the opportunity to offer amendments to
change the bill, so we are left to our only device as the minority, and
that is a motion to recommit. So that motion will act as kind of a sum
of our amendments that we would have offered and hoped to have passed,
to put the bill in a form that we hope will pass in a bipartisan
manner.
The bill that is before us today, though, without amendment raises
taxes by at least $54 billion. We believe it raises those taxes to fund
a massive expansion of government-controlled health care. This is not
just about helping low-income children. This bill today seems to be
spending government funds to lower middle-class, upper middle-class,
even wealthy, perhaps, families to opt out of private health coverage
and go to government health coverage.
I regret that we have not been able to work together in a bipartisan
fashion on this issue. Perhaps when this motion to recommit comes up,
we will have enough converts to adopt it, bring it right back to the
floor of the House, and we will have a bipartisan bill. Or perhaps if
this bill passes and something like it comes back to us in the form of
a conference report and the President vetoes it and we sustain the
veto, then we will have a chance to operate on a bipartisan basis and
reauthorize this program in a timely manner. I hope so.
But this bill before us today, in addition to having a substantial
increase on the tobacco tax, they try to hide, at least it appeared
that the majority tried to hide, a secret tax increase on health
insurance plans.
When it came before the Ways and Means Committee, we did have a
markup. We did have the opportunity to explore this bill, at least the
part that was in the jurisdiction of the Ways and Means Committee. We
discovered this tax increase. It wasn't in the Joint Tax score of the
bill. It wasn't listed as a revenue raiser in their report. We asked
CBO. They couldn't tell us about it, but we discovered it in the fine
print. It is a tax on health insurance policies.
Well, what is that going to do? It is going to raise the cost of
private health insurance. Maybe that is what the majority wants, to
raise the cost of private health insurance, to drive even more people
from private insurance into government health care.
This new tax is going to generate money sufficient to accumulate to
about a $3 billion pot of money over the next 10 years. That is a
substantial sum of money. And, as we have seen from past experience, a
tax like this, while it may not be big at first, it is awfully hard to
get rid of, and it is awfully easy to increase.
This legislation also cuts Medicare funding by about $200 billion. It
effectively eliminates the Medicare Advantage program. Now, I know the
majority is going to say no, no, no, it doesn't cut Medicare by $20
billion. We add back some Medicare benefits, so the net is not nearly
that much.
But for the people whose programs are going to be cut, they see it as
a cut. They don't understand this ``net'' thing. Medicare Advantage is
going to be cut substantially, and Medicare Advantage programs will go
away in most rural parts of this country and in a great many inner-city
areas serving low-income populations. This bill would effectively
eliminate options for millions of seniors who have depended on Medicare
Advantage to get better benefits and lower costs for their health care.
In addition, the bill cuts $7.2 billion in home health care benefits
and $6.5 billion in nursing home care benefits. These are cuts that are
real. They are going to be felt by people utilizing those services.
These cuts are not necessary. I want to stress, these cuts are not
necessary to cover needy children. The majority has deliberately chosen
to reduce Medicare funding for some of our neediest seniors in order to
expand SCHIP to cover anyone up to the age of 21, including, I have
heard here today, people up to 300 percent of poverty, 400 percent of
poverty.
I would tell my colleagues that have said that, they are wrong. This
bill doesn't say you can go up to 300 percent or 400 percent of
poverty. It says you can go anywhere you want to. You can cover
anybody. If a State chooses under this bill, they can not only choose
to cover people of unlimited income, $100,000, $150,000, $200,000. They
are entitled to the money.
There is also a bonus program in this bill that says if you get a new
enrollee, a new child, maybe he comes from having private insurance,
maybe he doesn't, but if he is new to this program, you are going to
get a bonus, which means you are going to get an even higher Federal
share to fund that new enrollee.
The State can waive the income eligibility as high as they want. So
we create a new entitlement program that guarantees States they can get
as much money as they want to cover anybody they want under their
government health care program. That is what this bill is all about.
That is why the minority is intent on stopping its passage today and
getting a better alternative for reauthorization for low-income
children.
This bill is about expanding government health care. Nothing more,
nothing less. The minority's motion to recommit will reauthorize the
SCHIP program in its bipartisan form. I urge all of us to wait until
that motion comes up, vote for that, and then we will truly have a good
program for low-income children in this country.
Mr. Speaker, I reserve the balance of my time.
Mr. STARK. Mr. Speaker, I yield myself such time as I may consume to
respond briefly to the distinguished ranking member of the Ways and
Means Committee, just to suggest that AHIP, representing America's
Health Insurance Plans, wrote to us recognizing ``the ambitious effort
will require significant resources. We believe that comparative
effective research should be carried out as a public-private
partnership, with funding from public sources and support from private
sources, including health insurance plans, employers and
manufacturers.'' And also to suggest that any recognition of children
above the previously stated levels had to be done with waivers from the
Bush administration to Governors requesting it.
Mr. Speaker, I reserve the balance of my time.
{time} 1630
Mr. McCRERY. Mr. Speaker, just in brief response to my good friend
from California, our understanding of the provisions of this bill and
provisions of the law would allow a State to present a State plan
amendment to the administration that is not subject to approval. They
have to approve it. So it is not up to the administration to approve
that. The States can do that at their own will.
Mr. Speaker, I yield 3 minutes to the gentleman from Missouri (Mr.
Hulshof).
Mr. HULSHOF. Mr. Speaker, I thank the gentleman from Louisiana.
Mr. Speaker, there seems to be a lot of self-congratulations, at
least on one side of this Chamber. Let me congratulate some who have
spoken here for what appears to this Member to be a pretty breath-
taking lack of consistency. My good friend from Fremont Hills has
pointed the finger to this side and said we Republicans, we don't care
about children.
I would remind my chairman, Mr. Speaker, that the children's health
program was created by a Republican majority. The gentleman points out
that this bill today is funded, as the gentleman is nodding, as that
bill was funded. And I would say, Mr. Speaker, 10 years ago and 2 days
on July 30, rollcall vote no. 345, on this floor, on the conference
report creating the Children's Health Insurance Program, I was proud to
be one of 346 ``aye'' votes. There were 85 ``no'' votes. The gentleman
from California was a ``no'' vote. The chairman of the Ways and Means
Committee was a ``no'' vote. I find that a bit interesting. Because,
today, the gentleman from California talks about this being the
identical bill. This is not the identical bill.
As my friend from Louisiana has said, we would love to reauthorize
the
[[Page H9475]]
program for needy children. But should we allow a family in New York
making $80,000 a year free health care, free to them, but paid for by
15,000 constituents I am privileged to represent who would have their
vision care or dental benefits or oxygen services cut, and the savings
then given to that couple making $80,000 in New York City?
One-half of the new enrollees under the majority's bill, those new
enrollees would be people who already have health insurance coverage.
There is, as the gentleman pointed out, a brand new, per capita tax on
every health plan in America that raises $2 billion. There are rifle-
shot reimbursements for hospitals in order, presumably, to sway
undecided Members from Michigan and New York and Tennessee.
And can anyone really defend the children's health program for
childless adults, childless adults now being able to qualify for the
children's health insurance program?
Needy children, absolutely. Well-to-do adults, I suggest no,
certainly not at the expense of cuts to senior citizens. We can do
better. I urge a ``no'' vote.
Mr. DINGELL. I yield myself 15 seconds to point out to my dear friend
from Louisiana (Mr. McCrery) that it is the administration which gives
waivers to cover parents and adults. The States do not have the
authority to do so, and they must get the authority from the Federal
Government, and it is from the Department of HHS that these kinds of
waivers come, not elsewhere.
Mr. Speaker, I yield 2 minutes to the distinguished gentlewoman from
Illinois (Ms. Schakowsky).
Ms. SCHAKOWSKY. Mr. Speaker, I thank the gentleman from Michigan for
yielding to me.
Mr. Speaker, 9 million children in this country lack health insurance
coverage, so it shouldn't come as a big surprise that 91 percent of
voters support extending to SCHIP coverage to 5 million more children.
That is 5 million more children according to the Congressional Budget
Office, and that Governors from both sides of the aisle are supporting
this legislation across the country.
The real surprise is that our President has threatened to veto this
bill, a bill to cover children and to improve Medicare for our Nation's
seniors and for people with disabilities. My question is, why are the
President and so many of our colleagues saying ``no'' to basic health
care to children, for adequate payments to doctors, for protecting
Medicare?
In yesterday's New York Times, I think Paul Krugman hit the nail on
the head when he said that President Bush must fear the intent of this
bill, which is to cover more children, because he fears that it
actually might work. That if America sees government helping children,
they will wonder why we can't do the same for everyone.
The President said he opposes expanding children's health care
because it will hurt private insurance companies. Astounding. Forget
uninsured kids. The President is the champion of insurance companies.
And people across the aisle are saying it is really about seniors
when they are talking about the Medicare Advantage programs. But let's
be clear. The Medicare Advantage HMOs are reaping overpayments of up to
40 percent. The overpayments are being subsidized by 80 percent of the
seniors and disabled people who are not in Medicare Advantage plans
through higher part B premiums.
I want to urge the former Speaker of the House to cease giving
patently false information about the Illinois SCHIP program which
insures far more children than their parents.
Let's be on the side of children.
Mr. McCRERY. Mr. Speaker, I yield myself such time as I may consume.
Perhaps if we had had a hearing on this bill, we could have
discovered what the truth is about this discussion of waivers and State
plan amendments.
But our appreciation of the law is that this is not a waiver. I'm not
talking about a waiver so it does not have to be approved by the
administration. I am talking about a State plan amendment that is
simply presented to the administration and it can contain what is known
as an income disregard. The attorneys with CMS tell us that the
administration does not have the discretion to turn down an income
disregard that is presented by a State.
What an income disregard means, in essence, is a State can cover kids
from families as rich as they want. And that is our understanding of
the law. It is too bad we didn't have, or at least the Energy and
Commerce Committee didn't have, a full-blown hearing on this provision
or other provisions of the bill so we could have explored that.
Mr. Speaker, I yield 2 minutes to the gentleman from Illinois (Mr.
Weller), a member of the committee.
Mr. WELLER of Illinois. Mr. Speaker, in 1997, I voted ``yes'' to
create the Children's Health Insurance Program. I was proud a
Republican Congress put this plan into place, and I support
reauthorization of this program, but I oppose this bill before us.
Why? This bill contains big tax increases. What is interesting, when
we want to make health insurance more affordable, they put a new $2
billion tax, they call it a per capita tax, on health insurance
policies, causing them to be more expensive.
Then there are some big Medicare cuts, in fact, almost $200 billion
in Medicare cuts, probably the biggest cut in Medicare in the history
of the program. They want to expand the program, but they want to pay
for it on the backs of senior citizens by cutting Medicare. So you
wonder who gets hurt when you cut Medicare to pay for the expansion of
this program.
If you just take the $7.6 billion in cuts to home health care, you
think of that elderly woman that many of us have met. We have been in
her home. She is an elderly woman with an easy chair by the window, by
the television. She has a tray or table there. It is filled with pill
bottles. She is homebound. She watches the world go by. And if she is
lucky, she has a cat or a dog for a pet and a companion. But, for her,
home health care is important, because not only is it contact with the
outside world, but home health care allows her to live in her home in
dignity even though she is homebound.
This plan today that is going to be voted on includes a $7.6 billion
cut in home health care. So if you vote ``yes'' for this legislation, I
hope you keep in mind that elderly woman stuck at home, homebound, who
is dependent on home health care; and today she will suffer when this
House passes this bill. Vote ``no.''
Mr. STARK. Mr. Speaker, I just make a comment that not all committees
are so blessed with ranking members who are so cooperative, and perhaps
there might have been hearings in other committees if that were the
case.
I yield 1 minute to the gentleman from Massachusetts (Mr. Neal), and
Mr. Neal recognizes that the American Academy of Pediatrics has said in
their letter that they want to stand with us on this important
legislation, and they will work for its passage.
Mr. NEAL of Massachusetts. Mr. Speaker, I think there is one
acknowledgment that we all ought to come to very quickly, and it goes
like this: The wealthy, the healthy and the strong have had a great run
of it for the last 6 years.
Think of that terror that overcomes that family with that child who
needs health care. Think of that child who died because he had not
gotten to a dentist in America in the year 2007. Think of what we are
doing today, advancing an opportunity for health care for all members
of the American family.
My friend, Mr. McCrery, said if we had had an opportunity to vet this
issue. Let me remind the audience, the Republicans required us to read
the bill. The Ways and Means Committee spent 6 hours reading the bill.
To argue that somehow there was not an opportunity to vet the issue
when we read the bill is akin to setting the fire and calling the fire
department. That is the argument we are being asked to embrace.
This is a good piece of legislation. It ought to have bipartisan
support. Use the model of the National Governors Association. That is a
bipartisan organization.
Mr. McCRERY. Mr. Speaker, it is apparent to me from the
misunderstandings apparent in this Chamber on this bill that perhaps we
should have read the whole bill in greater detail. Maybe we would know
more about it.
Mr. Speaker, I yield 2 minutes to another member of the Ways and
Means Committee, the gentleman from Kentucky (Mr. Lewis).
[[Page H9476]]
Mr. LEWIS of Kentucky. Mr. Speaker, I rise today on behalf of the
millions of seniors who will be hurt by this bill. In my home State of
Kentucky, over 73,000 seniors are enrolled in Medicare Advantage plans,
as well as all 19,000 of Kentucky's retired teachers. Each and every
one of these seniors will have their benefits cut as a result of this
bill, and some will find themselves without any Medicare Advantage
options at all.
It is unconscionable to me that this body would even consider robbing
seniors by cutting $197 billion out of the Medicare trust fund to give
to families making $80,000, or even more, free health insurance, many
of whom already have coverage.
This bill also cuts home health, hospitals, skilled nursing
facilities and dialysis centers. It is clear that this bill harms many
of our Nation's most vulnerable population. This bill should be about
providing poor children with health care, but it rations our Nation's
health care, taking from seniors and working-class families to shift
Americans from private health insurance into a big, liberal, tax-and-
spend government program. Folks, they're back.
I urge my colleagues to stand by their seniors and defeat this bill.
Let's get back to helping poor children, not a Michael-Moore-endorsed
health care system.
Mr. DINGELL. Mr. Speaker, before I yield to the distinguished
gentlewoman from Oregon (Ms. Hooley), I would like to point out, in
spite of what has been said by some of my Republican colleagues, this
is not an entitlement bill. It does, however, protect 11 million kids.
Mr. Speaker, I yield 2 minutes to the gentlewoman from Oregon (Ms.
Hooley).
Ms. HOOLEY. Mr. Speaker, I thank my good friend from Michigan for
yielding.
This bill is important to children. It was important to our
legislature. It was important to our governor. That is why they passed
it this session.
But I want to tell you why health insurance for children is so
important by telling you about Katelyn, a 6-year-old from Corvallis.
Katelyn's hardworking parents make too much money to qualify for SCHIP
under current Oregon eligibility levels but far too little to afford
the $520-a-month premium for insurance through her father's employer.
{time} 1645
Katelyn was ill for several days and her parents had been trying all
night to help her stop coughing. Without insurance, the couple had no
doctor.
However, the county health department offered pediatric services for
low-income children every Monday at reduced costs. So Katelyn's parents
decided to wait and take her to the clinic on Monday, 3 days later. By
Sunday, Katelyn was worse. Through tears, Katelyn complained that her
sides hurt.
When she was able to get to the doctor on Monday, Katelyn was
diagnosed with pneumonia. With insurance, Katelyn's parents could have
taken her right away to the doctor. Instead, she suffered for days.
This story could have had dire consequences. It is why SCHIP is
critically important. The CHAMP Act will provide Oregon with the
resources they need to expand health insurance coverage to more
children, and hopefully, stories like Katelyn will rarely exist.
Mr. STARK. Mr. Speaker, I yield 2 minutes to the distinguished
gentleman from Illinois (Mr. Emanuel) who helped create the CHIP bill.
I can't say he was a midwife for it, but he was there at its inception
and was instrumental in negotiating it.
Mr. EMANUEL. Mr. Speaker, in 2002 when I ran for Congress, I met
Dolores Sweeney. She works full time in an insurance company, but for
years she and her three children did not have health insurance until
SCHIP. Her children are enrolled in the health care program.
She did right by her family. She worked full-time, had three
children. She's trying to be both a good worker and a good parent, and
SCHIP allowed her to do both of those and do them well.
I just talked to her the other day. She has a 19-year-old now and a
14-year-old and a 12-year-old. This bill did right by her because her
children are three success stories out of the 6 million who did right.
So we stare at the 11 million children and ask, whose parents work
full-time, that are too wealthy for Medicaid, yet cannot afford private
insurance, are we just going to throw up our hands to them? Dolores
Sweeney and the other parents, they will get the same health insurance
that we ourselves will get and our children get. And the question
before us will be, are we better than these 11 million children?
You know, Dick Cheney gets a checkup every other day. Don't America's
kids deserve a visit to the doctor, I ask you.
And also I just want to say something to my colleagues who now say
they're for SCHIP. I was there when President Clinton proposed it.
Speaker Gingrich was against it. You were against it before you became
for it. I appreciate your conversion, but you originally were opposed
to it.
When President Clinton said that, you said you opposed it. Then you
said only pediatric care. Then you agreed to pediatric care, and then
eye and dental visits which is what President Clinton proposed, and I
do appreciate that you're for it.
Announcement by the Speaker Pro Tempore
The SPEAKER pro tempore. All Members are reminded that comments must
be made through the Chair.
Mr. EMANUEL. Mr. Speaker, Republicans were opposed to this bill
before they were for this bill, and what has happened is that pediatric
care and the eye and dental care that is in this bill was a principle
that President Clinton had and there would be no agreement on a
balanced budget until those kids had that bill.
You said then it was an entitlement program. Now you have Governors,
Senators of both parties, who are for this. The American Medical
Association is for this. Pediatric care is for this. AARP is for this.
And the ultimate question to those children who don't have health
care, this time we leave no child behind and give these children the
health care they deserve and the parents work full time and do right by
their children.
Mr. McCRERY. Mr. Speaker, in a continuing dialogue with the
distinguished chairman of the Energy and Commerce Committee, at least
in the manager's amendment presented to the Ways and Means Committee
during markup on page 10, this is under section 101 of our bill, it
states: if a State's expenditures, under this title, exceed the total
amount with allotments available, and if the average number of children
enrolled under the State plan exceeds its target average number of such
enrollees, the allotment under this section shall be increased. Not
may, shall. That is an entitlement to the States for as much money as
they want for this program. It is no wonder, I would say to my good
friend from Illinois, that the Governors are for this. Duh.
And with that, I yield 2\1/2\ minutes to a distinguished member of
the committee, Mr. Cantor.
Announcement by the Speaker Pro Tempore
The SPEAKER pro tempore. All Members are again reminded their remarks
should be addressed through the Chair.
Mr. CANTOR. Mr. Speaker, I thank the gentleman. I rise in opposition
to this bill.
And, Mr. Speaker, I want to speak to some of the remarks that were
just made about somehow the Republicans are against insuring poor
children and offering them access to health care.
I can tell you one thing, this Republican was not in this body when
President Clinton was in office. So I could never have been against
this program before I'm for it. So I take issue with that.
I am for, as I believe most of my colleagues are for, a program that
provides access to health care for poor children, but what we have here
is a 400 percent increase in the SCHIP price tag because what the
majority has done has increased eligibility to the 400 percent level
over poverty. In many areas of this country, we're well in excess of
families who are making $100,000 a year. These are children, 90 percent
of whom already have health care coverage.
So what that means is the price that we pay for this type of
expansion is a dangerous lurch forward toward a Washington-based,
bureaucratic-controlled health care system. Which
[[Page H9477]]
medicines will we get? Which surgeries will be available? And when? And
when? Which disease is worth treating? These are the vital choices that
right now American families are able to make, but frankly, the majority
wants the government to make.
But how do they pay for this? They pay for this largely by cutting
Medicare. That's what we're about here, choosing to cut Medicare, cut
seniors' ability to have a choice under the Medicare program so we can
provide access to insurance for children whose parents make over
$100,000 a year. That just doesn't make any sense.
Now, secondly, Mr. Speaker, I would say as my colleagues before me,
another way that this bill is funded is a brand-new tax on health
insurance for all Americans that have health insurance policies.
Again, the bill creates a health care competitiveness-affected
research trust fund. That's another attempt basically to allow perhaps,
if not run right, a government bureaucrat to dictate which therapies a
physician can use.
The bottom line, this bill is misguided. We need to take a much
better look at this, and frankly, the last point I was going to make,
Mr. Speaker, is this bill makes it up to the States, optional, whether
to require documentation as to anyone who is legal who wants to receive
benefits under this. This is another attempt, Mr. Speaker, at allowing
our SCHIP benefits to go to illegal immigrants, something that I don't
believe the American public is in favor of.
Mr. DINGELL. Mr. Speaker, I yield to an extremely valuable and
respected member of the Commerce Committee, my good friend from Utah
(Mr. Matheson) 2 minutes.
Mr. MATHESON. Thank you, Mr. Chairman.
My wife and I are very fortunate. We have two wonderful little boys.
Their names are William and Harris, and they're really fortunate
because they have access to health care because, as a Congressman, I
have access to the Federal employee health insurance program. And
that's how it is for all of us as Members of Congress. See, we have
health insurance and our kids have health insurance.
This debate isn't about us, and as we get caught up in these
discussions, this rhetoric about process and concerns about the way
this bill has come to the floor, I think we're losing sight about who
this issue is really about because we've got 11 million kids in this
country who are involved in households where they make enough money
they don't qualify for Medicare. How do we get them access to health
care?
The CHIP program's done a great job in the past 10 years, and we've
got about 6 million of them covered, but there are 5 million kids out
there who still aren't.
That's what this debate is about, and I think when you have something
sometimes you take it for granted, and all of us take for granted the
fact that we have health insurance.
Now, let me tell you why I don't take this for granted because, in my
household, my wife happens to be a pediatrician, and she works at a
children's hospital in Salt Lake City. She tells me the stories about
kids who come into that hospital who have not had access to preventive
care, who have health problems that escalated into far more serious
circumstances because they didn't have access to health care, and I
hear those stories all the time.
That's what we ought to be focused on in this debate. That's what
this debate is about. Vote for this bill. Let's do the right thing for
our country's children.
Mr. McCRERY. Mr. Speaker, may I inquire as to the remaining time.
The SPEAKER pro tempore. The gentleman from Louisiana has 30 minutes
remaining.
Mr. McCRERY. And what about the majority?
The SPEAKER pro tempore. The gentleman from California has 25\1/2\
minutes remaining. The gentleman from Michigan has 21\1/2\ minutes
remaining.
Mr. McCRERY. I think, Mr. Speaker, in order to kind of even out the
remaining time, I will yield to my colleagues in the majority if that's
okay.
Mr. STARK. Mr. Speaker, I yield 1 minute to the distinguished
gentleman from Oregon (Mr. Blumenauer), and he's a gentleman who
understands that most of us in Congress whose children are insured are
insured by a government-run, taxpayer-funded health insurance plan
which we like quite well.
Mr. BLUMENAUER. Mr. Speaker, actually, I'm not. I rely on my wife.
Mr. Speaker, the same framework that our friends have been
complaining about on the other side of the aisle is a State block grant
program has been retained. It's successful, but underfunded.
Their complaints of enhanced programs ring hollow when you examine
them. I heard my friend the distinguished minority whip come to the
floor and talking about his opposition to higher income levels, and I
find some irony in that because his State is one of them, Missouri
where there was a request by his son, the Republican Governor, for a
waiver from the Republican Bush administration which has been granted
that allows a level 3 times higher than the poverty level.
They don't feel comfortable with the requests that are coming from
the State level for the innovation. However, that's what it was about
in the first place.
This program is not about putting Medicare Advantage at risk. It's
being adjusted. This bill helps with reform. I am pleased that 157
counties in 27 States are being rewarded with an efficiency bonus. My
State's medical system is strengthened by helping kids.
I urge all to vote for this bill.
Mr. McCRERY. Mr. Speaker, I reserve the balance of my time.
Mr. STARK. Mr. Speaker, I'm pleased to yield 1 minute to the
gentleman from Wisconsin (Mr. Kind) who understands that the National
Rural Health Association has endorsed the 2007 CHAMP Act as critical to
rural children and seniors across the Nation.
Mr. KIND. Mr. Speaker, I thank the gentleman for yielding.
Mr. Speaker, last fall, my 8-year-old son Matt, while he was
sleeping, fell off the top of his bunkbed, broke his clavicle. As Tawni
and I were driving to the emergency room to get treatment to this kid
in excruciating pain, I thought of the numerous parents throughout
America who fear the financial consequences of taking care of their
child in an emergency or if they had an ear infection or an abscessed
tooth or an asthma attack because they didn't have adequate health care
coverage for that child. That is wrong. That is unacceptable. And we
change that today.
The CHAMP Act expands health coverage to 5 million more children, and
with the reforms we make under the Medicare system, we extend the
solvency of Medicare for three additional years, unlike the Republican-
passed Medicare reform bill passed just a few years ago that called for
the largest expansion of entitlement funding in over 40 years, with no
ability to pay for it.
We pay for this bill with a modest increase in the cigarette tax,
which is also the best thing we can do to prevent these kids from being
addicted to that poison and incurring smoking-related illness with
associated life-long health costs.
I ask my colleagues to support the bill.
{time} 1700
Mr. PALLONE. Mr. Speaker, I ask unanimous consent to control the time
of the gentleman from Michigan.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from New Jersey?
There was no objection.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from
Illinois (Mr. Rush).
Mr. RUSH. Mr. Speaker, I rise in support of the CHAMP Act of 2007.
I am disappointed that my Republican colleagues won't stand up to the
HMOs and won't stand up for healthy children. In the words of Dr.
Martin Luther King, ``Justice delayed is justice denied.'' The
Republicans just don't get it. Delay is not debate. Health care delayed
is health care denied.
There is no power like the power of a made-up mind; and, early on,
the Republicans in the Commerce Committee markup made up their mind to
forestall health care for our children. Then, last night and this
morning, on this very floor, they made up their mind to stall health
care for 12 million uninsured children.
Now it remains up to us, the Democrats in this House, to make up our
minds and to install health care for
[[Page H9478]]
children, for those 11 million children and low-income pregnant women.
Now is the time. There is no other time like this time, so now, most
definitely, now is the right time.
I urge my colleagues to support this bill for America's babies. We
must champion health care coverage for 11 million children. They need
us. They depend on us. They need this health care coverage.
