[Congressional Record Volume 153, Number 166 (Tuesday, October 30, 2007)]
[House]
[Pages H12211-H12218]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                                 SCHIP

  The SPEAKER pro tempore (Mr. McNerney). Under the Speaker's announced 
policy of January 18, 2007, the gentleman from Arizona (Mr. Shadegg) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. SHADEGG. I want to take this opportunity tonight to discuss one 
of the hottest topics here in Washington, a topic that has occupied 
much of our time. It's been an issue on which we have debated and 
discussed extensively. And I think that's been good for the American 
people because it has enabled them to learn what they didn't know to 
begin with.
  The topic I want to discuss is the proposed expansion of the State 
Children's Health Insurance Program, what you have commonly heard 
referred to as SCHIP. That's a program that was created a number of 
years ago, and the President has put on the table some parameters about 
how to renew the program, but the Democrats have decided, no, we need 
to dramatically expand the program. And I think it's important to 
discuss these issues and for the American people to understand what is 
involved.
  But on this one, I think it's more important than usual. And I think 
a way to illustrate that is that very recently a Republican colleague 
of mine was stopped by a reporter here on Capitol Hill. The reporter 
said to him, hey, how can Republicans possibly vote against the State 
Children's Health Insurance Program? And the reporter was incredulous 
at this thought, given that it's a health insurance for children and 
that its title said it's the State Children's Health Insurance Program, 
how is it the Republicans thought they could vote against a bill with 
that title? Well, fortunately, my colleague, who was quick of mind, 
said, I think a better question is, how could any Member of Congress 
vote for a bill based solely on its title? And, in fact, that's what 
the Democrats are urging us to do, vote for this dramatic expansion of 
this health care program just because its title indicates it's for 
children.
  And in reality, you begin to take apart the various levels of the 
onion, the layers of the onion and examine the program and you 
discover, well, it's supposed to be an insurance plan for poor, 
uninsured children; and yet, if you examine it, you discover that it's 
not for poor or even near-poor, it's not for uninsured and, in fact, 
it's not even for children, a rather stunning provision. You discover 
that it's actually for middle- to upper middle-income Americans, some 
of whose families make more than $60,000 a year, and in some States 
their families make more than $80,000 a year. That's hardly anybody's 
definition of poor.
  So, if it's not for poor children, then one would think, well, it's 
supposed to be for uninsured children. And yet, you discover, no, as a 
matter of fact, 61 percent of the children who originally became 
eligible for this program already had insurance. So, the program hasn't 
really been to help uninsured children, at least not initially, 61 
percent of the children who are eligible already had private insurance, 
and they dropped that insurance to go on this government program.
  Well, then you look at the CBO score of the current Democrat bill. 
And we ought to talk about how many times they've brought this up and 
the President has vetoed it, and I know there

[[Page H12212]]

are some of my colleagues here who will discuss that, but the 
Congressional Budget Office scored the current proposal that's before 
us, and CBO said that one out of every two children who become eligible 
under the new bill, under the bill that Democrats would have before us 
now, one out of every two will already have private health insurance. 
One out of two new children who become eligible for this program will 
already have private insurance. And if they decide to drop that private 
insurance and go on the SCHIP program, this Cuban-style, government-run 
program, well, half of those people will have already had private 
insurance and they will drop that insurance.
  That opens the door for a discussion, I think, about the fact that, 
and CBO estimates 2 million; if 2 million kids in America who have 
private insurance drop their private insurance to go on this new 
expanded government program, the cost of that private insurance for 
everyone else will go up. So, let's see: It's not for poor or near-
poor; it's not for the uninsured. Surely, this program must be for 
children because, after all, the Democrats are saying nobody can vote 
against a bill that's called the State Children's Health Insurance 
Program, but.
  Voila, you discover, no, it's not just for children. As a matter of 
fact, there are a number of States where there are more adults on the 
State Children's Health Insurance Program than there are children on 
the program. As a matter of fact, I think in Wisconsin, it's 61 percent 
of the money is spent, not on children, 61 percent of the SCHIP money, 
State Children's Health Insurance Program money, 61 percent is spent on 
adults. I believe in Minnesota it's 75 percent of the money for the 
State Children's Health Insurance Program is spent on adults.
  I looked at my own State. I thought, you know, I'm in Arizona, I'm 
interested in what's going on in Arizona. Kind of a shocking fact I 
discovered, and that is, Arizona had, at one point in time, put 110,000 
adults on the program, but, and listen to this one, this is the State 
Children's Health Insurance Program, they put 110,000 adults on the 
program, and 85,000 of those adults were childless. They didn't even 
have a child.
  Now, unfortunately, there is no such thing as truth in legislating, 
so it's okay to label a bill the State Children's Health Insurance 
Program and have it intend to cover poor and near-poor uninsured 
children, and then to dig into the weeds of the bill and read and 
discover, well, it's really not for poor and near-poor, it's for upper- 
and upper middle-income Americans. It's not for the uninsured, at least 
in several States, more than half are already uninsured. It's not even 
for children. It's for adults. And I think many Americans know that the 
President vetoed this bill. And then the majority party, the Democrats, 
decided to put off the override vote. And their thought was, well, we 
will put off the override vote and put these Congressmen under pressure 
to try to force them to vote for the State Children's Health Insurance 
Program and override the President's veto. Well, when the truth is on 
your side, when the facts actually help you, when the facts point out 
that the program isn't what its title says it is, it isn't really the 
State's Children's Health Insurance Program for poor and near-poor 
children who are uninsured, it actually covers middle-income kids and 
not-poor kids, it covers kids that are already insured and causes them 
to drop their private insurance, and it covers adults, the delay didn't 
help, and the delay caused more Americans to learn about the bill.

