[Congressional Record Volume 153, Number 145 (Thursday, September 27, 2007)]
[Senate]
[Pages S12235-S12247]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
FURTHER CHANGES TO S. CON. RES. 21
Mr. CONRAD. Mr. President, section 301 of S. Con. Res. 21, the 2008
budget resolution, permits the chairman of the Senate Budget Committee
to revise the allocations, aggregates, and other appropriate levels for
legislation that reauthorizes the State Children's Health Insurance
Program, SCHIP. Section 301 authorizes the revisions provided that
certain conditions are met, including that the legislation not result
in more than $50 billion in outlays for SCHIP over the period of fiscal
years 2007 through 2012 and that the legislation not worsen the deficit
over the period of the total of fiscal years 2007 through 2012 or the
period of the total of fiscal years 2007 through 2017.
I find that H.R. 976, the Children's Health Insurance Program
Reauthorization Act of 2007, satisfies the conditions of the deficit-
neutral reserve fund for SCHIP legislation. Therefore, pursuant to
section 301, I am adjusting the aggregates in the 2008 budget
resolution, as well as the allocation provided to the Senate Finance
Committee.
I ask unanimous consent that the following revisions to S. Con. Res.
21 be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
CONCURRENT RESOLUTION ON THE BUDGET FOR FISCAL YEAR 2008-S. CON. RES.
21; FURTHER REVISIONS TO THE CONFERENCE AGREEMENT PURSUANT TO SECTION
301 DEFICIT-NEUTRAL RESERVE FUND FOR SCHIP LEGISLATION
------------------------------------------------------------------------
In billions of dollars
------------------------------------------------------------------------
Section 101................................................
(1)(A) Federal Revenues:
FY 2007................................................ 1,900.340
FY 2008................................................ 2,022.051
FY 2009................................................ 2,121.498
FY 2010................................................ 2,176.937
FY 2011................................................ 2,357.666
FY 2012................................................ 2,495.044
(1)(B) Change in Federal Revenues:
FY 2007................................................ -4.366
FY 2008................................................ -28.745
FY 2009................................................ 14.572
FY 2010................................................ 13.216
FY 2011................................................ -36.884
FY 2012................................................ -102.052
(2) New Budget Authority:
FY 2007................................................ 2,371.470
FY 2008................................................ 2,504.975
FY 2009................................................ 2,523.486
FY 2010................................................ 2,579.022
FY 2011................................................ 2,697.385
FY 2012................................................ 2,734.795
(3) Budget Outlays:
FY 2007................................................ 2,294.862
FY 2008................................................ 2,469.884
FY 2009................................................ 2,570.685
FY 2010................................................ 2,607.628
FY 2011................................................ 2,703.144
FY 2012................................................ 2,716.346
------------------------------------------------------------------------
CONCURRENT RESOLUTION ON THE BUDGET FOR FISCAL YEAR 2008--S. CON. RES.
21; FURTHER REVISIONS TO THE CONFERENCE AGREEMENT PURSUANT TO SECTION
301 DEFICIT NEUTRAL RESERVE FUND FOR SCHIP LEGISLATION
------------------------------------------------------------------------
In millions of dollars
------------------------------------------------------------------------
Current Allocation to Senate Finance Committee:
FY 2007 Budget Authority............................... 1,011,527
FY 2007 Outlays........................................ 1,017,808
FY 2008 Budget Authority............................... 1,078,905
FY 2008 Outlays........................................ 1,079,914
FY 2008-2012 Budget Authority.......................... 6,017,379
FY 2008-2012 Outlays................................... 6,021,710
Adjustments:
FY 2007 Budget Authority............................... 0
FY 2007 Outlays........................................ 0
FY 2008 Budget Authority............................... 9,098
FY 2008 Outlays........................................ 2,412
FY 2008-2012 Budget Authority.......................... 47,678
FY 2008-2012 Outlays................................... 34,907
Revised Allocation to Senate Finance Committee:
FY 2007 Budget Authority............................... 1,011,527
FY 2007 Outlays........................................ 1,017,808
FY 2008 Budget Authority............................... 1,088,003
[[Page S12236]]
FY 2008 Outlays........................................ 1,082,326
FY 2008-2012 Budget Authority.......................... 6,065,057
FY 2008-2012 Outlays................................... 6,056,617
------------------------------------------------------------------------
I yield the floor.
The PRESIDING OFFICER. The Senator from Massachusetts.
Mr. KENNEDY. Mr. President, I thank my colleague from North Carolina
for extending the courtesy of my being able to proceed. We have been
moving back and forth. I understand there is 20 minutes left for the
Democrats, and the Senator from Pennsylvania has taken 5; am I correct?
How much time remains?
The PRESIDING OFFICER. Fifteen and a half minutes remains.
Mr. KENNEDY. I yield myself 7 minutes, and I ask the Chair to remind
me when there is 1 minute left.
Mr. President, I think this debate over the course of the day has
been enormously constructive. I think the American people have been
watching it, and they have a much clearer idea about the alternatives
that are before us. They should know by this time that when all is said
and done, this program, the SCHIP program, was fashioned to try to look
after the working poor, recognizing that Medicaid dealt with the very
poor but that the working poor were finding increasing pressure and
were, in increasing numbers, unable to get any kind of health
insurance. That was basically the targeted area.
As we reviewed earlier in the course of the discussion, this was
basically a State-run program. Using the private sector, it has
guidelines as to what the health care coverage should be in various
areas, but the States make those judgments and decisions--quite a bit
different from Medicaid. So the origin of it, having listened to some
of this debate, it is important to note this is very different from
other kinds of Federal programs but not greatly dissimilar from what
the President has indicated that he supported in the prescription drug
program. It was initially using the cigarette tax money that was a part
of the settlement earlier, where we were using it, and therefore the
relationship with the increase in the cigarette tax at the present
time.
Now, Mr. President, I only have a few minutes here, and we have gone
through these charts about how this is covering 6 million and we expect
that to go to 10 million. We have also reviewed the fact that when we
look at the comparison with adults and children, we can see under this
program that uncovered children have gone down dramatically and the
adults have gone up. So this has been an extraordinary success. CBO has
indicated this is the best way. If we are interested in covering
children, CBO has indicated this is the way.
The point I wish to make in the time I have remaining is that when
all is said and done, when we vote--and we are going to vote in just a
little while--the American families ought to realize a very important
fact; that is, every single Member of the Senate, with the exception of
one, has comprehensive health care and our children are all covered.
Understand that, America? All of our children are covered. All of our
children are covered. The next thing to know, Mr. And Mrs. America,
your taxpayer money is paying for 72 percent of our health care
coverage cost. Do we understand that now?
For those who are saying: Well, I am not going to support this
because it costs too much; I am not going to support this because it
may be 300 percent of poverty, we get paid $160,000. We are well above
the 200, the 300, the 400 percent of poverty level. Yet we are going to
have Members on the floor of the Senate this afternoon who are going to
turn thumbs down to American families who are watching this debate and
knowing that our premiums, our health insurance is being paid for by
the American taxpayers. I wonder how people do that. I wonder how they
do it. You would think, if they are so offended about Federal
Government spending or a Federal Government program, they wouldn't use
it themselves. But, no, they do. They will take it. But when it comes
to looking out for working families, there are going to be many in this
Chamber who will say: No, we are not going to look out for working
families. You can go ahead and pay for mine--I get my children
covered--but we don't think the Federal Government ought to be
tampering with this issue. We don't think the Federal Government ought
to be looking into whether it is going to have a program to provide
coverage for the sons and daughters of working families who cannot
afford a $10,000 health insurance program that would cover themselves
and their families although the taxpayers are paying for ours.
Mr. President, this is extraordinary hypocrisy we are about to see
here on the floor of the Senate. How can people in good faith do this
and still accept the Federal Government help? How can they be
complaining all afternoon about a Federal Government program and then
have a better Federal program paying for their own--paying for their
own. It is just hypocrisy of the greatest sort, and I think that is
something that is important.
The most important point has been mentioned eloquently by many of my
colleagues; that is, the importance of covering those children. The
most important point is that too many parents will cry themselves to
sleep tonight wondering whether their child is $200 sick because they
may have to go to the emergency room. That is the heart of this.
Before we all get worked up, Mr. President, it is important to note
what the financial bottom line on this is too. What has been pointed
out over the course of the past days, again, is the question of
priorities. We see in this chart here what we are talking about--
priorities. That is what this vote is. Do we want to say we can cover,
for 1 day in Iraq at a cost of $300 million, 246,000 children; for 1
week in Iraq at $2.5 billion, 1.7 million children; or for 41 days at a
cost of $12.2 billion, 10 million kids?
The PRESIDING OFFICER. The Senator has 1 minute remaining.
Mr. KENNEDY. Mr. President, this is a choice. There are those who
want to continue the ongoing flow of resources to Iraq when we have
asked our military to do everything they could, and they have done it
with great valor, and yet still the Iraqi politicians cannot get it
together. They are holding American service men and women hostage--
hostage. The blood of American servicemen is flowing in Baghdad, and
this is wrong.
This is an issue of priorities. I believe we ought to invest in the
children, and I think we have benefited enough here in the Senate from
our own largess from the Federal taxpayers in terms of supporting
ourselves that we should be ashamed if we cannot see the responsibility
we have to look after children of working families in this country.
I thank the Chair, and I yield the floor.
The PRESIDING OFFICER. The Senator from North Carolina.
Mr. BURR. Mr. President, it is my understanding I have 10 minutes.
The PRESIDING OFFICER. The Senator is correct.
