[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.

                          ____________________