[Congressional Record Volume 153, Number 158 (Thursday, October 18, 2007)]
[Senate]
[Pages S13030-S13032]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                                 SCHIP

  Mr. MARTINEZ. Mr. President, I want to talk this morning on the much-
talked-about subject of SCHIP. In this Chamber over the last several 
days--and I would say all over the Nation--there has been a lot of 
conversation about the future of the State Children's Health Insurance 
Program and whether this side will budge or that side will nudge the 
other one or who will blink first.
  Clearly, we are at an impasse. Today, the President's veto of this 
bill--which will enlarge Government by $35 billion--will be sustained 
in the House, I believe. Then we will find ourselves at a place where 
we have to regroup and decide how to proceed in reauthorizing this very 
important program. It is an important program, and a program so many of 
America's children have benefited from, and one for which I believe we 
need to find a way to move forward.
  I want to add my voice to those who have called for the program's 
reauthorization. This is a program that is working. It works in the 
State of Florida. It is a program that helps children. I know a lot of 
Florida children have been helped by it. So we have to find a way we 
can come together in the spirit of the program so every child who needs 
health care has the needed access to health care.
  We should take great care, however, to avoid switching SCHIP from 
being a program aimed at helping poor children to a program that moves 
us toward a Government-sponsored, Government-run health care system. 
That would not serve the people in the program, and it would not serve 
the greater cause of reforming the bigger problem we have, and which we 
also have to address, which is our entire health care system.
  The bill the President vetoed would have allowed coverage to the 
point where we would have essentially encouraged families who are today 
receiving coverage through private insurance to drop that insurance in 
favor of Government-sponsored health care coverage. I do not think that 
is the way to move forward with health care reform. I do not think that 
policy would lower health care costs or increase the access to quality 
health care. Both are important goals.
  In talking with people in my State of Florida, they want to see SCHIP 
reauthorized. They want to help poor children who need health care. 
They understand the debate we are having, and they want a better 
alternative than anything that is on the table right now. So we are at 
an impasse. But I think we can find common ground. A real compromise 
needs to be reached, one that keeps the spirit of SCHIP, one that adds 
provisions to help find children currently eligible for assistance and 
signs them up for insurance.
  We need a compromise that does not simply broaden the program's 
eligibility so people in private health insurance are forced to move to 
Government-sponsored health insurance because an employer sees an 
opportunity to save money. That is why later today I will introduce an 
alternative SCHIP reauthorization program composed of three elements--a 
full reauthorization of SCHIP, a child health care tax credit, and an 
aggressive outreach program to ensure all children eligible for the 
program have the opportunity to sign up for the insurance.
  The first element enacts a full reauthorization of SCHIP, where we 
continue to cover children in families with incomes at or below 200 
percent of the Federal poverty level.
  The second element of my proposal advances tax credits to families 
with incomes between 200 and 300 percent of the poverty level. If a 
family does not have insurance, a credit provides the resources 
necessary to go out and purchase health insurance. Families would have 
the ability to purchase health insurance, health care coverage tailored 
to their children's unique needs.
  The third element would enhance outreach for children who are 
currently eligible for SCHIP coverage but who are not currently 
enrolled.
  It is estimated between 500,000 and 1.5 million children who are 
today eligible for SCHIP are not enrolled simply because families do 
not know the program is available to them.
  Make no mistake: The underlying debate is not whether we are going to 
provide health insurance for our Nation's children. We all agree that 
our society can ill afford to not take care of children in need. The 
dispute is how are we best to achieve that goal.