Mr. BURR. I would ask the Chair to notify me when I have 2 minutes
remaining.
Mr. President, I heard my good friend from Massachusetts talk about
the Federal system. Let me take a minute to talk about the Federal
system.
I have been here for 13 years. The coverage I have is less and the
cost is more than when I was in the private sector working for a
company with 50 employees, but I accept that.
Last year, I learned something new, though. When my oldest son became
22, I got a notice that under the Federal plan he automatically falls
off our insurance. Well, it happens for every Federal employee, but
what was my experience? That is what I wish to share with you.
I called to find out what the Federal Government had negotiated so
that my child could have health insurance. They said the exact same
coverage would now be $5,400 for that individual--a 22-year-old college
student, healthy as a bull. I decided I would go to North Carolina and
I would negotiate to see if I couldn't find similar coverage. Not only
could I find similar coverage, but I found the same coverage, and I
found it with the same company. I now pay $1,500 a year for the same
coverage with the same company my son was covered by under the Federal
health care plan. Now, here is
[[Page S12237]]
the glaring difference. From a standpoint of my insurance, the Federal
Government still pays the same amount and I still pay the same amount.
When you take a healthy person off insurance, the premium doesn't go
down.
So for the 6 million kids who are targeted in SCHIP expansion--and
everybody agrees 3 million are uninsured and 3 million are currently
insured--I don't want anybody to walk away and believe we are reducing
the premium cost of the families who are currently privately insuring
these kids. As a matter of fact, the CBO statistics prove exactly what
happened with my son, in the fact that we will now transition to a
private sector program for him. For those 3 million SCHIP kids, we
could access health care coverage for an average of $1,130 a year. But
in this legislation, it says we will be paying $3,950 a year for the
same level of coverage for those kids. We will pay it for those who
weren't insured and we will pay it for those who were insured. Their
family insurance won't go down, and we will pay three times as much for
the coverage than if we went to the private sector and we negotiated
that coverage.
To some up here, that makes unbelievable sense. To those of us who
come out of business, to those of us who understand what the people in
our States whom we represent struggle with day in and day out, it makes
absolutely no sense.
Forget the fact that adults will still be covered under this
Children's Health Insurance Program; that private coverage will be
replaced with government-run coverage; that within this bill, this
children's health care bill, are hidden earmarks--earmarks that create
a health care center in Memphis and earmarks that deal with the pension
system in Michigan. My God, is this about kids and health care or is it
about what we can hide in a bill and disguise and cover as a benefit to
children? It overturns an administration rule targeting SCHIP for low-
income children. The bill would overturn an HHS directive that requires
States to focus first on covering low-income kids, thereby eliminating
any State accountability to cover the neediest kids first.
Well, most of us have done oversight work. If we could trust the
States or people we give money to, we wouldn't need oversight
committees. But they meet every day, all day long, because we can't
trust any single entity to follow the rules. We are basically taking
the rules and throwing them away. Will we cover adults? Sure, States
will make decisions to cover adults. States will make decisions that
will go far outside of low-income children.
Now, the speaker prior to Senator Kennedy said this was not a debate
about health care reform. He is right. It is one of the few things I
have heard on the floor today that is accurate. But it should be. This
should be about health care reform.
It is the belief of some that we should feel good about overpaying
for a program that will cover 3 million uninsured in this country and
reassign 3 million who are insured to now be under the dole of the
Federal Government and the American taxpayer when, in fact, we have 47
million uninsured in this country. That is exactly what we should be
debating on the Senate floor today--how do we reform health care to
where we cover the 47 million who are uninsured in this country.
Well, when we debated SCHIP before it was conferenced, we talked
about this incredible new plan that had been introduced by a number of
us--the Every American Insured Health Act--a plan that covered 47
million uninsured. It did it in a budget-neutral way. It eliminated the
cost shift that exists in our system today. We estimate saving $200
billion a year. That is for a plan that I suggest is very much targeted
for 47 million uninsured, and the CBO will verify that it is budget
neutral. For those who might not be one of those 47 million
individuals, who might say I don't have skin in this game: If we are
able, through the elimination of cost shifting because we are now
providing primary care for people who today do not have insurance, who
will not be in the emergency room accessing care at the most expensive,
most inefficient place--who actually have preventive care, who have
wellness access, who have a medical home, who have a doctor for the
first time, and we are able to squeeze out $200 billion of waste that
we can pump back into health care--an amazing thing happens. It brings
everybody's premiums down.
For a person in the country who might be sitting there saying, I have
insurance, I am covered, I am OK; it doesn't make any difference to me
whether they have this debate about insurance reform--it should matter
to you because it is unsustainable to continue the inflation rate of
health care at the rate it is going. If you want to see that end, if
you want to see your premium come down, we have to reform health care,
and I tell you it starts with insuring 47 million Americans, not 3
million kids. We should provide the resources so those 47 million can
access their care in their State with the most competitive products
they can find for the scope of coverage.
This plan is out there. We introduced it. We didn't ask for a vote.
We should have. But we have another opportunity and that opportunity
is, let's reauthorize the current SCHIP plan, let's put the dollars in
that are needed to make sure nobody falls off the system, but let's
choose not to expand it to include, at three times the cost, 3 million
kids and take 3 million kids off their parents' insurance and put them
over on the Government insurance for the taxpayers to pay for.
Rather than do that, why not engage in an honest, real debate on the
floor and let's come up with a reform package that covers the 47
million. Let's come out with a bill on the Senate floor that doesn't
leave anybody behind. If we are going to cover 3 million uninsured
kids, what about the other millions we are not covering? The reason we
do not go higher is because the higher you go, the larger the
percentage of kids you are pulling off of their parents' insurance.
What we have learned from my experience, and I think nobody would
disagree with me: It saved me no money. The Federal Government's share
of my health care today is more than it was when my first child was on
my insurance plan. And in December, I have the great fortune that I am
going to go through this again. I am going to have my second child who
will become 22, and this arcane Federal guideline, statute, whatever it
is at OPM, will kick in and they will say we will no longer cover your
healthy 22-year-old son.
I will go to North Carolina and I will access insurance, probably at
$1,500 like his brother has. I will now have $3,000 a year in
additional coverage, only to find out that the Federal Government, for
my plan for me and my wife, is paying more money than we were before.
There is a reason. It is because when you take healthy people out of
the pool, the actuaries look at us old folks and say: You know, they
are a greater risk to us.
The reverse is true, too. If over time we allow adults to infiltrate,
which we already have, the children's insurance program, amazing things
are going to happen. The premium is going to go up because we are
putting older folks, who are less healthy, in the pool.
This makes a lot of sense to me because it works the same one way as
it does the other. I think the sad thing today is I have to stand up
and say I am not going to support an expansion of SCHIP, but I will
support reauthorization of SCHIP with dollars that say nobody falls
off.
I will also commit today to be the most engaged Member of the Senate
if we will come down here and have a health care reform debate. Bring
the proposals to the floor. But don't come if you are not willing to
prove you are going to insure 47 million uninsured in the country.
Don't come unless you are willing to get all the cost shift out of the
health care system. Don't come unless you are willing to take $200
billion and have that impact positively on everybody's premium in this
country. Don't come to the floor unless you are willing to extend
wellness and preventive care through the policies we are able to
create. Don't come unless you are willing to reform insurance products
so they are truly market based. Don't come if you don't want insurance
products to be portable, when employees can take them from job to job
just like the retirement benefits we have and that we fought so hard
for.
Today I am disappointed because we have an opportunity in this
program.
[[Page S12238]]
We can't extend this program, though, if in fact passing a bad bill is
the result.
I yield the floor.
The PRESIDING OFFICER. The Senator from Iowa.
Mr. GRASSLEY. Mr. President, I say to the Senator from North Carolina
who just completed, I am willing to work with him on all the goals he
wants to do. Earlier in the writing of this legislation, back during
the months of March, April, and May, we tried to get the White House to
get some other Democrats involved and helping Senator Wyden, who wanted
to go in that direction, and the White House couldn't deliver.
When it comes down to doing something all at once, or doing it in two
separate pieces, sometimes you have to do it in two separate pieces.
This is one of those issues. We have to do the Children's Health
Insurance Program first and then I am going to join people like Senator
Burr. Only I am going to be working in a bipartisan way with Senator
Wyden, to see what we can do to take care of all of the uninsured in
America.
We can do that. The President wants to do it. There are Democratic
leaders who want to do it. Senator Clinton has come out with a program
doing it through private health insurance. But we cannot do it on this
bill. The people who have been talking for 6 months about doing it on
this bill had an opportunity, when it was up in the Senate, to offer an
alternative. For all their talk, for months, nothing was offered along
the lines of what they wanted to do.
Don't come back complaining after we get a compromise between the
House of Representatives and the Senate, and still complain, when you
had a debate on this 2 months ago and you didn't have a plan to offer.
You can't get anything passed in this Senate if you don't have it down
on paper and offer it to us for consideration. But now, after this job
is done, let's all get together and do it right. And we will do it
right.
I want to spend my time talking about some of the misinformation that
was spread about this bill when it was first considered in the Senate 2
months ago and is still being considered today, just as if the debate
and all the explanations we gave two Mondays ago didn't make a bit of
difference. So let's go through it again. Let's get very basic and
let's say where the misinformation is wrong.
I am not here to embarrass any of my colleagues so I am not going to
use any names. But yesterday a Member of my party took to the floor
talking about this bill pending before the Senate. I wish to address
some of those issues that were raised by my friend and colleague.
