[Congressional Record Volume 153, Number 127 (Friday, August 3, 2007)]
[Senate]
[Pages S10881-S10883]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
(At the request of Mr. Reid, the folowing statement was ordered to be
printed in the Record.)
FISA
Mr. KERRY. Mr. President, I was necessarily absent from the
votes related to the reauthorization of FISA. I strongly support the
critical efforts to protect our national security and, as I have
repeatedly stated in the past, I want the Federal Government to do all
that it can to aggressively pursue al-Qaida and other terrorist
organizations. I believe the legislation developed by Senators
Rockefeller and Levin achieves these goals without targeting American
citizens without court authorization. I believe the approach by
Senators Rockefeller and Levin will give the intelligence community all
the tools it needs to protect our national security while maintaining
the independence of the FISA Court. This legislation will give the
intelligence community the tools they need to collect foreign-to-
foreign intelligence communications. It will compel compliance from
communications providers. It will allow the intelligence community to
collect all foreign intelligence information. I hope my colleagues
support this important legislation.
Mr. FEINGOLD. Mr. President, last night, the Senate was able to
successfully pass the reauthorization of a popular program that has
reduced the number of uninsured children in our country by over 6
million. The Children's Health Insurance Program has helped lower the
rate of uninsured low-income children by one-third since its enactment
in 1997. That is a huge accomplishment, and has helped address a
problem in our country that is unacceptable--the millions of families
lacking insurance. Moreover, while the bill has a pricetag of roughly
$40 billion over 10 years, it is fully offset and would cover over 3
million more children. This program, according to CBO and numerous
economists, is the most efficient method of getting health care
insurance to low-income kids and parents, and that means CHIP provides
the best coverage available for low-income families.
In my home state of Wisconsin, CHIP is known as BadgerCare and it
provides health insurance for over 67,000 families. My State has done
an incredible job of covering uninsured families, and the positive
effects of this program are felt at schools, in the workforce, and at
home. This bill helps support Wisconsin's efforts and provides low-
income children in my State with better access to preventive care,
primary care, and affordable care. The end result is healthier
families. BadgerCare is vital to the well-being of many families in
Wisconsin and I am very pleased that this bill supports the program in
my State, including Wisconsin's choice to cover parents of CHIP and
Medicaid children.
The ability to cover adults in CHIP continues to be a priority for
States like Wisconsin. Many States extend coverage to low-income adults
and parents of children enrolled in SCHIP. This coverage has been given
prior Federal approval--including in the Bush administration--and has
significantly lowered the rate of uninsurance in our states. Wisconsin
provides family-based coverage, which is an important determinant in
children's coverage and use of services.
We know from numerous reports that when we cover parents, we bring
more uninsured children into the program as well. States like Wisconsin
have proven this time and again. No child is left off the rolls because
a parent is covered. Covering parents means covering more kids--bottom
line. Wisconsin chose to cover parents because research shows that it
is the best way to bring low-income children into BadgerCare. This
choice was wisely supported by this administration this May as CMS
approved parent coverage in BadgerCare for another 3 years. Despite all
the evidence and the widespread support for this policy, a number of
Senators wanted to remove all adults from the CHIP program.
I worked with the Senate Finance Committee and a number of other
Senators who represent States like Wisconsin on an agreement that will
allow our States to keep families in the CHIP program. I am grateful to
my colleagues Senator Baucus and Senator Rockefeller for working with
me to help Wisconsin keep parents on the rolls while also bringing
additional tens of millions of dollars to the State. The agreement
reflected in this bill ensures that Wisconsin will not have to drop a
single person from the insurance rolls, and will even be able to expand
coverage to more people in the State. I am happy to support this
agreement regarding parents today.
We also have a moral obligation to provide assistance to the very
poor, even if they do not have children. When we talk about childless
adults in CHIP, we are talking about the very poorest of the poor. Most
of the childless adults in the program live well below 100 percent of
Federal poverty. An adult at 50 percent of the Federal poverty level
must attempt to survive on less than $500 per month. This is not enough
to afford adequate food and shelter, let alone health insurance, in any
State. We all know a single visit to the emergency room can cost more
than someone in this situation makes in a year. Providing coverage to
childless adults increases their ability to see a doctor when a problem
is small, at a significantly lower cost than if care is delayed, the
problem is exacerbated, and the result is an emergency room visit.
Covering poor individuals helps to curb the cost of health care and
health insurance for all of us, because we all bear emergency room
costs through higher hospital and physician charges and then through
increased health insurance premiums.
I strongly believe we should continue to cover current populations.
CHIP has allowed states to mold the program to meet their specific
needs, and while we may not all agree with what each State chooses to
do, we should respect that decision. Additionally, we should never
impose policies on States that would result in a higher number of
uninsured for the State. It is bad policy, and it's the wrong thing to
do.