We must pass the CHAMP Act of 2007. We must put our poor children in
the winner's circle.
Mr. STARK. Mr. Speaker, I yield 3 minutes to the distinguished
majority whip, Mr. Clyburn.
Mr. CLYBURN. I thank the gentleman for yielding me the time.
Mr. Speaker, I rise today to urge my colleagues to support H.R. 3162,
the Children's Health and Medicare Protection Act of 2007.
I want to commend Chairs Rangel, Dingell, Stark and Pallone for
working with all of our caucuses in drafting this piece of legislation.
I also rise to explain why I and many of my colleagues are unequivocal
on the need for Congress to cover all eligible kids.
There is an old judicial axiom that says ``Justice delayed is justice
denied.'' The same is true for health care, and there is no better
example on how health care delay is health care denied than the story
of Devante Johnson from Houston, Texas. Thirteen-year-old Devante
Johnson from Houston, Texas, had advanced kidney cancer and could not
afford to be without health care coverage. But, last year, the Johnson
family spent 4 desperate months uninsured while his mother tried to
renew his Medicare coverage.
For years, Devante and his two brothers were covered by Medicaid.
Texas families who qualify for Medicaid or CHIP are required to renew
their coverage every 6 months. Devante's mother, Tamika, had tried to
get a head start by sending their paperwork 2 months before Medicaid
was set to expire.
That application sat for 6 weeks until it was processed and then
transferred to CHIP, because an employee believed the family no longer
qualified for Medicaid. At that point, the paperwork got lost in the
system.
For 4 months, Devante went without health insurance as employees
unsuccessfully attempted to reinstate his coverage. As a result, he
could no longer receive regular treatment and had to rely on clinical
trials for care. Meanwhile, his tumors grew.
It wasn't until the State representative intervened that Devante's
coverage was immediately reinstated. But it was too late. Devante
Johnson died on March 1, 2007.
I want you to look at him. He has to mean something to you. For, in
the words of Martin Luther King, Jr., ``There is nothing more dangerous
than sincere ignorance and conscious stupidity.''
We cannot allow this to continue. Support the Devantes of our great
country and give health care to all of our children.
Mr. McCRERY. Mr. Speaker, I yield 2 minutes to the gentleman from
Georgia (Mr. Linder), a member of the committee.
Mr. LINDER. Thank you for yielding.
Mr. Speaker, about 2 years ago, the Government Accountability Office
brought before the Ways and Means Committee a study that said if we
continue to tax at the current percentage of the economy and continue
to spend in discretionary spending at the current percentage of the
economy that just 33 years from today the entire Federal revenue stream
will be insufficient to just pay the interest on the debt.
I know the Democrats will say raise taxes. In 100 percent of the time
in the last 60 times that we have raised taxes, we have slowed the
economy and slowed revenues.
This Congress will not reduce spending. So what is their solution to
our dilemma? The problems are, as the GAO said, three entitlement
programs, Medicare, Social Security and Medicaid. They propose to give
us another one, with no caps, expanding coverage to illegal immigrants,
by the language from the CBO, expanding coverage to adults with no
children, by the definition of their act, and allowing the States to
lift the ceiling on eligibility entirely.
This is a back-door or front-door entrance for Hillary care, national
health care. You will recall that in that program if a doctor treated a
patient for free outside the system, they are liable for criminal
fines. That isn't in this bill, yet.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from
Maryland (Mr. Wynn).
Mr. WYNN. I thank the gentleman from New Jersey for yielding, also
for his outstanding leadership on this issue.
Mr. Speaker, I rise in support of this bill. I operate from a very
simple premise, and that is this, that if America is the greatest
country in the world, then all of our children should have health
insurance.
It's that simple. This bill does that. It covers 5 million additional
children of the working poor; and it gives them health care, dental
care and access to mental care health services. That's what's needed in
this country.
It's amazing to listen to the scare tactics of Republicans. It's
almost amusing.
First, they start talking about illegal aliens. No, that's not what
this bill is about. They said, well you are going to kill our private
insurance. These are working poor people. They don't have insurance.
They said, well, it's $100,000 families. No, it's the existing
eligibility limit. Then they say, well, you are going to create a
massive new entitlement program. No, it's a grant program with bonuses
for States that do a good job of insuring more people.
Finally, they resort to Hillary care. We are all supposed to be
scared.
We are taking this issue very seriously, because we understand that
there are working poor people in America that work every day. Half of
them are women. They work in the service industries, they work in labor
jobs, and those jobs do not offer health insurance. That's why we are
here.
We are here because when they don't have health insurance. Their
children don't get screenings. Their children don't get check-ups. They
can't get treated for asthma. When their children are in severe pain,
they go to the emergency room, and that costs more money.
I will give you example from my district. Deamonte Driver, he had a
toothache, tooth decay. It would have cost $80. He didn't get it. The
tooth became infected. The infection traveled to his brain.
Two surgeries costing $250,000 were attempted to save his life. They
were unsuccessful. Deamonte Driver died. We need to prevent these types
of tragedies in America.
I am appalled when I think about it, that if a third-world Communist
country like Cuba can offer health insurance to the families of factory
workers, we have to be able to do it here in America, the greatest
country in the world.
Mr. McCRERY. Mr. Speaker, before I recognize our next speaker, I want
to point out two things. Number one, there has been a couple of
references to this child who died because of a tooth problem. According
to the Washington Post story, I don't know this, but according to the
Washington Post story, this child was actually on Medicaid. He was
covered by Medicaid. But because so few dentists in that State accepted
Medicaid patients because of the poor quality of the Medicaid program,
this child didn't get access. But he was covered.
I don't see how it's relevant to the discussion we are having on
SCHIP.
Mr. Speaker, I yield 3 minutes to a distinguished member of the Ways
and Means committee and the ranking member of the Budget Committee, Mr.
Ryan.
Mr. RYAN of Wisconsin. I thank the gentleman for yielding.
Mr. Speaker, this debate is really puzzling. If this was a status quo
bill, if this was the same law that we already have in place, no new
people, then why does it cost $130 billion in more money? Why does it
cost so much more?
This bill goes way beyond insuring low-income children. If this was
all about just giving health insurance to uninsured low-income
children, no problem. You would have a near unanimous vote out of here.
That's not what this bill does.
They say this bill doesn't have those income limits. This bill has no
income limits. This bill says to the States, give it to whomever you
want, no asset test, no income limits. That's why this test costs so
much money.
[[Page H9479]]
In fact, the Congressional Budget Office is saying in analyzing this
bill that they will push 2.4 million kids off of private insurance onto
government health care, not my statistics, the Congressional Budget
Office.
They are already acknowledging that this is more about insuring low-
income, uninsured kids. This is really about putting people on
government health care, especially those who even have health insurance
today.
My friends, our constituents, the U.S. taxpayer, don't want to pay
for health care that's already being paid for by someone else. But that
is what this bill does. This bill creates an enormous budget mess.
I find it kind of ironic that the majority that could not find $1
worth of entitlement savings in their budget comes to this floor with
$200 billion of cuts to Medicare to pay for expanding this new program.
When it came time to reducing the deficit and keeping taxes low, no
savings to be found. Now, hey, $200 billion in Medicare cuts, cut 3
million seniors off the Medicare Advantage program to grow a new
entitlement.
Yes, this is a new entitlement program, a new entitlement for States.
It gives them a never-ending spigot of new money. But what's so, so
critical, what's so hypocritical about this bill is, after cranking up
spending for 5 years, after putting 5 million children on health care,
kicking 2.4 million off of private health insurance, what do they do to
conform with their PAYGO rules? What do they do to shoehorn this huge
program into their budget? They just kick everybody off. They just
rescind the program. They just turn the spigot money off.
Does anybody believe that after putting 5 million people on health
insurance we are just going to take it away from them in 2014? No,
we're not.
So this whole thing really is a bug sham. What they are saying is,
with this legislation, we want to give 5 million people health
insurance for kids, no matter what income limit. But, in 2014, we are
taking it away from them. That's crazy. That's not budgeting. That's
creating a new program, a new entitlement, and not paying for it.
This puts our fiscal house, which is already messed up, in serious
jeopardy.
I urge a ``no'' vote on this bill.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from
Washington (Mr. Inslee).
(Mr. INSLEE asked and was given permission to revise and extend his
remarks.)
Mr. INSLEE. Mr. Speaker, one of the great falsehoods I have heard
today, unfortunately, is this attempt by one side of the aisle who is
against trying to get kids health insurance here keep saying somehow we
are raising the eligibility to those folks who are hanging out at the
country club. That is simply not true. That is bogus. We are
maintaining the same levels of eligibility in America that exist today,
yesterday and tomorrow in this bill.
What we are doing is simply allowing our State governments, our local
governments, the ones that I know many of my Republican friends believe
are effective and more efficient than the Federal Government, to
fulfill their desire to reach these kids who are eligible today, but
the Federal Government is not actually reaching to provide this
insurance.
Now, where is the criminality in that in that? Where is the
inefficiency in that? We have simply said federally that children of a
certain income level should have health insurance, and we are simply
saying those same children of the same exact economic considerations
are now going to actually get it. That's all we are doing.
I want to mention another thing we are doing here. We have 11 States
that have really been ahead of the Federal Government in providing
health insurance for their kids. As a result, for a decade now, they
have been punished in that they haven't been able to use the same
resources to reach the kid they have already insured.
We fix that, 100 percent fix today. The States, if you are from the
States of Washington, Wisconsin, New Mexico, Connecticut, Hawaii, Rhode
Island, Minnesota, Maryland, New Hampshire, Vermont and Tennessee, do
not vote against this bill, because it finally, finally restores this
inequity that finally we will be able to get fair treatment for your
States and your children.
So, today, we have got a fair bill all the way around.
Mr. McCRERY. Mr. Speaker, I ask unanimous consent to have the
gentleman from Michigan (Mr. Camp), the distinguished ranking member of
the Health Subcommittee of the Ways and Means Committee, control the
remainder of the time for the minority.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Louisiana?
There was no objection.
{time} 1715
Mr. CAMP of Michigan. Mr. Speaker, I yield 2\1/2\ minutes to the
distinguished gentleman from Pennsylvania, a member of the Ways and
Means Committee.
Mr. ENGLISH of Pennsylvania. Mr. Speaker, today I rise in reluctant
opposition to H.R. 3162.
Yesterday, I joined my colleague, the gentlelady from New Mexico
(Mrs. Wilson) in the introduction of a bill which embodied the Senate
version of SCHIP reauthorization. I am proud to be an original
cosponsor; I fully support that legislation.
Unlike the bill we are debating today, the Senate version is far less
pernicious and does not raid low-income seniors to pay for an expansion
of coverage for middle-class families.
Proposed Medicare cuts in this legislation could have a devastating
impact on access to Medicare Advantage plans. The seniors that use
these plans, if they didn't experience an outright loss of coverage,
would, at minimum, experience higher premiums, benefit cuts, or both.
According to an April 2007 study by Emory University researchers Ken
Thorpe and Adam Atherly, 3 million people would lose their access to MA
coverage if Congress sets MA payments at the same level as payments for
traditional Medicare.
Moving from the macro numbers to the practical effects of seniors in
my district, it causes even more concern. Over 15,000 seniors in Butler
County, Pennsylvania would experience a 15 percent cut in their plan's
reimbursement. Nearly 15,000 seniors in Erie County would experience a
29 percent cut, and over 8,000 seniors in Mercer County would be
impacted by a 17 percent cut in their plan's reimbursement should this
bill be passed.
This blatant raid on seniors' pocketbooks contained in this bill is
enough to warrant a vote in opposition. But, Mr. Speaker, the most
troubling factor in this bill is that this raid on seniors is being
used to pay, in many cases, for families with incomes as high as over
$82,000 a year. At a time when so many seniors are tightening their
belts on fixed incomes, raiding their pocketbooks to pay for health
care for middle-class households is simply not right.
I have been a supporter of SCHIP from the beginning. I have trumpeted
its success. But this SCHIP reauthorization has been hijacked by people
who have a different agenda. We will have another vote on this when it
comes back from the other Chamber and from conference. I am voting
``no'' on this wrongheaded approach on a very important issue.
Mr. STARK. Mr. Speaker, at this time I am happy to recognize the
gentleman from New Jersey (Mr. Pascrell) for 1\1/2\ minutes, and,
pending that, point out that he recognizes that the hospitals and
physicians in Pennsylvania overwhelmingly endorse this bill.
Mr. PASCRELL. Mr. Speaker, we could certainly slow the aging process
down if it had to work its way through Congress.
This year, 6 million children will have access to quality affordable
health insurance because of the program we know as the SCHIP. These
children are in working families with parents who either can't afford
insurance or hold jobs that lack health care benefits. We have an
opportunity today.
In New Jersey, we have over 100,000 of eligible kids who aren't
enrolled in New Jersey alone. Are we going to do the same thing on
health care that we did to those kids in Head Start? So many eligible,
not enough resources, wrongheaded priorities?
Contrary to what my friends on the other side said, the Ways and
Means Committee has also worked to protect the integrity and solvency
of Medicare and to approve the benefits for all beneficiaries within
this bill.
[[Page H9480]]
The fully paid for CHAMP Act protects Medicare from privatization,
promotes fiscal responsibility, you have got to read the bill, by
reducing overpayments to private plans. I see nothing wrong with that.
Adding 3 years to the Medicare trust fund solvency, I think that is a
home run. Limiting premium increases, two home runs, and improving
access and benefits for all Medicare participants.
Mr. Speaker, this bill needs everyone's support in here. It should be
and will be bipartisan.
Mr. CAMP of Michigan. Mr. Speaker, may I ask how much time remains?
The SPEAKER pro tempore. The gentleman from Michigan has 22\1/2\
minutes remaining; the gentleman from California has 19 minutes
remaining; the gentleman from New Jersey has 15\1/2\ minutes remaining.
Mr. CAMP of Michigan. Mr. Speaker, I reserve the balance of my time.
Mr. STARK. Mr. Speaker, at this time, I am happy to yield 1 minute to
the distinguished lady from Nevada (Ms. Berkley).
Ms. BERKLEY. I thank the gentleman for yielding.
I rise in support of the CHAMP Act, and I want to tell you why. This
bill will ensure continued coverage for the 39,000 kids already covered
by SCHIP in my State of Nevada, while providing resources to reach the
70,000 children currently eligible but that remain uninsured because
there is not enough money.
This bill also makes needed updates and improvements to Medicare to
ensure that our seniors receive preventative services, mental health
care, and physical speech and occupational therapies that they need.
Almost 98,000 low-income seniors in Nevada will benefit from
improvements in Medicare savings programs and low-income subsidy
programs as well.
Passing this bill is also necessary to ensure access to physicians
for Medicare patients. The CHAMP Act restores funding necessary to
reimburse the doctors for their services.
My district has the fastest growing senior population in the United
States. It is essential that these seniors have access to their doctors
under the Medicare program. This bill ensures they will.
Mr. CAMP of Michigan. Mr. Speaker, I reserve the balance of my time.
Mr. STARK. Mr. Speaker, I am delighted to yield 1 minute to the
distinguished lady from Pennsylvania (Ms. Schwartz), who understands
that the National Committee to Preserve Social Security and Medicare
has overwhelmingly endorsed the 2007 CHAMP Act.
Ms. SCHWARTZ. Mr. Speaker, I rise proudly in strong support of the
Children's Health and Medicare Protection Act.
As someone who helped to create one of the first CHIP programs in the
country in Pennsylvania in 1992, I know what a difference it has made
in the lives of literally hundreds of thousands of children in
Pennsylvania. And since 1997, it has made a difference in the lives of
6 million children across this country.
Today, we build on the success of CHIP. It is a public-private,
Federal-State partnership and secures access to coverage for 11 million
children of hardworking American families.
At a time of rising health care costs for working families and
increasing numbers of uninsured children, today we have an answer for
American families. The action we take today will sustain health
coverage for 6 million children currently enrolled, and will make
available affordable coverage for an additional 5 million American
children.
This is an extraordinary step forward in ensuring access to health
coverage for American children. It is simply not good enough to say you
support improving access to health coverage for children and then vote
``no.'' Rather, vote with children of this country and their parents. I
urge passage of this legislation.
Mr. STARK. Mr. Speaker, I am delighted at this time to recognize the
distinguished gentleman from Connecticut (Mr. Larson) for 1 minute, who
understands well how private health insurance companies have
overprofited from their overpayment.
Mr. LARSON of Connecticut. Mr. Speaker, I want to applaud Mr. Stark,
Mr. Rangel, Mr. Dingell, and Mr. Pallone for their outstanding
leadership in bringing this bill before us today.
I turn to my colleagues on the other side of the aisle and say to
them, do not remain frozen in the ice of your own indifference towards
the needs of children in this country.
It is imperative that we pass this bill. It is imperative not because
of the statistics and the numbers, but because these are our children
and our kids. That you find the time and the money to blindly put
forward into reconstruction efforts in Iraq, but not the time, not the
effort to make sure that kids in our own country receive the necessary
funding that they need.
It is written that the difference between CHAMP and CHUMP is ``U.''
Do not become the vote that turns away the children in this country.
Announcement by the Speaker Pro Tempore
The SPEAKER pro tempore. All Members are reminded to address their
remarks through the Chair.
Mr. CAMP of Michigan. Mr. Speaker, at this time I yield 2 minutes to
a distinguished member of the Ways and Means Committee, Mr. Tiberi.
Mr. TIBERI. Mr. Speaker, I rise in reluctant opposition to this bill
today.
I support the Children's Health Insurance Program. The original goal
was worthy, Mr. Speaker: Cover poor children. Unfortunately this bill
does much more than that. It expands the program to more adults and to
children of middle-class parents who may already have insurance, and
funds this expansion through relying on tobacco taxes that are going to
bring in less revenues through the years, including tax increases on
private health care plans, cuts to community hospitals, nursing homes,
home health care providers, and, yes, cuts to Medicare beneficiaries.
Democrats are cutting Medicare, specifically the Medicare Advantage
program. Seniors in my district have been writing and calling me, and I
have been talking to them.
One said to me, ``The quality of our health coverage is greatly
improved through Medicare Advantage.'' Another said, ``I cannot afford
higher out-of-pocket costs. I get preventative care. I also get some
dental coverage and eye care that I would not be entitled to under
original Medicare.'' And, lastly, ``Please, in the name of decency, do
not vote to change my health care.''
Mr. Speaker, over 13,000 of my constituents benefit from Medicare
Advantage. I will not vote to cut their benefits today. I will not, Mr.
Speaker, support this bill which pits grandparents versus their
grandkids.
Mr. DINGELL. Mr. Speaker, at this time I yield to the distinguished
gentlewoman from Wisconsin (Ms. Baldwin) 2 minutes.
Ms. BALDWIN. Mr. Speaker, I rise in strong support of the CHAMP Act,
and our chairmen who have worked so hard to craft this bill deserve
great credit. It is a very strong measure.
There are many reasons to support this bill, but chief among them is
the fact that this bill will provide health care coverage for an
additional 5 million low income children, bringing the total to 11
million insured infants and children covered under SCHIP. This
represents real progress at reducing America's 46.6 million uninsured
people, and I am proud to support this progress.
Mr. Speaker, I am also proud to note that the CHAMP Act does not pit
children against seniors, as has been suggested by many of the
Republicans, but instead works to improve health care for both children
and seniors.
The bill includes many investments in Medicare that will directly
benefit the health of our seniors. The bill includes a physician fix so
that our doctors will not be subjected to the harsh 10 percent
scheduled cut in reimbursement, and, providing this fix will ensure
that beneficiaries have continued access to their physicians.
In addition, this bill provides many more protections to Medicare
beneficiaries by expanding and improving the programs which ensure that
Medicare remains affordable to those with lower income. The CHAMP Act
also expands access to preventative benefits and mental health benefits
for all Medicare seniors.
But back to my first point. If this Congress stands for anything, it
should stand for children, for providing them with comprehensive health
care, for giving them the support and care they need for a healthy
life.
[[Page H9481]]
I am reminded of the first day of this session when Speaker Pelosi
invited all the children to join her at the podium. This Congress
should be judged based on how we protect our Nation's children. That is
this vote.
{time} 1730
Mr. STARK. Mr. Speaker, I'm happy to yield 1 minute to the
distinguished lady from Ohio (Ms. Tubbs Jones). And, pending that, I
suggest that she understands that the American Nurses Association has
expressed their undying support for the Children's Health and Medicare
Protection Act.
Mrs. JONES of Ohio. Mr. Speaker, I rise today in support of H.R.
3162, the Children's Health and Medicare Protection Act. And for the
Record, I want to compliment the Chair, Mr. Rangel; the ranking member,
Mr. Stark; and the staff of the Ways and Means Committee for all of
their hard work, because I was one of those at the table battling on
behalf of a whole lot of people.
This piece of legislation will be critically important to children.
But while expanding access to health care for children is my key focus,
I remain watchful of the provisions that could have adversely affected
persons with end-stage renal disease. I'm pleased that there are
provisions in the bill that will help measure and, hopefully, reduce
racial and ethnic disparities in kidney care, bolster the health and
health care of our low-income seniors and protect our Nation's
hardworking health providers.
As I have said many times before, the CHAMP Act is an example of a
socially responsible and medically appropriate health policy that will
improve the health and well-being of our Nation's most vulnerable
residents.
I call upon all of my colleagues to join us in supporting this
legislation.
Announcement by the Speaker Pro Tempore
The SPEAKER pro tempore. The Chair must observe that if Members
yielding time in debate also include extensive comments, the Chair may
have to charge the time consumed by such remarks against that Member's
time for debate.
Mr. DINGELL. Mr. Speaker, at this time, I yield 2 minutes to my
distinguished colleague from North Carolina, Mr. Butterfield.
Mr. BUTTERFIELD. Mr. Speaker, I rise today to thank Chairmen Dingell,
Rangel, Pallone and Stark for their bold leadership in bringing this
legislation to the House floor. As Congressman for the 15th poorest
district in the Nation, a district where 50 percent of the children
qualify for SCHIP, I enthusiastically support passage.
The CHAMP Act of 2007 reflects what should be our Nation's
priorities. It is the duty of Congress to keep the promise of our
Constitution, to provide for the general welfare of our people. What
better way, Mr. Speaker, to keep that promise than to guarantee that
our children are afforded adequate health insurance.
The sad fact is that a majority of uninsured children are minority,
including 1.4 million black children and 3.4 million Hispanic children.
In my State of North Carolina, 195,000 children are eligible but not
enrolled in the program. We have a moral obligation to ensure all
children who are unable to afford insurance have that insurance. To do
less would be shameful.
Let me close, Mr. Speaker, by thanking the gentleman for giving me
this time and also expressing disappointment with my Republican friends
who have engaged in nothing but obstructionism and filibuster as we
have struggled to bring this legislation to the floor.
You insisted on reading a 495-page bill, consuming 18 hours of our
committee time. You have made your adjournment motions this week, and
you have wrongfully suggested that we want to insure illegal aliens.
That's wrong. And then you accuse us of taking Medicare benefits from
our seniors; and then you use that worn out phrase, ``tax increase''.
The American people have figured it out. You are doing every
conceivable thing to prevent giving insurance coverage to 5 million
children of the working poor.
My friends, you are wrong.
Mr. STARK. Mr. Speaker, as quickly as I can, I would like to
recognize the distinguished gentleman from Alabama (Mr. Davis) for 1\1/
2\ minutes.
Mr. DAVIS of Alabama. I've listened to a lot of allegations, Mr.
Speaker, that the Democratic Party, the party that crafted Medicare and
Social Security and Medicaid, is somehow cutting health care benefits.
I don't want this debate to end without putting a few simple facts in
perspective.
There is one party in this Chamber that said to 13 million working
class families on Medicaid for the first time, you have to make a co-
pay for your kids to go to the doctor.
There is one party in this Chamber that, 4 years ago, in the Medicare
Modernization Act, tucked in the fine print of the bill a requirement
of guaranteed Medicare cuts in the next several years.
There is one party in this Chamber that passed the prescription drug
bill that contained a massive doughnut hole for seniors which allowed
them to lose their coverage for a period of time.
There's one party in this Chamber that has sent five budgets, just in
my tenure, to the floor of the Congress cutting Medicaid benefits.
There is one party in this Chamber that has proposed to cut, that has
passed a guaranteed 10 percent cut for reimbursements for doctors, set
to go into effect beginning on January 1.
It is the Republican party.
Let there be no debate, Mr. Speaker. There is one party that has its
bona fides on the question of health care. It is the party that is
moving today a bill that will provide universal coverage for all
children who need it.
It is shameful for this debate to have been twisted and distorted in
the manner that it has.
Mr. CAMP of Michigan. Mr. Speaker, how much time is remaining?
The SPEAKER pro tempore. The gentleman from Michigan (Mr. Camp) has
21 minutes. The gentleman from California has 13\1/2\ minutes. The
gentleman from Michigan (Mr. Dingell) has 11\1/2\ minutes.
Mr. CAMP of Michigan. At this time, Mr. Speaker, I yield 2 minutes to
a distinguished member of the Ways and Means Committee, the gentleman
from California (Mr. Herger).
Mr. HERGER. Mr. Speaker, I rise in strong opposition to the CHAMP
Act. The message of this bill is, Washington knows best.
I recently received a letter from one of my over 4,500 seniors in my
district who could lose their Medicare Advantage benefits under this
bill. Kathleen Lopez of Marysville, California, writes, ``I chose a
Medicare Advantage plan because I receive Social Security benefits less
than $700 net per month. This plan encourages preventive care, has some
vision and dental coverage. This type of plan eliminates costly monthly
expenses for health coverage.''
In addition to slashing Medicare Advantage, this bill contains
massive expansion of SCHIP that takes kids from middle-class and even
upper-class families off private insurance and puts them into a
government-paid program.
All of us support reauthorization of SCHIP. Everyone supports health
care for low-income children. But what we are debating here today is
whether to turn this successful anti-poverty program into an open-ended
entitlement with effectively no limits on eligibility.
Mr. Speaker, we have a choice. We can move towards a 21st century
patient-centered health care system driven by competition and
innovation, or we can go backwards towards a system of socialized
medicine like the one that the Canadian doctors come here to escape.
Mr. Speaker, this bill goes in the wrong direction. I urge my
colleagues to reject it.
Mr. STARK. Mr. Speaker, at this time, I'm delighted to yield 1\1/2\
minutes to the gentlelady from Connecticut (Ms. DeLauro).
Ms. DeLAURO. Mr. Speaker, we all pay the price when 46 million
Americans, 9 million of them children, have no health insurance. We all
have a responsibility, a moral responsibility to make sure that our
most vulnerable get the health care coverage they need.