This colleague repeatedly referred to the Children's Health Insurance
Program as leading to a national system of health care.
The goal here 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.
I have one simple question to ask all the critics of this bill who,
when confronted with the actual policies in this compromise, respond by
shrieking: 80,000 income, $80,000 income; and that question is: If this
bill became law tomorrow, how many families earning $80,000 a year
would be eligible for this Children's Health Insurance Program? And the
answer is: None. None.
As they say in baseball: You can look it up.
I have one simple question to critics who, when asked to respond to
what is actually in the black and white of this bill, react by
screaming, as we heard in that quote I just gave: National health care,
socialized medicine. And that question I ask those folks is this: Under
what contorted reasoning is a capped block grant inclusive of policies
that prohibit new waivers for parents, phase childless adults
completely off of this children's program, and limit matching funding
for higher income kids, nationalized health care? That is what this
bill does. It takes care of problems that have developed over the last
10 years. There have been legitimate criticisms of it. It fixes those
problems and doesn't do any of the things that people say are going to
happen, such as families of $80,000 being able to put their kids on
this program.
You can call all of this rhetoric something. You can call it anything
you want. But in Iowa you can't call a cow a chicken and have it be
true.
I have some charts here I want people to see. This colleague of mine
also referred yesterday to what is ``budget gimmickry'' about this
legislation. I have this response to that colleague of mine. He said
this yesterday, ``There is the problem.''
He was pointing to this chart that he had up at that time. Let me
start the quote over again.
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--
meaning pay as you 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 . . . that is called a scam.
I end the quote of my colleague.
I am a proud member of the Budget Committee. I think I know how the
budget process works. I believe in fiscal discipline and spending
restraints. I agree that even under a Republican-controlled Congress,
spending got out of control. Part of the reason why Republicans lost
control of the Congress last election is because we didn't show concern
enough to control spending.
I believe part of the reason the President is threatening a veto of
this bill is he is trying to play catchup for failing to veto 6 years
of spending bills when Republicans controlled the Congress. I agree
that fiscal discipline ought to be applied to spending bills and we
should pay some attention to the level of spending and how spending is
financed.
From that standpoint, let me focus on the criticism that has been
made about how this Children's Health Insurance bill is financed. We
need to step back, and in stepping back we need to look at the whole
picture. The Children's Health Insurance Program is a pretty small part
of that picture. The thing about the Children's Health Insurance
Program is that it is not like Medicaid or Medicare. It is not a
permanent program. This program expired after 10 years. We are working
on it now to reauthorize it. It will expire after 5 years. You never
hear of Medicare or Medicaid expiring, sunsetting, so it has to be
reenacted. It has been going on for 43 years.
SCHIP, then, is not an entitlement and I have heard my colleagues
recently refer to it as an entitlement.
Now, there were some who wanted to turn this Children's Health
Insurance Program into an entitlement program. So it has been
discussed, I admit. I am not one of those. And nobody in the Senate
that I know of spoke that way. But the House bill would have lifted the
cap on the national allotment for the Children's Health Insurance
Program and extended the program forever.
The word ``entitlement'' may be applicable. I fought hard to maintain
the block grant concept, the sunset concept--as has been the case since
the program was started 10 years ago--- and to ensure that the program
did expire so that in the future, Congress would be forced to
reevaluate it and maybe improve or cut back, whatever the situation is
5 years from now, just as we have been doing this year with the sunset
program.
So despite the best efforts of House Democrats, because in the House
it is more partisan than the way we do business in the Senate, this is
a bipartisan bill. Regardless of the best efforts of House Democrats
under the compromise bill when the program expires, it truly ends. The
day after the authorization ends, poof, no more Children's Health
Insurance Program unless Congress reenacts it.
The Children's Health Insurance Program before us is an expiring
program. So let me say that again. It is an expiring program. It is not
an entitlement. Why do colleagues keep trying to fuzzy the debate by
using words that are not applicable?
Well, I know most of us in this Chamber would no sooner let the
Department of Defense expire then we would
[[Page S12239]]
let the Children's Health Insurance Program expire. That is a simple
fact. But that does not make it an entitlement any more than the
Department of Defense programs are entitlements. Because it is an
expiring program, it is subject then to a very particular budget rule
that makes this chart not exactly intellectually honest.
The budget rule says the Congressional Budget Office must score
future spending for programs based upon last year's program current
authorization. So the baseline for the Children's Health Insurance
Program right now, and for next year and next year, is $5 billion. For
the next 5 years, the baseline each of those years is $5 billion, and
also for the next 10 years. If you want to go beyond 5 years, and we do
not do it in this bill, but sometimes the Congressional Budget Office
does it, the baseline is still $5 billion. It is actually $5 billion a
year forever as far as the Congressional Budget Office is concerned.
Does anyone in this Chamber think the budget rule governing the
Children's Health Insurance Program is realistic? Well, it is obviously
not. But that is the way the Congressional Budget Office does business
around here. So let's not kid ourselves.
According to the Congressional Budget Office, over 1 million children
would lose coverage if we simply reauthorized the Children's Health
Insurance Program at the assumed baseline of $5 billion a year. Now, I
have never heard anybody around here saying they want to throw a
million kids off of this program. So what do you do? You provide for
where you are.
Well, you can throw them off if you want to, but I have not heard any
of my colleagues, even the ones complaining about this bill, I have
never heard them complain that we ought to throw 1 million kids off the
program.
Who would go home and tell their constituents that they voted to do
that? But over 1 million kids would lose coverage. That is not
politically viable.
During the consideration of this Senate Finance Committee bill, there
was a children's health insurance alternative that included an increase
in the Children's Health Insurance Program by spending $9\1/2\ billion
over 5 years.
Now, understand, the White House ought to hear that. Even Republicans
in the Senate are telling the President: Your $5 billion will not do
what you want it to do. Those are even the Members who oppose the
Finance bill, acknowledging that $5 billion was not enough. Everyone
knows the current baseline is not realistic, that it created a hole in
the budget that had to be filled.
So what do we do? If you do not want to throw kids off, you fill that
hole. It is that simple. We had to comply, though, with the budget
rule. That is the way you have to do business around here. You get a
point of order against your bill, and you have to have 60 votes to
override it. So we did.
Do those budget rules make sense? Well, that is a question for the
Budget Committee, not for our Finance Committee. The Budget Committee
sets those rules, and they are not for the Finance Committee to change.
There is another budget rule the Finance Committee was required to
follow. That rule is called pay-go, pay-as-you-go, which means that you
raise revenue or cut spending someplace else to pay for the new things
you are doing. It means the bill needs to cover its 6-year cost, and
that makes sense. After all, this bill proposes new spending, and we
should pay for it. And this bill does it. This bill complies with those
budget rules. It complies with the pay-as-you-go requirement.
Now, the children's health reauthorization that we are debating is
only a 5-year authorization. And, as I think everyone knows, the bill
is paid for by an increase in the tobacco tax, just like the original
CHIP bill was paid for when it was created by a Republican-controlled
Congress 10 years ago.
Now, just like in 1997 when the Republicans did it, we had a problem
with how the tobacco tax worked. The revenue from the cigarette tax is
not growing as fast as health care costs grow. So that means the
revenue raiser is not growing as fast as the costs of the program. So
the Finance Committee did what it was required to do to comply with
pay-go budget rules. The Finance Committee bill reduces children's
health insurance funding to just below the funding that is in the
current baseline.
That means the Finance Committee, in 5 years, will have the same
problem we faced in putting this bill together today. They will have to
come up with the funds to keep the program running, if that is what
they decide to do 5 years from now.
We are covering even more low-income kids in this bill. That is a
good thing. Assuming that Congress does not tackle the increasing
problematic issue of health care costs across the board, as Senator
Burr was begging us to do, the Finance Committee, in 5 years, will have
a bigger hole to fill. They will have more kids to keep covering, and
health care costs will be even higher than they are today. That is for
the Finance Committee to face down the road 5 years.
That is just like the job the Finance Committee had today if we were
going to continue the Children's Health Insurance Program beyond the
10-year sunset. So what I am saying is, this is really nothing new.
Now, my friend and colleague whom I have been quoting all the time, a
person for whom I have great admiration, has once again distorted the
so-called cliff that he referred to on this chart. That is where the
line goes down after the year 2012.
He has, once again, produced a chart that shows a dramatic decline in
funding of the program. Here is the chart used to raise the issue about
financing the compromised bill, which is largely the Senate Finance
Committee bill. It shows only the funding in our bill.
The approach that this chart takes reminds me of the story of the
seven blind men trying to describe an elephant. Each described
different parts of the elephant: one the tusk, another one the tail,
another one the ear, another one the leg, and none could describe the
whole elephant. They could not see the whole picture. So we have to
look at the whole picture.
As we all know, this program was created to supplement Medicaid. So I
am going to show you the whole picture. You have to involve Medicaid.
The goal of the program was to encourage States to provide coverage to
uninsured children with incomes just above the Medicaid eligibility:
Medicaid for the lowest income people, SCHIP to help lower income
people who maybe could not afford private health insurance or their
workplace did not have it.
So to put my colleague's concerns into perspective, we need to look
at the whole picture. We need, and we should, look at SCHIP spending as
it relates to Medicaid spending. I would like to draw your attention to
this chart so everyone can fully appreciate the consequences of our
SCHIP program that is a fiscal disaster to some of my friends, as you
listen to the debate, the consequences of the SCHIP program in the
context of the Medicaid Program which it supplements. So I want you to
take a closer look.
