[Congressional Record Volume 153, Number 157 (Wednesday, October 17, 2007)]
[Senate]
[Pages S12950-S12952]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CHILDREN'S HEALTH INSURANCE PROGRAM
Mr. LOTT. Mr. President, a lot of discussion has been going on today,
this week, and over the last few weeks about a very important program;
we call it SCHIP. That is Washingtonspeak for health care for children,
which has a very important role for the States to administer this
program. This week, the House will be voting on the President's veto of
this issue. That is the way things work in Washington. It is not very
pretty. I am not proud of the whole process we have gone through on
this issue.
First of all, I have a message for everybody involved. Let's put low-
income, poor kids first. Let's figure out how we deal with their needs.
That is what caused this program to begin with.
I had the pleasure of being the majority leader in the Senate in the
1990s when this program was created. I remember the debate. It was
pretty hot. Phil Gramm of Texas was saying: Wait a minute, we need to
put protections in
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here, and Senator Kennedy and Senator Hatch were very much involved.
But then a bipartisan agreement broke out, the way we used to have
happen around here occasionally. We created a program, well-
intentioned, that was targeted for low-income children, to make sure
they had insurance coverage. It was not a massive number; I guess we
were thinking in terms of 6 million, with the idea that might go up as
time went by and more people or parents were made aware of the program
and information was gotten to them and they could come onto the
program. I think it has worked well. It has been successful. It covered
a lot of low-income children who would not have been covered otherwise.
Now, of course, we come to a period where we have to extend the
program, and it has been very difficult. I acknowledge right up front
that Senator Grassley tried to find a way to work through this issue
and get a proper result. He and Senator Baucus, the chairman of the
Finance Committee, wound up coming together and getting an agreement. I
also acknowledge that a lot of the problems have been exacerbated by
the previous administration and this one because they kept granting
waivers to States to go above the 200 percent of poverty, up to as high
as 350 percent of poverty, making not just low-income, poor children
eligible but children of families making up to--I don't know the exact
number--$62,000 or $63,000, and some States were applying to go to 400
percent of poverty, which would go as high as an $80,000 income for
families. That was not our intent. Plus, adults have been added. Only
in Washington can you get confused about a program that is for kids and
then start putting adults on it. But States started doing that and
waivers were requested, and the administration, unfortunately, for a
while granted those waivers. I think we should put limits on those
waivers. Thank goodness, finally the administration turned down the
most recent application for going up to 400 percent of poverty.
So here we are. Some of us on the Finance Committee said: Look, we
want this program extended. The President recommended that it be
increased by $5 billion, which is about $1 billion a year. Some of us
on the Finance Committee realized that probably was not enough to cover
the children now on the program plus to get more low-income children
who should be eligible and should be covered, covered. So we were
looking at going above the $5 billion increase the President originally
suggested. How much? That is what the legislative process is about. Is
it perhaps $9 billion instead of $5 billion or maybe $12 billion? I
wasn't wedded to a number; I was wedded to a concept and a program to
make sure we cover those now on the program. Some should not now be on
the program. But we wanted to make sure low-income children are covered
first.
The administration, to its credit, did put in place a provision that
would say you cannot start insuring middle-income children until you
have insured 95 percent of low-income children. This bill which has
been vetoed by the President would knock that out. What? If our goal is
to insure low-income children, why would we not require that? But the
compromise that was worked out went to $35 billion. It would allow for
kids who are not in the low-income category to be covered.
The President vetoed it. I think he should. Now the House is going to
sustain that veto. My question is, Now what? We have made our positions
clear. We have had a grand old time playing politics with kids. Let's
get over it. We need to get a result. That is the way it works.
Somebody was saying in that very chair last night that the Congress has
a role to play. Yes, and so does the President. Some people say: Look,
there was a bipartisan compromise worked out. Yes, but some of us who
would like to have been involved, who were there when the program was
created, didn't get involved. We just thought we would do what we want
and shove it over to the President and say: Take this. But he doesn't
take it. So now we sit down and work it out.
What is the plan of the Democrats? To let the program just collapse?
That is unacceptable. Nobody is going to stand for that. Then I hear:
Well, the plan is to keep extending it in increments--maybe 30 days,
maybe 90 days. We want to keep it alive until next fall. Look, we can
play politics and partisan politics, but do we have to use kids in the
process? I don't think we should do that. We need to make sure we have
a program that works.