  But last week, on the last day we were here, once again the Democrat 
Party tried to stuff through a bill, without making any real changes to 
it, that had all these same flaws to it. And so, I thought it was 
important that we should come to the floor and talk about those issues. 
But there are actually more. I want to talk about the funding source. 
Because as challenging and as, in fact, untrue as the claims are about 
the bill covering poor children or uninsured children or even children, 
it turns out the funding mechanism is a scam as well. Actually, it's 
got all kinds of budget gimmicks in it, and it relies on certain things 
that simply will not come true and wouldn't be good policy if they did 
to fund it.
  But before we move on to the funding issues in this bill, which I 
think is important for the American people to know about, I would like 
to give some of my colleagues here on the floor a chance to talk about 
their view of the bill, why we do support health care for poor and 
near-poor children, we do support health care for uninsured children, 
we just don't want to do it for middle-income Americans. We don't want 
to do it for those who already have insurance. As a matter of fact, 
I've had a bill that I've introduced in this Congress every year for 
the last 10 years to give a refundable tax credit to every single 
American who can't afford health insurance and let them buy their own 
coverage. So, I support dealing with these kids who need care, but not 
in a way that deceives the public about what we're doing.
  I would be happy to yield to my colleague to give us her perspective 
on this important piece of legislation and help, perhaps, educate the 
American people about what this debate is and why we have the concerns 
we have about the bill.
  Mrs. BLACKBURN. I thank the gentleman from Arizona for yielding.
  Mr. Speaker, I am so pleased to be able to stand here and talk for a 
few moments about the SCHIP proposals, or I should say the health care 
proposal, the expansion of health care that has been brought under the 
name of SCHIP. It is, indeed, unfortunate that a fine program that is 
there to help underprivileged children has been hijacked, if you will. 
And on its back, on the backs of our Nation's children, on the backs of 
the children of the working poor has been placed this expansion of 
health care. It truly shows a level of disrespect toward the children 
of this country.
  I appreciate the leadership that the gentleman from Arizona shows, 
not only on this issue, but the leadership he brings to our Republican 
Study Committee. And those of us who are speaking on the issue tonight 
are members of the Republican Study Committee.
  Mr. Speaker, on the topic of this SCHIP, you know, one of the things 
that the American people said was, we want to change the way things are 
being done in Washington. We want smaller government, we want 
government to spend less money. So, we saw some changes take place last 
November. And the new majority went into control in January and they've 
authorized nearly $1 trillion in new spending since the time that they 
took over. And, of course, we are hearing that there are tax increases. 
One of the chairmen of Ways and Means calls it the ``mother of all tax 
increases.'' I take a little bit of offense to that, being female. And 
also, when you talk about the mother of something, you worry about what 
the offspring are going to look like, Mr. Speaker. And so we are 
worried about what that tax bill will look like.
  But on SCHIP, as I said, unfortunately for America's children, the 
liberal leadership of this House decided that they were going to put on 
their back the burden of carrying this enormous expansion of health 
care and changing a block grant program into an entitlement. That's not 
the kind of change the American people voted for. Just like the 
American people didn't vote to have the single largest tax increase in 
history take place.
  Now, one of the interesting things about all of this is the SCHIP 
proposals that have come out include allowing illegal immigrants to get 
health care. And I know we hear from the majority, oh, that's not going 
to happen. We have eligibility requirements. But, Mr. Speaker, I would 
direct my colleagues to either section 211 or section 605 of the bill 
where it plainly states, and you can read it for yourself, anyone 
watching could read that for themselves. They can look up H.R. 3963 or 
H.R. 976 and see what is contained in that bill.