Let's start with this tiny green line down to the bottom. That is the
Children's Health Insurance Program under current law, the straight
line across the bottom. I know we have to squint to see it. But that
green line represents the Children's Health Insurance Program baseline
under current law.
As I have already discussed, it is $5 billion each year for the next
10 years, and maybe forever, depending on what Congress does in the
future.
Now, let's look more closely and honestly at the actual problem we
are facing. This massive orange area above that green line I just
referred to is Medicaid for several years into the future, 10 years
into the future. It is a lot bigger, isn't it, than the Children's
Health Insurance Program?
Then, on top of that, we are looking to add what is in this bill, new
spending for the Children's Health Insurance Program. The new spending
is represented by that narrow blue line across the top there labeled
``funding in the compromise agreement.''
Again, you almost have to squint to see that blue line. And as you
can clearly see then, costs are growing at a rapid pace overall. The
overwhelming driver of the cost is not the relatively small increase of
the blue line. And then the decline, you see a decline in that blue
line on top in CHIP spending. That is just kind of a blip on the radar
compared to the massive increase we see in Medicaid spending.
We have a big problem. It is not going to go away. But it is not the
[[Page S12240]]
Children's Health Insurance Program. It is the entitlement program that
SCHIP is not a part of because I made a point--10 times in the last 2
days--that this is not an entitlement, even though my colleagues still
talk about entitlement. Where are they coming from? What planet? I
don't know.
But entitlement spending is, in fact, ballooning out of control in
future years if we do not act. We are going to struggle to keep these
programs afloat. When you look at the whole picture, this whole
picture, it puts things about the SCHIP program and the criticism of
the SCHIP program in perspective. But the criticism is not justified.
Now, remember all of the fire and brimstone about the awful cliff on
the chart that we had before, the awful cliff of this compromise bill?
The way that it continues to be described, you would think the world is
about to end. And now looking at the big picture, where exactly is that
cliff, you might ask? Again, you will have to squint to see that cliff.
That cliff starts downward after the year 2012. So you saw on the
previous chart, you see that big dropoff. That is what I raise about
the intellectual accuracy of that chart. OK?
If we go back to the other chart and look at the real program, that
is how it goes down a little bit after 2012. It is not that dramatic
compared to what we are doing on Medicaid. You can see how this debate
has tried to distort what we are accomplishing.
So this little blue line is what this debate is all about. This
little blue line is the funding in the compromise agreement. This
little blue line is what all the fuss is about. It seems like a whole
lot of hollering is going on over a dip that is hard to even see.
Let me tell you what the compromise agreement and this little blue
line is not. This is not, as some people want us to believe, a
government takeover of health care. This little blue line is not
socialized medicine or nationalized medicine or anything like that.
This little blue line is not bringing the Canadian health care system
to America. That little blue line is not the end of the world that we
know. To suggest that this little blue line and this tiny dip we see
after the year 2012 is the dismantling of the U.S. health care system
borders on hysteria.
While I concede that allotments under our bill in the years beyond
the 5-year reauthorization in this legislation do behave as described
in my friend's chart, the one with the big dropoff, I don't think it
warrants the heated rhetoric we are hearing today and yesterday. SCHIP
is not a real fiscal problem. The problem is that issue nobody wants to
talk about. What are we going to do about entitlements? Nobody has
political guts enough to agree with it, but they want to put this
Children's Health Insurance Program on the same par as those Medicaid
issues.
My friend I have been quoting all day and I worked together a year
ago, now maybe 2 years ago, on the Deficit Reduction Act, to try to
rein in this egregious Medicaid spending. I am proud of the work we
did. He praised me so much 2 years ago for the heavy lifting I did for
the entire Senate on saving some money--I should say Senate Republicans
for saving some money--but how times have changed. We also found out
how hard it is, at the time of the Deficit Reduction Act, to dial back
entitlement spending. Even in a Republican-controlled Congress and even
with the special procedural protections of reconciliation, we only
succeeded in shaving $26 billion off that orange part of the chart. The
problem of entitlement spending is still out there, and SCHIP is like a
pimple on an elephant compared to the elephant that Social Security,
Medicare, and Medicaid are.
I am very hopeful that once we are done with the CHIP debate, we can
roll up our sleeves and get down to the business of tackling health
care reform on a much larger scale, as Senator Byrd referred to, and I
have referred to Senator Wyden from Oregon working on it over a long
period of time. I know Senator Wyden wants to take this on, and I am
going to join him in that bipartisan effort.
As I have said many times, I had hoped we could have used this debate
on SCHIP to focus on these larger issues of health care reform and
helping the uninsured. I tried to engage my colleagues on the other
side. I was repeatedly thwarted in that effort and told that SCHIP had
to get done first. Well, hopefully we can get SCHIP done and then turn
to the bigger issues so the next time the Congress has to tackle the
Children's Health Insurance Program, this big orange block would not be
so huge.
Before closing, another criticism we had of this bill in the last
debate 2 or 3 months ago was this. I will quote Senator Lott. I don't
think he will mind my using his name. He was quoted on July 31: The
House is going to pass a bill at what, maybe $80, $90, $100 billion,
paid for by taking money away from Medicare beneficiaries. We go on
conference, what will happen? What always happens. You split the
difference. We are at 60. They are at 90. How about $75 billion. How is
that going to be paid for? Is it going to be paid for by cutting
benefits for the elderly or raising taxes of all kinds?
Well, it is paid for the same way we paid for it on July 31, 2007,
with the tobacco tax, not by Medicare money.
He went on to say: I fear what is going to happen in conference. I
don't know. Maybe the Senator from Montana and Senator Grassley can sit
there and say: Oh, no, no, no, we are not going above what we passed in
the Senate. But I think the reverse is going to be true. This is the
base. The $60 billion is the beginning.
Where did we come out? Exactly where Senator Baucus and I told the
Senate we were going to come out. We came out with the $35 billion that
passed this body. So all those people who are worried about the
position of the Senate being lost in conference by Senator Baucus and I
representing the Senate--and let's say Senator Rockefeller and Senator
Hatch as well--would you please tell me you were wrong?
I yield the floor.
The PRESIDING OFFICER (Mr. Nelson of Florida). Who yields time?
The Senator from Maryland.
Mr. CARDIN. Mr. President, I yield myself 2 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. CARDIN. Mr. President, today is truly an important day for
America's children. On Tuesday, the House passed the Children's Health
Insurance Bill, and very soon, the Senate will vote. We will provide
$35 billion over the next 5 years to expand health insurance coverage
for the children of America's working families.
We know that there is a crisis in health care in this country. More
than 46 million Americans don't have any health insurance coverage; 9
million of them are children, and most of them are in working families.
That is a disgrace.
Now there are many proposals out there to increase the number of
Americans with health insurance coverage. As Congress begins to
consider these proposals, there is something we can do today to
decrease the number of uninsured children by nearly 4 million.
Earlier this year, in February, I introduced to the Senate Finance
Committee a Baltimore family that has benefited from CHIP. Craig and
Kim Lee Bedford are working parents who own a small business and simply
cannot afford health insurance for their 5 children through the
commercial market. Through the Maryland MCHP program, the Bedford
Family's 5 children receive affordable, quality health care.
We have the evidence that enrollment in the CHIP program improves the
health of the children who are enrolled, their families, and the
communities in which they live.
When previously uninsured children are enrolled in CHIP, they are far
more likely to receive regular primary medical and dental care, and
they are less likely to use the emergency room for visits that could be
handled in a doctor's office.
They are more likely to get necessary immunizations and other
preventive care, and to get the prescription drugs they need.
But there are still millions of children who have not enrolled in the
programs offered by their States.
Our States are making progress--simplifying their enrollment
procedures, expanding outreach efforts, and using joint applications
for Medicaid and CHIP so that families can enroll together.
But this reauthorization bill, with $35 billion in added funding, is
needed to help them make real progress.
[[Page S12241]]
I want to talk for a moment about Maryland's program.
It has one of the highest income eligibility thresholds in the
Nation, and this is important because of the high cost of living in our
State.
It is at 300 percent not because our Governor wants to move people
from private insurance to public insurance plans. It is at 300 percent
because working families at this income level do not have access to
affordable health insurance policies. Those families need CHIP.
Children under the age of 19 may be eligible for MCHIP if their
family income is at or below 200 percent of the Federal poverty level,
or up to $34,000 for a family of three.
We also have an MCHIP Premium program, which extends coverage to
children at moderate income levels--between 200 and 300 percent of
poverty, or up to $51,500 for a family of 3.
The premiums, which are paid per family, regardless of the number of
eligible children, are between $44 and $55 a month.
Our program has been a true success. Enrollment has grown from about
38,000 enrollees in 1999 to more than 101,000 today.
In my State of Maryland, the need has always exceeded the available
funds. The Federal match through the CHIP formula established in 1997
is not enough to meet all of the costs of the MCHIP program.
Some States do not use their entire allotment, while other States,
like Maryland, have expenditures that exceed their allotments. Congress
has addressed this problem by redistributing the excess to the
shortfall States.
The 109th Congress passed provisions to address the Fiscal Year 2007
funding shortfalls.
That bill didn't include any new money, but it allowed the
redistribution of $271 million already in the program, and that was
important for thousands of Maryland families.
Without that legislation, Maryland would have been forced to either
freeze enrollment or reduce eligibility for CHIP.
Now, we must move forward for future years. That is what we are doing
on the floor of the Senate today.
This conference report increases the allotment for Maryland for next
year from its current projected level of $72.4 million for fiscal year
2008 to $178.8 million.