One of my big problems about the plan we have is that it would put 2
million kids who now have private insurance on the Government rolls.
That is part of the plan. The plan is to get them off of the private
plan, which the families can afford; they could not get on Medicaid, so
we will get them on the SCHIP program. I think that is a mistake. Of
course, I think there is phony budgeting in the bill the President
vetoed. I think the funding is not reliable.
Now, at least the Senate came up with something that was a little
more defensible than what the House was working on. They said: We want
to take money from Medicare Advantage, elderly people in rural areas,
and use that savings to pay for the children's health program. That was
a total nonstarter with the Senate, thank goodness.
What did we come up with? Cigarette taxes. Who wants to stand up here
and defend tobacco? I will. I smoke a pipe. I don't do it in public. My
mother wouldn't approve of me doing that. By George, I make that
choice. I don't apologize for it. But, oh, it is a part of the
politically correct position now: Let's make everybody quit smoking
cigarettes. There are no good tobacco products.
This is still America. We do still have choices. And by the way,
let's assume it works. If we jack the price of a package of cigarettes
a buck a package, which is what this would do, it is going to
eventually, I guess, discourage people and low-income, poor working
families: Gosh, we can't afford cigarettes; maybe we will quit. Good,
that is great. I don't deny it is not good for your health. Maybe they
will quit.
This is the problem: If they do quit, we would not get the money to
pay for the SCHIP program. Think about that. We are do-gooders here, we
are going to raise taxes on tobacco products to pay for the Children's
Health Insurance Program. That way we will make them quit smoking. And,
oh, you mean then we would not have the money? Yes. You can't have it
both ways. It is the kind of stuff we do around here. It is ridiculous.
So the money would not be there. The program is not going to be
funded. We all know better than that; it is going to be funded. At some
point, if the tobacco money doesn't come in, which I assume it would
not because we have gone crazy trying to tax it out of existence--by
the way, this is an area States usually handle. But, no, we are going
to put a 61-cent Federal tax on cigarettes and that will further block
what the States might do to raise revenue for their programs. By the
way, they do a better job of running the health programs than we do
anyway. It is part of the inconsistency here.
There are many problems with this bill. I have always said, OK, let's
have our political debates. Let's stake out our partisan positions and
then let's sit down and work something out. Is that what the people
expect us to do? That is what the legislative process is all about.
I don't have the Holy Grail in this area. I realize it would be a
give and take. I believe Senator Grassley and I and representatives
from the administration and Democrats can work out this legislation.
The President said: Let's negotiate. Yes, I think he ought to send his
top people down here and humbly say to the leaders in the Congress,
Republicans and Democrats in the House and Senate: What can we do to
work through this bill now and get this program extended to where it
covers genuinely poor kids and get it beyond the next election? I urge
we do that.
I don't presume to try to say who would be in the room. Pick anybody.
But I say this: That is what needs to be done. Let's go ahead and rack
up the political points and politically let's say this one goes to the
Democrats. Policywise, I have no qualms about the position I have
taken. I am perfectly comfortable with it. But also I am prepared to
say enough is enough, let's move on, let's get a compromise worked out,
and let's protect this program which is well intentioned but which, for
good reasons, we have gotten carried away.
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There are some people who might say: Let's cover all children with a
federally funded health insurance program. Maybe we can raise taxes to
$5 a package, 10 bucks a cigar. It is ridiculous. There are other ways
we can get revenue. I hope we will get started on that as soon as the
House votes. They will sustain the veto, and then we can sit down and
work this out.
I yield the floor.
The PRESIDING OFFICER (Mr. Salazar). The Senator from Iowa.
Mr. GRASSLEY. Mr. President, I came to the Chamber to speak on an
oversight issue on which I have been working for well over a year. But
before I speak on that subject, I wish to take advantage of the
opportunity to respond to incorrect impressions about the compromise
State Children's Health Insurance Program bill on which the House is
going to be voting tomorrow. I am speaking as much to Republicans in
the House of Representatives as I am responding to some of the points
Senator Lott has made. These reminded me that regardless of how many
speeches one gives around here, regardless of how many explanations one
gives of what our bill does and does not do, nobody listens. We get the
same wrong statements being made time after time. I wonder, does
anybody ever listen? Maybe they don't like to have Chuck Grassley say
it.