                              {time}  1745

  We know that this would result in $3.7 billion in new spending over a 
10-year period of time if the new liberal majority had its way. You can 
go into the allocation section, section 102 of the bill, and you can 
look at what is going to take place when you get mid-year 2012. Do you 
know what happens, Mr. Speaker? All of a sudden, no money. So what are 
you going to do, throw 80 percent of the people off the

[[Page H12213]]

bill? We all know that is not going to happen.
  But, Mr. Speaker, my question is why would anybody support a bill, 
support a program, that they are setting up to fail. Why would they 
have that level of disrespect for this program, that they would pass 
legislation that would plan for it to fail. Then, as my colleague has 
said, we have the problems with spending more, insuring less children, 
and not making available to the children truly that are eligible for 
the program the opportunity to have that access to affordable health 
care.
  We could go on and on with the problems with this bill. I just find 
it so unfortunate that in this day and in this age that we would have 
the new majority and the new leadership take a block grant program that 
is working well, that the States like and change it to an entitlement 
program that is put on auto pilot when we know some of the greatest 
pressures we have on our budgeting process are on our entitlement 
spending.
  I thank the gentleman from Arizona for yielding. I appreciate his 
leadership on the health care issues. I appreciate his concern for how 
our constituents continue to access health care in this country.
  Mr. SHADEGG. Reclaiming my time, I would like to just bring out a 
couple of the points that the gentlewoman from Tennessee mentioned and 
drive them home a little bit. I think the key one you mentioned was 
coverage of illegal aliens. As I understand it, the way the bill is 
written, it, in fact, appears to prohibit illegal aliens from being 
covered under the bill, but the authors of the bill have 
conscientiously, intentionally chosen vague language that would require 
virtually no proof of citizenship. Is that not correct? Would you 
explain that?
  Mrs. BLACKBURN. Yes. If the gentleman will yield, and indeed that is 
correct. What you see is a play on words and how unfortunate that we 
have this disingenuous approach to this issue, have a play on words 
with the eligibility requirements and allowing, putting something in 
words and then allowing a loophole. As I said, the two sections, 
sections 211 and 605, with that we can look at the income disregards.
  Now, Mr. Speaker, how many people have ever said let's have the 
income disregards when they are trying to decide who goes on to a 
program? Well, I had one of my constituents in my district come up, and 
they said, Tell me what is an income disregard? I said, Do you know 
what, an income disregard is when you do not consider the income. And 
they said, How can that be for the sake of considering SCHIP which is 
to be for children of the working poor? And I said, Because you don't 
want the income to matter. And if you don't want the income to matter 
and you want to make it available to what the IRS calls ``high-income 
earners,'' you establish that doubletalk with income disregards.
  Mr. SHADEGG. Income disregards is a perfect segue to what I want to 
talk about in this bill, and it stuns me, and I know that the authors 
of the bill have been confronted, and they have been asked to change 
the language to make it clear that this coverage would not go to 
illegal aliens. They have rejected that. They use the term ``income 
disregard.'' What the heck is an income disregard? People in my 
congressional district certainly don't know what it is. But it is game-
playing.
  This is one I love. And you used the phrase, why would anyone write a 
bill and have it intentionally designed to fail; have it through kind 
of shifty means, through kind of squeaky wording, through provisions 
that you know won't hold up, have the program designed to fail. I think 
you are referring to one part of the bill that I find fascinating, and 
that is here as demonstrated on this graph.
  It turns out that for the first 5 years of this program in the bill 
the majority has put together, the Democrats' bill, they provide the 
funding for the program, for this new expanded SCHIP program. But we 
fund our bills over 10 years. It turns out that because of their rules 
on budgeting that they have to cut off funding, and in year 5, actually 