The State Children's Health Insurance Program is perhaps the best
social policy success story of the last decade. At a time when most
Americans want to see this program reach more of the 6 million children
who are eligible but still uninsured, the administration's proposal
would result in hundreds of thousands of children losing their
coverage. That is the wrong direction and the wrong choice for our
country.
[[Page H9482]]
The Children's Health and Medicare Protection Act will take us in the
right direction, reaching children most in need, while improving
Medicare for 44 million seniors and people with disabilities.
This is about embracing our Nation's most serious challenge, a
challenge the Federal government has the ability, the capacity, the
resources and the moral obligation to help us meet.
We all have a stake in solving this crisis. No one, not even the
President, should be able to undermine the great promise of a healthy
future for our kids.
Mr. DINGELL. Mr. Speaker, I'm delighted to yield 1 minute to my good
friend and colleague from Iowa (Mr. Loebsack).
Mr. LOEBSACK. Mr. Speaker, I rise in strong support of the Children's
Health and Medicare Protection Act. This bill provides health care to
those who most need it, our children. That's what this bill is about.
The CHAMP Act means that the coverage of almost 50,000 children
enrolled in Iowa's CHIP Program, called the Hawkeye program, will be
secured. This bill also provides essential funding for the State to
reach the almost 30,000 children who are eligible for the program but
remain uninsured.
In addition, the CHAMP Act would provide the State of Iowa with a new
option to cover an additional 47,000 children who are aging out of
Medicare and CHIP.
No child should go without health care. No child should go without
regular checkups, preventive care and treatment of illnesses. The CHAMP
Act serves as a crucial health care safety net for low-income,
uninsured children. That's what it's all about. And I urge my
colleagues to support its passage.
Mr. CAMP of Michigan. Mr. Speaker, at this time, I yield 2 minutes to
a distinguished member of the Ways and Means Committee, the gentleman
from Texas (Mr. Brady).
Mr. BRADY of Texas. Mr. Speaker, for the Record, there is only one
party that fought hard to make sure our seniors had life-saving drugs,
even though our colleagues across the aisle had 8 years of the White
House and control of the Senate and never brought a bill to the floor
to help our seniors with their medicines.
And I'd point out that while many lobbyists in Washington support
this bill, I've not heard from one hospital, not one nurse, not one
physician, not one senior who supports this bill.
380,000, that's how many Texas elderly will likely lose their
personal Medicare plan as a result of this bill. 107,000, that's how
many seniors in the Houston-Beaumont-Huntsville region will see serious
cuts in their Medicare Advantage plan, or be forced into other plans
with less health care coverage as a result of $50 billion of
unnecessary and drastic Medicare cuts.
This is kid care versus Medicare. And only in the poisonous
environment of Washington do politicians pit children against their
grandparents. It is a cynical and a false choice that will leave many
seniors stranded without the health care plan that fits their needs.
I, like others, support covering more children for health insurance,
but not at the expense of elderly.
I sit on the committee charged with preserving Medicare, keeping
seniors healthy; and these Medicare Advantage plans are the preferred
plan for many of our Texas elderly. They're especially critical to our
rural and low-income and minority seniors because they provide a
comprehensive plan with medicines and emphasis on prevention.
I also believe that before Congress expands CHIP to higher-income
families, it should first help the children of low-income families
which the program was designed to serve. Maybe we should subsidize the
coverage for the bank president's kids, but shouldn't we first help the
health care for the bank teller's kids?
Texas, like many States, barely covers half of the children already
eligible for this; and, as a Congress, our goal should be to cover the
children of working poor first.
Mr. STARK. Mr. Speaker, at this time, I'm privileged to yield 1
minute to the Delegate from the Virgin Islands (Mrs. Christensen).
Mrs. CHRISTENSEN. I'm proud to be here, Mr. Speaker, to stand in
strong support of the Children's Health and Medicare Protection Act of
2007.
We also have additional champs in Chairmen Dingell, Rangel, Stark and
Pallone, as well as the Speaker and the Democratic leadership.
Today, we're fulfilling a commitment we made on the first day of this
Congress to take care of America's children. By passing H.R. 3162, we
will take the first step to insuring the 6 million low-income, now
uninsured children in this country, including many who are racial and
ethnic minorities; and we'll be investing in a healthier future for
them and our country by ensuring they get comprehensive care.
{time} 1745
In CHAMP we also fulfill a commitment to our seniors and persons with
disabilities, especially those of low income, to remove some of the
remaining barriers to Medicare. This bill helps children and seniors.
And we are beginning to help bring provider payments in line with the
rising cost of providing medical care as well as to start the reform
this country needs. This legislation is not only good for our children,
our seniors, and our disabled, it is good for our country.
If we only extended CHIP, as our Republican colleagues suggested, it
would cause 800,000 children to lose coverage. We can't do that.
Support this bill. Reject the motion to recommit.
Mr. CAMP of Michigan. Mr. Speaker, I yield 2 minutes to the
distinguished gentleman from Indiana (Mr. Pence).
(Mr. PENCE asked and was given permission to revise and extend his
remarks.)
Mr. PENCE. Mr. Speaker, I thank the gentleman for yielding.
I have heard a lot of generosity on the floor today, Mr. Speaker.
People can always be generous with other people's money. And it seems
that the new majority back in power has already gone the way of the old
Democratic majority and, in fairness, along the way of mistakes that we
made.
I was one of the Republicans that opposed our effort to vastly expand
Medicare with the prescription drug entitlement. I think voters
actually put some of us on the pavement because, with an $8 trillion
national debt, they are tired of reckless and runaway spending in
Washington, D.C.
This bill is a massive increase in the government's role in health
care. It makes millions of middle-class families eligible for
government insurance, many of which are already covered under private
plans. I don't think taxpayers should be required to pay for government
insurance for the children of parents who earn up to $80,000 a year.
And we do this at the expense of seniors, cutting into the Medicare
Advantage program.
And I would say to you American taxpayers should not have to support
a system that provides health insurance coverage for illegal
immigrants. This legislation allows funding of illegal immigrants in
health care. It cuts health care for millions of senior citizens in the
Medicare Advantage program. It provides government insurance for
higher-income families, and it drastically expands the role of the
government in America's health care system.
It just seems to me this new majority does well when it reminds the
American people that we have a moral obligation to come to terms with
an $8 trillion national debt. The next time I hear one of those
speeches on the floor, Mr. Speaker, you will forgive me if I run to the
floor to remind people of a $47 billion middle-class entitlement that
passed the Congress today.
I urge my colleagues to oppose the CHAMP Act, to oppose middle-class
entitlements.
Mr. STARK. Mr. Speaker, at this time I am pleased to yield 1 minute
to the gentlewoman from Texas (Ms. Jackson-Lee).
(Ms. JACKSON-LEE of Texas asked and was given permission to revise
and extend her remarks.)
Ms. JACKSON-LEE of Texas. Mr. Speaker, on the other hand unlike the
minority, I rise to champion the CHAMP Act. Let me thank Chairman
Stark, let me thank Mr. Dingell, and Mr. Rangel for providing the
threesome who understood that our children are in need!
Mr. Speaker, it is a crisis. The CHIPS is getting ready to expire. I
am very glad that we did something monumental in 1997 by implementing a
program to help America's children--
[[Page H9483]]
CHIP. Five million children will be added. It will make it a total of
11 million children. Also seniors will have their choice of hospitals
an doctors and they will be able to get all of their benefits under
Medicare.
We will follow the current immigration law so the argument regarding
undocumented immigrants is unfounded. But a sick person is a sick
person, a sick baby is a sick baby, and Texas needs dollars, and
America needs this health coverage.
At the same time, I look forward to working with the committee so
that our doctor-owned hospitals in rural and underserved areas will be
able to get a waiver so that they can continue to serve in those areas.
But I am proud that we are providing more benefits, not fewer benefits,
and we are providing more dollars for the State of Texas' most neediest
residents--children and seniors--they need good health care now.
I urge my colleagues to support the CHAMP Act.
Mr. Speaker, I rise today in strong support of the Children's Health
and Medicare Protection Act of 2007 (CHAMP Act). I would like to thank
my colleague Mr. Dingell for introducing this legislation, and for his
leadership, together with that of Mr. Rangel, in shepherding this
legislation through both the Energy and Commerce and the Ways and Means
Committees.
This important legislation commits $50 billion to reauthorize and
improve the State Children's Health Insurance Program, SCHIP, and it
also makes critical investments in Medicare to protect the health care
available to our Nation's senior citizens. I strongly urge my
colleagues to join me in supporting this excellent bill.
Mr. Speaker, SCHIP was created in 1997, with broad bipartisan
support, to address the critical issue of the large numbers of children
in our country without access to health care. It serves the children of
working families who earn too much money to qualify for Medicaid, but
who either are not able to afford health insurance or whose parents
hold jobs without health care benefits.
Children without health insurance often forgo crucial preventative
treatment. They cannot go to the doctor for annual checkups or to
receive treatment for relatively minor illnesses, allowing easily
treatable ailments to become serious medical emergencies. They must
instead rely on costly emergency care. This has serious health
implications for these children, and it creates additional financial
burdens on their families, communities, and the entire Nation.
This year alone, 6 million children are receiving health care as a
result of SCHIP. However, funding for this visionary program expires
September 30. Congress must act now to ensure that these millions of
children can continue to receive quality, affordable health insurance.
President Bush has employed rhetoric in support of this program while
on the campaign trail, stating in 2004 that ``In a new term, we will
lead an aggressive effort to enroll millions of poor children who are
eligible but not signed up for government health insurance programs.''
Unfortunately, however, in practice both the Administration and my
colleagues on the other side of the aisle in Congress have proposed
significant cuts in the program. If these are approved, millions of
children will lose health coverage.
As chair of the Congressional Children's Caucus, I can think of few
goals more important than ensuring that our children have access to
health coverage. It costs us less than $3.50 a day to cover a child
through SCHIP. For this small sum, we can ensure that a child from a
working family can receive crucial preventative care, allowing them to
be more successful in school and in life. Without this program,
millions of children will lose health coverage, further straining our
already tenuous healthcare safety net.
Additionally, through this legislation, we have an opportunity to
make health care even more available to America's children. The
majority of uninsured children are currently eligible for coverage,
either through SCHIP or through Medicaid. We must demonstrate our
commitment to identifying and enrolling these children, through both
increased funding and a campaign of concerted outreach. This
legislation provides States with the tools and incentives they need to
reach these unenrolled children without expanding the program to make
more children eligible.
In my home State of Texas, as of June 2006, SCHIP was benefiting
293,000 children. This is a decline of over 33,000 children from the
previous year. We must continue to work to ensure that all eligible
children can participate in this important program. To this end, Texas
Governor Rick Perry signed legislation in June to, among other things,
create a community outreach campaign for SCHIP.
In addition to reauthorizing and improving the SCHIP program, this
legislation also protects and improves Medicare. Due to a broken
payment formula, access to medical services for senior citizens and
people with disabilities is currently in jeopardy. Physicians who
provide healthcare to Medicare beneficiaries face a 10 percent cut in
their reimbursement rates next year, with the prospect of further
reductions in years to come looming on the horizon. The budget proposed
by the Bush administration does not help these doctors, or the patients
that they serve.
Mr. Speaker, I believe that senior citizens and individuals with
disabilities deserve access to quality and affordable healthcare.
Currently, there are 35 million seniors without private health plans,
and, at current rates, the Medicare Trust Fund will be depleted early
because of excess payments to HMOs. This legislation reverses
Republican efforts to privatize Medicare, and it ensures that seniors
will have access to the doctor of their choice.
This is extremely important legislation providing for the health
coverage of 11 million low-income children, as well as protecting the
health services available to senior citizens and persons with
disabilities. I strongly support this bill, and I urge my colleagues to
do the same.
Mr. DINGELL. Mr. Speaker, at this time I yield 1 minute to the
distinguished gentleman from Tennessee (Mr. Cohen).
Mr. COHEN. Mr. Speaker, I am astonished at what I have heard from the
other side of the aisle: disingenuous talk about great deficit; the
deficit caused by the Republican majority's work or lack of work over
the last 12 years; giving tax breaks to the rich while sending our
troops to a war that has cost us half a trillion dollars and
approaching a trillion dollars. That is where the deficit has come
from, and this disingenuous talk is shocking to hear.
And the admission that they are against giving children of middle-
class families health care. The Republican party, Mr. Speaker, used to
say they cared about the middle class. Now they say they don't want to
give health benefits to their children. That is amazing. And doctors,
who used to be one of their main interest groups, would get
reimbursement that they are entitled so that they can continue to
participate in Medicare under this plan, and they oppose that.
I would ask you to look at the wall and Daniel Webster, who says,
engraved in stone here: Do something of monumental proportions. Do
something that generations will remember, something great.
That is what this bill will do. I am happy to be here in support of
the CHAMP bill. Hubert Humphrey was a champion of children, and I am
happy to stand here for him.
Mr. CAMP of Michigan. Mr. Speaker, I yield 2\1/4\ minutes to the
distinguished gentleman from Kentucky (Mr. Whitfield).
Mr. WHITFIELD. Mr. Speaker, if there ever was a bill that should have
bipartisan support, it is this SCHIP bill. All of us support health
care for children.
But the problem that we have in this process is that this is a bill
that really did not receive the full vent of the Congress. And so here
we find ourselves on the floor debating a bill that is going to be a
dramatic change and expansion of government health care.
The original SCHIP program was designed for 250 percent of the
poverty level and above. This bill removes that limit so that States
can do whatever they want to.
Today there are 700,000 adults on the Children's Health Program. This
bill is going to greatly expand the number of adults on the program.
There even are incentives so that children will leave their parents'
health plan and go to the government health plan, and in doing so,
since children are generally a healthy group, the private health plan
premiums are going to increase in cost. They are also imposing a fee on
every private health plan in America, every self-insured health plan in
America.
In addition to that, they are going to lower the reimbursement for
the Medicare Advantage program, which is particularly strong in rural
areas, which will hurt the seniors on the Medicare Advantage program.
So the bottom line, and philosophically we are not questioning
anyone's motives, but there should be a full debate on this. This is
dramatically expanding government health care and diminishing private
health care. And that is what this debate is really all about.
[[Page H9484]]
And I would say this: We need a strong private health system. That
has been the tradition in America. And last year, for example, the MD
Anderson Cancer Center in Texas spent more money on research and
development in health care and health needs and curing diseases than
all of the entities in the Canadian health plan. That is why we are
upset about this program. Not that we don't want to cover children.
I thank the gentleman for his generosity of time.
Mr. STARK. Mr. Speaker, at this time I yield for the purpose of
making a unanimous consent request to the distinguished gentleman from
Oregon (Mr. Wu).
(Mr. WU asked and was given permission to revise and extend his
remarks.)
Mr. WU. Mr. Speaker, I rise in support of the CHAMP Act and the
reauthorization of the State Children's Health Insurance Program, or
SCHIP.
This bill will cover the nearly 11 million children who fall into the
gap between Medicaid and private insurance.
Not only will the CHAMP Act provide health insurance for millions of
additional children, but also the peace of mind for millions of
families who work hard to provide all of life's essentials for their
families.
For my state of Oregon the passage of the CHAMP Act means many of the
107,000 uninsured children will have access to health care.
And while the legislation before us today is a suitable and necessary
short-term solution, the long-term need remains: America is falling
short of our moral obligation to provide all children with access to
health care.
Access to health care is not only a struggle for those with the
lowest incomes; it now also is a struggle for those we have
traditionally considered middle-class, and therefore should be able to
afford health insurance.
Since 1965 Medicare has ensured our Nation's senior citizens have
access to health care. That success should be extended to cover our
youngest citizens. I am developing new legislation will do just that.
My MediKids legislation would provide access to comprehensive health
care for all children and expecting mothers. Every child would be
automatically enrolled at birth. But parents would retain the right to
choose to enroll their children in private plans or others such as
SCHIP or Medicaid.
MediKids also would act as a safety net. If parents have a lapse in
other insurance, a common concern and constant worry among many
families, MediKids would provide coverage.
America has the best health care in the world, but fewer and fewer
families can actually afford it. We should not make our children, and
their parents, wait any longer.
I urge my colleagues to support the legislation before us, but to
continue to work toward a long-term solution for today's and tomorrow's
youngest citizens.
Mr. DINGELL. Mr. Speaker, at this time I am delighted to yield 1
minute to the distinguished gentleman from Pennsylvania (Mr. Altmire).
Mr. ALTMIRE. Mr. Speaker, I continue to hear my colleagues on the
other side of the aisle say that this bill is a move towards
government-run health care that will cause seniors to lose their
Medicare.
I would suggest to my colleagues who complain inaccurately that
Medicare beneficiaries will lose coverage under this bill that, if my
colleagues are so worried about that, they should consider the
implications of doctors refusing to see Medicare patients, which is
exactly what could happen if we don't pass this bill and fix physician
reimbursement.
SCHIP is a State block grant program and will remain so under this
bill. Nearly every State contracts out the SCHIP program to private
insurers. That is far from a government-run program.
These are children who live in families where the head of household
works but they don't make enough money to afford health insurance.
These are families that work hard and play by the rules but still can't
afford health care for their kids. That is what we are talking about
here today, Mr. Speaker.
This bill protects and strengthens the Medicare trust fund and
invests in our children, and I ask my colleagues to support this bill.
Mr. CAMP of Michigan. Mr. Speaker, I yield myself 2 minutes.
First, I would like to make one point perfectly clear. Republicans
support health care for low-income children. We support reauthorizing
the program we passed in 1997. And that shouldn't come as a surprise to
anyone. After all, it was the Republican majority that created the
State Children's Health Insurance Program, and we did it in a
bipartisan manner.
Today, sadly, we do not have a bipartisan bill before us. When we
talk about insuring the Nation's needy children, we should talk about
it in a bipartisan way. And if the majority had crafted a bill that was
just about helping low-income children, we would stand here today ready
to overwhelmingly approve that legislation.
Unfortunately, this bill doesn't focus on low-income children.
Instead, it draws scarce resources away from these needy children in
order to take a giant leap toward universal, government-controlled
health care.
Worst of all, this dramatic step comes at the expense of Medicare,
seniors' health insurance, in order to give middle-class and even upper
middle-class families a new Federal health benefit.
These are not minor cuts in senior health care. The majority's bill
cuts or eliminates many Medicare benefits and services: $157 billion in
cuts to Medicare Advantage, which are health plans that offer
additional benefits to low-income seniors like disease management,
vision, dental, and hearing benefits, and improves the quality of care
they receive; billions in cuts to hospitals; billions in cuts to home
health care services, to wheelchairs, to patient rehab facilities, to
nursing homes, to dialysis patients, and to oxygen treatment. And
because of a new insurance tax on every insured American, health costs
to seniors and all Americans will go up.
I don't know about you, but I can't look a 75-year-old widow in the
eye in my district and honestly ask her to give up her benefits so that
a 45-year-old couple making $80,000 a year or more with a 21-year-old
can receive government health care.
This bill did not have to be this way. It should not be this way. I
urge my colleagues to vote against this bill, and I urge the majority
to bring us back a bill that focuses on helping low-income children.
That is a bill we can all support.
Mr. STARK. Mr. Speaker, I would like to yield 1 minute to the
distinguished gentleman from Connecticut (Mr. Murphy).
Mr. MURPHY of Connecticut. Mr. Speaker, I thank my friend from
California for yielding.
We talked a lot about how this bill is great for kids. I want to join
Mr. Altmire in talking about this bill is great for seniors as well.
Four years ago this House passed an expansion of the Medicare program
to cover drugs. It should have done it a long time ago. The problem was
when you finally did it under Republican control, it ended up
benefiting the drug companies and insurance companies and really being
a burden for many senior citizens. That ends in large part today with
the passage of this bill.
The underlying CHAMP Act today is going to finally allow seniors to
be able to switch their plans when the plans change the drugs that they
cover. It is going to begin to remove the doughnut hole, especially for
the most vulnerable Medicare recipients out there. And it is finally
going to get rid of those burdensome late penalties for the lowest of
income seniors.
This bill is undoubtedly a great bill for kids. This bill is also
going to be a great step forward for the millions of seniors around
this country who have been struggling with the Medicare part D program
for the last 4 years.
I thank the gentleman for his work on this bill.
{time} 1800
Mr. CAMP of Michigan. At this time, Mr. Speaker, I yield 1 minute to
the gentleman from Florida (Mr. Bilirakis).
Mr. BILIRAKIS. I thank the gentleman for yielding.
I rise in opposition to a bill that is more about politics than
children's health insurance. The so-called CHAMP Act represents a
missed opportunity to expand SCHIP in a focused manner to help provide
health care to our Nation's neediest kids.
I'm extremely disappointed that this bill raises taxes and cuts
Medicare to expand the program well beyond its original intent. This
bill would cut Medicare benefits to more than 45,000 of my constituents
who rely on their Medicare Advantage plans for services
[[Page H9485]]
and benefits they otherwise could not afford.
Mr. Speaker, I urge our colleagues to, instead, support the motion to
recommit, which will extend the SCHIP program and stop scheduled
Medicare physician payment cuts without raising taxes or cutting
Medicare.
I will oppose this bill if the motion to recommit fails because I
oppose politicizing an issue that should be above the partisan
differences that too often divide us.
Mr. DINGELL. Mr. Speaker, at this time, I am delighted to yield 1
minute to the distinguished gentleman from Georgia (Mr. Scott) and to
note that he provided extraordinary leadership in the creation of a
program of this type in Georgia. He is entitled to speak, I think, with
real wisdom. We thank you.
Mr. SCOTT of Georgia. I thank the distinguished gentleman, Mr.
Dingell, for his courtesies.
This is, indeed, our finest hour of opportunity, and I urge my
Republican friends not to blow this.
Now, I have come to this well because I come from Georgia, a State
that is in dire need of this bill being passed. We have nearly 300,000
children who are affected by this program. And I want to take just a
minute because there is so much I want to say I have only a minute to
say it.
There are so many reasons that the Republicans have used to try to
come up against this bill. I cannot for the life of me understand why
you are not standing forefront in favor of getting health care for our
children. But perhaps the most devious one of all that you use is to
try to fight the immigration fight on this bill.
In this law, it clearly states, ``No Federal funding for illegal
aliens.'' Nothing in this act allows Federal payment for individuals
who are not legal residents. Gentlemen, that is a false, false horse to
ride.
Vote for the children. Vote for this bill.
Mr. CAMP of Michigan. Mr. Speaker, at this time, I yield 1 minute to
the gentleman from Arizona (Mr. Flake).
Mr. FLAKE. I thank the gentleman for yielding.
Yesterday, we passed lobby reform legislation that deals with
earmarks, gives Members certain notice. You have to put your name next
to it. There is certain transparency and accountability, some of which
is good.
I should note, with this legislation, in the middle of the night last
night we did the equivalent of earmarking on an authorization bill. We,
in the middle of the night, designated some 25 hospitals, giving them a
different designation, which will save those hospitals millions and
millions of dollars. That's the equivalent of appropriation earmarks in
an authorization bill, done without debate, without notice. We're
getting it now.
And there is a process within the executive branch to deal with this.
We have circumvented that process and said we're going to do it
legislatively. That is simply not right and certainly not in keeping
with the spirit of legislation that was passed just yesterday.
Mr. STARK. Mr. Speaker, I yield myself such time as I may consume to
respond to my distinguished friend from Arizona.
And I have to admit, in honesty, that there are earmarks in this
bill. There are 11 million earmarks, six million children whose names
we now have and five million children to be added to the bill. And I'm
proud to say those earmarks are in the bill.
Mr. Speaker, I am pleased to yield 30 seconds to the gentleman from
New York (Mr. Rangel).
Mr. RANGEL. I want to compliment my colleague on his concern about
earmarks; and I hate to see your record and credibility shattered
merely because many Members, Republicans and Democrats, did not want
certain hospitals to suffer the cuts, as has been recommended by this
administration. And where we could and where there appeared to be some
doubt, I gave my word to the members of the Ways and Means Committee,
as did Mr. McCrery, that Pete Stark and I would be taking a look at
each and every one of them. But it would be a tremendous stretch of
anyone's imagination to call that an earmark.
Mr. CAMP of Michigan. Mr. Speaker, I yield 1 minute to the gentleman
from Georgia (Mr. Westmoreland).
Mr. WESTMORELAND. I appreciate the gentleman for yielding.
Mr. Speaker, I have been listening to the debate, and I haven't heard
of any way that this is going to be paid for, the 130 something billion
dollars over 10 years, except for 45 cent a pack increase in the tax on
tobacco. So while I heard some Members over there talking about this is
going to be a deterrent to people smoking, you better hope a bunch of
people start smoking because you're going to have to sell a ton of
cigarettes to come up with $132 billion. But then the closer you look
at it, you find out that this is, again, smoke and mirrors from this
majority in Congress.
What this is going to do in 2011 is actually cut doctors' pay 12
percent. Now, if anybody really believes in this room that we're going
to cut doctors' pay by 10 or 12 percent, they're kidding themselves.
This is another gimmick, more smoke and mirrors, more illusion for the
people of this country.
The people of this country are smarter than that. When they recognize
what this is, then I think that the majority is going to find out that
they do not want the CHUMP bill passed.
Mr. STARK. Mr. Speaker, at this time, I'm pleased to yield 1 minute
to the distinguished gentleman from Pennsylvania (Mr. Fattah).
Mr. FATTAH. It's been said that it is how we treat the least of these
that we will be judged. I think about my own four children, Francis and
Chip and Cameron and Chandler. I think about the night I spent at the
Children's Hospital all night long with my daughter because she
suffered from dehydration. It's wonderful that she has insurance and we
can provide for the best coverage at the best Children's Hospital, I
think, anywhere in the world. But this bill is about helping all of our
children, the six million that will continue to have coverage and the
five million that we're adding.
The AMA, the AARP, the National Committee to Preserve and Protect
Social Security, the Children's Defense Fund, all of these entities
that represent these interests have lined up on behalf of this bill.
And we need to line up this House on the right side of history.
I want to commend the chairmen, Rangel and Dingell and Pallone and
Stark, for their work and ask for a unanimous vote on behalf of the
CHAMP Act.
Mr. CAMP of Michigan. Mr. Speaker, I yield 1\1/2\ minutes to the
gentlewoman from Tennessee (Mrs. Blackburn).
Mrs. BLACKBURN. Mr. Speaker, what a fascinating debate it is that we
are having; and I thank the gentleman for yielding a few moments of
time.