It also allows us to continue to cover children in families with
incomes up to 300 percent of poverty. Maryland would also have access
to a contingency fund if a shortfall arises and additional funds based
on enrollment gains. With this new money, Maryland can cover as many as
42,800 children who are now uninsured over the next 5 years.
There is another vitally important part of this conference report
that I want to talk about. Title 5 ensures that dental care is a
guaranteed benefit under CHIP.
According to the American Academy of Pediatric Dentistry, dental
decay is the most common chronic childhood disease among children in
the United States.
It affects one in five children aged 2 to 4; half of those aged 6-8,
and nearly three-fifths of 15-year-olds. Tooth decay is five times more
common than asthma among school age children. Children living in
poverty suffer twice as much tooth decay as middle and upper income
children. Thirty-nine percent of black children have untreated tooth
decay in their permanent teeth; 11 percent of the Nation's rural
population have never visited a dentist; an estimated 25 million people
live in areas that lack adequate dental care services.
I want to say a few words about a young man named Deamonte Driver. He
was only 12 years old when he died last February from an untreated
tooth abscess. It started with an infected tooth. Deamonte began to
complain about a headache on January 11. By the time he was evaluated
at Children's Hospital's emergency room, the infection had spread to
his brain, and after several surgeries and a lengthy hospital stay, he
passed away.
For want of a tooth extraction that would have cost about $80, he was
subjected to extensive brain surgery that eventually cost more than a
quarter of a million dollars. That is more than 3,000 times as much as
the cost of the extraction. After Deamonte's death, the public took
note of the link between dental care and overall health that medical
researchers have known for years.
His death showed us that, as C. Everett Koop once said, ``there is no
health without oral health.''
Deamonte's brother, DaShawn, is still in need of extensive dental
care, and, like him, there are millions of other American children who
rely on public health care systems for their dental needs.
No child should ever go without dental care. I have said before that
I hoped Deamonte Driver's death would serve as a wake-up call for the
110th Congress. I believe that it has.
Earlier this year, I brought Deamonte's picture down to the floor. I
have it with me again today.
It is here because we must never forget that behind all the data
about enrollment and behind every CBO estimate, there are real children
in need of care.
When I spoke about Deamonte right after his death, I urged my
colleagues to ensure that the CHIP reauthorization bill we send to the
President includes guaranteed dental coverage.
This bill would make guaranteed dental coverage under CHIP the law of
the land, and I want to take this time to personally thank the members
of the conference committee for ensuring that a dental guarantee is in
this bill.
One other tragic piece of Deamonte's story is that, once his dental
problems came to light, his social worker had to call 20 dental offices
before finding one who would accept him as a patient.
The conference report includes a provision that will make it much
easier for parents and social workers to locate participating
providers.
It requires the Secretary of Health and Human Services to include on
its Web site www.insurekidsnow.gov and the HHS toll free number, 1-877-
KIDS-NOW, information about the dental coverage provided by each
State's CHIP and Medicaid programs, as well as an up-to-date list of
providers who are accepting CHIP and Medicaid patients.
Parents will be able--with one phone call or a few mouse clicks--to
find out what their child is covered for and where they can receive
care. There is more work to do, as I have learned from working with my
dedicated colleagues here on this issue, particularly Senators Bingaman
and Snowe.
We still have to improve reimbursement for dental providers, and get
grants to the states to allow them to offer dental wraparound coverage
for those who may have health coverage, but no dental insurance. But
these provisions are a very good start.
I am deeply disappointed by the President's statements about CHIP.
When he says that this is Government-run insurance, he is mistaken.
This program is administered by our States, with help from the
Federal Government, to ensure that working families who cannot afford
private health insurance, can enroll their children in private health
insurance plans.
I would hope that after today's vote in the Senate, he will
reconsider his position on this bipartisan, responsible, and paid-for
bill.
CHIP covers urban and rural children, who live in every state,
whether Democratic or Republican.
Congress has come together after months of work to reauthorize a
program that's been a proven success and has served the needs of
America's working families. I urge the President to join us in this
truly bipartisan effort and sign this bill into law.
I thank the leadership for bringing forward this bill. We have talked
about the fact that we have 46 million people without health insurance,
9 million children without health insurance. We can do something about
it today. This bill will cover 4 million uninsured children. We can do
something about the uninsured. During the course of the hearings in the
Senate Finance Committee, I brought Craig and Kim Lee Bedford,
constituents from Maryland, to testify before the committee. These are
working parents with five children. They simply could not afford health
insurance. But the CHIP program has allowed us in our State to cover
these children. Mrs. Bedford said: I no longer have to decide whether
my child is sick enough to go to a doctor. That is the practical effect
of this legislation. It is going to help families in our State.
[[Page S12242]]
I heard the arguments about over 200 percent of poverty. In our
State, we cover up to 300 percent of poverty. That is $51,500 a year.
You have to pay a premium. The premium is between $44 to $55 a month
for the entire family. But in Maryland, you can't afford health
insurance if you make that type of income for a family. This bill will
allow us to cover those children. For my own State of Maryland, bottom
line means we are going to be able to cover 42,800 more children. In
Maryland, we had the tragic circumstances of Deamonte Driver, a 12-
year-old who died as a result of untreated tooth decay. That should
never happen in America. This bill will help us to cover American
families and our children.
I urge my colleagues to support the bill and yield the floor.
The PRESIDING OFFICER. The Senator from South Carolina.
Mr. DeMINT. Mr. President, I am encouraged that the Senate is taking
up the whole issue of health care in America. We know this is one of
the most important issues to the American people. We know a number of
Americans don't have access to health care, and it is very important
that we debate this as a Senate, not just children but the American
goal of how do we get every American insured. How do we make sure every
American has access to good health care throughout their life and their
children do as well? We can agree on that goal. It is not just about
children, it is about health care in America and figuring out as a
Congress how do we make sure every American has access to good health
care.
The question today and the question we need to continue to debate is:
Do we want the Government to provide that health care or do we want to
figure out how to make sure that individuals have access to a health
insurance policy that they can own and keep? Because we know the best
and most efficient delivery of health care is going to come through
individually owned policies that people don't lose when they change
jobs, they don't lose when they retire. I hope our focus will turn from
Government health care to helping individuals have a policy that they
own and can keep. We should all question, do we want the Government
that ran the Katrina cleanup or runs the Post Office or spends $1,000
for a hammer at the Pentagon and wastes billions, literally hundreds of
billions of dollars in waste, fraud and abuse every year, do we want
that Government to take care of our children, to take care of our
seniors, and to run the health care system today?
We are talking about health insurance for children. A number of
people are saying individuals cannot afford to buy it. Before we
consider that, we need to realize this Congress has made it very hard,
if not virtually impossible, for individual Americans to have a health
insurance policy they can own and keep. We need to be reminded that
this Congress has created a Tax Code that gives tax breaks to
businesses who provide health insurance but not to individuals who want
to buy it. That means the cost of individual insurance is higher and
many times unaffordable. We have proposed in Congress--unfortunately,
my Democratic colleagues have fought back--to allow small businesses to
come together and pool their resources so they can buy health insurance
and make it available to their employees when they cannot afford it as
individual companies. But this Senate killed that idea. It would have
made it more affordable for individuals. Yet we complain about the
uninsured.
We know a number of States have added so many mandates onto their
insurance policies, it is too expensive for citizens to buy it. Yet
this Congress will not allow Americans to buy health insurance anywhere
they want in the country. We have allowed individual States to create
monopolies, where someone in South Carolina can't buy a policy from New
Mexico unless it is certified in South Carolina. We know we could
create a national market and make individual policies much less
expensive, but this Congress would not do it.
The fact is, this Congress has made individual health insurance
unaffordable and unaccessible to Americans and now, today, we are going
to ride in on our white horse and save the day with Government health
insurance.
Children should have health insurance. This whole plan of children's
health insurance started for poor children whose families make too much
for Medicaid but were still under 200 percent of poverty. Today we are
proposing not just to reauthorize and continue this program for poor
children but to raise it so children and families with incomes up to
$82,000 are going to get free Government health care. When this plan is
fully implemented, about 75 percent of the children who live in America
today will be on Government health insurance, which means we as a
Congress have made a decision that we want America to have Government
health plans and not to have individual plans they can own and keep.
Because if 75 percent of the children are on Government plans and our
seniors are on Government plans and many of our military are on
Government plans, there is no more room for private market health
insurance policies to work. In effect, what we are doing is deciding
today that we want national health care in America when we vote for
this.
I have heard this bill talked about as a compromise and that we can
split the difference. But colleagues, you can't split the difference
between freedom and socialism. You can't split the difference between
Government health care and individuals owning their own health plans.
We are talking about something that doesn't exist. What we have split
the difference between is spending $80 or $90 billion more than we need
for poor children, and we have brought that down a little bit. We have
funded it with some bogus funding, and we think we are doing something
to help America.
This bill is not for children. This bill is selling out the future
for every child in America because we are turning this country into a
socialistic style of government, taking away people's freedom. We are
here, once again, pretending we are doing something we are not. We are
not taking care of children. We are selling their freedom away under
the pretense of children. We have learned in this body that all we have
to do is do it for the children and come down and say it applies to
children, and we dare anyone to vote against it. I am going to vote
against it because this is not for our children, and it is not for our
country.
We are selling out our future. If we would focus ourselves on helping
individuals access private policies, we could get every American
insured. If we made our Tax Code fair for everyone, if we allowed
States to partner with us, we could have every American with a health
insurance policy without the Government running this. We should not
even pretend we expect this Government to run the health care system in
an efficient way.