6 months into year 5, 80 percent of the funding for the entire program 
goes away. It is kind of like Lucy and the football. They say, Well, we 
will fund it for 5 years, and then we are going to take 80 percent of 
the funding away in year 5, and that way we will trick people and make 
it appear that we have the money to fund the program.
  But that is not even quite as fascinating as one of the points I 
really want to bring out tonight in this debate, and that is, one of 
the funding mechanisms of the bill is a 61 cent per-pack increase in 
the cigarette tax. Now, you might say, Look, smoking is bad for people. 
Smoking is a habit we should discourage. So I am all for increasing the 
tax on cigarettes. I wouldn't have an argument with that.
  But here is the problem, and this is where we go to terms like 
``income disregard'' and, actually, not honestly confronting the 
funding of the bill. It turns out that for this 61 cent income, or 
cigarette tax, to be sufficient to fund the bill, more people than 
currently smoke would have to take up the habit. As a matter of fact, 
the official estimates are that to pay for the bill with a cigarette 
tax increase that is in it, a staggering 22 million Americans will need 
to take up smoking.
  Now, I thought, how can a graph demonstrate 22 additional million 
Americans starting smoking? So I had my staff get 22 cartons of 
cigarettes. Here they are. We have got all 22 stacked here. I would 
like to have them out there where you can see them. There are 22 
cartons of cigarettes here. And each carton represents an additional 1 
million nonsmokers in this country who, to fund this bill if you leave 
it funded with the Democrat 61 cent per-pack cigarette tax, will have 
to start smoking.
  Now, maybe proponents of this bill think that having 1 million people 
for every one of these 22 cartons of cigarettes take up the habit and 
pay their tax is a good idea. I happen to not think it is a good idea.
  Mr. Speaker, for anybody who just tuned in, I want to tell them where 
we are. We are discussing the proposed expansion of the SCHIP program, 
a program that many of us are concerned is a bill that we will be 
forced to vote for because of its title. It is supposed to be a health 
care bill that provides health care to poor uninsured children. And it 
turns out that it provides health care not to poor children but to 
middle- and upper-income children whose families are making 60 to 
$80,000 a year, in some instances more. It turns out to cover not just 
uninsured children, but 61 percent of the people originally covered 
already had insurance, and that would displace them, causing the cost 
of private insurance for the rest of us to go up.
  It turns out it was supposed to be for children, and it is not 
actually for children. In some States, in Minnesota and Wisconsin, 
there are more adults covered than children and more money is spent on 
adults.
  Then the final point I was just making, and I don't know, I hope the 
camera will get the cigarette cartons stacked in front of me, but one 
of the funding mechanisms in the bill is an increase in the cigarette 
tax. You might think that an increase in the cigarette tax is a good 
idea. But unfortunately it doesn't do the trick because the proposed 
increase in the cigarette tax of 62 cents a pack, it turns out, will 
only work, it will only provide enough money to pay for the program 
called for in the bill if an additional 22 million, staggering, 22 
million Americans take up smoking and pay the tax.
  So I thought to graphically illustrate that, I would get my staff to 
go out and acquire 22 cartons of cigarettes. Well, we couldn't afford 
the 22 cartons of cigarettes so we just got the outside of the cartons. 
But here they are stacked in front of me. You might say, Why are those 
cartons of cigarettes stacked in front of him? What's the big deal 
there? Doesn't he like cigarette taxes? That is not the issue. The 
issue is if each one of those cartons of cigarettes in front of me 
represents a million people in America who don't smoke today, a million 
Americans who don't smoke today, who, in order to fund this bill and 
have enough money coming in based on their cigarette tax, will have to 
start smoking in order to pay for the bill? Maybe somebody thinks that 
is good policy. Maybe somebody thinks we ought to be encouraging people 
to take up smoking and pay the 61 cent tax. I know my colleagues in 
Congress who are doctors probably don't think that is a great idea.
  I do have my colleague from Georgia here, Mr. Westmoreland. I would 
be