You know, we're beginning to hear from some of the nearly 54,000
Medicare beneficiaries that we have in our district because they have
figured out that this is going to be financed on their back; and we
have nearly 9,000 Medicare Advantage beneficiaries that are in our
district. Our Congressional Budget Office estimates are telling us that
this looks like it's going to end up costing us over $11 million in our
district.
Now, we know that we're going to see the tax on private insurance.
We've heard from some of our individuals who are questioning why in the
world are you putting a tax, you've got a tax on everything, why are
you taxing our health insurance benefits?
We're hearing from our tobacco farmers and our friends in the
agriculture community that are quite upset about cigarette and cigar
and tobacco taxes there. And as the gentleman from Georgia just said,
this grand plan basically says, seniors, we need you to smoke more so
that you can help pay for this plan to expand SCHIP to middle- and
upper-income families.
And being a mother, I can tell you that a 25-year-old probably is a
little bit offended to be called a child, because 25-year-olds are
adults. They are young adults, and they are working, and they do not
need to be on those programs.
Mr. STARK. Mr. Speaker, at this time, I am pleased to yield as much
time as he may consume to the distinguished chairman of the Ways and
Means Committee, Mr. Rangel.
(Mr. RANGEL asked and was given permission to revise and extend his
remarks.)
Mr. RANGEL. Let me extend an olive leaf to my friends on the
Republican
[[Page H9486]]
side, because it just wouldn't be fair for you to be going home
thinking that people will be talking about politics and process when
the bottom line is: Where were you when this government, as big as it
is, wanted to protect 11 million kids in health insurance? That's going
to really be the bottom line.
And if you think that government is really so big that $50 billion is
just too much money to invest in these little kids, then kind of think
about what you're willing to invest in Afghanistan, in Baghdad, in
improving its schools and its hospitals.
And think of what we get back. Just think of what we get back in
preventing these kids from getting diseases and illnesses that would
not only cost us billions of dollars in health care, but the lost
competition, the inability to learn and to be productive. What a heck
of an investment this is, even for our United States Government, to be
concerned with 11 million Americans becoming healthy, better educated
and competitive.
This is not a question of Democrats being so dumb, so stupid, so
apolitical that we want to hurt our own folks. Unlike children, they
vote. And every organization that has dedicated themselves to older
Americans for health services have endorsed this: the hospitals, the
doctors, the nurses, the Catholics, the Protestants, the Jews, the
gentiles. People who are concerned about human lives are concerned that
we do these things.
What do you think we are? We were born yesterday? No. I don't know
what the President intends to do, but you can't hurt this President
anymore. You don't have to do this to yourselves. Just think about your
explanations: The bill wasn't ready; it didn't come out of committee. I
don't know. How are you going to pay for it in 2012? Or maybe some of
you youngsters have to think about it. But just think about how many
people are going to get health care between now and 2012 before we look
at the President's tax cuts. Somehow they kind of broke it off at 2010.
So it's not the first time people had these creative ideas.
But let me suggest this to you: This bill expires on September 30.
Now, I don't know whether they have town hall meetings on the other
side or not, Steny, but I would hate to be at one of them when they
explain why there is not going to be insurance for these six million,
and additional five. I hate for them to say how they were reading the
bill because they didn't participate.
These are things that we can improve upon. And Mr. McCrery and I work
every day to see whether we can do a better job on communication. But
don't you let our lack of communication interfere with having coverage
for 11 million kids who deserve better than what we've given them in
terms of the debates and the discussion on this historical piece of
legislation.
So we have the opportunity to join with hundreds of Americans that
are concerned about our young people, our old people, a better America.
Our educators, our teachers want to do this. I cannot think of anything
that's more important for our national security and our national
defense than investing in these young people who carry the torch of
freedom for the generations that follow us.
But if you don't do this, if they find themselves without health
care, if their parents cannot be productive on the job because they're
worried about their kids and not being able to get to a clinic, if they
can't enjoy the preventive care that you enjoy and I enjoy and our
children and grandchildren enjoy, you explain it, that we weren't
talking to each other, we didn't cooperate, and the program just
expired.
No. I don't want you to go that way. I don't even think the President
wants to go that way. I want you to think about the bottom line: 11
million kids, an improved Medicare system, $15 billion helping citizens
or older that don't have the funds to get insurance, 5 billion for
those in the rural areas that don't have access to health care. This is
what we're doing.
You may not have liked the roadmap, but you can't walk away from what
we've done. You can never say anything that's wrong about helping
children. So let us try to think about how we end this up, because come
this November people will be asking the questions. I don't think it's
going to be on process. I don't think it's going to be how long you
kept us up at night. I don't think it's going to be how many
parliamentary maneuvers we had. I don't think it's whether we missed
our Easter recess. Did you let this program expire and were you there
when the children called on you?
I hope we can count on your vote.
{time} 1815
Mr. CAMP of Michigan. Mr. Speaker, I yield 1\1/2\ minutes to the
gentleman from Texas (Mr. Culberson).
Mr. CULBERSON. Mr. Speaker, everyone who is about to vote for this
bill needs to read it.
Mr. Speaker, on page 3 of the bill, on the bottom of the page, each
State is going to conduct its own audit of eligibility of people that
they are providing federally funded health insurance for.
Now, we know already the State of California has said they want to
provide health insurance coverage to all children in the State,
regardless of whether they are here legally or not. But they can't do
that. California cannot extend health insurance to people who are
undocumented, because Federal law currently requires that you must
prove you are here legally or that you are a citizen under existing
law. But this bill repeals that verification requirement. The bill
specifically allows each State ``shall audit itself.''
Under State law, States can use any verification method they wish to
determine whether or not somebody is a citizen or they are here
legally. Obviously, this law repeals the verification requirement and
allows the State to provide health insurance coverage to people who are
here illegally or undocumented aliens. In fact, there is no way to even
verify their income level.
This is an open-ended faucet that the States are going to be able to
tap into the Federal treasury. This is a creation of ``HillaryCare''
where everyone in this Nation under the age of 25, we are going to kick
seniors off of Medicaid and Medicare and allow States to sign up people
who are undocumented aliens for the first time in this Nation's
history, at a time of record debt, record deficit, and at a time the
taxpayers cannot afford it.
Mr. Speaker, this spendthrift majority is going to bankrupt this
Nation.
Mr. STARK. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, first of all, I take this opportunity before we have
closing remarks to thank the ranking member of the Ways and Means
Committee and the ranking member of the Health Subcommittee for their
comity during all of our discussions and the hearings in the past.
I also want to take the chance and take the time to thank our staff,
Cybele Bjorklund; Debbie Curtis; Deb Mizeur; Jennifer Friedman; Chad
Shearer; Dr. Gene Rich, one of the most overpaid physicians in the
country; Drew Dawson; Dana Sun, our intern from the Massachusetts
Institute of Technology; Karen McAfee; Ed Grossman; Jessica Shapiro;
Mark Miller and the MedPAC staff.
I would also like to thank Chuck Clapton, Joelle Oishi and Dan Elling
from the minority staff.
I would like to thank also the staff of the Energy and Commerce
Committee: Bridgett Taylor, Amy Hall, Yvette Fontenot, Heather Foster,
and Christie Houlihan. All of these people contributed to work to see
that we could be as fair and as equitable as we could in drafting this
bill. I think they can all be proud of both the work and their efforts
to see that this bill was fair and equitable.
Mr. Speaker, I reserve the balance of my time.
Mr. DINGELL. Mr. Speaker, could I ask how much time remains to the
different Members?
The SPEAKER pro tempore. The gentleman from California has 30 seconds
remaining, the gentleman from Michigan (Mr. Camp) has 4\3/4\ minutes
remaining, and the gentleman from Michigan (Mr. Dingell) has 7\1/2\
minutes remaining.
Mr. DINGELL. Mr. Speaker, I yield 1 minute to the distinguished
majority leader (Mr. Hoyer).
Mr. HOYER. Mr. Speaker, I want to thank my extraordinarily generous
friend from Michigan, for whom I have not only great respect but great
affection as well. I want to thank him for his more than half a century
of leadership on issues of health care in America, on extending health
care and insurance to every American, to ensuring
[[Page H9487]]
that in this great country of ours every American has the opportunity
to receive the extraordinary quality health care that we have available
in this great country.
I also want to thank my good friend, the chairman of the Ways and
Means Committee, Charlie Rangel, who has for so many years fought the
good fight. As he said on this floor, this is an opportunity for us to
extend to children the benefits of health care. I want to mention the
President's intent as well.
I want to thank my friend from California, Pete Stark, who has been
the Chair of this subcommittee and who has been so faithful.
And I want to thank Mr. McCrery and the ranking member of this
subcommittee. I understand we may have a difference of view, but we are
working together now, as the American people expect us to do.
I said on this floor last night that we would have a robust debate on
this important legislation, the Children's Health and Medicare
Protection Act. I think we have had that robust debate.
While we may disagree on elements of this bill, I believe that
virtually all of us agree that it is unacceptable and, indeed, immoral
that millions of children in the wealthiest Nation on the face of the
Earth do not have health insurance. That is unlike every industrialized
nation in the world, other than ourselves.
This historic legislation addresses this national challenge, building
upon the successes of the State Children's Health Insurance Program,
which received strong bipartisan support in the Republican-led Congress
in 1997 and which was signed into law by a Democratic President,
President Clinton.
Under this bill, 11 million American children, six million who
currently are covered under SCHIP and an additional five million
children who currently lack health insurance, will have access to
quality, affordable health insurance. It seems to me that is why so
many of us serve in this body, to ensure that our people have that
access.
Let us be clear. Contrary to the claims of some, including, sadly, at
this point in time, President Bush, this legislation does not expand
the SCHIP program. Let me repeat that. This legislation does not expand
the SCHIP program. Instead, this legislation provides the resources
needed to enroll children who are eligible under existing law but who
are currently not enrolled. Let me reiterate. The CHAMP Act maintains
current law regarding eligibility for SCHIP.
Furthermore, this legislation ensures seniors access to the doctors
of their choice by stopping a scheduled 10 percent payment cut to
doctors. It phases out overpayments to private plans.
My friends on the other side, of course, want to make sure that the
government is very careful in its expenditure of funds, and it urges us
to adopt the practices of the private sector, which are driven by
competition on price. However, in this case, we have mandated by law
that the competitors receive 100 percent reimbursement while the
competitors that are favored receive 111 to 130-plus percent. That is a
little bit like the prescription drug bill where we can't negotiate for
price.
This bill maintains competition and access, and in so doing, the bill
would extend Medicare solvency by 3 years, while protecting seniors and
people from disabilities from having to pay higher monthly premiums. In
addition, my friends, this bill improves Medicare by, among other
things, providing new preventive benefits.
I must note, Mr. Speaker, that nearly 3 years ago, in the middle of a
presidential campaign, President Bush said the following, and I quote.
And this, by the way, was at the 2004 Republican national convention
when President Bush was seeking the votes of Americans throughout this
country to be reelected President.
This is what he said: ``America's children must have a healthy start
in life,'' to which clearly all of us as we watched the television
said, Amen. ``In a new term,'' he said, ``we will lead an aggressive
effort to enroll millions of poor children who are eligible but not
signed up for government health insurance programs.''
Mr. President, that is what we are doing this afternoon.
But now, unfortunately, a mere 36 months later, the President is
threatening to veto legislation that does precisely what he said he
wanted to do in 2004 as he was running for President and seeking the
votes in that convention.
Mr. Speaker, contrary to the claims of the President and other
opponents of this bill, it does not constitute a government takeover of
health care. That is a straw man. That is a shibboleth. That is not
accurate. In fact, three-fourths of the children in the SCHIP program
receive care today through private insurance plans that contract with
the States.
Nor is the bill fiscally irresponsible. A curious claim, I would say,
coming from the President and congressional Republicans whose policies
added more than $3 trillion to the debt. I got a letter just a few days
ago, maybe you got it as well, Mr. McCrery, from Secretary Paulson. He
said, ``you know, we are running up against the debt limit.''
Does anybody here know in the 4 years preceding this Bush
administration's policies how many times we raised the debt? Not once.
But we have raised it five times in the last 6 years, if we raise it
again.
So when we talk about fiscal responsibility, it is fiscally
responsible to invest in the health care of our children, because they
will be healthier citizens, more productive citizens, and we will have
a better, more economically viable country. In fact, the Democratic
majority has taken pains to pay for this legislation and abide by pay-
as-you-go budget rules which provided for 4 years of surplus
immediately preceding this administration.
Mr. Speaker, in the final analysis, the question before the Members
of this body really is this: Do you support reauthorizing this critical
program and providing health insurance to eligible children, eligible
children, eligible children, or not? I urge my colleagues, vote to
provide health care for our children. Vote to improve and protect
Medicare. Vote for the CHAMP Act.
Mr. CAMP of Michigan. Mr. Speaker, I yield to the distinguished
gentleman from Florida (Mr. Young) for the purpose of making a
unanimous consent request.
(Mr. YOUNG of Florida asked and was given permission to revise and
extend his remarks.)
Mr. YOUNG of Florida. Mr. Speaker, I rise in support of children and
older Americans this afternoon because I have supported and initiated
many legislative efforts in this House to provide health care benefits
to both groups.
Yet I must oppose this legislation today because the process under
which we are considering it is a disservice to young and old alike. We
have before us a major expansion of a Federal entitlement program, a
$54 billion tax increase, and the largest cut in the history of the
Medicare program under a procedure that allows no member--Republican or
Democrat--to offer an amendment to improve this bill. This is the
people's House, and yet only a handful of our 435 members have had a
chance to write this legislation. Two major committees--Ways and Means
and Energy and Commerce--had primary jurisdiction over this matter, but
the Energy and Commerce Committee did not even hold public hearings on
this important issue.
The State Children's Health Insurance Program (SCHIP) was established
with my support in 1997 through a bipartisan effort of this Congress.
It has been an unqualified success in providing life-saving medical
care to children throughout our Nation. The SCHIP program in Florida
now covers children in families with annual incomes of up to 200
percent of the poverty level. In the 10th Congressional District I have
the privilege to represent, 21,779 families, or 34 percent of all
families with children under the age of 18, are already eligible for
Medicaid or SCHIP.
While we could have extended the current, very successful program and
modified it to make some program improvements in the coverage of those
children who have no insurance, those who wrote this legislation seek
to expand the program to include children who come from families that
already have health insurance. Children from families with incomes as
high as $82,000 could become eligible for health care benefits. And the
authors of this legislation pay for this new coverage by cutting
Medicare benefits upon which thousands of seniors in my district rely
on for their health care needs. It is estimated that these cuts total
upwards of $194 billion over the next 10 years.
This would cut funding for the 42,843 seniors in my district who are
currently enrolled in a Medicare Advantage Program.
This legislation cuts payments for seniors' hospital and inpatient
care by $2.7 billion.
This legislation cuts payments for seniors' inpatient rehabilitation
services by $6.6 billion.
[[Page H9488]]
This legislation cuts payments for seniors' skilled nursing
facilities by $6.5 billion.
This legislation cuts payments for seniors' home health care services
by $7.2 billion.
This legislation cuts payments for those of all ages with End Stage
Renal Disease by $3.6 billion.
This legislation would impede the mobility of seniors by making them
wait a full month to receive Medicare coverage for a motorized
wheelchair.
And this legislation would reduce the amount of time seniors can
receive Medicare coverage of home oxygen equipment from 36 to 13
months.
Mr. Speaker, my district is home to All Children's Hospital in St.
Petersburg, Florida. My wife Beverly and I have spent countless hours
there with children and their families, as well as with their doctors
and medical staff. You can be sure we understand the special needs of
children, particularly those without health insurance coverage. The
program we established 10 years ago was a major improvement in
expanding the health care options of children. It also provided
important reassurance for their parents.
There is no doubt that we could have improved this legislation by
working together. Republicans and Democrats alike support providing
health care coverage for children and seniors. Instead, this
reauthorization of what was a major bipartisan health care initiative
has been rewritten with the input and ideas of just a select few
members without the opportunity of amendment by all the members of this
House.
In fact, the last changes to this legislation were made at 3 this
morning. Those changes even wrote into this bill specific program carve
outs for 36 hospitals identified by name or location. None are in
Florida. How were those hospitals selected?
Mr. Speaker, when it comes to providing health care for young or old
alike we should work together in a bipartisan manner to create the best
program possible. The best ideas do not reside in just one committee or
one political party. We should all have the opportunity to contribute
to this legislation, to debate amendments, and to vote on those
amendments. A majority of members, not a majority party, should
determine what is best for the American people.
While I will vote against this legislation today in large part
because of the procedure under which it is being considered and my
concern about the negative impact it will have on older Americans, it
is my hope that when it returns from the Senate and a conference
between the House and Senate, it will be something that I can support,
that the majority of my colleagues can support, and most importantly
that Americans of all ages can support.
Mr. CAMP of Michigan. Mr. Speaker, I yield 1\1/2\ minutes to the
gentleman from Texas (Mr. Hensarling).
Mr. HENSARLING. I thank the gentleman for yielding.
Mr. Speaker, it is clear, the Democrat majority will soon ram through
this Congress the single largest step in Washington-controlled,
bureaucratized, rationed, socialized health care. And they are going to
do it all under the guise of helping the neediest of our children. But
by passing this bill, they are threatening the quality, the access and
the choice of health care for all children in America. It is a sad day
indeed for our children's physical health. It is a sad day for their
fiscal health.
We all know, Mr. Speaker, that Medicaid is the program for the
neediest of our children, and we know that SCHIP today is providing for
the health care of those low-income working parents.
This is about something else. This is about taking adults off of
private health care and putting them on public health care. It is about
creating a new permanent entitlement, no matter what the majority may
say. There will be no income limit on SCHIP eligibility, no sunset of
the program, no annual allotment for the States. It shifts children
participating in private insurance that their parents have chosen to
that run by the government.
In creating a new entitlement, we are on the verge of leaving the
next generation with a lower standard of living. Defeat this program.
{time} 1830
Mr. DINGELL. Mr. Speaker, I believe here we have two remaining
speakers. As I understand the practices of the House, it is, of course,
the right of the chairman of the committee of jurisdiction to close.
I am the only speaker other than our Speaker who wishes to speak and
from whom we wish to hear. I would ask first my colleagues on the
minority side how many more speakers they have.
Mr. CAMP of Michigan. I just have one speaker remaining, Mr. Speaker.
The SPEAKER pro tempore. The Chair will recognize Members to close in
the following order: the gentleman from California, the gentleman from
Michigan (Mr. Camp), and then the gentleman from Michigan (Mr.
Dingell).
Mr. DINGELL. I would ask unanimous consent that I be able to speak
but that our Speaker be able to close for this side.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Michigan?
Mr. CAMP of Michigan. Reserving the right to object, if I can inquire
of the gentleman, are there only two speakers?
Mr. STARK. I will be glad to yield back the balance of my time.
The SPEAKER pro tempore. The gentleman from California may reserve
the \1/2\ minute to recognize the Speaker if he wishes.
Mr. STARK. I would like to do that if I may.
Mr. CAMP of Michigan. I withdraw my reservation of objection.
Mr. SPEAKER pro tempore. The reservation is withdrawn.
The Chair will note that the gentleman from California will yield his
\1/2\ minute to the Speaker. The gentleman from Michigan (Mr. Dingell)
has 6\1/2\ minutes remaining. The gentleman from Michigan (Mr. Camp)
has 3\1/4\ minutes remaining.
Mr. DINGELL. If the gentleman from Michigan so desires, I would defer
to him and allow him to speak now, then I will have my remarks, and
then the Speaker will close.
The SPEAKER pro tempore. The gentleman from California will be first
recognized to close. The gentleman from Michigan (Mr. Camp) will be
next recognized to close. The gentleman from Michigan (Mr. Dingell)
will be recognized to close. Mr. Dingell can reserve 1 minute at the
end of his time to recognize the Speaker to close if he wishes.
Mr. DINGELL. That is my unanimous consent request.
The SPEAKER pro tempore. In that case the gentleman from California
(Mr. Stark) has 30 seconds.
Mr. STARK. Mr. Speaker, I am happy to yield back the balance of my
time.
Mr. CAMP of Michigan. Mr. Speaker, I yield the balance of my time to
the gentleman from Louisiana (Mr. McCrery), the distinguished ranking
member of the Ways and Means Committee.
The SPEAKER pro tempore. The gentleman from Louisiana is recognized
for 3\1/4\ minutes.
Mr. McCRERY. Mr. Speaker, I think this has been a good debate today.
It has been a good debate in part because I believe a number of Members
on both sides of the aisle have learned things about this legislation
that they didn't know before this debate. I think there are enough
questions that were raised today about exactly what is and is not in
this bill to warrant this House taking more time to get it right.
The motion to recommit that we will offer in just a few minutes will
give this House that opportunity because we in the motion to recommit
ask the committee to report back forthwith, which means that this House
can today pass what is in our motion to recommit. And in that motion to
recommit we will reauthorize the current SCHIP program for 1 year, and
we will do a fix for the doctors' reimbursement for 1 year. That will
allow this House to give the appropriate amount of time to discover
what is and what is not in this legislation that the majority has
presented us today and figure out, perhaps in a bipartisan way, the
best manner in which to proceed on a long-term basis with the SCHIP
program.
I would ask those fiscal conservatives in the majority, some of whom
have in good conscience complained about some of the actions of the
former majority, there are signs in the hall talking about the national
debt, and I ask those Members to think before they vote for this bill.
Do they really want to establish a new entitlement program that is
open-ended in this country, that is not properly funded? It is funded
with a tobacco tax. That is going to be a decreasing source of revenue
for this country, not increasing. It is funded with changes to the
Medicare program, cuts to the Medicare Advantage program. That is not
going to have long-
[[Page H9489]]
lasting consequences? So, really, I want those people who are concerned
about the deficit and concerned about the debt to think before they
vote for this bill.
We are giving you an opportunity in the motion to recommit to sustain
the SCHIP program, do what you've talked about doing, fix the doctors'
reimbursement for a year, and give us more time to talk back and forth
a little bit and explore the consequences of some of the provisions
that are in this bill that we think would do injury to the fitness of
this country, and we think that we can work together to provide a
better way for insuring children in this country, not the way that is
in this bill.
I believe that this bill is fiscally irresponsible. It is too bad we
didn't have fuller hearings and fuller opportunities in committees, in
both the Ways and Means Committee and the Energy and Commerce
Committee, to explore some of the particulars that the majority decided
to put into this bill and just informed the House about within the last
24 hours or so.
Had we had that opportunity, I believe Members with goodwill on both
sides of the aisle could have worked out what I believe would have been
a much, much better bill than what I perceive to be a hastily put
together bill that is before us today.
General Leave
Mr. DINGELL. Mr. Speaker, I ask unanimous consent that every Member
have 5 legislative days in which to revise and extend their remarks and
include extraneous material on the legislation now before us.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Michigan?
There was no objection.
Mr. DINGELL. Mr. Speaker, I yield myself 6 minutes, and I yield the
balance of the time to our distinguished Speaker for purposes of
closing.
Mr. Speaker, we have had a good debate. I believe the Members have
become understanding of not only the situation but of the legislation
before us.
I want to particularly commend the staff of the Energy and Commerce
Committee: Amy Hall, Yvette Fonteno, Christie Houlihan, Heather Foster,
Jessica McNiece and Bridgett Taylor, who all did a superb job on behalf
of the Congress.
I also want to thank Cybele Bjorklund, Deb Mizeur, Jennifer Friedman,
Chad Shearer, Brian Biles, Bobby Clark, Debbie Curtis, Ed Grossman and
Jessica Shapiro from the Ways and Means Committee staff. Their really
valuable contribution did much to make this possible.
I want to commend my colleagues on the minority side, Mr. Camp and
Mr. McCrery and Mr. Barton, and my special friend, Mr. Stark, and the
distinguished Chairman Rangel for the superb job they have done. I also
thank the subcommittee chairman in the Energy and Commerce Committee,
Mr. Pallone, for his outstanding job.
The legislation before us is really very simple. The issues before us
are not procedure. Rather, they are: Are we going to take care of our
kids?
For this Congress, this is perhaps the greatest opportunity we will
have. We have three responsibilities to the country and to our kids:
See that they are properly nourished, see that they are properly
educated, and see to it that they have the health that they need so
they can be meaningful contributors to the future of this country. It
is not only a humanitarian and compassionate concern of this country,
it is the future of the country.
I know the President has indicated that he thinks that this is bad
legislation. I grieve that he has come to that conclusion. He has no
reason to do so.
First of all, we have the pay-fors. We have taken care of the cost of
this. We are seeing to it that, first of all, a modest tax on tobacco
comes into play.
Second, we are seeing to it that HMOs that are getting as much as 30
percent more than other HMOs are going to get 100 percent of what other
HMOs get, no more, no less. We are not taking anything away from senior
citizens. I think we are just taking it out of the pocket of a few
people who have too much in the HMO business.
Having said that, let's look to see who supports this legislation. I
think that tells us as much or more as anything we can get. The NAACP,
the AMA, the different health organizations, the hospital associations,
the National Rural Health Association, the American Academy of
Pediatrics, the March of Dimes, the Children's Defense Fund, and the
National Governor's Association whose meeting I attended last weekend
in Traverse City where a major concern was how are we going to provide
them the means that they desperately need to provide for the health
care for the children under CHIP? That was on the lips, the mind, and
in the heart of every one of the governors who spoke there.
I would observe that the Catholic Health Association also speaks to
this because they have a concern that this is the best way we can take
care of the children and we can see to it that we give a decent right
to life to every American.
I would offer to my colleagues, any or all of them, a list of those
who do, the organizations who are supportive of this legislation; and I
point out that you will find almost every organization that cares about
kids or health or the well-being of our young people as supporters of
this bill, including the great American labor organizations, the AFL-
CIO and the UAW. That should speak clearly to us of the needs.
I would point out that there are a number of misunderstandings that
have been stated here. It has been said this is going to raise costs
and it is going to raise the amount that is paid to individual
recipients. Not so. This is a program which is going to be governed by
the costs which were fixed when the legislation was first offered and
first introduced and first put into law under the leadership of, for
example, Newt Gingrich and Dick Armey. So it is not fiscally
irresponsible.
The legislation is going to do something else. It is not going to
take care of illegals, nor is it going to engage in any weird
practices. If there are waivers given, and they can be given, they will
be given in the same fashion as they were given before, and that is by
this administration saying this is something that is justified,
justifiable and proper and which will help kids. I will note that they
have not been overly generous in giving those particular waivers.
So what we have a chance to do today, Mr. Speaker, and my friends and
colleagues, is to take care of the kids, to support those who are least
able to look to their own well-being and who are most defenseless and
to suit them best for a healthy, growing adult life so they may
contribute to a better, richer, stronger and safer America.
