[Congressional Record Volume 153, Number 144 (Wednesday, September 26, 2007)]
[Senate]
[Pages S12080-S12082]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CHILDREN'S HEALTH INSURANCE PROGRAM
Mr. GREGG. Madam President, we are today going to vote on what is
euphemistically known as the SCHIP bill. It is clearly incorrectly
identified because under that reading one would think it was for
children, but it is actually a bill that also covers adults. I think
there is a general consensus and no disagreement about the fact that
children who are at or near poverty--even considerably above poverty--
families who have that type of fiscal constraint should be covered.
There is agreement on that.
The issue is whether we should take a program which covers children
in poverty, or near poverty, up to 200 percent of the poverty level--
which, if we define poverty, it is twice as much as what poverty is--
whether we should cover children who are in families who have incomes
well above 200 percent of the poverty level and adults who have no
children at all, and whether we should do that extra coverage through a
nationalized system.
That is what is at issue. The issue is not whether children who come
from families who are not that well off--not necessarily poor families
but are not well off--those children are covered under the President's
proposal, under proposals which I would support, children from families
with incomes up to 200 percent of poverty.
The issue is whether we should have States, for example, such as New
Jersey, where families who make $71,000 a year--$71,000 a year--should
be able to be covered under a federally, totally subsidized, taxpayer-
paid-for health care plan, and whether families that are not even
families--because they are two adults with no kids--should also be able
to be covered under that federally subsidized health care plan, where
the taxpayers pick up all the costs, and whether those plans should be
structured in a way that they are single-payer, Government-directed,
nationalized health care plans.
What is the practical implication of taking a program, which is
supposed to be directed at children who come from low-income families,
and expanding it radically in the way that the bill we are going to get
does?
Well, the first practical implication is it spends a heck of a lot of
money: $71 billion over 10 years in additional spending--$71 billion--
to cover children in families with up to $71,000 in income. In fact,
they go up to 400 percent of the poverty level, with families who make
up to $80,000 a year, and they cover adults who do not have children.
Yet they claim it is a children-in-need health care program.
So you are going to increase the Federal Government and the size of
the Federal Government and the spending of the Federal Government--
which, remember, comes from taxpayers--by $71 billion under this
proposal.
The President has proposed increasing spending in this area over the
baseline--which is about $25 billion--by an additional $5 billion over
5 years. Some of us have proposed we even go a little higher so we make
sure every child in that category of 200 percent of poverty can be
covered.
But to expand this program to a $71 billion increase is a huge
explosion in the Federal program, in the size of the program, and in
the cost to the taxpayers. Remember this: Another effect
[[Page S12081]]
of this policy of covering families who make up to $80,000 a year with
this federally taxpayer-paid health care insurance is that families
that presently have their children insured by the private sector are
going to move their insurance from the private sector, which is paying
for the cost--the business they work for--over to the public sector.
In fact, it is estimated, under the proposal before us, 4.4 million
children will be covered who are not covered today by this new SCHIP
program which covers families up to $80,000 and spends an extra $71
billion. However, what people do not tell you--at least folks from the
other side do not tell you--is 2.4 million of those children who are
going to be picked up by this plan are already covered--they are
already covered--by private insurers.
So we are basically shifting the burden from the private insurance
over to the public side, which means the taxpayers--average working
Americans--are going to have to pay more to cover kids who are already
covered by the private sector through their taxes.
Does that make sense? Of course it does not make sense. Why would you
do something like that? Why would you set up a program like that? Why
would you expand a program to families that make $80,000; to adults who
do not have children; to children who already are insured and draw them
out of the private insurance into the public insurance? Why would you
do something like that?
Well, the answer is pretty obvious. This is part of the effort of the
other side of the aisle to move us toward a single-payer, nationalized
system of health care. There is no hiding that fact. That has been
stated as the purpose, even by the chairman of the Finance Committee.
So the goal is not necessarily to bring more kids under insurance who
need to be insured because they come from families of less means. That
is going to be done under either program. The goal is to radically
expand the size of a public insurance program to families that are
really doing quite well, families making up to $80,000 that may not
have children or the children may already be insured by the private
sector because you want to move more people onto the public insurance
system because you want to have a nationalized system.
Now, I do not happen to support a nationalized system of health care.
But I think if we are going to have a nationalized system of health
care, we should not do it through the back door. We should not do it
through this bait-and-switch approach that this bill represents. We
should do it in a very open, honest statement, much as what Senator
Clinton proposed back in the early 1990s: We are going to nationalize
the health care system of this country. There is going to be one payer.
It is going to be the Federal Government. And all your health care will
be provided for by the Federal Government, with the cost being picked
up by the American taxpayer.