[[Page H12214]]

happy to let him give his comments on the idea of 22 million new people 
starting smoking to pay for this bill that really isn't for uninsured 
poor children.
  Mr. WESTMORELAND. I appreciate the gentleman yielding. To get 22 
million people to smoke, I don't know how much money we will have to 
appropriate to a ``get smoking campaign.'' We have been spending 
millions and millions of dollars, as the gentleman from Arizona knows, 
trying to get people to recognize the health effects of cigarette 
smoking and to quit. So I think for the Democrats to have this 
proposal, and I understood the gentleman from Arizona to say, too, that 
not only is the 61 cent cigarette tax misleading that it would fund the 
program, that they have a cliff that this program falls off of after 5 
years and 6 months.
  We have got the chart right here that shows that this is really more 
smoke and mirrors trying to get around the PAYGO in the fact that this 
is fully funded for the first 5 years and 6 months, and then after 
that, it drops off about 80 percent. And you can see over here the red 
line goes down.
  Now, anybody who believes that we should let these families get on 
this health insurance program and then pull the rug out from under them 
is not fair. In fact, what has happened, when this program was first 
initiated under Republican control in 1997, there was a need there to 
help people who made 200 percent or less of the poverty level, and that 
is about $42,000. So we said, If your children are uninsured, we have 
got a program that can help you. And we let the States administer it.
  There are over, I believe the gentleman from Arizona, I don't know if 
you quoted this or not, but I think there is probably close to between 
a half million and a million children in the United States today that 
were eligible and had not been insured yet by these States.
  Mr. SHADEGG. Reclaiming my time, that is absolutely correct. One of 
the objections that those of us who think this is not a well-written 
piece of legislation, we support the policy. We are all in favor of 
taking care of poor children and ensuring that they have health care 
coverage. Indeed, as I mentioned earlier, I have introduced a bill 
every year for the last 10 to provide a refundable tax credit to those 
children. But one of the things that we object to is the program 
currently covers adults and in several States there are more adults on 
the program than children; and yet as the gentleman from Georgia 
pointed out, there are millions of children who are, in fact, poor and 
who are, in fact, eligible to participate in this program who aren't 
currently participating.
  One of the amendments that we have suggested, but have never been 
allowed to offer on the floor because we have never been allowed to 
offer an amendment on the floor, would be an amendment that says, You 
can cover people at a higher level of poverty, you can go on up the 
income scale, after you have covered the poorest American children. The 
President has proposed that, as well.
  Mr. WESTMORELAND. That's right. That is a great point. The Republican 
Congress, in 1997, when they came up with this program, and they funded 
this program, it was a block grant to the States. And they thought that 
the States would be there looking after these children that belonged to 
families under the 200 percent poverty level that didn't have health 
insurance to give them some affordable, or at least some, health care. 
But what happened is these States didn't work hard enough to go out 
looking for these children, so they said, Look, we'll insure adults.