Colleagues, I appreciate the debate on health care. We need to have
it. We need to have an American goal that every citizen is going to
have access to good health care and health insurance. This is not the
way to do it. This is a decision to become more like socialized Europe,
to sell out our freedoms, and to give Government control of our health
care.
I encourage all of my colleagues to rethink this decision to vote for
this bill, and to vote against it.
I yield back.
The PRESIDING OFFICER. The Senator from New Mexico.
Mr. DOMENICI. Mr. President, I thank the Chair. I believe I have up
to 10 minutes, and I yield myself that time.
The PRESIDING OFFICER. The Senator is recognized for 10 minutes.
Mr. DOMENICI. Mr. President, I have heard my distinguished friend
from South Carolina, and have great respect for his thought process,
for the way he presents things. Frankly, I do not mind listening to
him, so I was here early, and I got to hear what he had to say.
But we have been working on this issue of SCHIP for more than a few
months, in fact, for more than a few years. So some come in at the end
and have a whole new theory about it, and others, like myself, who
happened to be the Budget chairman back a few years ago, when this
program was born--and I remember making room for it in a budget
resolution so it could be a reserve fund, and we could end up with this
amount of money. It kind of lived through 2 or 3 years of getting
knocked around and not doing its job, and doing part of it, and as
things progressed I ended up supporting a proposal that involved SCHIP.
[[Page S12243]]
This Children's Health Insurance Program Act of 2007 is now before
us. I indicated my support for it when Senator Chuck Grassley and his
cohort, the chairman of the Finance Committee from Montana, were
putting together a compromise bill using this money that had been
allocated for health care some 3 or 4 years ago. So I supported it as
Senator Grassley and others put together a program.
New Mexico has a terrible problem with uninsured children. Nearly 25
percent of the children have no insurance--worst in the country. SCHIP
will help this problem, no doubt about it.
The bill we are voting on today--whether my good friend who spoke
just before me agrees with the terminology--is a compromise. Many on
the other side of the aisle wanted $50 billion to $70 billion more in
spending. On my side of the aisle, they wanted much less. Some wanted
as low as $5 billion. This bill gave us $35 billion--right down the
middle. Whether that means anything, it does to me. It means some
people worked very hard to try to get a bill we could support, that
would begin to get us somewhere with reference to changing the
direction of health care for children who might see light someday. The
bill gave us $35 billion, I repeat.
In August, I came to the floor and made a statement. I said I did not
like what the House of Representatives was doing. I said I did not
support massive increases in spending and eligibility proposed by the
House. I made it very clear I did not want a reauthorization that
included revisions to the Medicare Program.
Now, I am just one Senator, but it turns out that five or six or
seven Republican Senators somehow or other all thought the same way.
They were thinking just as I was, that we were not going to let
ourselves get used so that this SCHIP was opening a crack in the door,
and we did not know what we were talking about, and we would open the
door, and we would spend three times what we had in mind.
Well, that was not going to happen. Senator Grassley came around and
asked, and I said: $35 billion. That is it. If you put any more in, I
am out.
I remember him coming to me and saying: Is that it?
Twice I said: That is it. Don't bother me anymore. I am your friend,
but anybody can understand $35 billion is $35 billion. It is not $38
billion. It is not $50 billion. If you want to do any more, go look for
somebody else to make your majority.
He said: No, I don't want to do that. I want you. Is that all you
will do?
I said: Yes, that is all I will do.
So everything I did is not part of the record, but I am reflecting
for the Senate and for those on my side of the aisle who do not
understand why I am doing what I am doing and want the President to
veto this bill. I do not want him to veto it. I think it is a mistake,
and I am saying it right now, and I will say it again.
But I did say I did not want massive increases in spending and
eligibility proposed by the House. I did say I did not want a
reauthorization that included revisions to the Medicare Program.
Clearly, I made that point. I made it not only to Senator Grassley, but
I made it to the chairman of the committee, Senator Max Baucus of
Montana.
We got to where Senator Baucus would speak to me every 2 or 3 days
and report to me what was going on. I was not on the conference. But
the reason he did that was he understood if he went to conference and
changed that $35 billion, which had become a very important number, he
would start losing me.
So I was just as effective as being at the conference, but so were
about seven or eight others who were still on board and who still think
$35 billion is enough because the cheapest insurance around is
insurance to cover children. We all know that. Now, that is not
degrading. It is a fact. You can buy more insurance for children per
dollar than for any other class of people. That is logical. Children do
not get sick as much as old people. They do not get sick as much as
middle-aged people. So they are healthy. The insurance is cheap.
Now, the conference committee listened--the one that Senator Grassley
and Senator Baucus were part of--they compromised the bill before us,
and they did it in a fair way. What was fair? Thirty-five billion
dollars--no more, no less--the amount we had agreed to that we said we
would help them with. If they wanted to dream about big dreams for this
small program--that I remember vividly we started in the Budget
Committee, and it languished around. We started it some 4 years ago, or
5. I have not been back as chairman of that committee for quite a
while, so it was not done yesterday.
The conference committee, as I said, listened, and they did exactly
what Senator Grassley and Senator Baucus had told us would happen. They
provided $35 billion in new resources to provide health coverage for
millions more children in working families.
Here we get into an argument: Who is working in families and who is
not? Well, I understand we could have that argument and extend it
beyond 8 o'clock. We could be here until morning. But we are not going
to do that. It is established.
It strengthens outreach and enrollment efforts to make sure all
children who are eligible for the program get the services they need.
That has always been a problem with children. The Presiding Officer
knows that. We cover children, and then in 2 years they come back and
say: Yes, we covered them, but they did not get covered.
What do you mean?
Well, we did not find them.
Well, how do we find them?
Well, the best way is to wait until they go to the emergency room,
and then you find them in the emergency room and you sign them up.
I thought: My, is that the best way we can do it? It turns out it is
very difficult, especially among our poor people, to get them to round
up their children and come and get them lined up. The best way is if
they happen to go to a hospital. You get them then. You don't want them
to go to a hospital, but I am telling you what it turns out to be.
Maybe it has changed since I last worked on this. Years do go by. But I
think what I said is still right.
It also makes improvements to the program such as mental health
parity, which I know a little bit about. I am glad this legislation
ensures plans that offer mental health services provide benefits that
are equivalent to other physician and health services. This is one of
the most difficult areas of unfairness for American coverage we have
had, and we are making big strides toward resolving it. This bill makes
its little contribution to resolving that problem.
The administration has issued a statement indicating the President
will veto this legislation. Mr. President, that is a mistake. Maybe you
will win; maybe you won't. I guess in the Senate you won't win, Mr.
President. Maybe you will win in the House. I don't know. But this will
not go away. It is solved. It ought to be done. We ought to go on and
look somewhere else if we are going to try to find money to save. Those
who think this is a great veto item, I think what I have just explained
is, it is not a very good one. We ought to go ahead and take care of
some of the children and get on to some other issues.
A majority of my colleagues have said they support this bill. Sixty-
nine Members voted for cloture this morning--cloture meaning to cut off
debate and get on with the vote.
My commitment to children's health care remains firm today. It
remains as firm as when I agreed to the first use of SCHIP money in a
new and different, innovative way so its asset value could multiply
significantly. I support the passage of the compromise SCHIP
reauthorization.
All in all, it is a pretty good bill. I hope it outlasts our debate
and is voted on tonight. Then I hope it is not vetoed by the President.
I yield the floor and thank the Presiding Officer for recognizing me.
The PRESIDING OFFICER. The Senator from South Dakota is recognized
for 10 minutes.
Mr. THUNE. Mr. President, I have listened intently to much of the
debate today on this SCHIP reauthorization. Let me preface my remarks
by saying, first and foremost, I do support children. I like children,
contrary to the implication that has come out of this debate that
people who are not in favor of this particular piece of legislation are
not in favor of the children. I am very much supportive and in favor of
helping children. Furthermore, I also
[[Page S12244]]
support extending the SCHIP program. I would even support increasing
funding for the SCHIP program in a way that would cover those children
who are eligible but are not currently being covered.
That is a substantial number of children across the country, which is
why I think it is essential if we are going to reauthorize this
program, if we are going to extend this program, we do it in a way that
takes into consideration there are a lot of children in America today
who are eligible for the SCHIP program who are not being covered. So,
frankly, I support not only extending the program but also increasing
funding for the program.
We had a number of amendments that would have done that during the
debate in the Senate that would have increased it substantially and,
frankly, would have also, according to the CBO, covered more children
than this piece of legislation we are going to vote on today.
But I have to say for a lot of us who do support extending the
existing program and increasing funding to cover children who are
eligible but not currently covered, this is a bridge too far because
what this essentially does is, it not only expands the scale of the
program, it expands the scope of the program. That is where a lot of us
take issue with this legislation.
If you look at what the SCHIP program costs today, it is about $5
billion a year. It has cost us $40 billion over the course of the last
10 years. This legislation today would increase the 5-year cost to $60
billion, the 10-year cost to $121 billion. So where we are paying $5
billion a year today for the SCHIP program, this increases that to $12
billion a year, $60 billion over 5 years, or a $35 billion increase
over the existing program, and $121 billion over 10 years.
Now, that again is an expansion, not just of scale but also of scope,
because this covers adults, it increases the income levels that are
eligible under the program that the States can incorporate up to 300
percent of the poverty level, and even allows and grandfathers in those
States which have asked for waivers to go to 300 percent or 400 percent
of the poverty level. So it does substantially increase or expand the
scope of the program.