  One of the major differences between the vetoed SCHIP program and my 
alternative is that the vetoed bill created a newly eligible population 
and moved them into a system of Government health insurance. My 
proposal is patient focused. It retains for families the choice of 
providers and practitioners and gives parents the resources necessary 
to add their children to their existing health care plan.
  Where our proposals are similar is in the number of children we 
insure. Under my proposal, 10 million children would have access to 
health insurance. That is the same number who would have been covered 
by the vetoed bill.
  It is essential we come together as Republicans and Democrats to talk 
about a viable alternative, about how we can get this done, about 
something that would ensure the reauthorization of SCHIP and that 
expands rather than diminishes private health care coverage for 
children.
  I would be willing to continue to discuss this issue in a way that 
allows us to debate whether in the reauthorization part of this bill--
the $5 billion probably is not enough to cover all of the children who 
need to be insured under this program. I think a larger number than 
that $5 billion is necessary, probably closer to $10 billion.
  But once we did that, then how do we go about covering that 200 
percent to 300 percent of poverty--those working families who still 
cannot find a way to insure their children without Government 
assistance? We would do that through a tax credit. That tax credit 
would also be beneficial. It would be a way of allowing them to 
continue to have a private health care option, which I think is always 
preferable.
  The insurance marketplace would adjust and continue to innovate in a 
way that I think would give us a much stronger, much better health care 
system for the children of America who so much need insurance for 
themselves and for us to be sure we have a healthy future for them.
  I look forward to continuing to work with my colleagues in the coming 
days

[[Page S13031]]

to strike a middle ground, to strike a compromise on SCHIP, to be sure 
we come together to let the people of America know this Congress, 
Republicans and Democrats, can come together to work together on 
something as important as the health of our children. I look forward to 
the days ahead, as we continue to discuss this important topic, and I 
look forward to having others join this effort.
  I am very gratified that quite a number of the Members of the House 
have adopted this as their idea and are going forward with this as a 
plan that may have viability, may be the answer. I hope an increasing 
number of Senators who are now not only looking at it but also finding 
favor with it will create the kind of middle way that will allow us to 
come together to find a solution and put this important issue back 
where it belongs: moving forward and taking care of the children of 
America.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Louisiana.
  Mr. VITTER. Mr. President, I rise to join my distinguished colleague 
from Florida and many of my other colleagues in urging the sort of 
consensus building, practical problem solving Senator Martinez is 
talking about.
  It is clear we are at a current impasse on the SCHIP debate. The 
version that passed the Senate and passed the Congress has been vetoed 
by the President. It will be made even more clear in the next day or so 
that veto will not be overridden.
  I think what the American people want us to do is not talk endlessly, 
debate endlessly, and simply try to score political points, but to come 
together around a practical compromise, a practical resolution that 
advances health care, particularly for poor children.
  So I join my colleague from Florida in urging us to do that. My ideas 
about what that reasonable, practical compromise would be are very much 
like his. I applaud Senator Martinez in terms of the ideas he has put 
forward to resolve this SCHIP debate.
  I could not support the Senate Finance Committee version of the SCHIP 
bill. I could not support it for a very simple reason: I am all for the 
SCHIP program. I am all for covering poor children. I am not for 
expanding that program well beyond the boundaries of poor kids so that 
it is a precursor, quite frankly, to government-run, government-
dominated health care. I think that is a mistake. I think expanding a 
program such as this and actively pushing people off private insurance, 
which the Finance Committee version would do, is a big mistake and 
moves us in the opposite direction of where we should be moving with 
regard to health care reform in this country.