We are doing something else. We are seeing to it that we are
compassionate, and we may best be judged by that because, in doing
that, we are best looked at by being those who really care for those
who have the least.
I urge my colleagues to vote for the CHAMP legislation. It is good.
It is in the public interest.
I now yield to the distinguished Speaker. Madam Speaker.
The SPEAKER pro tempore. The gentlewoman from California, the
distinguished Speaker of the House of Representatives, is recognized
for 1 minute.
Ms. PELOSI. Mr. Speaker, as I rise here today, something after 6:30
p.m., I was reminded as I listened to the presentations of a poem that
most of us memorized when we were young by Henry Wadsworth Longfellow:
Between the dark and the daylight,
When the night is beginning to lower,
Comes a pause in the day's occupations,
That is known as the Children's Hour.
That's this time of day. This is the children's hour. Because of the
leadership of so many of our colleagues, we are able to meet our moral
obligation to our children. It isn't a pause in our occupation. It is
our mission, this moral obligation that we have to the future.
When I was sworn in as Speaker, I was surrounded by children. It was
very exhilarating, and I called the House of Representatives to order
on behalf of all of America's children, establishing this Chamber as
the champion for our children and for the future.
Our legislation is called CHAMP because it does just that. It
champions quality health care for America's children and for our
seniors, strengthening families. It is just one way in which this new
direction Congress is putting health care and particularly the needs of
our children at the top of the Nation's agenda.
[[Page H9490]]
With the passage of this legislation, the new-direction Congress will
ensure that 11 million of America's children receive health care
coverage, and seniors will receive improved benefits under Medicare.
I want to join those of my colleagues who have expressed their
appreciation for the exceptional leadership of our chairmen of the full
committees and the subcommittees and the ranking members of the full
committees and the subcommittees for the honest debate that we are
having about this legislation today.
{time} 1845
I think it's important to note, because it's history, that our
distinguished chairman of the Energy and Commerce Committee, Mr.
Dingell, when he was a new Member of Congress gaveled down the Medicare
bill. That's his family tradition, looking out for health care for all
Americans. His father was a leader on that subject in this Congress,
and imagine that he as a young Member, well still a young Member, but a
younger Member of Congress, gaveled down Medicare. And today, he is in
the lead on this legislation that will strengthen Medicare for
America's seniors.
And at the same time, thank you, Mr. Chairman and Mr. Rangel. Between
the two of them, Mr. Rangel and Mr. Dingell, they had 22 hearings on
the subject of SCHIP. So this Congress has had a thorough review of
this subject, and this excellent legislation is the product of that.
I was inspired by your speech, Mr. Rangel. You persuaded me, not
persuaded me to vote for the bill. I always intended to do that, but
persuaded me that it was possible that we might have a strong
bipartisan support for this bill because it is so much the right thing
to do.
I thank Congressman Stark and Congressman Pallone, Chairs of the
appropriate subcommittees of their committees, for their leadership,
their intense knowledge of this subject, the judgment they were able to
bring on decisions that we had to make about what would be in this
bill. Thank you, Mr. Stark and Mr. Pallone, and thank you again, Mr.
Rangel.
And I thank again Mr. McCrery for his, again, comity and the dignity
and the knowledge that he brings to this debate. Thank you, Mr.
McCrery.
And to all of the staff on both sides of the aisle, thank you for
your hard work on this. Their efforts will help millions of American
children and seniors live better lives.
SCHIP, created by a Republican Congress and a Democratic President,
signed into law by President Clinton, SCHIP has dramatically reduced
the number of poor, uninsured children in America. The legislation
before us today will improve SCHIP and the lives of millions of working
families in America by improving coverage for all 6 million children
currently insured under SCHIP and by extending that coverage to 5
million additional children. Those children will receive dental care
and, thanks to Congressman Patrick Kennedy, mental health services.
Dental care, we so take it for granted for our own children, but
after this legislation is passed, no more will we have the Demonte
Driver where we have to have a situation like that where a child will
die because he had an abscessed tooth that turned into a brain
infection. We're all familiar with the details of that sad story.
Today, we are doing something about it.
Let us be clear, most SCHIP beneficiaries receive their coverage
through private managed care plans, not through the government.
And let us be clear, as the chairman just pointed out, this
legislation is paid for; no new deficit spending, no heaping mountain
of debt on these children to pay for the health care they so rightly
deserve.
In addition to providing coverage to children, the CHAMP Act also, as
we know, strengthens and improves Medicare for every senior by
eliminating coinsurance requirements and deductibles for preventive
care. Imagine that, for preventive care, how important that is. The
legislation reduces copayments and provides for mental health parity,
and many more seniors will no longer face the doughnut hole. Remember
our old friend, the doughnut hole. Well, many more seniors will no
longer face the doughnut hole in the prescription drug benefit. We do
all of this and more for seniors and, I repeat, with pay-as-you-go
budget rules and extend the life of the Medicare trust fund by 3 years.
By passing the CHAMP Act, the New Direction Congress is keeping our
promise to seniors on Medicare and meeting our obligation to our
future, our children. Again, and it is paid for. I can't say that
enough.
The distinguished chairman of the Energy and Commerce Committee read
a long list. There are pages and pages. I would submit them for the
Record, except it would be very expensive to print. There are so many
names that are endorsing this legislation. They range from the
Children's Defense Fund, as was mentioned, the Catholic Hospitals
Association, National Committee to Preserve Social Security and
Medicare, the old, the young, everyone across the board, all the health
organizations that administer to the needs of our children and our
seniors.
I just say in conclusion, Mr. Speaker, as Pearl Buck said, ``If our
American way of life fails the child, it fails us all.'' With this
CHAMP Act, we are not going to fail America's children. We are
championing them and their grandparents.
This legislation has fiscal soundness. It has a values base, and it
should have the support of everyone in this body.
Mr. VAN HOLLEN. Mr. Speaker, I rise in strong support of the CHAMP
Act, the Children's Health and Medicare Protection Act.
The CHAMP Act reauthorizes and improves the very successful State
Children's Health Insurance Program, SCHIP. Created in 1997 by Congress
with broad bipartisan support, the SCHIP program currently covers 6
million children who otherwise would have no access to health
insurance. Despite its many successes, there are still more than five
million children who are eligible for SCHIP, but not yet enrolled in
the program. This bill seeks to cover those vulnerable children.
Unfortunately, President Bush's proposal seeks to turn back the clock
and take us in the wrong direction. The President has proposed funding
SCHIP at a rate that does not even take into account any increases for
inflation or population growth. Under the President's proposal, more
than 1.5 million children will lose SCHIP coverage and many States,
including Maryland, will continue to face funding shortfalls. Indeed,
the non-partisan Congressional Budget Office, CBO, has confirmed that
the President's proposal would be too little to keep covering the
children who are currently enrolled in SCHIP.
In contrast to President Bush's proposal, this bill will extend
coverage to an additional 5 million children who are currently eligible
for SCHIP but are not yet enrolled. I am also pleased that the bill
provides for guaranteed dental coverage in SCHIP--good oral health care
is integral to the health of children and no child should have to
suffer because they cannot access adequate dental care. No family
should have to suffer the loss of a child because they lack access to
dental care, as happened in the tragic case of Deamonte Driver, a 12-
year old Marylander who died earlier this year when an infection from
an untreated abscessed tooth spread to his brain. I am also pleased
that this bill provides important mental health coverage for children.
The reauthorization and improvement of SCHIP will benefit the
approximately 136,000 children who are currently enrolled in Maryland's
CHIP program and prevent Maryland from facing further funding
shortfalls in its SCHIP allotment as has been the case in recent years.
The CHAMP Act will also provide essential funding to Maryland to enroll
68,000 children in families with incomes under 200 percent of the
federal poverty level who remain uninsured. It will also provide
Maryland with a new option to cover more than 65,000 children who are
aging out of Medicaid and SCHIP. And because of the bill, Maryland will
have an increase in its SCHIP allotment of $99.7 million from last
year, allowing it room to reach additional eligible but uninsured
children.
Not so long ago, President Bush promised to expand coverage of SCHIP
to include eligible children who are not yet enrolled. In his September
2004 speech to the Republican National Convention, the President
stated--and I am quoting here, ``America's children must also have a
healthy start in life. In the 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.''
Now, the President has reversed course. In his July 10, 2007, speech
in Cleveland, Ohio, he forgot his 2004 pledge and stated, ``I mean,
people have access to health care in America. After all, you just go to
an emergency room.''
[[Page H9491]]
I hope the President will reconsider his position and help Congress
provide health insurance to 11 million children who are one of the most
vulnerable segments of our society.
In addition to reauthorizing SCHIP, the CHAMP Act makes improvements
in Medicare that will strengthen that important program. The
legislation reduces overpayments to Medicare Advantage plans, which are
paid, according to non-partisan CBO and other independent entities
analysis, on average, 12 percent more than the cost of care in
traditional Medicare. This will increase Medicare's solvency by two
years. In addition, the legislation prevents the impending physician
reimbursement cuts and provides positive updates in 2008 and 2009.
Also, the bill will increase Medicare beneficiaries' access to
preventive services by eliminating co-payments and deductibles for
current and future preventive benefits and authorizing Medicare to add
additional preventive services.
The CHAMP Act also increases the tobacco tax by 45 cents to a total
of 84 cents. Increasing the tobacco tax will save billions in health
costs and is one of the most effective ways to reduce tobacco use,
especially among children. In short, raising the tobacco tax will
prevent thousands of children from starting to smoke and the proceeds
of the tax will be used to expand health coverage for children. That is
a win-win result.
Mr. Speaker, the clock is ticking. I urge all of my colleagues to
vote for this much needed legislation.
Mr. LANGEVIN. Mr. Speaker, I rise in support of H.R. 3162, the
Children's Health and Medicare Protection Act. I know that this was not
an easy piece of legislation to put together and I appreciate the hard
work of my colleagues on the Committees on Rules, Energy & Commerce and
Ways & Means.
This bill is an important step in addressing the health care crisis
faced by millions of families. Access to affordable insurance and
quality preventive care is critical to the well-being and security of
all Americans. The CHAMP Act will ensure that all eligible children are
afforded the opportunity to enroll in State Children's Health Insurance
Programs and takes important steps to improve efficiency and secure the
solvency of the Medicare program, relied on by so many of our seniors.
The State Children's Health Insurance Program SCHIP, known as RIte
Care in Rhode Island, has made health insurance a reality for over
12,000 children in my home State this year--the majority of them in
families where one or more adult is part of the workforce. It is a
critical component of health care delivery in Rhode Island, as it is
across the country. I am so honored to be part of a Congress that is
taking steps to ensure that all children who are eligible for this
program are able to participate. By reauthorizing the SCHIP program, we
renew our national commitment to achieving the goal of insuring all
children whose parents cannot afford private health insurance coverage.
This bill also contains important components for Medicare
beneficiaries. The elimination of overpayments to private plans that
participate in Medicare delivery is a necessary step to increasing
efficiency of this program. This action will go a long way in
preventing premium increases for Medicare beneficiaries and will
strengthen Medicare's finances for the future. While we still have work
to do in improving certain aspects of the Medicare program--
particularly the prescription drug benefit--this bill will ease the
process for seniors who wish to change their prescription drug plan,
and it will increase access to preventive services, saving lives and
money.
Finally, I would also note that this legislation contains a fix to
the scheduled 10 percent cut in physician payments under Medicare. I am
pleased to support this fix and look forward to working with my
colleagues to craft a permanent solution to the flawed funding formula
that continues to recommend such cuts. We cannot offer high quality
health care to our Nation's seniors if health care providers cannot
afford to see Medicare patients.
I am pleased that this Congress has made access to health care a
priority, particularly for our Nation's children and seniors. I urge
all my colleagues to vote in favor of the CHAMP Act.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the gentleman for
yielding. Mr. Speaker, I rise in strong support of H.R. 3162, which
represents the agreement between the House and Senate on the ``Honest
Leadership and Open Government Act of 2007,'' which the House passed in
May 2007. With the adoption of this legislation, we begin to make good
on our pledge to ``drain the swamp'' and end the ``culture of
corruption'' that pervaded the 109th Congress.
It is critically important that we adopt the reforms contained in
H.R. 3162 because Americans are paying for the cost of corruption in
Washington with skyrocketing prices at the pump, spiraling drug costs,
and the waste, fraud and no-bid contracts in the Gulf Coast and Iraq
for Administration cronies.
The cozy relationship between Congress and special interests we saw
during the 109th resulted in serious lobbying scandals, such as those
involving Republican super lobbyist Jack Abramoff. In this scandal,
several congressional staff members and a former congressman pleaded
guilty to conspiring to commit fraud--accepting all-expense-paid trips
to play golf in Scotland and accepting meals, sports and concert
tickets, while providing legislative favors for Abramoff's clients.
But that is not all. Under the previous Republican leadership of the
House, lobbyists were permitted to write legislation, 15-minute votes
were held open for hours, and entirely new legislation was sneaked into
signed conference reports in the dead of night.
The American people registered their disgust at this sordid way of
running the Congress last November and voted for reform. Democrats
picked up 30 seats held by Republicans and exit polls indicated that 74
percent of voters cited corruption as an extremely important or a very
important issue in their choice at the polls.
Ending the culture of corruption and delivering ethics reform is one
of the top priorities of the new majority of House Democrats. That is
why, as our first responsibility in fulfilling the mandate given the
new majority by the voters, Democrats are offering an aggressive ethics
reform package. We seek to end the excesses we witnessed under the
Republican leadership and to restore the public's trust in the Congress
of the United States.
Mr. Speaker, Federal lobbying is a multi-billion dollar industry, and
spending to influence members of Congress and executive branch
officials has increased greatly in the last decade. While the Lobbying
Disclosure Act of 1995, LDA, is one of the main laws to promote
transparency and accountability in the federal lobbying industry and
represents the most comprehensive overhaul of the laws regulating
lobbying practices in 50 years prior to 1995, it falls far short of a
complete solution, as even recognized by its staunchest supporters,
during congressional hearings on the issue.
The need for further reform was highlighted by a major study of the
federal lobbying industry published in April 2006 by the Center for
Public Integrity, which found that since 1998, lobbyists have spent
nearly $13 billion to influence members of Congress and other federal
officials on legislation and regulations. The same study found that in
2003 alone, lobbyists spent $2.4 billion, with expenditures for 2004
estimated to grow to at least $3 billion. This is roughly twice as much
as the already vast amount that was spent on federal political
campaigns in the same time period.
The LDA contains a number of measures to help prevent inappropriate
influence in the lobbying arena and promote sunshine on lobbying
activities. However, according to the Center's study, compliance with
these requirements has been less than exemplary.
For example, the report found: during the last six years, 49 out of
the top 50 lobbying firms have failed to file one or more of the
required forms; nearly 14,000 documents that should have been filed are
missing; almost 300 individuals, companies, or associates have lobbied
without being registered; more than 2,000 initial registrations were
filed after the legal deadline; and in more than 2,000 instances,
lobbyists never filed the required termination documents at all.
Under the LDA, the Secretary of the Senate and the Clerk of the House
must notify in writing any lobbyist or lobbying firm of noncompliance
with registration and reporting requirements, and they must also notify
the U.S. Attorney for the District of Columbia of the noncompliance if
the lobbyist or lobbying firm fails to respond within 60 days of its
notification. It appears that until very recently, however, these cases
of noncompliance were not being referred to the Department of Justice
for enforcement. It is also clear that the infractions that are
actually being investigated by the Secretary or the Clerk do not
coincide with the extent of noncompliance, and it is entirely unknown
whether enforcement actions are being effectively pursued by the
Department of Justice. Clearly, further reform is needed.
Mr. Speaker, I commend the leadership of Speaker Pelosi and her team
for the excellent work in preparing this lobbying reform package. The
reforms contained in the package are tough but not nearly too tough for
persons elected to represent the interests of the 600,000 constituents
in their congressional districts. Indeed, similar bipartisan lobbying
and government reform proposals were debated and passed by the House
and Senate in 2006 but the Congress failed to reconcile the two
versions.
Mr Speaker, I support H.R. 3162 because it closes the ``Revolving
Door,'' requires full public disclosure of lobbying activities,
provides tougher enforcement of lobbying restrictions, and requires
increased disclosure.
H.R. 3162 closes the ``Revolving Door'' by retaining the current one-
year ban on lobbying by former members and senior staff and requires
them to notify the Committee on Standards of Official Conduct within
three days of
[[Page H9492]]
engaging in any negotiations or reaching any agreements regarding
future employment or salary. The members' notification will be publicly
disclosed.
The bill also requires members and senior staff to recuse themselves
during negotiations regarding future employment from any matter in
which there is a conflict of interest or an appearance of a conflict.
Mr. Speaker, this legislation also ends the ``K Street Project,''
made notorious during the 12 years of Republican control of Congress.
Members and senior staff are prohibited from influencing employment
decisions or practices of private entities for partisan political gain.
Violators of this provision will be fined or imprisoned for a term of
up to 15 years.
Second, H.R. 3162 requires full public disclosure of lobbying
activities by strengthening lobbying disclosure requirements. It does
this by mandating quarterly, rather than semiannual, disclosure of
lobbying reports. It covers more lobbyists by reducing the contribution
thresholds from $5,000 to $2,500 in income from lobbying activities and
from $20,000 to $10,000 in total lobbying expenses. It also reduces the
contribution threshold of any organization other than client that
contributes to lobbying activities to $5000, $10,000 under current law.
Third, the legislation increases disclosure of lobbyists'
contributions to lawmakers and entities controlled by lawmakers,
including contributions to members' charities, to pay the cost of
events or entities honoring members, contributions intended to pay the
cost of a meeting or a retreat, and contributions disclosed under FECA
relating to reports by conduits.
Fourth, the bill requires the House Clerk to provide public Internet
access to lobbying reports within 48 hours of electronic filing and
requires that the lobbyist/employing firm provide a certification or
disclosure report attesting that it did not violate House/Senate gift
ban rules. And it makes it a violation of the LDA for a lobbyist to
provide a gift or travel to a member/officer or employee of Congress
with knowledge that the gift or travel is in violation of House/Senate
rules.
Transparency is increased by the requirements in the bill that
lobbyists to disclose past Executive and Congressional employment and
that lobbying reports be filed electronically and maintained in a
searchable, downloadable database. For good reason, the bill also
requires disclosure of lobbying activities by certain coalitions but
expressly exempts 501(c) and 527 organizations.
Finally, Mr. Speaker, H.R. 3162 increases civil penalties for
violation of the Lobby Disclosure Act from $50,000 to $200,000 and adds
a criminal penalty of up to 5 years for knowing and corrupt failure to
comply. Finally, the bill requires members to prohibit their staff from
having any official contact with the member's spouse who is a
registered lobbyist or is employed or retained by such an individual
and establishes a public database of member Travel and Personal
Financial Disclosure Forms.
Mr. Speaker, it is wholly fitting and proper that at the beginning of
this new 110th Congress, the Members of this House, along with all of
the American people, paid fitting tribute to the late President Gerald
R. ``Jerry'' Ford, a former leader in this House, who did so much to
heal our Nation in the aftermath of Watergate. Upon assuming the
Presidency, President Ford assured the Nation: ``My fellow Americans,
our long national nightmare is over.'' By his words and deeds,
President Ford helped turn the country back on the right track. He will
be forever remembered for his integrity, good character, and commitment
to the national interest.
This House today faces a similar challenge. To restore public
confidence in this institution we must commit ourselves to being the
most honest, most ethical, most responsive, most transparent Congress
in history. We can end the nightmare of the last 6 years by putting the
needs of the American people before those of the lobbyists and special
interests. To do that, we can start by adopting by H.R. 3162.
Ms. CORRINE BROWN of Florida. Mr. Speaker, today I rise in strong
support of the CHAMP Act. The CHAMP Act is another achievement that the
Democratic Congress can point to that is fulfilling the needs of the
American people.
In my home State of Florida, KidCare--Florida's CHIP program--covered
303,595 children in 2006, but 718,603 children remain uninsured. The
CHAMP Act could provide Florida with approximately $2.54 billion in new
federal funding and an opportunity to get more children covered. States
like Florida need to step up to the plate and fund their CHIP program
to the fullest extent.
The CHAMP Act would provide continued health insurance to six million
children already covered and add an additional five million children
who currently lack health insurance nationwide. That alone should be
enough to vote for this bill, but the Republicans continue to play
political games.
Fortunately, the Republicans have no ground to stand on this bill and
they know it. They are trapped in a corner crying about tax increases
instead of supporting health care for five million children. Let me
tell you, this is why your party is no longer in control--you've
stopped listening to the people.
Opponents also say this is a fiscally irresponsible bill. Let me say
that your party doesn't understand fiscal responsibility. The
Republican party has run up the largest deficits in history and they
call this bill fiscally irresponsible. We have spent over $600 billion
on the President's war in Iraq and we can't spend less than $3.50 a day
to cover a child through CHIP. Seventy-six percent of Americans believe
that access to health insurance is more important than cutting taxes.
This bill will be one of the most important healthcare issues this
Congress will deal with and the American public will know who voted for
it. The number of uninsured children in the country is an
embarrassment. The Democrats are making the American public a priority
again and I encourage all of my colleagues to support this bill and
vote for the children.
Mr. ORTIZ. Mr. Speaker, today's CHAMP bill is one of the best pieces
of legislation the house has considered in a decade. It illustrates the
difference between how this Congress writes legislation and how the
Republican Congress wrote bills; today's bill favors children, the
Republican bill favored insurance companies.
This bill will provide health care to 11 million kids--five million
who currently lack health insurance and six million who are currently
covered by the Children's Health Insurance Program, SCHIP--by
reauthorizing and improving SCHIP. In Texas, more than 120,000 will
benefit.
This bill also reverses the Republican drive to privatize Medicare
and strengthens Medicare to: ensure beneficiaries' access to their
doctors; expand preventive benefits, mental health services and
physical, occupational and speech therapies; reduce costs for seniors
and people with disabilities with low incomes; protect consumers; and
extend policies that protect access to health care in rural
communities.
Congress created SCHIP in 1997 with broad bipartisan support. This
year, six million children have health care because of SCHIP. The
program has worked well in Texas. This is an excellent investment for
this Nation given that health care costs without insurance would be
much more expensive.
The funding for SCHIP expires September 30. If Congress does not act,
these six million children will no longer have access to quality,
affordable health insurance. These children are in working families
with parents who either cannot afford insurance or hold jobs that lack
health care benefits.
The President highlighted his support for SCHIP while running for re-
election in 2004, yet the Bush Administration and our Republican
colleagues propose underfunding the program significantly, which would
cause millions of children to lose coverage.
The CHAMP Act protects Medicare from privatization and promotes
fiscal responsibility by reducing overpayments to private plans.
Current overpayments to private plans cost taxpayers tens of billions
of dollars. According to nonpartisan analysts, private plans are paid,
on average, 12 percent more than traditional Medicare--and overpayments
to certain plans exceed 50 percent.
These overpayments are the result of a decade-long campaign by
President Bush and Republicans in Congress to privatize Medicare by
undermining traditional Medicare and promoting private insurance.
Republicans believe that the greater the number of beneficiaries
enrolled in private plans, the easier it will be to privatize Medicare.
The CHAMP Act guarantees seniors and people with disabilities can
continue to see their doctors by preventing scheduled physician payment
cuts from taking place.
The CHAMP Act extends expiring provisions that, if left unchanged,
would negatively affect rural beneficiaries' access to physicians,
hospitals, home health, ambulances, and lab services--all of which are
important to south Texas.
The bill also adds important consumer protections to Medicare. It
provides States with the authority to regulate private plans' marketing
abuses and increases penalties for violations, enables all
beneficiaries to switch Part D plans if plans alter their formulas.
This empowers low-income beneficiaries to change plans at any time. It
also requires greater quality reporting to ensure patients are getting
the best care available.
I urge my colleagues to support this important bill--and I encourage
the President to do the right thing and sign it, our children and their
grandparents are waiting.
Mr. CONYERS. Mr. Speaker, I rise in strong support of H.R. 3162, the
Children's Health and Medicare Protection Act (CHAMP Act). This
legislation will reauthorize the State Children's Health Insurance
Program, ensuring
[[Page H9493]]
that millions of children receive the care they need, and will protect
Medicare for America's seniors.
Even though I support this legislation, I rise today with a heavy
heart. It is nothing short of a disgrace that here, in the wealthiest
country on earth, eight million children lack health insurance
coverage. We ought to be ashamed that we are having this debate at all.
I am absolutely stunned that Congressional Republicans and the
President are opposing this legislation, particularly in light of the
fact that the President used CHIP as part of his campaign platform in
2004. Talk about shock and awe! I am shocked beyond belief that they
can stand before the American people with straight faces and refuse
health care for children. I am in awe of the gall required to base the
denial of these vital, life-saving services on an ideological talking
point. Madam Speaker, the ideology of my colleagues on the other side
of the aisle has not provided health care for these children yet. It is
impossible for any serious person to believe that if this legislation
is defeated the Republican ideology will suddenly start working its
magic and provide health care for these children whose parents can't
afford to buy it in the open market.
In my years fighting for universal health care, we have often said,
``Covering children is easy. How could anyone publicly refuse to
support coverage for children?'' It was coverage for adults that was
always perceived as the real challenge.
But today, the Republicans have stooped lower than even I thought was
possible. Not only are they saying ``We can't afford to give our
children health care.'' This is the same party, by the way, that finds
money for tax cuts for the rich, that finds money to fund a disaster of
a war. Many times more money than what is needed to cover these
children, in fact.
Not only are the Republicans admitting that they prioritize tax cuts
for the wealthy and feeding the military industrial complex over
insuring our children. They are now standing before the American people
and saying ``It is not our job to guarantee health insurance coverage
for America's children.'' They are refusing to make that promise.
Instead, they propose that our children's health should be subject to
the ups and downs of the stock market, that it should depend on their
parents' employment status, or how much they have in a bank account. It
is utterly beyond conception how the Republicans can possibly think
these ideas will be accepted by the American people. But I will leave
my colleagues on the other side of the aisle to face the repercussions
of this folly next November.
Let me move on to a more positive subject: the bill under
consideration today, which we will pass over these shameful objections.
The Children's Health and Medicare Protection Act, also known as the
CHAMP Act, reauthorizes the State Children's Health Insurance Program
(CHIP) and protects coverage for 6 million children, including 89,257
in Michigan, while extending health care coverage to another 5 million
low-income children. All told, this bill will ensure essential health
care coverage for 11 million of our most vulnerable children.