I oppose that type of an approach for a variety of reasons: first and
most honestly because in every other nation that has tried that, it has
led to dramatic rationing of care. Depending on your age, you simply
are not able to get certain types of care, treatment. You go to Canada,
and you wait for months, sometimes years for certain types of
procedures or you go to England and you wait for months, years, and you
cannot even get certain types of procedures. So you get rationing.
Secondly, you undermine research. You do not get people investing in
creating new products and new ways to make people healthy because the
cost is not reimbursed.
Thirdly, if you take the private sector out of providing health care,
you immediately create huge inefficiencies because you reduce
competition, you reduce the forces for cost control that private
insurance brings into play.
So I do not support a single-payer plan. But I especially find it
inappropriate that the way the other side of the aisle is trying to get
to a single-payer program is through this surreptitious back door of
taking one chunk of the population--kids who are already insured by the
private sector--and moving them over to the public sector in the name
of protecting children who are from lower or moderate-income families.
All the proposals that are pending around here--the proposal by the
President, the proposal I would support--protect children in families
at 200 percent of poverty or less.
One of the ironies, of course, is that as they expand to higher
income families, in States such as New Jersey, for example, where
people making up to $71,000 are covered under the single-payer plan,
they actually leave out low-income kids. For example, in New Jersey,
there are about 19,000 kids who are in families that are under 200
percent of poverty and are not covered under the New Jersey plan.
Wouldn't it make a lot more sense, if we were honestly trying to
address low-income kids, to put in place a plan which actually covered
kids who were in family situations where the income was less than 200
percent of poverty and make sure everybody was covered? That was the
proposal from our side of the aisle, by the way, but it was rejected in
this rush toward trying to get a big bite on the apple of
nationalization, single-payer proposals.
So that is the policy problem with this bill. But there are a lot of
other problems. Call them technical, if you want, but they are pretty
big technical problems. For example, there is the problem that there is
a scam going on, a scam in this bill as to how it is paid for.
You can see this chart I have in the Chamber. This reflects the
increased costs of the bill as it goes forward. But in order to make
their own budget rules, which they claim so aggressively to be
following, such as pay-go, they have to take the program, in the year
2013, from a $16 billion annual spending level down to essentially
zero. In other words, they are zeroing out this program in the year
2013. They are not spending any money on it at all so they can hit
their budget numbers. That is called a scam. That is called a scam. It
is a budget scam. And it is being played against a background of
claiming they are going to do all these wonderful things with all of
this extra money, such as nationalize the system for people making
$80,000 or less, but they are simply not going to claim how they are
going to pay for it. This big, white area in here, they have no idea
how they are going to pay for that. None. None. I will tell you how
they are going to pay for it: by raising taxes on the rest of working
Americans. That is how they are going to pay for it. Working Americans
are going to pay for it so they can nationalize the system.
Then, on top of that, they have set up a verification system which
uses Social Security numbers which the Social Security Administration
says will lead to illegal immigrants being the people who get the
benefit of this program, primarily--or not primarily but in part--
because the Social Security Administration is incapable of accurately
monitoring whether these numbers are correct. So you are going to have
a lot of illegal immigrants getting coverage, claiming they are legal,
because the system has been set up to accomplish that. Maybe this was
the back-door approach toward some level of amnesty or something, but
if it was going to be done, it should have been done more openly than
the system that is being used in this bill. This is a fundamental flaw
of this bill. It is a bill which, in its present form, is not paid for
and has a huge cap.
The PRESIDING OFFICER. The Senator's time has expired.
Mr. GREGG. Madam President, I ask unanimous consent for 1 additional
minute.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. GREGG. Madam President, it has a huge gap in the way it is paid
for. Secondly, it sets up a system of verification which the Social
Security system says it can't accomplish, and, therefore, presumes that
a large number of people who are in this country illegally will end up
in this program.
I ask unanimous consent to have printed in the Record the response of
the Social Security Administration on this point and a letter to Jim
McCrery, who is a Congressman and the ranking member of the Ways and
Means Committee.
There being no objection, the material was ordered to be printed in
the Record, as follows:
[[Page S12082]]
House of Representatives,
Committee on Ways and Means,
Washington DC, September 21, 2007.
Commissioner Michael J. Astrue,
Social Security Administration, Office of the Commissioner,
Baltimore, MD.
Dear Commissioner Astrue: As Congress prepares to debate
the reauthorization of the State Children's Health Insurance
Program (SCHIP), I am writing to request your assistance in
clarifying an issue raised by a provision in the Senate
passed bill. Specifically, I would request that the Social
Security Administration provide technical assistance to
explain the impact of Section 301 of H.R. 976, which was
passed by the Senate on August 2, 2007.
Concerns have been raised that the implementation of this
provision could make it easier for illegal aliens to qualify
for government funded healthcare programs including SCHIP and
Medicaid. In order to better assess the accuracy of these
claims, I would request that you provide answers to the
following questions by no later than the evening of Monday,
September 24, 2007.