I think the other thing which is important and which is a concern for
me in this whole debate is the fact that when you get to the year 2012,
it is no longer paid for. Nobody here is disputing that fact. This is
funded for the first 5 years or so of this program, but when you get to
the last 5 years of the program, there is a cliff, and there isn't
funding there to fund the program. In fact, the funding which is
provided in the form of a cigarette tax increase actually assumes there
are going to be 22 million new smokers over the course of the next 10
years. That would create a substantial number of problems for the
health care system in this country and is certainly not something we
want to encourage. But the reality is that when you get to 2012, you
hit a cliff, and this is not paid for. It is going to have to be paid
for in some form or fashion, which we all assume is going to be some
substantial tax increase because it is going to be about $60 billion
underfunded during the last 5 years of the program.
The other thing I will say which is, again, of great concern to me is
this doesn't solve the underlying problem we have in this country. We
have a health care problem in this country that needs to be addressed,
that Congress needs to address head-on.
There are a lot of wonderful proposals and ideas that have been
discussed, some of which have been proposed in the form of legislation,
some of which have been voted on, and some of which have been defeated
in the Senate.
A small business health plan, something many of us have supported for
a long time, going back to my days in the House of Representatives,
actually has been defeated on numerous occasions in the Senate. It is a
proposal that would allow small businesses to form together, to
leverage that group size they have and be able to lower the cost of
health insurance coverage.
We heard my colleague from South Carolina talk earlier today about a
national market for health care.
We have had suggestions, bipartisan suggestions about allowing a tax
deduction that each individual could use in order to buy health
insurance.
There is the proposal for a tax credit that has been offered by a
couple of my colleagues on this side.
There are a lot of good ideas out there we ought to be adopting, or
at least debating, and driving toward health care reform which empowers
consumers in this country, which puts more people in charge of their
own health care, and which allows them to have access to coverage where
they own their own health care coverage and can make better and more
informed decisions and get the cost of health care in this country
under control. I don't believe this does that because what this
legislation does is it increases government-run, Washington-controlled
health care. This is an expansion of the government component of health
care. It does nothing in the long run to address what is a very serious
crisis in this country; that is, the need to bring reforms to our
health care system.
The other thing I will say which I, frankly, take issue with as well
with regard to this legislation is the fact that low-cost, efficient
States such as South Dakota--and we have a 200-percent Federal poverty
level in our SCHIP program in South Dakota--end up subsidizing higher
costs in inefficient States. We have taxpayers in South Dakota who are
covered, as I said, up to 200 percent of the Federal poverty level, or
about $41,000 per family, who are going to end up subsidizing States
that choose to exercise the option to go to a higher level. Frankly,
there is no incentive for States not to go to the higher level, to go
to the 300 percent, and those that already have requested waivers to go
to 350 or 400, you are already talking about, in the case of 400
percent of the Federal poverty level, over $80,000 a year.
Now, what is ironic about that is the Federal Government is going to
be telling people in this country that not only are you poor--in other
words, you are eligible for this particular low-income health insurance
program--but you are also rich, so rich that you are going to be
subject to the alternative minimum tax.
I offered an amendment to the debate we had weeks ago that would have
prevented those who are subject to the alternative minimum tax because
under the Internal Revenue Code in this country they are considered
rich--rich enough to pay the alternative minimum tax--that would have
said that people who are subject to the alternative minimum tax cannot
at the same time be eligible for a program that is designed to help
low-income families and low-income children. That was defeated in the
Senate by a vote of 42 to 57.
So there are a lot of issues with regard to this legislation that
give me grave concerns, reasons that I can't support it. As I said
before, an expansion of a government-run health care program in this
country--it is not paid for after the year 2012--leads us toward
nationalized, Washington-controlled health care and moves us away from
what ultimately ought to be our goal; that is, providing access for
more Americans to coverage through our market-based system in this
country.
It requires that low-cost, efficient States such as my State of South
Dakota are going to be subsidizing high-cost, inefficient States--
States such as in the New Jersey, New York area--that are already
talking about going to 350 percent or 400 percent of the poverty level,
which, as I said earlier, in the case of New York, that would get you
up to where you would have those in the income level of over $80,000 a
year qualifying and being eligible for a program that is designed to
help low-income children and low-income families and, ironically,
subjects them to the alternative minimum tax. The alternative minimum
tax was a tax put into place in the first place to tax people who are
making too much money and not paying enough taxes. That, to me, seems
to be a very conflicted message we are sending with this bill.
We need a strong, market-based health care system in this country. We
need to start that debate. This debate delays that debate because we
are going to be adopting legislation that increases--adds to the
government-run component of health care in this country and moves us
away from the debate we ought to be having, which is, how
[[Page S12245]]
can we improve access for more Americans to affordable health care
coverage, where they can own their own coverage, where they don't have
to rely on a government system that is inefficient, that is Washington-
based, and that is controlled by bureaucrats here in Washington, DC?
We want to put people and patients more in control of health care.
This particular bill does not do that. I will be voting no, and I urge
my colleagues as well to vote no. I hope we can get to the big debate,
the debate we ought to be having; that is, how do we reform the health
care system in this country?
With that, Mr. President, I yield back the remainder of my time.
The PRESIDING OFFICER. The Senator from Maine is recognized.
Ms. COLLINS. Mr. President, I rise in support of the legislation that
will extend and increase funding for the State Children's Health
Insurance Program.
One of the very first bills I cosponsored as a new Member of the
Senate back in 1997 was the legislation that first established the
SCHIP program. I remember Senator Hatch coming to talk to me about this
bill and enlisting my support for it. I am very happy I was one of the
original cosponsors of the SCHIP bill.
This program provides much needed health care coverage for children
of low-income parents who simply cannot afford the cost of health
insurance and do not get health insurance through the workplace; yet
they make a little bit too much money to qualify for the State's
Medicaid Program.
Since 1997, the SCHIP program has contributed to more than a one-
third decline in the number of uninsured low-income children. That is a
tremendous success. It is hard for me to understand why anyone would
vote against an extension, a modest expansion, of what has been such a
highly successful and effective program. Today, an estimated 6.6
million children, including more than 14,500 in the State of Maine,
receive health care coverage through this program.
Still, as this legislation recognizes, there is more we can do to
further decrease the number of uninsured low-income children. While the
State of Maine ranks among the top four States in reducing the number
of uninsured children, we still have more than 20,000 children who
don't have coverage. Nationally, about 9 million children remain
uninsured.
Unfortunately, the authorization for the SCHIP program, which has
done so much to help low-income children in working families obtain the
health care they need, is about to expire. That is why I encourage and
I urge all of my colleagues to join me in supporting this legislation.
I commend the Senate conferees on this bill. They did a very good job
of coming up with a very reasonable proposal--a proposal that costs
less than the House version and yet will make a real difference to low-
income uninsured children. I would point out that this is a bipartisan
bill. On the cloture vote earlier today, it had overwhelming support,
as 69 Senators voted to proceed with the vote on this bill.
The legislation that is before us will increase funding for the SCHIP
program by $35 billion over the next 5 years--a level which is
sufficient to maintain the coverage for the 6.6 million children
currently enrolled, as well as to expand the coverage so that we can
reach more children who are currently uninsured. In the State of Maine,
the bill before us will allow us to cover an additional 11,000 low-
income children who are currently eligible for SCHIP but not enrolled.
The bill also improves the program in a number of important ways.
Like Senator Domenici, I am very pleased that the bill includes a
requirement for States to offer mental health services through their
SCHIP program. Treating behavioral and emotional problems and mental
illness while children are young--early intervention--can make such a
difference. I know from hearings I have held in the Homeland Security
and Governmental Affairs Committee that the current systems for
providing mental health care to children are woefully inadequate. The
result is oftentimes parents are faced with a horrible choice of giving
up custody of their children in order to secure the treatment they need
for serious mental illnesses. That is a choice no parent should ever
have to make.
We also need to improve oral health care, dental health care for
children, and this bill will do just that. Despite the demonstrated
need, children's dental coverage offered by States isn't always what it
should be. Low-income and rural children suffer disproportionately from
oral health problems. In fact, 80 percent of all tooth decay is found
in just 25 percent of children--80 percent of the problems in 25
percent of the kids. That is simply because they don't have access to
oral hygiene, they don't have access to dentists and dental hygienists
who could help ensure their health. I am very pleased, therefore, that
the bill before us will strengthen the dental coverage offered through
SCHIP to ensure that more low-income children have access to the dental
services they need to prevent disease and promote good oral health.
Finally, the bill will eliminate the State shortfall problems that
have plagued the SCHIP program as well as provide additional incentives
to encourage States to increase outreach and enrollment, particularly
of the lowest income children.
The bill before us today is the prescription for good health for
millions of our Nation's low-income children in working families. That
is why I am so disappointed that the President has threatened a veto of
this legislation. I just do not understand his decision, and I think it
could be a terrible mistake. This important program can simply not be
allowed to expire. I urge all of our colleagues to join me in
supporting it.
Let me make one final point. I have heard a lot of our colleagues on
my side of the aisle argue that we need a far more extensive debate on
health care policy in this country, and they are right. But we should
not hold the SCHIP program hostage to that broader debate. We do need a
broader debate. We need a broader debate on how to lessen the number of
uninsured Americans, which now exceeds 45 million Americans. We need a
broader debate on how to help our small businesses better afford the
cost of health insurance for their employees.
We need a broader debate on how we can effectively use the Tax Code
to help subsidize the cost of insurance for those who don't receive
insurance through the workplace.