The Children's Health and Medicare Protection Act also makes needed
fixes to the Medicare program. It stops a 10 percent payment cut to
doctors, thereby ensuring that I, we seniors will continue to have
access to the doctors of their choice. It encourages seniors to seek
preventive health benefits by eliminating co-payments and deductibles
for these services. The bill protects low-income seniors by expanding
and improving programs that help keep Medicare affordable for those
with lower incomes. It stops overpayments to HMOs that are draining
money away from health care and into their profit margins. And it also
shores up Medicare's finances by extending the solvency of the Medicare
Trust Fund by two years.
Failing to pass this legislation would have real consequences for
children and seniors. If the State Children's Health Insurance Program
is not reauthorized by September 30th, 2007, millions of children could
lose their health insurance. Seniors will lose access to their doctors
and pay higher Medicare premiums to subsidize overpayments to HMOs. I
find it quite interesting that we haven't heard these so-called
fiscally responsible Republicans lamenting the fact that their friends
in the HMO industry are overbilling our government to line their
pockets. It seems that fiscal responsibility only applies when poor
children are on the receiving end.
Let's defeat the sham S-CHIP bill offered by Representatives Barton,
Shimkus and Blackburn that would leave millions of children without
health care while slashing Medicare and harming our seniors. Let's tell
the White House and Congressional Republicans that it's time to stop
playing political games. Let's tell them it's time to work together to
ensure more children across the country have the high-quality medical
care they deserve and strengthen Medicare for our seniors. They might
not be able to understand that it's the right thing to do, but the
American people certainly will.
Mr. UDALL of Colorado. Mr. Speaker, I rise in strong support of this
bill.
Dr. Martin Luther King, Jr. said ``of all the forms of inequality,
injustice in health care is the most shocking and inhumane.'' The CHAMP
Act addresses many problems that we currently have in our health care
system. It does not end health care inequality, but it will increase
coverage for low income children, and it will stave off payment cuts
for hardworking physicians, while increasing choices for seniors and
strengthening traditional Medicare.
I believe that health care should be a right, not a privilege, and
this act is a step in the right direction. The Children's Health
Insurance Program (CHIP) is set to expire on September 30, 2007. This
year, six million children have health care because of CHIP. If
Congress does not act, these six million will no longer have access to
quality, affordable health insurance. This legislation also provides
coverage for an additional 5 million children who currently qualify but
who are not yet enrolled under CHIP. These children are in working
families with parents who either can't afford insurance or have jobs
that lack health care benefits.
Despite claims by some, this bill does nothing to ``expand'' the CHIP
program. Instead, it maintains current eligibility requirements for
CHIP. The majority of uninsured children are currently eligible for
coverage--but better outreach and adequate funding are needed to
identify and enroll them. This bill gives states the tools and
incentives necessary to reach millions of uninsured children who are
eligible for, but not enrolled in, the program.
It has been said that the CHAMP Act creates an entitlement for
illegal immigrants. But in fact the CHAMP Act does not change existing
law, which states that undocumented immigrants are not eligible for
CHIP or regular Medicaid. And the CHAMP Act explicitly states that it
provides no federal funding for Medicaid or CHIP for undocumented
immigrants and requires audits of all State programs to ensure that
federal funds are not being spent on undocumented children.
The CHAMP Act will protect and improve Medicare by increasing fiscal
responsibility and ensuring access to doctors for seniors and those
with disabilities. Currently experts agree that Medicare Advantage (MA)
plans receive, on average, 12 percent more than the cost of care in
traditional Medicare. Overpayments to certain plans can exceed 50
percent. By phasing out these overpayments over the next four years the
Congressional Budget Office estimates that billions of dollars will be
saved each year. While, increasing the solvency of Medicare and
simultaneously reversing the catastrophic 10% payment cuts to
physicians who serve Medicare patients. By reducing overpayments to
Medicare Advantage plans, wasteful spending will be reduced while
increasing patient access to physicians.
Medicare Advantage plans originally sought to give beneficiaries more
choices at a lower cost. However, overpayments to MA plans do not
increase benefits but rather pay for the administrative costs,
marketing costs and profits for private plans. The CHAMP Act levels the
playing field by decreasing premiums for those enrolled in traditional
Medicare.
By curbing the overpayments to Medicare Advantage plans, this
legislation decreases the cost for preventative health services for
seniors, eliminating co-payments and deductibles for these vital
services while saving lives and money. Further, this bill includes $3
billion for the rural health care safety net. This ensures access to
quality care for those in rural America.
The health of our children is vital to the success of our society.
The CHAMP act will raise the federal tobacco tax by 45 cents. According
to the Campaign for Tobacco-Free Kids, a 45-cent increase means that
1,381,000 fewer children will take up smoking. Adults, too, would be
less likely to smoke, which means fewer smoking-related illnesses and
lower health costs. Estimates are that this tobacco tax increase will
result in long-term health savings of $32.4 billion and 669,000 fewer
smoking related deaths.
The CHAMP Act has the support of the American Medical Association,
American Association of Retired Persons, Catholic Health Association,
National Rural Health Association, American Hospital Association,
Federation of American Hospitals, American Nurses Association, Families
USA, National Partnership for Women and Families, Children's Defense
Fund, Child Welfare League of America, and the National Committee to
Preserve Social Security & Medicare.
I am proud to vote for this bill that seeks to protect those that are
most vulnerable in our society by increasing health insurance coverage
for low-income children and protecting and improving coverage for those
enrolled in Medicare and Medicaid.
Mrs. McMorris Rodgers. Mr. Speaker, I rise in opposition to the Rule.
Mr. Speaker, I strongly believe we must ensure access to
[[Page H9494]]
quality and affordable health care; this has been a top priority for me
as eastern Washington's Representative in this House. I wholeheartedly
support renewing the SCHIP program, which was originally created under
Republican control of Congress in a bipartisan fashion. Ensuring health
care for low income children who need it the most should be our
priority.
I also wholeheartedly support access to health care for seniors--but
unfortunately, because of partisan politics, a vote for this proposal
is a vote to kick over 157,000 seniors off their Medicare advantage
plans in Washington state.
Further, if this rule and this bill pass the House today, two
hospitals in my district, North Valley Hospital in Tonasket and Mid-
Valley Hospital in Omak, would be forced to close their doors to our
community.
These hospitals were started by concerned physicians who banded
together to provide health care in a remote region that is largely
comprised of Medicare and Medicaid beneficiaries. This bill forces
these doctors to sell their ``share'' of the hospital--which is less
than 1 percent a piece--because it incorrectly assumes they are
unethically self-referring patients.
That may be a problem in other parts of the country but not in
Okanogan County. These two hospitals are the closest hospitals within
5,000 square miles and serve the county's 40,000 residents. There has
to be a better way to prohibit unethical practices. Shutting down the
only vehicle for health care delivery is not the answer, which is why I
cosponsored an amendment to this rule that would have allowed these
hospitals to continue to serve all residents--from kids to seniors--in
Okanogan County. Unfortunately, this amendment was not allowed under
the Democratic leadership.
Not only does this bill devastate the already delicate rural health
care infrastructure in parts of eastern Washington, but it cuts deep in
the pocket of seniors in order to pay for a runaway expansion of this
children's health program that covers a 25-year-old adult.
Proponents of this bill might argue that it is necessary to kick
seniors off of their Medicare plans in order to cover poor children. I
would then ask them: do you consider a family of four making $82,000
dollars a year, a poor family? That is who we are covering here.
In eastern Washington alone, over 10,000 seniors would lose their
choice in Medicare coverage to pay for this reckless expansion. They
will be forced to find and pay out of pocket for their own prescription
drug plans, pay for rapidly increased premiums, lose direct senior
services, and have a harder time finding a primary care doctor because
most prefer the Medicare Advantage payment rate.
Meanwhile, this rule and the underlying bill will make it easier for
illegal immigrants to get health care--funded on the backs of middle
class families and small businesses. Not only do this bill and the
underlying rule slash $193 billion from seniors' health care, but its
stealth tax increases will draw off money from every American with a
health insurance plan. This rule endangers seniors in my community--Mr.
Speaker, we can and must do better.
Mr. BOUSTANY. Mr. Speaker, I rise in opposition to H.R. 3162. Last
night, I offered an amendment in the Rules Committee that would require
states to report their plan to target the lowest income families for
enrollment first and to report their plan to avoid displacing private
insurance coverage that families already enjoy. Unfortunately, the
Majority does not want to encourage states to work to cover the
neediest children first.
Many low income families in hurricane damaged areas of my own
district remain eligible but not enrolled in SCHIP. According to the
State of Louisiana, more than 68,000 children in families that make
less than 200 percent of the federal poverty level remained eligible
but unenrolled in SCHIP as of May 2007.
Instead of targeting sufficient outreach to low income families, the
bill wastes scarce outreach dollars by encouraging states like New York
to enroll families making more than $82,000 who already have insurance.
Research by the Kaiser Family Foundation shows that half of the
children in families making 300 percent above the federal poverty level
who currently have private insurance could be pushed out of that
coverage and onto new government programs.
The bill also harms rural seniors who will be harmed by cuts to
Medicare Advantage. Don't forget that more than 2,000 seniors in
Calcasieu Parish lost coverage after Washington's last cuts to that
program, and now Washington is poised to do it again.
Scarce federal tax dollars should be used to target the neediest
children first. I urge my colleagues to oppose the bill.
Ms. DeGETTE. Mr, Speaker, as co-chair of the bipartisan Congressional
Diabetes Caucus, one of the largest House Caucuses-with over 250
members, I want to highlight the increased investment in diabetes
research included in the ``Children's Health and Medicare Protection
Act,'' As the single most costly chronic disease in the United States,
diabetes places a tremendous economic burden on our country, costing
more than $132 billion annually and accounting for one out of every
three Medicare dollars.
Diabetes inflicts an enormous personal toll on individuals and their
families. Individuals with diabetes have more than twice the prevalence
of disability from amputation, loss of vision, and other serious
complications such as stroke, kidney failure and heart disease. Even
with continuous and vigilant management, patients are still susceptible
to developing serious, long-term complications.
Absent a significant federal investment in conquering this disease,
the personal and economic toll of diabetes will continue to grow. It is
estimated that one out of every three children who are born in the year
2000 will develop diabetes during their lifetime.
Despite this alarming trend, real advances are being made and
tremendous research opportunities exist, in large part due to the
Special Statutory Funding Program for Type 1 Diabetes Research which
was originally created as a provision of the State Children's Health
Insurance Program in 1997. This program has produced tangible results
that are improving people's lives today as we continue towards our
ultimate goal of a cure. However, unless this program is reauthorized,
there will be a 35% reduction in federal support for type 1 diabetes
research.
Chairman Dingell, I want to thank you for including a one year
extension at current funding levels for this program. I know that
difficult choices had to be made to accomplish multiple goals within a
tight budget, and his support for this critical program is greatly
appreciated.
It is important to note, however, that because the program has
previously provided continuity of funding over multiple years, the
National Institutes of Health has been able to support longer-term,
innovative research projects that have led to significant advances.
Such efforts would not be continued if the program was not extended for
multiple years.
I am committed to continuing my work with Chairman John Dingell and
the rest of my colleagues on this issue to ensure that we can
adequately fund this program in upcoming years.
Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, I rise in support of
H.R. 3162, the Children's Health and Medicare Protection Act.
Texas has the highest rate of uninsured children in the nation.
Twenty-five percent of Texas kids have no health insurance.
The Texas state legislature has done a great disservice to these
children, and they are working to remedy the problems but have a long
way to go.
The Federal Government can help by expanding SCHIP so that States can
enroll more kids into the program. These are children of the working
poor.
I support generous expansion of this program.
Children with health insurance are more likely to be up to date on
immunizations and to receive treatment for sore throats, ear aches and
other illnesses.
Good health means fewer sick days and better school performance--and
less burden on our emergency rooms.
I urge my colleagues to avoid delay in passing this bill, that is
critical for the health of so many children.
Mrs. JONES of Ohio. Mr. Speaker, the House Ways and Means Democrats
have put our nose to the grindstone and produced a well-balanced piece
of legislation that will ultimately provide necessary and much improved
care for both children and seniors.
Along with providing health care to 11 million children, including
five million who currently lack health insurance, it eliminates pending
physician cuts in 2008 and 2009 and enacts a positive .5 percent
increase in both years, providing for stability in reimbursement and
ensuring that beneficiaries can continue to see the doctor of their
choice. Additionally, the legislation expands preventive benefits
including mental health services and physical, occupational and speech
therapies, and reduces costs for seniors, people with disabilities and
low incomes.
Some of the most encouraging provisions of this legislation relate to
health disparities. The legislation provides both incentives and
instructions to our national health care providers on addressing the
critical and debilitating phenomenon of health care disparities in the
minority community. For the first time we identify, codify and target
health care disparities with a goal toward eradicating these problems.
Additionally, the bill proposes significant changes to the treatment of
patients in End Stage Renal Disease and I have proposed a study on its
impact on the African American community. Through this study we will
learn how best to provide this most critical service to some of the
nation's most vulnerable patients.
I am pleased that we were able to secure a Medicare waiver for the
Ireland Cancer Center of University Hospital Health Systems that will
[[Page H9495]]
allow them to provide immediate care to Medicare patients upon
operation.
While I do have some concerns regarding provisions regarding wheel-
chair access, oxygen and imaging services, I am confident that as we
move toward enhancing our healthcare systems that these issues will be
adequately addressed.
Mrs. BIGGERT. Mr. Speaker, I rise in opposition to the CHAMP Act.
I am a strong supporter of the State Children's Health Insurance
Program--or SCHIP as it is commonly called. In my State of Illinois,
there are approximately 167,000 low-income children who are enrolled in
the program. Many of these children are in families where their parents
work hard each month to make ends meet. And for many of these families,
SCHIP is the safety net they need when they cannot afford private
health insurance.
I support reauthorization of the SCHIP Program when the goals of the
reauthorization are to cover low- to moderate-income children that do
not already have health insurance. However, I cannot support
legislation that will provide government-sponsored insurance for
higher-income families at the expense of seniors.
The legislation we are considering today would allow States to cover
children and adults well above the poverty level. A little-know
provision in current law known as ``income disregard'' allows States to
determine what is and is not income for the purposes of determining
eligibility. This loophole allows States to provide SCHIP coverage to a
family of four making more than $72,000 a year, or 350 percent of the
Federal poverty level. While $72,000 a year may not get you on the
cover of Forbes magazine, it is a level that most Americans would agree
is above poverty.
For families with private health insurance making $72,000 a year,
this legislation would provide them with an incentive to shift from
their private insurance to the Government program. And who can blame
them? But I don't think that the taxpayers in my district would support
a bill that shifts individuals from private insurance to Government
programs.
To expand coverage to middle-income families, the legislation would
cut coverage to seniors in the Medicare Advantage program. In my
district, there are more than 5,000 seniors who are enrolled in
Medicare Advantage plans. I often hear about the additional benefits
that these individuals enjoy that are otherwise unavailable or
available at a much higher cost.
We should not be forced to choose between seniors and children--
particularly when the majority does not allow the minority to properly
review the legislation, debate it in the committee or on the floor, or
allow amendments and alternative ideas to be considered.
I support reauthorizing the SCHIP program when that legislation is
focused on the most vulnerable population--the population the program
was intended to help--poor children. But I cannot support legislation
that will eliminate coverage for senior in order to provide coverage to
middle-income adults and children--many of whom already have health
insurance.
I urge my colleagues to oppose this legislation.
Mr. MARKEY. Mr. Speaker, I rise today in strong support of the
children's Health and Medicare Protection Act.
The United States has the highest gross domestic product in the
world. We have the most advanced technology, the strongest research
program, and for some, the best medicine in the world.
But last year, 18,000 Americans died because they were uninsured and
did not have access to health care. Many of them were children.
Providing health care for poor children used to be a bipartisan
issue. But today the Republicans say that they philosophically object
to this bill claiming that it is a massive expansion of Government-run
healthcare.
But this bill does not change the structure of the program that the
Republicans voted for in 1997. The only explanation is that they
philosophically object to spending the $50 billion necessary to find
and give healthcare to all 11 million poor, eligible children. What
kind of philosophy is that?
President Bush used to talk about compassionate conservatism, but
this debate has exposed a Republican Party that is neither
compassionate nor conservative.
Instead, we are seeing some on the other side of the aisle choosing
corporations over children. They demand that we continue Federal
subsidies for their friends in the big, for-profit, insurance
companies, while denying uninsured children the healthcare they need.
If you kick these Republicans in the heart, you'll break your toe.
I urge you to vote ``yes'' on this critical children's health bill.
Mr. TOWNS. Mr. Speaker, I believe that we have a good bill that will
help provide needed health insurance for 5 million more low-income
children, that helps us reduce health disparities, equalizes payments
under Medicare to allied health professions, acknowleges the role of
schools in health care service delivery and protects senior citizens
from deceptive and aggressive marketing tactics by private Medicare
sales people. I applaud the inclusion of health information technology
in this bill. I have a draft bill in this area related to connecting
medically underserved communities to reduce health disparities and I
believe this bill could further that process.
I applaud this bill for making a number of efforts to collect racial
and ethnic health data. Numerous groups including the Rand Corporation,
the Congressional Black Caucus, and the Kaiser Family Foundation and
others have stressed that efforts to reduce and eliminate racial and
ethnic health disparities cannot proceed without comprehensive data
collection.
I am pleased that this bill creates payment fixes under Medicare for
a number of allied health professions, including midwives and marriage
and family therapists. I had hoped a similar provision for physicians'
assistants could have been included. However, this bill can address the
ability of physicians to delegate hospice care to physicians'
assistants without any further cost considerations.
I am particularly pleased that the overall tone of the bill is to
help children improve their lives and their health by offering a
guaranteed dental benefit and helping States enroll and retain more
eligible children, including the children of legal immigrants. I am
fully supportive of the idea of allowing ``qualifying States'' to use
their CHIP allotments for Medicaid if that will cover more kids.
I believe that the attempt to categorize this bill as cutting
Medicare is nothing more than a sham. Thousands of seniors who need
part ``D'' assistance will benefit from easier enrollement procedures.
Almost 550,000 seniors in my State will be protected on limitations to
out-of-pocket costs for prescription drugs. Companies have for 3 years
overcharged Medicare from 19 to 70 percent and have told seniors that
cutting these over payments will cut their benefits. That is simply not
true. It is not necessary to choose between funding health care for
children and health care for seniors. This legislation does both.
Urban and rural districts will benefit from the proactive approach in
this bill to reach out to ``hard-to-reach'' communities to spread the
word about enrolling in SCHIP. That makes good sense and is supported
by a wide range of groups in our community, including the National
Medical Association.
My city, State and many stakeholder groups are also fully supportive
of simplifying the applications process and speeding up and
streamlining eligibility determinations. In addition, States like New
York that fund SCHIP beyond 200 percent of Federal poverty levels are
appreciative of the ability to earn bonus payments available to States
that have implemented 5 of 7 practices that would increase outreach,
enrollment, and retention efforts.
In addition, I am supportive of the option to enroll children who
would otherwise age out of Medicaid or CHIP.
The majority tried very hard to include all medically necessary
services, but cost factors did not make that fully possible. Indeed, I
am appreciative that you were able to include dental and mental health
services in this bill as a State mandate because these services are
predictors of good health status. In fact when these services are not
readily available it can be tragic. We witnessed the unfortunate demise
of young Deamonte Driver in Maryland from a tooth abscess this past
winter, preventable by extracting a tooth at the cost of about $80.
Instead, he suffered a brain infection that cost the system $250,000 in
surgery bills and Deamonte his life because he could not receive
treatment in time. This bill will help avoid these types of tragedies.
I am very supportive of the creation of the Children's Access Payment
and Equity Commission because I believe that with a good balance of
commissioners, including those from medically underserved communities,
we can more closely monitor access to care from these communities.
Other features of this bill that I fully support include: coverage of
pregnant women; the increase for allowable resources for asset testing;
continuous enrollment and the encouragement of culturally appropriate
enrollment and retention practices.
I do, however, have a number of concerns. I am very concerned that
New York's public hospital system stands to lose up to $350 million if
the moratorium on intergovernment tax transfers is not extended. In
addition, our State and city will lose even more than that if we
eliminate graduate medical education payments. I hope that we can work
together to prevent this tragedy, not rust for my own State and city,
but for others as well.
I am still concerned that we need to give a date certain to the
Secretary of Health and Human Services to begin an additional compendia
to support coverage of off-label uses of cancer drugs.
[[Page H9496]]
I am concerned that the freeze on payments to the home health
industry will continue to have negative effects in my State and city.
I am also concerned that Medicare beneficiaries will not receive all
of the necessary treatments available to them. Further, I would prefer
they have the broadest formulary coverage so that seniors are not
forced to switch to other medications which are not rated as
therapeutic equivalents.
Mr. WELDON of Florida. I rise to express my opposition to the bill
before us. As a physician who still sees patients I find this piece of
legislation to be completely unacceptable and extremely irresponsible.
The Democrat majority--under the guise of providing insurance to
uninsured lower-income children--has chosen to expand the State
Children Health Insurance Program (SCHIP) far beyond its original
intent of insuring low-income children. What is worse, they've chosen
to pay for it by cutting benefits for Seniors and other Medicare
beneficiaries by more than $157 billion.
They have rushed this 500-page bill to the House floor without first
allowing the committees of jurisdiction to fully debate and amend the
bill. They introduced their bill last night just before midnight.
Shortly after midnight, they added a 45-page amendment. This morning
they made this available to Members of the House. Now they have only
allowed two hours of debate and denied Members of Congress any
opportunity to offer amendments to the bill. In fact, they are brazenly
complaining that by giving Members time to read the bill, it would
unnecessarily delay moving this bill forward.
What is so offensive about suggesting that Members of Congress have
an opportunity to read the bill before being asked to vote on it? Why
the rush? Why the secrecy? Why are they shutting down the legislative
process and rushing this bill through before anyone can read it?
It is because they don't want the American people to know what they
are doing until it is too late. And they don't want Members of Congress
to know what they are voting on and what the true effects of the
legislation will be.
They don't want the 780,000 seniors in the state of Florida--
including over 40,000 seniors in my congressional district--to know
that their Medicare benefits will be cut in order to provide health
insurance to non-U.S. citizens, including illegal immigrants, and
millions of children who already have health coverage.
They don't want 8 million seniors enrolled in Medicare Advantage
plans across this Nation to know that their benefits are being cut so
that the SCHIP program can be expanded to subsidize health care
benefits for adults in states like New Jersey, some with annual incomes
of $80,000 per year.
They want to hide from America's seniors the fact that Medicare
benefits are being cut in order to subsidize health care benefits to a
new group of ``children'' who happen to be between 18 and 25 years of
age.
They don't want seniors to know that budget experts in Congress
estimate that nearly one-half of the children who will be signed up to
the SCHIP program after this bill passes--using money that is being cut
from Medicare--are simply dropping their private health care coverage
in order to get the federal subsidy under the SCHIP program.
Earlier this year, I was troubled by the fact that Democrats planned
to significantly expand the SCHIP program and I offered an amendment in
the House Appropriations Committee that would have focused the program
so that states would first be required to ensure that all children in
homes earning below 200 percent of the poverty level were covered. My
amendment was rejected by the Democrat majority in that Committee who
said they opposed it because my amendment would focus the program on
serving uninsured children. They made it clear that they had no intent
of focusing this program on lower income children, but rather planned
to expand the program to those well above the poverty level and to
include adults and non-citizens.
What else is in this bill that they are trying to hide from the
American people?
They repeal the requirement that individuals must prove citizenship
in order to enroll in Medicaid and SCHIP. This opens the program to
fraud and the enrollment of illegal immigrants. In 2006, the Inspector
General (IG) of the Department of Health and Human Services found that
46 states allowed anyone seeking Medicaid or SCHIP to simply state they
were citizens. The IG found that 27 states never sought to verify that
enrollees were indeed citizens. The Congressional Budget Office (CBO)
estimates that repealing this requirement will cost $1.9 billion.
The bill provides a bonus payment to states that choose not to
implement an asset test for those enrolling in SCHIP. In other words, a
family could hold assets of as much as $1 million (a house, car, mutual
fund) but could still qualify for SCHIP if their income for that year
fell within the amount allowed for SCHIP enrollment. For example, a
family of four living in a $1 million home in New York with an annual
income of $80,000 could qualify for enrollment in SCHIP. And if New
York does this--they get a bonus!
It is my understanding that this 500-plus-page bill imposes a tax on
private health insurance. Certainly, they want to hide that from the
American people.
Mr. Speaker, it is clear that they don't want the American people to
know that they are creating a massive new entitlement program just at
the time when the financial strains of the Social Security and Medicare
entitlements are being stretched as Baby Boomers retire. They are
putting this Nation on a path to bankruptcy by creating a huge new
entitlement program that they have no way of sustaining long-term. This
is the wrong time to be saddling the American taxpayers with a gigantic
new program.
Additionally, I am concerned that this bill fails to secure the
senior's long-term access to quality physicians. The 1997 Budget Act (a
bill I voted against) created a formula that has resulted in payment to
doctors being cut. As a result, today some doctors (typically the best
doctors with the busiest practices) are starting to refuse to see new
Medicare patients. This SCHIP bill does not fix this problem. It
provides doctors with a 1 percent increase over 2 years then cuts
doctor reimbursement by 12 percent in 2010 and 12 percent in 2011, or
23 percent over 2 years. The effect of these cuts could be devastating
with many doctors facing the possibility of losing money when they see
Medicare patients. The result will be seniors will not be able to see a
doctor.
Mr. Speaker, I could go on about the additional cuts to Medicare,
including cuts to the following Medicare benefits: home health, end
stage renal disease, oxygen therapy, imaging services, dialysis, and
skilled nursing facilities.
By cutting Medicare and spending the money elsewhere, this bill will
make the challenge of securing the long-term solvency of Medicare even
more difficult.
Mr. Speaker, it is disappointing that the Democrat leaders have
chosen to pit health care benefits for America's senior citizens
against those of children. There is a better way. Had the Democrat
leadership chosen to consider this bill under the regular legislative
process, we could have worked through this in a bipartisan manner.
Unfortunately, Speaker Pelosi has chosen to put politics before
prudence. This bill goes far beyond the bill passed by the Senate, and
the President has vowed to veto the House bill. This bill should be
sent back to committee and debated in regular order. America's seniors,
uninsured children, and the American taxpayer deserve better.