I was a negotiator for the Republicans. I never had a single
Republican tell me since January that they didn't want the SCHIP
program reauthorized after a 10-year sunset. I never had one of them
say it wasn't a program that was serving a good purpose. I had a lot of
people express faults about what is wrong with the present program.
Most of those issues have been corrected in the legislation the
President vetoed.
I finally got people to realize the $5 billion the President put in
his budget on top of baseline is not enough to do what we are already
doing. Even the Republicans on this side offered $14.5 billion over
baseline, which still is not enough to do what needs to be done to take
care of the kids we are taking care of now and extend coverage to other
eligible but uninsured low income children.
Some people are saying this bill should have been vetoed because
there are adults in the program. But it was this Administration that
approved the waivers to cover adults. The bill that the President
vetoed did away with waivers. What has been in the program for 10 years
this bill does away with. Childless adults are not going to be on the
program. New waivers for parents under SCHIP is prohibited. For states
that currently cover parents, the federal match is reduced. But yet
people are still saying to me, from the other body, as I talk with
Republicans over there to vote to override the President's veto: Why
are we letting all these adults on? The waivers did that, and we do
away with the waivers.
Also, in my conversations with people in the other body, as I try to
convince them they ought to vote to override the veto, this $83,000
number keeps coming up. There was an inference made to it in the
previous speech. That is not in our bill, and yet the President in his
veto message referred to our bill allowing people up to $83,000 to get
on SCHIP. That is in the law. It has been in the law for 10 years, and
that can only happen if the President of the United States says a State
can do that upon that State's request. Only the President can allow
that to happen. That has been that way for 10 years. So don't tell me
our bill allows States to go up to $83,000. That has been the law.
What about the statement of having genuine poor children on this
program? I agree. Do you know that 92 percent of the kids on the
program are in families under 200 percent of poverty? Somebody can say:
What about the other 8 percent? OK, so what do we do about that?
Because there has been an inference to a State Health Official letter
to states released on August 17, 2007 that we did away with what would
have prevented that. But the policies in that letter were flawed and
unworkable. What we did is we made those policies workable in our
legislation. So the emphasis on kids under 200 percent of poverty works
out this way: First, we reduce the Federal match to the Medicaid match
for any state that wants to go over 300 percent of poverty, beginning
upon enactment of the bill. Then, by 2010, any State that wants to go
or to continue to go above 300 percent of poverty for children has to
demonstrate that they have reached the targets determined by the 10
best States covering kids under 200 percent of poverty. If they do not
meet the target, they get no Federal match for kids over 300 percent.
So don't tell me the bill before us does not have emphasis on low-
income kids. It has emphasis on low-income kids.
It was not brought up in the previous speech, but in my conversations
with the House of Representatives, I have had this other smokescreen
thrown at me: Our bill allows illegal immigrants to get on the program.
For the first time, we are doing in SCHIP what has never been done
before, what we have done for Medicaid in the Deficit Reduction Act. We
are making it so that illegal immigrants cannot get on the SCHIP
program.
People are paid to read legislation, and I don't know how the
President of the United States, who gets paid a heck of a lot more than
I do and has a lot of advisers who get paid a heck of a lot more than I
do--I don't know how they can have him put in a speech that this bill
allows people over $83,000 to get into the program, or there can be
speeches in the Chamber of the other body saying we are opening the
door for illegal immigrants to be covered by this program when we are
doing more than existing law does in that area and where existing law
already allows, if the President approves it.
And then this business of adults being in the program--absolutely
right, three States have more adults on the program than other States.
How did that happen? This administration gave waivers for that to
happen. We do away with those waivers. I have heard all the complaints
from this side of the Senate, the Republican side of the Senate, that
there is no ``A'' in SCHIP--and I agree, it shouldn't be for adults--
and I even heard Democrats strongly speak to this point. This program
should never have gone in that direction. We do away with waivers.
I ask everybody to read the legislation, and particularly Republicans
in the other body, before they vote tomorrow to override or not
override because all these inaccurate representations of the compromise
bill are creating a very bad mistake. It's so bad politically that the
White House is looking for some way to get out of this situation.
Probably that some way to get out of it is negotiating another bill
with us. But it would be smart if the White House would send a signal
to the House of Representatives: Override our veto; we made a mistake.
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