1. If implemented as written, would the name and Social
Security number verification process in section 301 of the
Senate SCHIP bill allow the Social Security Administration
(SSA) to verify whether someone is a naturalized citizen?
2. Would Section 301 require SSA to perform any
verification of a person's status as a naturalized citizen?
3. Would the implementation of this provision detect and/or
prevent a legal alien who is not a naturalized citizen (and
therefore generally ineligible for Medicaid), from receiving
Medicaid?
4. Would the name and Social Security number verification
system in Section 301 verify that the person submitting the
name and Social Security number is who they say they are?
5. Would the name and Social Security number verification
system in Section 301 prevent an i1legal alien from
fraudulently using another person's valid name and matching
Social Security number to obtain Medicaid or SCHIP benefits?
6. Would the name and Social Security number verification
system in Section 301 prevent an individual who has i1legally
overstayed a work visa permit from qualifying for Medicaid or
SCHIP?
7. Based on the accuracy of your database, please comment
as to the volume of false positives or false negatives that
could occur under the Social Security number verification
process in section 301 of the Senate SCHIP bill.
Thank you for your prompt attention to this matter. If you
should have questions about any of the requests in this
letter, please contact Chuck Clapton of the Ways and Means
Committee Republican staff.
Sincerely,
Jim McCrery,
Ranking Member,
Committee on Ways and Means.
____
Social Security Administration,
Baltimore, MD, September 24, 2007.
Congressman Jim McCrery,
Longworth House Office Building,
Washington, DC.
Dear Congressman McCrery: Thank you for your letter of
September 21, 2007, concerning Section 301 of H.R. 976 passed
by the Senate.
I have enclosed answers to your seven questions. Please
feel free to contact me if you need any additional
information. The Office of Management and Budget advises that
there is no objection to the transmittal of this letter from
the standpoint of the President's program.
Sincerely,
Michael J. Astrue,
Commissioner.
1. If implemented as written, would the name and Social
Security number verification process in Section 301 of the
Senate SCHIP bill allow SSA to verify whether someone is a
naturalized citizen?
No, the name/SSN verification process only indicates
whether this information matches SSA's records. Our
understanding of Section 301 is that it would provide States
with the option of using a match as a conclusive presumption
that someone is a citizen, whether naturalized or not. Since
we have no data specific to this particular population, we
have no basis for estimating how many non-citizens would
match if this language were passed by Congress.
2. Would Section 301 require SSA to perform any
verification of a person's status as a naturalized citizen?
Section 301 would not provide for verification of
citizenship but would create a conclusive presumption based
on less reliable data that a person is a citizen. As we read
Section 301, it would not require use of DHS data to make a
verification of citizenship.
3. Would the implementation of this provision detect and/or
prevent a legal alien who is not a naturalized citizen (and
therefore generally ineligible for Medicaid), from receiving
Medicaid?
No. Our current name/SSN verification procedures will not
detect legal aliens who are not naturalized citizens.
4. Would the name and Social Security number verification
system in Section 301 verify that the person submitting the
name and Social Security number is who they say they are?
No.
5. Would the name and Social Security number verification
system in Section 301 prevent an illegal alien from
fraudulently using another person's valid name and matching
SSN to obtain Medicaid or SCHIP benefits?
No.
6. Would the name and Social Security number verification
system in Section 301 prevent an individual who has illegally
overstayed a work visa permit from qualifying for Medicaid or
SCHIP?
The name/SSN verification system in Section 301 would not
identify individuals who have illegally overstayed a work
visa permit.
7. Based on the accuracy of your database, please comment
as to the volume of false positives or false negatives that
could occur under the Social Security number verification
process in section 301 of the Senate SCHIP bill.
Due to a lack of data specific to this particular
population defined in section 301, we have no basis for
projecting how many ``false negatives'' or ``false
positives'' would be produced by enactment of Section 301,
but they will occur.
Mr. GREGG. Madam President, to summarize, everybody around here is
supportive of a plan which would fully fund what is necessary to take
care of children whose families make 200 percent of poverty or less.
But what we on our side don't want to see is an expansion of this
program as a method of taking people out of private insurance and
putting them on the public system, creating a single-payer plan and, as
a result, moving down the road toward the nationalization of the entire
health care industry. It would be at a cost of $71 billion to the
American taxpayer, a cost which isn't accounted for in this bill and
which is not paid for. The program has a fundamental flaw in it as to
how they verify who is participating so we don't even know if we are
going to have citizens participating in this program versus illegals.
It is a bill which is flawed. It should be opposed, and it should be
vetoed.
I yield the floor.
The PRESIDING OFFICER. The Senator from Texas is recognized.
____________________