Mr. ETHERIDGE. Mr. Speaker, I rise reluctantly in opposition to the
Children's Health and Medicare Preservation Act. I fully support the
goals of this legislation--to provide healthcare to millions of
uninsured children, to improve Medicare benefits for our seniors, and
to help rural areas provide healthcare. Unfortunately, however, I
cannot support legislation that unfairly impacts the second district
and all of North Carolina with the burdens of this cost.
I have been a long-time supporter of the State Children's Health
Insurance Program, or SCHIP, and I am proud that the Budget Committee
on which I serve authorized the increase reflected in this bill. I
support reauthorizing and strengthening SCHIP, without which nearly six
million children will lose access to healthcare. In North Carolina, NC
Health Choice provides cost-effective and high-quality health services
to 250,000 at-risk children. An additional 180,000 uninsured children
in North Carolina are eligible for coverage, and the $50 billion in the
budget I helped write would enable more of these children to be
covered.
It is also vital that we enable physicians to provide health
services, in SCHIP, Medicaid, .and in Medicare. This legislation
implements a 2-year fix that enables doctors to continue their
participation in the program without going bankrupt. Without this fix,
North Carolina physicians will lose $460 million for the care of
elderly and disabled patients over the next 2 years, and face a 1.6
percent geographic cut above the baseline reductions in other parts of
the country. I appreciate Medicare physicians who have made many
sacrifices to continue to cover the Medicare population, and without a
fix this year doctors may start dropping out and refuse to see Medicare
patients. We must maintain our commitment to universal coverage for our
Nation's seniors and people with disabilities. This legislation takes a
positive step in that direction.
There are many other positive provisions in this legislation: fixes
that strengthen the Medicare Trust Fund, provide more access to
preventative care, and provide lower premiums for many seniors;
extensions for important rural health care initiatives that ensure
access to care for people across the country, especially in the second
district of North Carolina; support for the Special Diabetes Programs,
which provide essential funding for research and innovative diabetes
prevention activities for thousands of children in communities
throughout the country; provides parity for
[[Page H9497]]
mental health coverage under Medicare; the list goes on and on. I
understand what these improvements mean to the people of North
Carolina, and I wholeheartedly support them.
These provisions have a cost, however, and as important as these
priorities are we also must value the principle of fairness. I do not
support smoking, and I have never smoked, but this bill is not fair to
those who grow or use tobacco. The cigarette tax is regressive; falling
hardest on those who can least afford it. Although it is a national
tax, it also unevenly impacts the country, with North Carolina and a
few other states footing the bill for the benefits the CHAMP Act seeks
to deliver. North Carolina's citizens pay over four percent of the
costs of this legislation while receiving about two percent of the
benefit.
Researchers at North Carolina State University estimate that North
Carolina's economy would lose at least $540 million a year through the
tax's indirect impact as well. North Carolina's tobacco farmers grow a
legal crop. These hard working farm families have suffered greatly from
transformations in the global economy. Because my district is the
second largest tobacco producing district in the country, H.R. 3162
disproportionately affects my constituents who work hard to be able to
pay their bills and provide a better life for their children. This just
doesn't pass the fairness test.
Mr. Speaker, I wish I could support this bill for all of its laudable
goals. I join with my colleagues in my desire to provide healthcare for
children, strengthen Medicare and protect it from privatization, and
improve health services for rural communities, diabetes patients, and
others. When we are able to do so without placing undue burden on North
Carolina's farmers and low-income families, I will gladly vote in favor
of doing so. With the current funding mechanism, however, I cannot
support this bill.
Mr. MORAN of Virginia. Mr. Speaker, Republicans have attacked a
provision in the CHAMP Act that would allow states flexibility in how
they verify the citizenship of the American children applying for or
renewing coverage under Medicaid, claiming that language in the 2005
Deficit Reduction Act (DRA) that imposed harsher citizenship
verification requirements on state Medicaid programs is the only
barrier protecting taxpayer dollars from being spent on healthcare for
illegal immigrants.
Empirical evidence from the first nine months of the implementation
of this rule demonstrates, in fact, that the new requirements have
denied tens of thousands of American children access to health care.
In my own state of Virginia, this draconian requirement has adversely
affected thousands of U.S. citizen children, children who are among the
most medically vulnerable in the state. In the first nine months of
implementation, there was a net decline of more than 11,000 children
enrolled in Medicaid. Had growth in enrollment continued at the same
rate it had during the previous 2 years, the state would have seen a
net increase of 9,000 poor children, suggesting that overall, at least
20,000 have been denied access to health coverage.
Among those who do receive coverage, the average wait time for
processing has increased from sixteen days to four to six months.
Twenty-one other states also reported declines in enrollment since
the implementation of the DRA, including a net decline of 14,000
children in Kansas.
While the DRA's requirements have unfortunately limited access to
care for so many low-income U.S. citizen children, they also have
imposed enormous administrative costs on the states, our financial
partners in this program. In Virginia, the number of ``pending'' cases
awaiting further documentation skyrocketed from about 50 per month to
4000. The DRA requirements have made measures to increase the
efficiency of the Medicaid application process (including mail-in,
phone and online applications) impossible.
The DRA requirements don't seem to be succeeding in fulfilling its
objective: in the first nine months of implementation, six states spent
$17 million implementing the DRA requirements, but only identified
eight undocumented immigrants out of a total of 3.6 million Medicaid
beneficiaries.
In addition, enrollment has fallen significantly in these states
among white and African-American children, while enrollment among
Latino children has increased--which would not be occurring if the
provision were affecting undocumented immigrants, 78% of whom are from
Mexico, Central America or South America, according to the Pew Hispanic
Center.
The DRA requirements imposed substantial bureaucratic costs on the
states, but have produced almost no cost savings. Instead, millions of
dollars spent implementing the DRA requirements have served only to
deny care to tens of thousands of American children.
The costs of care denied to low-income U.S. citizen children are
passed on to taxpayers in the form of uncompensated emergency room
visits and costs to treat the infectious diseases that these children
may contract and unknowingly pass on while awaiting access to
treatment.
The debate about CHAMP should be about the public health and
improving the health of our children. Attacks on this provision come
from Members who are grasping at straws, trying to come up with reasons
to oppose this bill, which takes monumental steps to improve the health
of low-income children in this country.
In a recent survey, 90 percent of parents applying for Medicaid for
their children indicated that they have no other health coverage
available. Allowing state flexibility in citizenship verification is
sound public health policy that would enable thousands of American
children access to vital health services to help them live better,
healthier, and more productive lives. Because Medicaid is now the
single largest cost to state taxpayers, we ought to make a concerted
effort to support state flexibility.
State flexibility is widely supported. Twenty-four Senators signed
letters to Chairman Baucus asking him to include this measure in the
Senate's bipartisan SCHIP bill, and fifty-one other House Members
joined me in requesting that Chairman Dingell include this provision in
the bill. I urge your support of this landmark legislation to protect
the health of our most vulnerable low-income children, and your support
of state flexibility in citizenship verification.
Mr. HERGER. Mr. Speaker, I rise in strong opposition to the ``CHAMP
Act.'' I do support averting the 10 percent cut in physician payments
scheduled for next year, and I am pleased that the bill reforms the
Medicare geographic cost payments index for California and holds rural
counties harmless through 2010--although I would have preferred to see
a permanent fix so that the physicians I represent do not face the
prospect of a 5 to 7 percent cut a few years down the road.
However, I am very troubled by the overall thrust of the CHAMP Act,
which is to expand big government health care at the expense of
competition and consumer choice. This bill would effectively destroy
the Medicare Advantage program, especially in rural areas like the
district I represent.
I would like to read to my colleagues from a letter I received just
the other day from one of my constituents, Kathleen Lopez of
Marysville, California. Kathleen writes, ``I chose a Medicare Advantage
plan because I receive Social Security benefits less than $700 net per
month; our annual income hovers around $20 thousand. This plan
encourages preventive care, has Plan D Medicare, has some vision and
dental coverage. . . . This type of plan eliminates costly monthly
expenses for health coverage as well as prescription drug coverage.''
Over 4,500 other senior citizens in my district are receiving similar
benefits. Most--if not all--of them will lose their benefits under this
bill.
Mr. Speaker, not only does this bill sharply reduce incentives for
Medicare Advantage plans to offer coverage to low-income rural seniors
like Kathleen Lopez, it also imposes new constraints and regulations to
prevent Medicare Advantage plans from offering better deals. The
message of this bill is ``Washington knows best.'' Instead of promoting
competition and choice, we are going to push everybody into a one-size-
fits-all plan.
That message is reinforced with the massive expansion of SCHIP that
takes kids from middle-class and possibly even upper-class families off
private insurance and puts them into a government program. Mr. Speaker,
all of us support reauthorizing SCHIP. Everyone supports providing
health care for low income children. But let us be clear: That is not
the question we are discussing today. What we are debating is whether
to turn SCHIP into a massive new entitlement under which every child in
America--even if their families are well-off, even if they already have
good health coverage--can become eligible for health care provided by
the Federal Government.
Don't be fooled--this bill is the first step toward the Federal
Government taking over health care. Some members who were closely
involved in writing this bill have even openly stated their support for
creating a government-run health care system and literally banning
market-driven health care providers. We have a decision before us: We
can move toward a 21st-century, patient-centered health care system
driven by competition, choice, and innovation. Or we can go backwards
toward a system of socialized medicine, like the ones that are
crumbling in Europe or the one that Canadian doctors come to our
country to escape.
Mr. Speaker, this bill goes in the wrong direction, and I urge my
colleagues to reject it.
Ms. Pryce of Ohio. Mr. Speaker, this legislation wasted an
opportunity to reauthorize a bipartisan health care program for low-
income children. I support SCHIP and would welcome its renewal and
improvement. But this House is abandoning its mission of providing
needed health care coverage for low-income children who otherwise would
go without, and instead
[[Page H9498]]
enrolling millions of middle class families--even adults--with income
upwards of $80,000, some who already have private insurance, in this
government-run health care plan.
Why are we pushing our middle class into government health care when
there are so many low-income kids who still need help? And why are we
asking seniors to pay for it? In Ohio, 70 percent of uninsured children
who are currently eligible for SCHIP are not enrolled in the program.
Congress should work to cover these children before it pursues this
overly ambitious and costly entitlement expansion on the backs of our
senior citizens.
In my district, some 13,000 seniors would be dropped from their
Medicare plan to pay for this bill. Additionally, many of the services
seniors rely on most will be cut under this bill--from cuts to skilled
nursing facilities, to oxygen, to wheelchairs, to home health care.
This is simply unnecessary and unfair.
I have devoted much of my career in the House to giving a voice to
children and promoting programs to help them. It is therefore truly
unfortunate and disappointing that the Democrat majority has rushed
this bill to the floor, with no Republican input and no chance of
improving it through the amendment process. And, I regret, that due to
this unnecessary over-reaching, one-sided legislative process, I was
compelled to oppose this irresponsible bill. We can do better. Our kids
and our seniors deserve better.
Mr. PETRI. Mr. Speaker, I am a strong supporter of the State
Children's Health Insurance Program (SCHIP) that provides needed health
care coverage to millions of children across this nation. It is vital
to our nation's children and is in need of expansion in order to cover
all eligible uninsured children.
In fact, this February I joined many of my colleagues in sending a
letter to the Budget Committee requesting that the fiscal year 2008
budget include sufficient funding to maintain existing SCHIP caseloads,
as well as make reauthorization of the program a high priority.
Unfortunately, I believe that H.R. 3162 takes the wrong approach and
goes beyond what is necessary to cover uninsured children in America.
Furthermore, the legislation puts seniors in my district at risk by
making cuts to the Medicare Program. By trying to do too much in this
bill, we have shifted our focus from helping our nation's children and
now have a bill that has become mired in controversy.
I believe the Senate's stand-alone reauthorization legislation is a
more reasonable approach. It focuses solely on strengthening SCHIP by
implementing measures to expand the enrollment of low-income children
as well as to improve the quality of health care that children in the
program receive.
House passage today is not the final step in the legislative process,
of course. While I cannot support the bill before us today, I hope that
when a conference report is brought before us, it will be a reasonable
compromise that provides needed expansion of SCHIP without the
troublesome provisions of this bill. We need to reauthorize and
strengthen this important and necessary program.
Mrs. MALONEY of New York. Mr. Speaker, I rise today in strong support
of H.R. 3162, the Children's Health and Medicare Protection Act (CHAMP
Act).
This important legislation will provide health care to 11 million
children by reauthorizing and strengthening the Children's Health
Insurance Program (CHIP).
Insuring America's children is an affordable goal. It costs less than
$3.50 a day--about the cost of a Starbucks Frappuccino--to cover a
child through CHIP. Certainly we can all agree that this is an
investment worth making.
In addition to providing health coverage to children, this bill
strengthens Medicare to ensure beneficiaries have access to their
doctors and improves benefits to cover preventative and mental health
services.
This bill lays the groundwork for a long-term solution to the
physician payment system.
Medicare physician payment rates are set to be cut by 10 percent in
2008 and a 5 percent cut each year thereafter under current law. This
bill eliminates pending cuts and enacts a .5 percent increase in both
2008 and 2009.
Congress has a responsibility to protect our children's access to
affordable health care and strengthen Medicare for patients and
physicians.
This bill accomplishes both these goals.
I urge my colleagues to support this important legislation.
Mr. Bishop of Georgia. Mr. Speaker, since its inception in 1997, I
have been a steadfast proponent of SCHIP. This was perhaps most evident
in January of this year when PeachCare, Georgia's SCHIP funded program,
faced a $131 million shortfall. I hosted a bi-partisan delegation of
Georgia lawmakers and public health officials who came to Washington to
persuade the House leadership to fix the problem. In May, Congress
approved and the President signed into law legislation which eliminated
this shortfall faced by Georgia and other states.
While my support of children's health care has never been in
question, my vote today in favor of the bill was a difficult choice.
I'm very uncomfortable with voting for any excise tax, especially one
as regressive as a tobacco tax. The CHAMP Act presents a dilemma:
improve access to health insurance for our youngest and most vulnerable
citizens, or oppose the legislation to avoid causing harm to the many
retailers and employees whose livelihoods depend upon the sale of
tobacco, as well as the state and local governments that depend upon
revenues generated from tobacco sales.
This is not a perfect bill. But let us not let the ``perfect'' be the
enemy of the ``good.'' This bill will ensure our children grow up
healthy and strong, save millions of dollars for the taxpayers who pick
up the tab for indigent care in emergency rooms, strengthen access to
health care in rural America, and protect our nation's seniors by
giving them the healthcare they deserve
Mr. Latham. ``Mr. Speaker, I rise today in opposition to R.R. 3162.
First, I fully support reauthorizing the SCHIP program and preserving
this important program intended to provide health insurance to low-
income children.
Having said that, I cannot support a bill that robs America's seniors
of their Medicare benefits in order to give taxpayer-financed health
care to illegal immigrants. The bill before us eliminates requirements
that applicants show proof of citizenship, potentially allowing
millions of illegal immigrants access to Medicaid and SCHIP.
Furthermore, there is no requirement to ensure that eligible children
from low-income families are enrolled before expanding coverage to
children from middle-class or wealthier families. No limits on income
eligibility are included, allowing a virtually open-ended expansion of
the program to children that already have private health insurance.
Meanwhile, 70 percent of uninsured children are already eligible for
Medicaid or SCHIP and most of these are in the low-income category. The
original intent of SCHIP was to cover low-income children, and we need
to give these kids priority.
To pay for the expansion of SCHIP, Democrats are cutting over $157
billion from Medicare Advantage, which provides enhanced benefits like
prescription drug, vision and dental coverage, as well as lower out-of-
pocket costs, for almost 51,000 Iowa seniors. This will result in a
reduction of benefits for seniors enrolled in Medicare Advantage, and
an increase in their costs. These drastic cuts will even force 3
million current beneficiaries out of the program.
Pitting grandparents against their grandchildren is simply wrong. I
urge my colleagues to reject this bill. Let's go back to the drawing
board to produce a more responsible bill focused on providing health
insurance to children from low-income families.''
Mrs. Bono. Mr. Speaker, I would like to express my strong support for
the State Children's Health Insurance Program, or SCHIP, and the need
for this program to be reauthorized. But, unfortunately, I must also
state my opposition to the proposals that we have before us on the
floor today.
Since its enactment in 1997, SCHIP has been a tremendous success.
SCHIP has been adopted in one form or another in every state across the
nation. In my own state of California, we have enacted a combination of
the SCHIP and Medicaid program to optimize coverage in the state. This
program is better known as Healthy Families and currently provides
coverage to more than 800,000 children. I strongly support the coverage
that currently exists in California and voice my continued commitment
to maintaining that coverage.
I was heartened to see the bipartisan compromise that emerged from
the Senate Health, Education, Labor, and Pensions (HELP) Committee
earlier this month and that is currently being debated on the Senate
floor. This legislation ensures that states will have adequate federal
funding to continue their existing programs, while allowing others to
expand coverage to more children. The bill also allows states to cover
pregnant women and includes provisions to transition childless adults
into Medicaid. The Congressional Budget Office (CBO) estimates that
this bill will lead to the coverage of three and a half million new
children. And all this was done at $15 billion less than the SCHIP
portion of the proposal that we have before us today. While I recognize
that the Senate proposal is still a work in progress, I am supportive
of many of the principles laid forth in this legislation and appreciate
the flexibility with which states are allowed to continue operating
this program.
This CHAMP Act that is before us includes many provisions that are
positive and attempt to address some very real and very serious
problems facing the health care community. I know that my own state
would benefit greatly from the Adult Day Health Care Services provision
within the bill and would allow California and 7 other states to
continue operating their long standing and successful programs. There
[[Page H9499]]
are provisions that will amend Medicare Part D to aid patients relying
on the AIDS Drug Assistance Program or ADAP to pay for their drugs.
Perhaps most importantly, this legislation also includes a two year
update for payments to physicians under the Medicare fee schedule. If
current law is allowed to move forward doctors will be forced to absorb
a nearly 10% cut in reimbursements. As the daughter of a doctor, I am
sympathetic to this cause and have been supportive of efforts to stave
off devastating cuts that have been pending in years past. I strongly
believe that the problems we face as a result of the Sustainable Growth
Rate (SGR) deserve our full and careful attention. I do not, however,
believe that this is the vehicle to do so.
While I support many, if not most of the provisions in this bill, I
have a responsibility to vote for programs and policies that are
necessary for the public and affordable for the taxpayer. This bill is
typical of what we have come to expect from a Congress that refuses to
put limits on what they are willing to support and ask the taxpayers to
fund.
I joined with several of my colleagues in co-sponsoring H.R. 3269,
the Children's Health Insurance Program Reauthorization Act of 2007,
which was introduced by Representative Heather Wilson yesterday
afternoon. I am proud to have co-sponsored this legislation that will
do what needs to be done in an affordable and responsible manner. It
would be a tragedy if this bill, that has bipartisan support in the
Senate, were to lose and so many important projects pushed off track
because this Congress refuses to deal with everyday realities of
taxpayers struggling to make ends meet. I am deeply disappointed in the
decision made by my colleagues on the Rules Committee to not only allow
rejection of this amendment but every other amendment that may have
helped to improve and reign in this irresponsible bill.
To help pay for the obscene $90 billion price tag of this
legislation, cuts have been proposed to hospital payments, inpatient
rehabilitation services, skilled nursing facilities, and home health
care services to name a few. I am very alarmed that a lion's share of
these cutbacks will be felt by Medicare Advantage and the 8 million
Medicare beneficiaries currently enrolled. In Riverside County alone,
nearly 50 percent of Medicare beneficiaries have chosen to participate
in a Medicare Advantage plan, more than 100,000 seniors. The bill that
we have before us today will put each of us in the position of having
to choose between children and seniors.
As I have often stated, SCHIP must be reauthorized; 6.6 million
children who are currently enrolled will find their coverage
jeopardized if Congress does not act. We have long known that September
30th was looming and instead of acting, the leadership of the various
Committee's of jurisdiction have chosen to wait until the 11th hour,
and not just act on SCHIP, but to create a veritable Christmas tree of
major health care policy reforms with no legislative hearings. We can
and should act on behalf of SCHIP. I encourage my colleagues in the
House to follow the example of the Senate and consider a bill that is
clean and focused and allows members to vote their conscience on
coverage for children.
I will not be voting for the CHAMP Act today for these reasons. I
hope that my colleagues on both sides of the aisle will come together
during Conference, put aside partisanship, put aside a grab bag of
legislation and bring back a bill that is truly for our children.
Mr. KIND. Mr. Speaker, I rise today in support of HR 3162, the
Children's Health and Medicare Protection Act. The CHAMP Act makes
crucial investments in children's health, preventive care, rural
providers, and improved services for Medicare beneficiaries. I urge all
of my colleagues to support this important legislation.
Over the past several months, this Congress has debated how best to
resolve serious problems facing this country's healthcare system: how
do we provide responsible, reasonable healthcare coverage to children
of working families? How do we modernize the benefits package provided
to seniors under Medicare? How do we ensure that physicians and other
providers caring for these seniors are paid fairly under Medicare? And
finally, how do we accomplish all of these goals while at the same time
adhering to the responsible budgeting rules this Congress has adopted
for itself through pay-as-you-go budgeting rules?
As a member of the Ways and Means Committee faced with these issues,
I can tell you that it has not been easy. I do not believe, however,
that our constituents elected us to come to Washington and make the
easy decisions. We are here to govern, to balance competing and often
equally deserving interests, and to arrive at a solution that we think
is best for this country. I believe the CHAMP Act accomplishes all of
these goals.
This legislation will expand health care coverage to some 5 million
new children across the country, allowing them to receive the vital
preventive care that we know is essential for a healthy future. The
CHAMP Act pays for this new investment through an increase in the
federal tobacco tax, a move that itself will improve the health of our
children by making cigarettes more expensive to buy. The forty-five
cent tobacco tax increase included in this bill will reduce youth
smoking rates by almost seven percent and will result in significant
future savings in healthcare costs.
The CHAMP Act also invests in this country's seniors by eliminating
cost-sharing for preventive services under Medicare. This move will
allow seniors to get essential services--such as check-ups, cancer and
diabetes screenings, and flu and pneumonia vaccines--for no out-of-
pocket costs.
We know that in order to improve seniors' quality of life and to
prevent and detect life-threatening diseases, we must make this
investment in prevention and primary care. I am proud of this important
advance.
Lastly, this legislation ensures that rural healthcare providers are
paid fairly for the services they provide to seniors. The Medicare
program provides a vital healthcare safety net for seniors living in
rural areas. The CHAMP Act ensures that this level of care can continue
by providing fair payments to physicians, ambulance providers, home
health agencies, and other practitioners who care for the more than 9
million seniors living in rural areas.
The CHAMP Act is the right choice for Wisconsin and the right choice
for this country.
The SPEAKER pro tempore. All time for debate has expired.
Pursuant to House Resolution 594, the previous question is ordered on
the bill, as amended.
The question is on the engrossment and third reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.
Motion to Recommit Offered by Ms. Granger
Ms. GRANGER. Mr. Speaker, I offer a motion to recommit.
The SPEAKER pro tempore. Is the gentlewoman opposed to the bill?
Ms. GRANGER. I am, Mr. Speaker, in its present form.
Mr. DINGELL. Mr. Speaker, I reserve a point of order. After the
motion is read, I will know whether to insist on the point of order or
not.
The SPEAKER pro tempore. The point of order is reserved.
The Clerk will report the motion to recommit.
The Clerk read as follows:
Ms. Granger moves to recommit the bill, H.R. 3162, to the
Committees on Energy and Commerce and Ways and Means with
instructions to report the same back to the House forthwith
with the following amendments:
Amend title I to read as follows:
TITLE I--EXTENSION OF STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP)
SEC. 101. EXTENSION OF SCHIP.
Section 2104(a) of the Social Security Act (42 U.S.C.
1397dd(a)) is amended--
(1) by striking ``and'' at the end of paragraph (9);
(2) by striking the period at the end of paragraph (10);
and
(3) by adding at the end the following new paragraph:
``(11) for fiscal year 2008, $5,000,000,000.''.
SEC. 102. ADDITIONAL ALLOTMENTS TO ADDRESS SCHIP FUNDING
SHORTFALLS FOR FISCAL YEAR 2008.
Section 2104 of the Social Security Act (42 U.S.C. 1397dd)
is amended by adding at the end the following new subsection:
``(i) Amounts To Eliminate Fiscal Year 2008 Funding
Shortfalls.--
``(1) In general.--From the amounts appropriated under
paragraph (4), the Secretary shall allot to each shortfall
State described in paragraph (2) such amount as the Secretary
determines will eliminate the estimated shortfall described
in such paragraph for the State for fiscal year 2008.
``(2) Shortfall state described.--For purposes of paragraph
(1), a shortfall State described in this paragraph is a State
with a State child health plan approved under this title for
which the Secretary estimates, on the basis of the most
recent data available to the Secretary as of a date
(specified by the Secretary) during fiscal year 2008, that
the projected Federal expenditures under such plan for the
State for fiscal year 2008 will exceed the sum of--
``(A) the amount of the State's allotments for each of
fiscal years 2006 and 2007 that will not be expended by the
end of fiscal year 2007;
``(B) the amount of the State's allotment for fiscal year
2008; and
``(C) the amounts, if any, that are to be redistributed to
the State during fiscal year 2008 in accordance with
subsection (f).
``(3) Proration rule.--If the amount available under
paragraph (4) is less than the total amount of the estimated
shortfalls determined by the Secretary under paragraph (1),
the amount of the estimated shortfall for each shortfall
State determined under such paragraph shall be reduced
proportionally.
``(4) Appropriation; allotment authority.--For the purpose
of providing additional
[[Page H9500]]
allotments to shortfall States under this subsection, there
is appropriated, out of any funds in the Treasury not
otherwise appropriated, such sums as are necessary for fiscal
year 2008, but not to exceed $1,500,000,000.''.
SEC. 103. OPTION FOR QUALIFYING STATES TO RECEIVE THE
ENHANCED PORTION OF THE CHIP MATCHING RATE FOR
MEDICAID COVERAGE OF CERTAIN CHILDREN.
Section 2105(g) of the Social Security Act (42 U.S.C.