  Why do I say that about the Finance Committee bill? Well, for a 
simple reason: It goes well beyond the original intent of SCHIP, which 
is to cover poor kids. It goes beyond that in several ways. First of 
all, it raises the general limit of eligibility from 200 percent of 
poverty to 300 percent of poverty. In the United States today, 300 
percent of poverty is $62,000, a family income of $62,000. But, in 
fact, that limit is well above that in most cases. Why? Because under 
the Finance Committee bill, States can define family income in 
innovative ways. They can take out large expenditures such as tuition 
from family income, so we are not talking about gross family income of 
$62,000. Once you take out those major components, those major sources 
of spending of a family, you could easily be talking about a family 
income of $80,000.
  In addition to that, under the bill the administration--any 
administration--would be urged, if not mandated, to grant waivers to 
States in many cases to go well above even that 300-percent-plus line. 
So clearly, you would dramatically expand the children and the families 
covered under the program, and you would go well beyond what any 
reasonable person would define as the truly poor.
  Now, why is this bad? Well, for one thing, you are crowding out 
folks--pushing folks off--of private insurance. There have been several 
analyses done of the Finance Committee bill which passed the Congress 
and which the President vetoed. Under those analyses of new enrollees, 
it is estimated that between 45 and 51 percent would be dropping 
private insurance to enroll in SCHIP. Now, is that the direction we 
want to move in, encouraging folks who have private insurance to drop 
it, to flee private insurance to come under the care of the Government? 
I think that is the wrong direction to move in.
  Beyond that, if you look at new eligibility groups--in other words, 
not all new enrollees, but the new groups of people who would become 
eligible under the bill--there is a 100-percent crowd-out effect. 
Everybody in those new groups would be dropping private insurance to 
enroll in SCHIP. Is that the direction we want to move in? I think not. 
We talk about the problem of the uninsured in this country. Why do we 
want to grow that problem versus solve it by encouraging people and 
helping people keep their private insurance or get onto private 
coverage? That is not the direction we want to move in.
  I believe the direction we want to move in is to encourage coverage, 
to make it more available, to make it more affordable. That is the sort 
of solution that Senator Martinez and myself and others have been 
talking about. That is why I support the McConnell-Lott SCHIP bill and 
support furthering the goal of health care for all American families 
with tax credits that can make private coverage available and 
affordable.
  Step 1: A real SCHIP reauthorization focused on poor kids. That is 
what the legislation I support does. That bill costs $8 billion in new 
costs over 5 years, but those new costs are fully offset. That bill 
would keep eligibility at 200 percent of the poverty line, but it would 
enroll many more new kids: 1.3 million by 2012 and 1.5 million new kids 
by 2017. It would also extend coverage to pregnant women and their 
children in the womb. That is important as well. That is a real 
reauthorization of the SCHIP program as it was originally designed and 
intended.
  Now, is that good enough with regard to children's health care needs 
and families' health care needs? Absolutely not. There are other needs 
out there which we must address. Health care insurance isn't available, 
isn't affordable to enough folks. But rather than encouraging them to 
get on a government program and in half the cases actively pushing them 
off private insurance, why don't we help them stay on private insurance 
or obtain private insurance? That is the additional step we need to 
take through tax credit or other legislation.
  So again, I urge us to do what the American people want, which is not 
to simply argue, talk, debate, and try to score political points 
endlessly, but to come together around a real and valid and commonsense 
compromise. That is what the American people want, so let's do it. That 
compromise is clearly within striking distance if we have the political 
will to come together around those ideas. Again, I believe the 
principle we should look at is a real reauthorization of SCHIP for poor 
children, supplemented with some additional help for those families 
that need the help to stay on or to get on private insurance. I don't 
believe the path of the current SCHIP bill, which actively pushes 
families off private insurance in so many cases, is the way to do it.
  The proponents of that bill laud it because it would sign up 4.4 
million new enrollees. Well, guess what: 4.4 million of that 2.4 
million currently could have private insurance. Is that progress? Is 
that a great accomplishment, to push off of private insurance 2.4 
million and get them on a government program at the expense of the 
taxpayer, when there is a better, cheaper alternative to help them stay 
on private insurance, to help them have more choice and control and 
autonomy of their health care future? That is what the American people 
want: More control, more choice, more autonomy, making good health 
insurance available and affordable. Let's reauthorize SCHIP for the 
truly poor and let's give them ways to make health care insurance 
available and affordable through instruments such as tax credits.
  I yield the floor, and I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mrs. BOXER. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Casey). Without objection, it is so 
ordered.

[[Page S13032]]

  Mrs. BOXER. Mr. President, I ask unanimous consent that whatever time 
remains for the Republicans be reserved until the Democrats have 
finished our time.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from California is recognized.
  (The remarks of Mrs. Boxer, Mr. Lieberman, Mr. Inhofe, Mr. Warner, 
Mr. Coleman, Ms. Collins, and Mr. Alexander, pertaining to the 
introduction of S. 2191 are located in today's Record under 
``Statements on Introduced Bills and Joint Resolutions.'')

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