Another issue critical to children's health is to ensure that
unnecessary or burdensome barriers to enrollment are removed. The
onerous citizenship documentation requirements established in the 2005
Deficit Reduction Act, DRA, are keeping hundreds of thousands of
eligible beneficiaries from the health care they need. This provision
has created a serious new roadblock to coverage. As a result of the
provision, which requires U.S. citizens to document their citizenship
and identity when they apply for Medicaid or renew their coverage, a
growing number of States are reporting a drop in Medicaid enrollment,
particularly among children, but also among pregnant women and low-
income parents. Health care coverage is being delayed or denied for
tens of thousands of children who are clearly citizens and eligible for
Medicaid but who cannot produce the limited forms of documentation
prescribed by the regulations. These children are having to go without
necessary medical care, essential medicines and therapies. In addition,
community health centers are reporting a decline in the number of
Medicaid patients due to the documentation requirements and are faced
with treating more uninsured patients as a result.
In Wisconsin, more than 26,000 individuals--half of whom were
children under age 16--lost Medicaid or were denied coverage solely
because they could not satisfy the federal documentation requirements.
About two-
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thirds of these people are known by the state to be U.S. citizens; most
of the remainder are likely to be citizens as well, but have yet to
prove it.
A study of 300 community health centers, conducted by George
Washington University, found that the citizenship documentation
requirements have caused a nationwide disruption in Medicaid coverage.
Researchers estimate a loss of coverage for as many as 319,500 health
center patients, which will result in an immediate financial loss of up
to $85 million in Medicaid revenues. The loss of revenue hampers the
ability of safety net providers to adequately respond to the medical
needs of the communities they serve.
In addition to consequences suffered by eligible U.S. citizens,
states have reported incurring substantial new administrative costs
associated with implementing the requirement. They have had to hire
additional staff, retool computer systems, and pay to obtain birth
records. States are also reporting that the extra workload imposed by
the new requirement is diverting time and attention that could be
devoted to helping more eligible children secure and retain health
coverage.
States are in the best position to decide if a documentation
requirement is needed and, if so, to determine the most effective and
reasonable ways to implement it. States that do not find it necessary
to require such documentation could return to the procedures they used
prior to the DRA and avoid the considerable administrative and
financial burdens associated with implementing the DRA requirement.
Most importantly, these states could avoid creating obstacles to
Medicaid coverage for eligible U.S. citizens.
Despite significant support for allowing states to determine the best
way to document citizenship, that complete fix is not included in the
underlying bill. The restrictions are eased, and this is an important
first step, but I hope we can continue to move forward on this issue
and return this requirement to a State option. I am pleased that this
is done in the CHIP reauthorization in the House version of this
legislation, and I hope that as we continue to work to support
children's health care, we will also work to remove barriers to
enrollment that are preventing our children from receiving the care
they need.
In addition to these issues that we considered in the Children's
Health Insurance Program Reauthorization, I would like to talk about
the bigger picture of health care reform. There is a crisis facing our
country, a crisis that directly affects the lives of over 45 million
people in the United States, and that indirectly affects many more. The
crisis is the lack of universal health insurance in America. It is
consistently the number one issue that I hear about in Wisconsin, and
it is the No. 1 issue for many Americans. Nevertheless, the issue has
been largely ignored in the Halls of Congress. We sit idle, locked in a
stalemate, refusing to give this life-threatening problem its due
attention. We need a way to break that deadlock, and that is why last
April, I introduced a bill with the Senator from South Carolina,
Lindsey Graham, that will do just that the State-Based Health Care
Reform Act.
Senator Graham and I are from opposite ends of the political
spectrum, we are from different areas of the country, and we have
different views on health care. But we agree that something needs to be
done about health care in our country. In short, our bill establishes a
pilot project to provide States with the resources needed to implement
universal health care reform. The bill does not dictate what kind of
reform the States should implement, it just provides an incentive for
action, provided the States meet certain minimum coverage and low-
income requirements.
Even though Senator Graham and I support different methods of health
care reform, we both agree that this legislation presents a viable
solution to the logjam preventing reform.
This bipartisan legislation harnesses the talent and ingenuity of
Americans to come up with new solutions. This approach takes advantage
of America's greatest resources--the mind power and creativity of the
American people--to move our country toward the goal of a working
health care system with universal coverage. With help from the Federal
Government, States will be able to try new ways of covering all their
residents, and our political logjam around health care will begin to
loosen.
We are fortunate to live in a country that has been abundantly
blessed with democracy and wealth, and yet there are those in our
society whose daily health struggles overshadow these blessings. Over
the past few days, my colleagues have shared tragic stories of children
who have suffered as a result of being uninsured, and we have listened
to the heartwarming stories of families who have--quite literally--been
saved by the Children's Health Insurance Program. The Children's Health
Insurance Program reauthorization marks an important leap forward in
getting coverage to those who need it. I was pleased to support this
bill's final passage, and I look forward to the day that everyone in
our country has access to the basic right of health care.