                              {time}  1800

  Then you learn from your mistakes. This program has been going on 10 
years, and I think the President and the administration saw some of the 
errors that were in this program and tried to correct them and want to 
correct them in a new bill.
  What it would do is say, look, all the States are going to be at a 
200 percent poverty level. What has happened is States such as New 
Jersey and others have gone in and gotten waivers to go up to 300 and 
400 percent, and that has caused a disbalance in some States that have 
taken their block grant, that have insured the children, spent the 
money wisely, and then others that have taken advantage of the system.
  Mr. SHADEGG. Mr. Speaker, reclaiming my time briefly, when we talk 
about 300 percent of the Federal poverty level or 400 percent of the 
Federal poverty level, the abuse of the program, can the gentleman tell 
us about how much money that means?
  We say this program is not directed just at poor or even, I like to 
say, nearly poor children. Poor children are supposed to be taken care 
of by Medicare. This is supposed to be for the near-poor.
  Mr. WESTMORELAND. Mr. Speaker, I thank the gentleman for yielding, 
but let me put this in terms we can all understand. Two hundred percent 
of poverty is $42,000, 300 percent is $63,000, 400 percent is 
approximately $84,000.
  Mr. SHADEGG. There are some people on the program at that high a 
level.
  Mr. WESTMORELAND. There are some people on the program at 400 
percent.
  Mr. SHADEGG. Eighty thousand dollars-plus.
  Mr. WESTMORELAND. Eighty thousand dollars-plus. To me, this program 
was intended for those poor children that were in a situation with a 
family of four making $42,000 that could not afford the health 
insurance, so the government stepped in and said we are going to help 
you out.
  We as Republicans want to see these children insured. We don't want 
to see the program being abused as is being done now. So I think that 
is the point that is so hard to get back to, is the point that we want 
to do this. The President has increased the funding.
  But, you know what? It is one of those things that I think the 
gentleman from Arizona said this in his opening comments, the name of 
the bill sounds so good. There are a lot of smart people up here that 
make these pieces of legislation have great names, that you just feel 
like I can't vote against this because of what it is named.
  This bill's original intent was to help the children in families of 
four that makes less than $42,000. We are now trying to make it now 
where families that make up to $84,000 can taken their children off of 
private insurance and immediately put them on this government program.
  Let me say this: I think this is the first step to national health 
care. I don't know that that has been brought out enough. But if you go 
back and look at the national health care program that the Clinton 
administration brought up in 1993, if you look at what one of the 
Presidential candidates said, if we can't get the whole enchilada, 
let's try to do the kids first. This is going back to that.
  Mr. SHADEGG. Mr. Speaker, reclaiming my time for a moment, I think it 
is kind of sad to take a children's bill, a bill that says this is a 
health care bill for poor, uninsured children, and exploit it. I would 
be happy to have a debate about how more Americans can get help getting 
health insurance. As I said, I have had a refundable tax credit to do 
that. But to try to pass a bill based on its title, and like this 
reporter says, how can Republicans possibly vote against a bill called 
the State Children's Health Insurance Program? You can't possibly vote 
against that.
  Well, fortunately, democracy allows us to get into an open debate and 
say wait a minute. If it really were a bill focused on poor or even 
near-poor children who are uninsured, we might have a program we could 
support. But it turns out it is not for the poor or the near-poor, it 
is not for the uninsured, because more than half already have 
insurance, and then you discover it's not even for children; it is for 
adults.
  Mr. WESTMORELAND. Let me bring up one point that you mentioned. Open 
debate. Wouldn't that be a novelty here in this House? It would be nice 
to offer an amendment, to be able to open the debate. And the fact that 
the negotiations on this bill has gone on between Democratic House 
Members and Republican Senate Members. They have not even opened up a 
dialogue with the chairmen of Energy and Commerce or of Ways and Means 
to look at pay-fors for this bill.
  Mr. SHADEGG. They don't want to talk about it; they just want to peel 
a few Members off.
  I see that we have been joined by one of your colleagues from 
Georgia, a

[[Page H12215]]

medical doctor, Dr. Gingrey. I have been railing against this bill, as 
you heard me a few moments ago. I have been saying that I find it 
stunning that the pay-for in this bill contemplates an additional 22 
million people who are nonsmokers today needing to take up the smoking 
habit so they can pay the 61-cent per pack tax in order to have enough 
money to pay for the bill.