1397ee(g)) is amended--
(1) in paragraph (1)(A), by inserting ``subject to
paragraph (4),'' after ``Notwithstanding any other provision
of law,''; and
(2) by adding at the end the following new paragraph:
``(4) Option for allotments for fiscal years 2008 through
2012.--
``(A) Payment of enhanced portion of matching rate for
certain expenditures.--In the case of expenditures described
in subparagraph (B), a qualifying State (as defined in
paragraph (2)) may elect to be paid from the State's
allotment made under section 2104 for any of fiscal years
2008 through 2012 (insofar as the allotment is available to
the State under subsections (e) and (i) of such section) an
amount each quarter equal to the additional amount that would
have been paid to the State under title XIX with respect to
such expenditures if the enhanced FMAP (as determined under
subsection (b)) had been substituted for the Federal medical
assistance percentage (as defined in section 1905(b)).
``(B) Expenditures described.--For purposes of subparagraph
(A), the expenditures described in this subparagraph are
expenditures made after the date of the enactment of this
paragraph and during the period in which funds are available
to the qualifying State for use under subparagraph (A), for
the provision of medical assistance to individuals residing
in the State who are eligible for medical assistance under
the State plan under title XIX or under a waiver of such plan
and who have not attained age 19, and whose family income
equals or exceeds 133 percent of the poverty line but does
not exceed the Medicaid applicable income level.''.
SEC. 104. MAINTAINING LIMITATION ON ELIGIBILITY FOR ALIENS.
Nothing in this Act shall be construed as changing the
limitations imposed under title IV of the Personal
Responsibility and Work Opportunity Reconciliation Act of
1996 on eligibility of aliens for medical or child health
assistance benefits.
SEC. 105. MAINTAINING CITIZENSHIP DOCUMENTATION REQUIREMENTS.
Nothing in this Act shall be construed as changing the
citizenship documentation requirements under the Medicaid
program under title XIX of the Social Security Act, as
originally provided under the amendments made by section 6036
of the Deficit Reduction Act of 2005 and as subsequently
amended.
SEC. 106. BIPARTISAN AND OPEN, TRANSPARENT PROCESS.
It is the sense of Congress that the State Children's
Health Insurance Program (SCHIP) under title XXI of the
Social Security Act should be reauthorized and reformed
through a bipartisan, open, fiscally responsible process.
In title II, strike all section but sections 201 and 202.
Amend title III to read as follows:
TITLE III--PHYSICIAN PAYMENT UPDATE
SEC. 301. UPDATE FOR PHYSICIANS' SERVICES FOR 2008.
(a) Update for 2006.--Section 1848(d) of the Social
Security Act (42 U.S.C. 1395w(d)) is amended--
(1) in paragraph (4)(B), in the matter preceding clause
(i), by striking ``and (6)'' and inserting ``, (6), and
(8)''; and
(2) by adding at the end the following new paragraph:
``(8) Update for 2008.--The update to the single conversion
factor established in paragraph (1)(C) for 2008 is 0
percent.''.
(b) Treatment.--The amendments made by subsection (a) shall
not be treated as a change in law for purposes of applying
section 1848(f)(2)(D) of the Social Security Act (42 U.S.C.
1395w-4(f)(2)(D)) and, for purposes of calculating the per
capita rate of growth in expenditures under section 1853 of
such Act for 2009 and subsequent years, such rate of growth
in expenditures shall be calculated as if such amendments had
not been enacted. In carrying out the previous sentence, the
Secretary of Health and Human Services shall make such
calculation for 2009 in conjunction with the promulgation of
the physician fee schedule under section 1848 of such Act for
that year and shall use such calculation for subsequent years
in computing payment rates under part C of title XVIII of
such Act.
SEC. 302. FIXING PHYSICIAN SGR PROBLEM.
It is the sense of the House of Representatives that
Congress should permanently fix the problem of the physician
fee schedule update under section 1848 of the Social Security
Act being tied to a sustainable growth rate (SGR).
In title IV, strike all sections but sections 431 and 432.
In title V, strike all section but sections 504, 505, 508,
and 509.
In the matter inserted by section 601(a), strike ``2009''
and insert ``2008''.
In subtitle A of title VI, strike all sections but sections
601, 605, and 611.
In subtitle C of title VI, strike sections 635 through 639.
Strike subtitle D of title VI.
In title VII, strike all sections but sections 702, 705,
706, and 707.
Strike title VIII.
Strike title IX.
Strike section 1002.
Ms. GRANGER (during the reading). Mr. Speaker, I ask unanimous
consent that the motion be considered as read and printed in the
Record.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from Texas?
Mr. STARK. I object, Mr. Speaker.
The SPEAKER pro tempore. Objection is heard.
The Clerk continued to read.
Mr. DINGELL (during the reading). Mr. Speaker, I ask unanimous
consent that the motion be considered as read and printed in the
Record.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Michigan?
Mr. STARK. I object.
The SPEAKER pro tempore. Objection is heard.
The Clerk continued to read.
Mr. STARK (during the reading). Mr. Speaker, I ask unanimous consent
that the motion be considered as read and printed in the Record.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
The SPEAKER pro tempore. Does the gentleman from Michigan wish to
maintain his reservation?
Mr. DINGELL. Mr. Speaker, I withdraw my point of order.
The SPEAKER pro tempore. The point of order is withdrawn.
Pursuant to the rule, the gentlewoman from Texas is recognized for 5
minutes in support of her motion.
Ms. GRANGER. Mr. Speaker, my motion to recommit corrects a Democrat
bill that will do great harm to America's seniors and working class.
It's also the only chance that the minority's been given in this
disappointing process to amend the bill before us today. This is not
the House that was promised in November.
My motion to recommit reauthorizes the SCHIP program for 1 year and
provides States with the resources they need to be able to continue to
provide needed health care coverage for children. The SCHIP program is
a good program. It insures mental care is available to children who are
needy but who are not poor enough to qualify for Medicaid.
{time} 1900
Currently, approximately 6.7 million children receive health care
through the SCHIP program, which is broadly supported.
Let there be no doubt, Republicans support SCHIP, because we were
instrumental in its creation 10 years ago. We don't support the
reckless underlying bill that raises taxes and cuts Medicare by $200
billion, taking health care away from some of our neediest seniors.
The underlying bill is the first step to government-controlled health
care and takes America in the wrong direction. It's the most blatant
attempt to expand government-run health care we have seen since
HillaryCare. It takes a sensible, bipartisan program aimed at helping
low-income children and turns it into a monster that will suck millions
of middle-class Americans into government-run health care. The bill
would create a massive new entitlement with totally inadequate funding.
At a time when we already face a $40 trillion unfunded obligation for
Medicare and Social Security over the next 75 years, that's the exact
opposite of responsible public policy.
The Democrat bill takes SCHIP far beyond what it was intended to do
by reversing the existing status that does not allow adults to be
enrolled. The Democrats not only allow States to enroll childless
adults but also eliminates a requirement for illegal immigrants to wait
5 years before receiving welfare benefits. The Republican motion to
recommit continues current law enforcing the 5-year wait.
The bill in its current form also eliminates verification of
citizenship status. This means that persons who come here illegally
could be provided SCHIP because we don't want to ask the right
questions.
Taking benefits from seniors to expand government-run health care to
adults and illegal immigrants is unconscionable. Our motion to recommit
keeps the 5-year wait for SCHIP. It also maintains the standards to
verify citizenship. This motion requires citizenship documentation
verification for
[[Page H9501]]
eligibility for SCHIP and welfare benefits.
While taking care of our children, Republicans also value our seniors
and have taken care in providing Medicare benefits. Medicare Advantage
is a critical source of comprehensive medical coverage for over 8
million individuals. It provides coverage for seniors, and a recent
bipartisan poll this year found that 90 percent of enrollees are
satisfied with their Medicare plans.
The underlying bill cuts payments to Medicare Advantage plans and
cuts Medicare payments to Medicare providers, including hospitals,
nursing homes and home health agencies.
The cuts proposed by the Democrats in Medicare will result in nearly
3.2 million seniors losing their Medicare Advantage coverage. We would
be providing coverage for children whose parents make $100,000 a year
on the backs of seniors and the Medicare coverage they chose. This
would be the largest cut of Medicare in history.
In my district, 17,279 Medicare Advantage enrollees will lose their
benefits if the Democrat CHAMP Act passes. This motion to recommit
protects our seniors by eliminating the Medicare cuts in the bill.
Perhaps most alarming in this bill is the establishment of a new
mandatory tax on private health insurance plans. While Republicans have
been trying to level the playing field and eliminate the uninsured,
this bill places a tax on health care plans, except those provided by
the government.
The Democrat bill raises taxes by $54 billion in an attempt to lure
middle-class families to opt out of private coverage by establishing a
new mandatory tax on private health insurance plans. Our motion to
recommit eliminates the Democrats' new tax on America's health
insurance plans.
In addition to eliminating the Medicare cuts in the Democrat bill,
the motion to recommit maintains Medicare changes that improve services
for Medicare beneficiaries.
These changes will ensure improved service in rural areas, an
extension of the therapy cap, special needs plans, and demonstration
projects on end stage renal disease services.
I urge my colleagues to vote for this motion to recommit that will
protect our seniors, prevent massive tax increases, and reauthorize the
current SCHIP program.
If the motion to recommit passes, the House will be able to vote on a
bill that protects America's seniors and hard working citizens while
also providing health care for our neediest children.
If the motion fails, I strongly urge my colleagues to vote against
the Democrat CHAMP Act.
Mr. EDWARDS. Mr. Speaker, I rise in opposition to the motion.
The SPEAKER pro tempore. The gentleman from Texas is recognized for 5
minutes.
Mr. EDWARDS. Mr. Speaker, on behalf of 11 million children in our
Nation and their families, I rise in opposition to this ill-advised
motion to recommit.
Unbelievably, this motion would only reauthorize the children's
health insurance program for only 1 year, only 1 year. So what we have
here is the same Members of Congress who fought passionately to
guarantee a permanent $220,000 tax break for people making over $1
million a year are saying right now we should only guarantee health
care for children from low-income working families for 1 year.
What's fair about that? Think about it. Permanent tax breaks for the
wealthiest 1 percent, but only a 1-year extension of health care for
children of low-income working families. Is that the new face of
passionate conservatism?
If my Republican colleagues actually think for one moment that this
proposal to cut millions of children short reflects American family
values, it is clear proof just how out of touch they have become with
the values and priorities of hard-working American families.
Let me clear up one myth, the myth that this motion is somehow about
keeping illegal immigrants from receiving SCHIP insurance. The truth is
that under present law and in this reauthorization, illegal immigrants
do not qualify for SCHIP benefits, period.
This is nothing more than an overused, worn-out, divisive fear-driven
tactic with no basis in fact. It's a transparent fig leaf to hide the
real purpose of this motion, which is to take care of the powerful
special interests who put their profits above the interest of 11
million American children.
We have a very clear choice before us right now. The motion to
recommit continued the sound bite politics of the past, the politics of
fear, and the politics of catering to powerful special interests. In
contrast, we can vote for a new day, a new politics. We can vote to put
the interests of the 11 million children and the families who love them
above the special interest of the powerful insurance companies, who
sometimes care more about their huge profits at taxpayers' expense and
helping so many children.
The choice is clear: Either vote for our children, 11 million of
them, or vote to take care of a handful of well-heeled special
interests who support this motion to recommit.
This choice is about real people, people such as Jamie Jones. Listen
to her words with me spoken 3 years ago after the Texas legislature had
cut off CHIP insurance for her child.
``I am Jamie Jones. I am 28 years old.
``I live in Teague, Texas. I have a little girl that's three, Bailey.
``Two years ago in March, my husband was killed in a house fire. She
was put on CHIPS, and I knew no matter what happened, she was going to
be ok.
``And then about 6 months ago she was denied. I haven't changed, I
haven't gotten a raise at work--she was just denied.
``There are so many people out there who work so hard. I do not want
Welfare, I just want good insurance for my child.
``And I am working hard. Yeah, I could quit my job tomorrow and she
would be set--but I am not going to do that.
``And there are a lot of people out there who are not going to do
that. And why that group has to get hurt--I don't know.
``Look at my little girl, look into her eyes and tell her why she is
not good enough to be taken care of.''
Tonight we have a chance to do something right and good. We can say
to Jamie Jones and her little daughter Bailey that we value them and
millions of other working Americans like them.
By opposing this motion to recommit and by voting for this bill, we
can turn the politics of the past into the politics of hope, hope for
11 million American children. Let us at long last put the interest of
our children above the politics of special interests. It is the right
thing to do. The time is now. Our children are waiting.
The SPEAKER pro tempore. Without objection, the previous question is
ordered on the motion to recommit.
There was no objection.
The SPEAKER pro tempore. The question is on the motion to recommit.
The question was taken; and the Speaker pro tempore announced that
the noes appeared to have it.
Ms. GRANGER. Mr. Speaker, I object to the vote on the ground that a
quorum is not present and make the point of order that a quorum is not
present.
The SPEAKER pro tempore. Evidently a quorum is not present.
The Sergeant at Arms will notify absent Members.
Pursuant to clause 9 of rule XX, the Chair will reduce to 5 minutes
the minimum time for any electronic vote on the question of passage.
The vote was taken by electronic device, and there were--yeas 202,
nays 226, not voting 5, as follows:
[Roll No. 786]
YEAS--202
Aderholt
Akin
Alexander
Bachmann
Bachus
Baker
Barrett (SC)
Barrow
Bartlett (MD)
Barton (TX)
Biggert
Bilbray
Bilirakis
Bishop (UT)
Blackburn
Blunt
Boehner
Bonner
Bono
Boozman
Boustany
Brady (TX)
Broun (GA)
Brown (SC)
Brown-Waite, Ginny
Buchanan
Burgess
Burton (IN)
Buyer
Calvert
Camp (MI)
Campbell (CA)
Cannon
Cantor
Capito
Carney
Carter
Castle
Chabot
Coble
Cole (OK)
Conaway
Cubin
Culberson
Davis (KY)
Davis, David
Davis, Tom
Deal (GA)
Dent
Donnelly
Doolittle
Drake
Dreier
Duncan
Ehlers
Ellsworth
Emerson
English (PA)
Everett
Fallin
Feeney
Flake
Forbes
Fortenberry
Fossella
Foxx
Franks (AZ)
Frelinghuysen
Gallegly
Garrett (NJ)
Gerlach
Gilchrest
Gillmor
Gingrey
Gohmert
Goode
Goodlatte
Granger
Graves
Hall (TX)
Hastert
Hastings (WA)
Hayes
Heller
Hensarling
Herger
[[Page H9502]]
Hill
Hobson
Hoekstra
Hulshof
Hunter
Inglis (SC)
Issa
Jindal
Johnson (IL)
Jones (NC)
Jordan
Keller
King (IA)
King (NY)
Kingston
Kirk
Kline (MN)
Knollenberg
Kuhl (NY)
LaHood
Lamborn
Latham
LaTourette
Lewis (CA)
Lewis (KY)
Linder
LoBiondo
Lucas
Lungren, Daniel E.
Mack
Manzullo
Marchant
Marshall
McCarthy (CA)
McCaul (TX)
McCotter
McCrery
McHenry
McHugh
McKeon
McMorris Rodgers
Mica
Miller (FL)
Miller (MI)
Miller, Gary
Moran (KS)
Murphy, Tim
Musgrave
Myrick
Neugebauer
Nunes
Paul
Pearce
Pence
Peterson (PA)
Petri
Pickering
Pitts
Platts
Poe
Porter
Price (GA)
Pryce (OH)
Putnam
Radanovich
Ramstad
Regula
Rehberg
Reichert
Renzi
Reynolds
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
Roskam
Royce
Ryan (WI)
Sali
Saxton
Schmidt
Sensenbrenner
Shadegg
Shays
Shimkus
Shuler
Shuster
Simpson
Smith (NE)
Smith (NJ)
Smith (TX)
Souder
Stearns
Sullivan
Tancredo
Taylor
Terry
Thornberry
Tiahrt
Tiberi
Turner
Upton
Walberg
Walden (OR)
Walsh (NY)
Wamp
Weldon (FL)
Weller
Westmoreland
Whitfield
Wicker
Wilson (NM)
Wilson (SC)
Wolf
Young (AK)
Young (FL)
NAYS--226
Abercrombie
Ackerman
Allen
Altmire
Andrews
Arcuri
Baca
Baird
Baldwin
Bean
Becerra
Berkley
Berman
Berry
Bishop (GA)
Bishop (NY)
Blumenauer
Boren
Boswell
Boucher
Boyd (FL)
Boyda (KS)
Brady (PA)
Braley (IA)
Brown, Corrine
Butterfield
Capps
Capuano
Cardoza
Carnahan
Carson
Castor
Chandler
Clay
Cleaver
Clyburn
Cohen
Conyers
Cooper
Costa
Costello
Courtney
Cramer
Crowley
Cuellar
Cummings
Davis (AL)
Davis (CA)
Davis (IL)
Davis, Lincoln
DeFazio
DeGette
Delahunt
DeLauro
Diaz-Balart, L.
Diaz-Balart, M.
Dicks
Dingell
Doggett
Doyle
Edwards
Ellison
Emanuel
Engel
Eshoo
Etheridge
Farr
Fattah
Ferguson
Filner
Frank (MA)
Giffords
Gillibrand
Gonzalez
Gordon
Green, Al
Green, Gene
Grijalva
Gutierrez
Hall (NY)
Hare
Harman
Hastings (FL)
Herseth Sandlin
Higgins
Hinchey
Hinojosa
Hirono
Hodes
Holden
Holt
Honda
Hooley
Hoyer
Inslee
Israel
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Johnson (GA)
Johnson, E. B.
Jones (OH)
Kagen
Kanjorski
Kaptur
Kennedy
Kildee
Kilpatrick
Kind
Klein (FL)
Kucinich
Lampson
Langevin
Lantos
Larsen (WA)
Larson (CT)
Lee
Levin
Lewis (GA)
Lipinski
Loebsack
Lofgren, Zoe
Lowey
Lynch
Mahoney (FL)
Maloney (NY)
Markey
Matheson
Matsui
McCarthy (NY)
McCollum (MN)
McDermott
McGovern
McIntyre
McNerney
McNulty
Meek (FL)
Meeks (NY)
Melancon
Michaud
Miller (NC)
Miller, George
Mitchell
Mollohan
Moore (KS)
Moore (WI)
Moran (VA)
Murphy (CT)
Murphy, Patrick
Murtha
Nadler
Napolitano
Neal (MA)
Oberstar
Obey
Olver
Ortiz
Pallone
Pascrell
Pastor
Payne
Pelosi
Perlmutter
Peterson (MN)
Pomeroy
Price (NC)
Rahall
Rangel
Reyes
Rodriguez
Ros-Lehtinen
Ross
Rothman
Roybal-Allard
Ruppersberger
Rush
Ryan (OH)
Salazar
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Schakowsky
Schiff
Schwartz
Scott (GA)
Scott (VA)
Serrano
Sestak
Shea-Porter
Sherman
Sires
Skelton
Slaughter
Smith (WA)
Snyder
Solis
Space
Spratt
Stark
Stupak
Sutton
Tanner
Tauscher
Thompson (CA)
Thompson (MS)
Tierney
Towns
Udall (CO)
Udall (NM)
Van Hollen
Velazquez
Visclosky
Walz (MN)
Wasserman Schultz
Waters
Watson
Watt
Waxman
Weiner
Welch (VT)
Wexler
Wilson (OH)
Woolsey
Wu
Wynn
Yarmuth
NOT VOTING--5
Clarke
Crenshaw
Davis, Jo Ann
Johnson, Sam
Sessions
Announcement by the Speaker Pro Tempore
The SPEAKER pro tempore (during the vote). Members are advised 2
minutes are remaining in this vote.
{time} 1929
Ms. HOOLEY changed her vote from ``yea'' to ``nay.''
Messrs. GOODE, GALLEGLY, FRELINGHUYSEN, JOHNSON of Illinois, and
MARSHALL changed their vote from ``nay'' to ``yea.''
So the motion to recommit was rejected.
The result of the vote was announced as above recorded.
The SPEAKER pro tempore. The question is on the passage of the bill.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. McCRERY. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. This will be a 5-minute vote.
The vote was taken by electronic device, and there were--yeas 225,
nays 204, not voting 4, as follows:
[Roll No. 787]
YEAS--225
Abercrombie
Ackerman
Allen
Altmire
Andrews
Arcuri
Baca
Baird
Baldwin
Barrow
Bean
Becerra
Berkley
Berman
Berry
Bishop (GA)
Bishop (NY)
Blumenauer
Boswell
Boucher
Boyd (FL)
Boyda (KS)
Brady (PA)
Braley (IA)
Brown, Corrine
Butterfield
Capito
Capps
Capuano
Cardoza
Carnahan
Carney
Carson
Castor
Chandler
Clay
Cleaver
Clyburn
Cohen
Conyers
Costa
Costello
Courtney
Cramer
Crowley
Cuellar
Cummings
Davis (AL)
Davis (CA)
Davis (IL)
Davis, Lincoln
DeFazio
DeGette
Delahunt
DeLauro
Dicks
Dingell
Doggett
Doyle
Edwards
Ellison
Emanuel
Engel
Eshoo
Farr
Fattah
Ferguson
Filner
Frank (MA)
Giffords
Gillibrand
Gonzalez
Gordon
Green, Al
Green, Gene
Grijalva
Gutierrez
Hall (NY)
Hare
Harman
Hastings (FL)
Herseth Sandlin
Higgins
Hinchey
Hinojosa
Hirono
Hodes
Holden
Holt
Honda
Hooley
Hoyer
Inslee
Israel
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Johnson (GA)
Johnson, E. B.
Jones (OH)
Kagen
Kanjorski
Kaptur
Kennedy
Kildee
Kilpatrick
Kind
Klein (FL)
Kucinich
LaHood
Lampson
Langevin
Lantos
Larsen (WA)
Larson (CT)
Lee
Levin
Lewis (GA)
Lipinski
LoBiondo
Loebsack
Lofgren, Zoe
Lowey
Lynch
Mahoney (FL)
Maloney (NY)
Markey
Matheson
Matsui
McCarthy (NY)
McCollum (MN)
McDermott
McGovern
McNerney
McNulty
Meek (FL)
Meeks (NY)
Melancon
Michaud
Miller (NC)
Miller, George
Mitchell
Mollohan
Moore (KS)
Moore (WI)
Moran (VA)
Murphy (CT)
Murphy, Patrick
Murtha
Nadler
Napolitano
Neal (MA)
Oberstar
Obey
Olver
Ortiz
Pallone
Pascrell
Pastor
Payne
Pelosi
Perlmutter
Peterson (MN)
Pomeroy
Price (NC)
Rahall
Rangel
Reyes
Rodriguez
Ross
Rothman
Roybal-Allard
Ruppersberger
Rush
Ryan (OH)
Salazar
Sanchez, Linda T.
Sanchez, Loretta
Sarbanes
Schakowsky
Schiff
Schwartz
Scott (GA)
Scott (VA)
Serrano
Sestak
Shays
Shea-Porter
Sherman
Sires
Skelton
Slaughter
Smith (WA)
Snyder
Solis
Space
Spratt
Stark
Stupak
Sutton
Tanner
Tauscher
Thompson (CA)
Thompson (MS)
Tierney
Towns
Udall (CO)
Udall (NM)
Van Hollen
Velazquez
Visclosky
Walz (MN)
Wasserman Schultz
Waters
Watson
Watt
Waxman
Weiner
Welch (VT)
Wexler
Wilson (OH)
Woolsey
Wu
Wynn
Yarmuth
NAYS--204
Aderholt
Akin
Alexander
Bachmann
Bachus
Baker
Barrett (SC)
Bartlett (MD)
Barton (TX)
Biggert
Bilbray
Bilirakis
Bishop (UT)
Blackburn
Blunt
Boehner
Bonner
Bono
Boozman
Boren
Boustany
Brady (TX)
Broun (GA)
Brown (SC)
Brown-Waite, Ginny
Buchanan
Burgess
Burton (IN)
Buyer
Calvert
Camp (MI)
Campbell (CA)
Cannon
Cantor
Carter
Castle
Chabot
Coble
Cole (OK)
Conaway
Cooper
Cubin
Culberson
Davis (KY)
Davis, David
Davis, Tom
Deal (GA)
Dent
Diaz-Balart, L.
Diaz-Balart, M.
Donnelly
Doolittle
Drake
Dreier
Duncan
Ehlers
Ellsworth
Emerson
English (PA)
Etheridge
Everett
Fallin
Feeney
Flake
Forbes
Fortenberry
Fossella
Foxx
Franks (AZ)
Frelinghuysen
Gallegly
Garrett (NJ)
Gerlach
Gilchrest
Gillmor
Gingrey
Gohmert
Goode
Goodlatte
Granger
Graves
Hall (TX)
Hastert
Hastings (WA)
Hayes
Heller
Hensarling
Herger
Hill
Hobson
Hoekstra
Hulshof
Hunter
Inglis (SC)
Issa
Jindal
Johnson (IL)
Jones (NC)
Jordan
Keller
King (IA)
King (NY)
Kingston
Kirk
Kline (MN)
Knollenberg
Kuhl (NY)
Lamborn
Latham
LaTourette
Lewis (CA)
Lewis (KY)
Linder
Lucas
Lungren, Daniel E.
Mack
Manzullo
Marchant
Marshall
McCarthy (CA)
McCaul (TX)
McCotter
McCrery
McHenry
McHugh
McIntyre
McKeon
McMorris Rodgers
Mica
Miller (FL)
Miller (MI)
Miller, Gary
Moran (KS)
Murphy, Tim
Musgrave
Myrick
Neugebauer
Nunes
Paul
Pearce
Pence
Peterson (PA)
Petri
Pickering
Pitts
Platts
Poe
Porter
Price (GA)
Pryce (OH)
Putnam
Radanovich
Ramstad
Regula
Rehberg
Reichert
Renzi
Reynolds
Rogers (AL)
Rogers (KY)
Rogers (MI)
Rohrabacher
[[Page H9503]]
Ros-Lehtinen
Roskam
Royce
Ryan (WI)
Sali
Saxton
Schmidt
Sensenbrenner
Sessions
Shadegg
Shimkus
Shuler
Shuster
Simpson
Smith (NE)
Smith (NJ)
Smith (TX)
Souder
Stearns
Sullivan
Tancredo
Taylor
Terry
Thornberry
Tiahrt
Tiberi
Turner
Upton
Walberg
Walden (OR)
Walsh (NY)
Wamp
Weldon (FL)
Weller
Westmoreland
Whitfield
Wicker
Wilson (NM)
Wilson (SC)
Wolf
Young (AK)
Young (FL)
NOT VOTING--4
Clarke
Crenshaw
Davis, Jo Ann
Johnson, Sam
Announcement by the Speaker
The SPEAKER (during the vote). Members are advised there are 2
minutes remaining on this vote.
{time} 1937
So the bill was passed.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.
____________________