Mr. DODD. Mr. President, I am in strong support of H.R. 976, the
Small Business Tax Relief Act. There are few more important issues
facing the Senate than the health and well-being of our nation's
children. The vote to pass this legislation is a vote for children. It
is a vote to do what's right for our nation's youth.
As the father of two young daughters, I know the importance of having
the peace of mind to know that if one of them gets sick they have the
health insurance coverage that will provide for them if they break a
bone or get a cold. For millions of parents, every slight sniffle or
aching tooth could mean the difference between paying the rent or
paying for medical care.
It is our national shame that nine million children wake up every day
lacking any form of health insurance. For their parents, the lack of
access to health insurance means a regular check up is sidelined, a
dental exam goes unscheduled, or an early diagnosis of a chronic
condition such as asthma or diabetes is postponed. For families, such
delays in access to proper health care set the stage for children to
grow up underperforming in school, developing preventable or treatable
conditions, or worse, permanent disability or even premature death.
The lack of health insurance goes beyond poor health outcomes. Health
insurance is inextricably linked with alleviating child poverty. Low-
income families without insurance often get stuck in an endless cycle
of medical debt. Personal debt due to medical expenses is a primary
cause of bankruptcy filings in this country. Parents already struggling
to make ends meet should not have to choose between buying medication
for their children and putting food on the table.
I commend the chairman and ranking member of the Finance Committee
for working so hard to put together a bill that will benefit the lives
of millions of children and their families. Through their leadership
and that of Senators Hatch, Rockefeller, Kennedy and many others, since
the Children's Health Insurance Program was first enacted, the number
of uninsured children has decreased by one-third. The bill passed by
the Senate is an important vote for children. Although I supported
efforts to broaden the bill to cover an additional one million
uninsured children, the bill passed by the Senate is a tremendous
investment in the health and future of our children.
Specifically, this bill continues providing coverage for 6.6 million
children currently enrolled in CHIP and provides coverage for 3.2
million children who are currently uninsured today. It will reduce the
number of uninsured children by one third over the next 5 years.
In my own State of Connecticut, our CHIP program, commonly known as
HUSKY B, has brought affordable health insurance to more than 130,000
children in working families since its inception in 1998. H.R. 976 is
essential to states like Connecticut so that they may continue to
operate programs like HUSKY B and build on their proven success to
insure even more children.
I am additionally very pleased that my Support for Injured
Servicemembers Act amendment was included in the final SCHIP bill. This
amendment provides up to 6 months of Family and Medical Leave Act,
FMLA, leave for family members of military personnel who suffer from a
combat-related injury or illness. FMLA currently allows three months of
unpaid leave. Fourteen
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years ago, FMLA declared the principle that workers should never be
forced to choose between the jobs they need and the families they love.
In the years since its passage, more than 50 million Americans have
taken advantage of its provisions to care for a sick love one, or
recover from illness themselves, or welcome a new baby into the family.
Mr. President, if ordinary Americans deserve those rights, how much
more do they apply to those who risk their lives in the service of our
country? Soldiers who have been wounded in our service deserve
everything America can give to speed their recoveries--but most of all,
they deserve the care of their closest loved ones. Given the severity
of their injuries, and our debt of gratitude, our servicemembers need
more. That is exactly what is offered in the Support for Injured
Servicemembers Act.
Senator Bob Dole and former Secretary of Health and Human Services
Donna Shalala have been instrumental in this effort as well, through
their thoughtfulness and work on the President's Commission on Care for
America's Returning Wounded Warriors. It's not surprising that the
Commission found that family members play a critical role in the
recovery of our wounded servicemembers. The commitment shown by the
families and friends of our troops is truly inspiring. According to the
Commission's report, 33 percent of active duty servicemembers report
that a family member or close friend relocated for extended periods of
time to help their recoveries. It also points out that 21 percent of
active duty servicemembers say that their friends or family members
gave up jobs to find the time.
I am pleased that Senator Clinton is the lead co-sponsor of my
amendment. FMLA was the very first bill that President Clinton signed
into law, and I am grateful that his wife, Senator Clinton, continues
to support the principles that I have been fighting for over 20 years.
I am pleased that Senators Dole, Graham, Kennedy, Chambliss, Reed,
Mikulski, Murray, Salazar, Lieberman, Menendez, Brown, Nelson of
Nebraska, and Cardin are co-sponsoring this amendment. I thank Senator
Baucus and Senator Grassley for accepting this important amendment and
appreciate the support of all of my colleagues in this effort.
Mr. President, I am troubled by the comments from the Bush
administration about this bill. It is a bill to help children and an
overwhelming majority of members on both sides of the aisle have voted
to support that goal. The CHIP Program is a model of success and this
bill provides sustainable and predictable health care coverage for low
income children regardless of their health status. One day soon, the
President will make a decision on whether to sign CHIP reauthorization
into law. At that moment, all Americans will know whether the President
stands for children or would rather stand in the way of children's
access to critically needed health care.
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