  So I did this graphic. I created all these cartons. There are 22 
cigarette cartons sitting in front of me, representing 22 million, a 
million for each carton, new Americans who don't smoke now who would 
have to take up the habit to pay for the bill.
  I think that is a little deceitful. I certainly can't believe that 
the proponents of this bill would walk down here and say they think it 
is a great idea to have 22 nonsmokers in America start the habit.
  But as a medical doctor, I would sure be interested in your opinion 
on that issue, or any other comments you have on some of the details on 
this bill that are important for the American people to know.
  Mr. GINGREY. Mr. Speaker, I certainly thank the gentleman from 
Arizona, a member of the Energy and Commerce Committee. We heard, Mr. 
Speaker, earlier from Mrs. Blackburn, also a member of the House Energy 
and Commerce Committee. These Members are on the Committee of 
Jurisdiction from whence the bill came.
  Unfortunately, their only input into this CHAMP legislation, as the 
Democrats originally phrased it in their acronym, their only 
opportunity, the Republican members of the Energy and Commerce 
Committee, is to be here on the floor during this Special Order hour to 
try to educate Members on both sides of the aisle. The gentleman from 
Arizona has been on the committee for a number of years, and he knows 
of what he speaks.
  Mr. Speaker, talking about this issue of the pay-for, now, the PAYGO 
idea was the Democrat's campaign pledge, that if they had a new program 
or they expanded an existing program, and this is an expansion of an 
existing program, that they would pay for it. They would pay for it by 
either cutting spending somewhere else or raising taxes.
  So this is one of those programs. This is a renewal of a program that 
has worked very well. It needs some additional funding. I don't think 
any of us would argue about that. Republicans, as well as Democrats, 
can support a reasonable renewal and expansion of the Children's Health 
Insurance Program.
  But this is such a massive expansion that the Democrats found 
themselves in a bind. Mr. Speaker, to this day, they find themselves in 
a bind, and the bind is they are trying to pay for this with a massive 
increase, a tax increase, sin tax, if you will, on tobacco, especially 
cigarettes at 61 cents a pack.
  As the gentleman from Arizona pointed out and as my colleague the 
gentleman from Georgia, Mr. Westmoreland, it would require 22 million 
additional people, grandparents, parents, and, yes, indeed, even the 
children, to start smoking, to pick up the smoking habit.
  Mr. Speaker, I delivered 5,200 babies over a 31-year career as an OB/
GYN physician, and I would hate to think that some of those kids who 
are in their late teens or early twenties now, would have to be puffing 
away so they could pay for a health insurance program for their little 
brothers and sisters. Now, that makes a whole lot of sense, doesn't it?
  Mr. SHADEGG. If the gentleman would yield back briefly, and I would 
like him to continue making that point, I have a hunch there are voters 
out there, people out there across America, people listening to this 
saying, no, it can't really be true. It couldn't really be true that 
the SCHIP covers people who are already insured. It couldn't really be 
true that the SCHIP program that is supposed to be for poor Americans 
covers kids in families that make $80,000 a year. It couldn't really be 
true that the Children's Health Care Program in many States covers more 
adults than children. Those things couldn't be true, but in fact they 
are.
  This chart illustrates the point you were just referring to, and I 
thought it might be a good graphic for your remarks. This is the number 
of new smokers needed to provide tobacco tax revenues for the SCHIP 
bill. As the bill has been written and been voted here on the floor two 
times now, and as the President vetoed it, this chart shows that this 
many new Americans, this many new nonsmokers, going up to 22.4 million 
nonsmokers, to fund the bill by this revenue stream at least, will have 
to start smoking.
  I just find so many aspects of this bill just stunning and 
unbelievable. But there is one; 22.4 million new smokers will need to 
take up the habit and pay the tax in order to have the revenues that 
the Democrats project will be needed for this new SCHIP bill.
  Mr. GINGREY. If the gentleman will yield back, in his chart, my 
colleagues, it is so telling, because as it points out, this is over a 
10-year period, up to 2017, but yet this program, all of a sudden they 
let it fall off the cliff.
  The other chart there in front of my colleague from Texas, if you pay 
attention to that, again, the cigarette tax continues over the next 5 
years, and all of a sudden they slash the funding for SCHIP so that the 
numbers work.
  Because even with the cigarette tax, enticing 22 million additional 
people to get addicted to tobacco over that period of time, it still 
falls short of funding the full program by $40 billion. So that is why 
they say at the end of 5 years, around 2012, all of a sudden there is 
no money. There is not sufficient money. Even though our young people 
are addicted to cigarettes, puffing away, trying to pay for the 
program, it doesn't pay for it. So they use this trick, Mr. Speaker, 
and I think that is really deplorable.
  I will close my remarks by saying this and then yield back to my 
colleague from Arizona who is controlling the time. I know there are 
other Members that want to speak.
  But the original bill that the Democrats brought to us, the 
Democratic majority in this house, called for not $60 billion worth of 
funding on SCHIP, but $90 billion. Thank goodness they were reined in a 
little bit.
  They called that the CHAMP Act. Well, I call it, based on what we 
have presented here tonight in this disingenuous funding mechanism, I 
call it the CHUMP Act. The only difference in ``CHAMP'' and ``CHUMP,'' 
I say to my Democratic majority is you; you, the majority, trying to 
hoodwink the American public on this bill.
  Do what is right. You have an opportunity. The President will work 
with you. The Republican minority will work with you. Just simply do 
what is right, and for once, tell the truth.
  Mr. Speaker, I yield back to the gentleman from Arizona.
  Mr. SHADEGG. I just want to emphasize some of the points that the 
gentleman made. I love the name the CHUMP Act. Again, I think it would 
be hard for Americans to believe that this program is as it is. For 
example, these cartons represent, each one of them, 22 cartons of 
cigarettes, 22 million new Americans that will need to start smoking to 
pay for the SCHIP bill. I guess you can call that a CHUMP Act, because 
I don't think 22 million Americans who don't smoke now are going to 
start.
  If the gentleman will stay, I want him to explain that chart one more 
time. It shows the kid climbing up and then it shows the kid 
parachuting down. You call it the CHUMP Act. We call it here the cliff.
  Maybe you can explain one more time for the voters back home what 
this cliff means in terms of the funding of the program, because I 
think it is important for people to understand that it appears the 
funding is there, but then in year 5, whoops, it disappears.
  Mr. GINGREY. What the gentleman is saying, and I thank the gentleman 
for yielding once again, because the Democrats are determined, Mr. 
Speaker, to increase this funding to a point that they get 4 million 
additional children covered under this SCHIP program.
  Under the current law, about 6.5 million children in this country, I 
think close to 300,000 in my great State of Georgia, are covered under 
the program. There may be 750,000 kids in that income range of 100 to 
200 percent of the Federal poverty level up to $42,000 a year for a 
family of four, as was pointed out early in the discussion, there may 
be 750,000 kids that have fallen through the cracks.
  That is why the President said let's renew the program and increase 
the