I hope Senate leaders will charge the relevant committees to
undertake a couple of months of hearings to bring together the best
minds possible and then dedicate a month of debate on the Senate floor
to a wide variety of solutions to both promote broader access to health
care, to help our uninsured better afford health coverage, and to
improve the quality of health care in this country.
That is an important and overdue debate. In fact, the Senator from
Louisiana, Senator Landrieu, and I have, for several Congresses,
introduced a broad health care bill with these goals in mind.
Let us not jeopardize the existence of a successful, effective
program for low-income children because we want to have that broader
debate. Let's send this bill to the President. Let's urge him to sign
it into law, and then let's turn our attention to this long, overdue,
much needed debate.
I yield the floor.
The PRESIDING OFFICER (Mr. Whitehouse). The Senator from Arizona is
recognized.
Mr. KYL. Mr. President, I want to begin my remarks by noting that,
along with my colleagues, I support reauthorization of SCHIP.
Unfortunately, the bill before the Senate today is not just an SCHIP
reauthorization; it is an SCHIP expansion, based on the following
misguided principles:
First, it would turn a program for low-income children into a program
for adults as well.
Second, it expands SCHIP to cover children from higher income
families.
Third, it covers people already insured, not just the uninsured.
Fourth, it circumvents budget rules to hide a $41 billion cost not
paid for under the bill.
I will address the first issue. When we authorized this program in
1997, the Republican-led Congress intended SCHIP to provide health
coverage to low-income, uninsured children. Ten years later, the
program created for children covers adults.
In fiscal year 2006, 14 States enrolled over 700,000 adults in SCHIP.
In fact,
[[Page S12246]]
this year, 13 percent of SCHIP funds will go to adults other than
pregnant women. For example, Wisconsin covers almost twice as many
adults as children under the SCHIP program, spending 76 percent of its
SCHIP funds on adults. Illinois spends 62 percent on adults. Rhode
Island spends 54 percent on adults. New Jersey spends half of its money
on adults.
So what happens under the bill before us? It allows the States, with
these existing waivers, to continue enrolling new parents--adults,
obviously--at a higher reimbursement rate than Medicaid.
There is no ``a'' in SCHIP. If Congress created SCHIP for low-income
children, we in Congress should ensure that is where the funds go;
otherwise, we are being dishonest with the American people and we
should rename the program.
Second, when the program was created, in 1997, we targeted low-income
children whose families earn too much to qualify for Medicaid but not
enough to obtain private health insurance. We never intended for all
children, regardless of the income of their families, to become
dependent on a Government health insurance program. That is not what is
happening today.
Eleven States have income thresholds at or above 300 percent of the
Federal poverty level. Rather than refocusing SCHIP on low-income
children, nothing in the bill prohibits States from increasing
eligibility levels above 300 percent of the Federal poverty level.
In fact, the bill grandfathers in the two States with the Nation's
highest levels and at a higher reimbursement rate than the rest of the
country. Why should Arizonans, my constituents, pay their taxpayer
dollars, which are intended for low-income children, to be sent to New
York and New Jersey to cover families earning up to $82,600 a year?
I have heard some say over and over again this will only happen if
the administration allows it. That is not true.
First, I direct my colleagues' attention to page 82, lines 3 through
11 of the bill. It states there is an exception for any State with an
approved State plan amendment or waiver--that is New Jersey--or a State
that has enacted a State law--that is New York. There is an exception.
So it is not that the President can stop this. The bill provides the
exception.
To clarify the policy even further, page 82 includes new language
that was not in the Senate-passed bill. This new language reinforces
that States should have the flexibility to set their own income
eligibility levels, no matter how high, making it nearly impossible for
any administration to reject such State requests.
Third, very importantly, the bill guts an August 17 letter issued by
the administration designed to make sure that States enroll low-income
families first and foremost. They said you have to make sure 95 percent
of your low-income, eligible kids are enrolled in the SCHIP program
before you can expand it to cover the higher income families. Well,
that has been taken out of the bill and the bill guts the provision.
From my analysis, nothing in this bill gives the administration the
clear authority to prevent taxpayer dollars from being sent to higher
income families. Even the Concord Coalition, a nonpartisan advocacy
group, warns that the bill ``fails to target new entitlement spending
at those most in need.''
Third, as a result of expanding SCHIP to children from higher income
families and some adults, the bill ``crowds out'' private health
insurance and substitutes that coverage with government-run, taxpayer-
subsidized insurance.
The Congressional Budget Office estimates that 2 million people will
drop their private coverage under this bill. For every two individuals
added to SCHIP, or Medicaid Program, one drops private coverage. This
is why we say it is a step toward government-run health care--you take
people with good private health insurance and take them off of the
private health insurance roll and substitute in the government health
insurance program.
For the newly eligible populations--the people not yet enrolled in
the program--CBO shows a one-for-one replacement, meaning that for each
600,000 newly insured individuals, 600,000 individuals go off of
private coverage. Is that what we are all about, what we should be
doing here? Should Congress not focus on ways to provide health care
coverage to the uninsured, rather than to those who already have
insurance? Of course, the answer is yes.
Finally, the SCHIP bill is not paid for. Under our rules, we are
required to state the cost of a program such as this over 10 years and
pay for it over that time period. Under the bill, SCHIP spending goes
up every year for 5 years and, all of a sudden, magically,
artificially, the spending drops off precipitously, as if there is no
more need for it. It basically disappears. Obviously, the reason for
that is to circumvent the budget rules and avoid paying for the bill.
The assumption, obviously, is artificial and wrong and everybody knows
it. The program is, in fact, going to continue out over the full 10
years; it doesn't stop after 5. So you need to make up the last 5
years.
How much does that cost? According to the CBO, $41 billion will be
needed to sustain the program for the last 5 years of the 10-year
program. In other words, the bill has in it a $41 billion hole. If you
fill in that hole over the course of the 10 years, the cost of the bill
exceeds $110 billion. That is why some of us appreciate the President's
determination to veto the bill as too much spending on a program that
has been expanded way beyond its original purpose and is substituting
private health insurance coverage for a new government program.
A future Congress will have no other choice than to disenroll
millions of children, which will not happen, or more likely, raise
taxes to fill that $110 billion cost. Of course, it will be our
children who will bear this bill's deficit.
I will conclude where I started. Like everybody else in the Chamber,
I support the reauthorization of SCHIP. I don't support its expansion
in the way it has been done under this bill. Republicans have offered a
fiscally responsible alternative that reauthorizes SCHIP for 5 years,
preserving health care coverage for millions of low-income children. It
adds 1.3 million new children to SCHIP. It is offset without new taxes
or budget gimmicks. It minimizes the reduction in private health
coverage by targeting it to low-income children.
We should pass an SCHIP extension and we should work toward a
reauthorization, such as the Republican alternative, that is fiscally
responsible and upholds SCHIP's original intent. Doing so is a step
toward renewing our commitment to America's children.
Mr. GRASSLEY. Mr. President, since the Senate passed the bill the
first time, the subject of ``crowd-out'' has become a lot more
important in this debate.
Crowd-out is the substitution of public coverage for private
coverage. Crowd-out occurs in CHIP because the CHIP benefit is very
attractive and there is no penalty for refusing private coverage if you
are eligible for public coverage.
On August 17, CMS put out a letter giving States new instructions on
how to address crowd-out.
I appreciate the administration's willingness to engage on the issue.
I think they have some very good ideas. But I also think there are some
flaws in their policy.
States are supposed to cover 95 percent of the low-income kids. But
it has been a month since they issued the letter and CMS still cannot
explain what data States should be using.
Personally, I think CMS should have answers before they issue
policies. And if they still can't a month later, I believe, as the
saying goes, they obviously aren't ready for prime time.
So the compromise bill replaces the CMS letter with a more
thoughtful, reasonable approach.
The Government Accountability Office and the Institute of Medicine
would produce analyses on the most accurate and reliable way to measure
the rate of public and private insurance coverage and on best practices
by States in addressing crowd-out.
Following these two reports, the Secretary, in consultation with
States, will develop crowd-out best practices recommendations for the
States to consider and develop a uniform set of data points for States
to track and report on coverage of children below 200 percent FPL and
on crowd-out.
[[Page S12247]]
Next, States that extend CHIP coverage to children above 300 percent
FPL must submit to the Secretary a State plan amendment describing how
they will address crowd-out for this population, incorporating the best
practices recommended by the Secretary.
After October 1, 2010, Federal matching payments are not permitted to
States that cover children whose family incomes exceed 300 percent of
poverty if the State does not meet a target for the percentage of
children at or below 200 percent of poverty enrolled in CHIP.
Simply put, cover your low-income kids or you get no money to cover
higher income kids.
Now I know some people are obsessed with the State of New York and
their and their efforts to cover kids up to 400 percent of poverty.
It seems to come up in the talking points of every person who speaks
out against our bill. This bill does not allow any State to go to 400
percent of poverty.
In fact, the bill makes it very difficult for any State to go above
300 percent of poverty; it will make it very difficult for New Jersey,
the only State currently covering kids above 300 percent, to continue
to do so if they don't do a better job of covering low-income kids.
If you are concerned about the State of New York, don't waste your
time looking at this bill. You will not find answers to New York's fate
here.
The answer is where it has always been--in the office of HHS
Secretary Mike Leavitt. Only he has the authority to allow any State to
cover children up to 400 percent of poverty. This bill does nothing to
change that authority. It is up to the Secretary.
I heartily encourage those of you who haven't to read the bill. It is
all there in black and white.
____________________