[[Page H12216]]

funding by 20 percent. A 20 percent increase is not chicken feed, Mr. 
Speaker. That is a lot of money.
  But what the gentleman from Arizona is referring to in regard to this 
cliff, if you all of a sudden try to cover an additional 4 million, 
where are those kids coming from? Well, they are coming from families 
who already have health insurance for their kids in the private market. 
Of course, if you get an opportunity, who wouldn't? You are making 
$60,000 a year and you are providing health insurance for your wife and 
yourself and your two kids, and all of a sudden you get an opportunity 
to get the kids on the government trough and you do that, and then you 
are used to that wonderful largesse of ``Uncle Sugar'' for 4 years, and 
all of a sudden you get to the point where there is no funding, who 
comes off first? They do. That is where they drop off the cliff. I 
thank the gentleman for pointing that out.

                              {time}  1815

  Mr. SHADEGG. I thank the gentleman for participating in this debate. 
I am thrilled we have a democracy here where, while our colleagues may 
come to the floor and put up pictures of children and say those mean 
Republicans don't want to cover children, at least we can bring out 
some of the facts. We can bring out the fact that there is a funding 
cliff and that you would have to have 22 million nonsmokers take up the 
habit to pay for the bill. Unfortunately, we have not been able to 
offer amendments to correct those deficiencies in the bill.
  But we do support health care for poor and near-poor children. I 
support it for uninsured children. I have introduced every year for the 
last 10 years a bill that would give a refundable tax credit to every 
poor American to go out and buy their own health insurance. The reason 
I like the idea of giving them the money to buy their own care is 
because they will buy a plan that meets their needs, not some 
bureaucrat's needs. They will buy a plan based on choice, not based on 
government rationing of their care. They will buy a plan that their 
family likes and a plan that they will have control of. And if they 
don't get the service they want, they can fire that plan and buy 
another. It would be portable, and they can take it with them.
  Instead, we are talking about expanding a government-run program 
with, quite frankly, a lot of smoke and mirrors that, sadly, people 
will vote for just because of the name of the bill. Or maybe just 
because of the name of the bill and because the advocates of the bill 
can put up a picture of a child and say, Don't you want insurance for 
that child?
  Well, I do want insurance for that child. I just don't want insurance 
for adults under a program that is supposed to be for children. I don't 
want insurance for already insured kids causing them to drop their 
insurance.
  We are joined by Mr. Hensarling from Texas, and I know he has details 
and thoughts about this program and about how important it is that 
Americans understand the details of this, so it is not just are you for 
children or against children. It is a deeper discussion than that. I 
yield to the gentleman.
  Mr. HENSARLING. I thank the gentleman for yielding. I especially 
thank him for his leadership in this area to try to make health care 
more affordable, more portable, high quality, and accessible for all of 
the children in America. The gentleman from Arizona (Mr. Shadegg) has 
been a great leader in this effort. I also appreciate his leadership in 
the conservative caucus in Congress, the Republican Study Committee, 
and all he has meant to that group in advancing the cause of freedom 
and free markets in America.
  People need to listen closely to this debate. The debate is not about 
whether or not we are going to have an SCHIP program, a State 
Children's Health Insurance Program. It is really a tale of two SCHIPs, 
if you will. People need to know, number one, when they hear America 
needs to provide health insurance for poor children, well, I am not 
sure that anybody disagrees with that in America. That is why we have 
something called the Medicaid program, for the poor in America. So that 
is a nonissue. That is totally a nonissue.
  What we are talking about is health care for the working poor, those 
up to 200 percent of the poverty level, and the SCHIP program was 
actually started 10 years ago by a Republican Congress to provide 
health insurance benefits to, number one, the uninsured; number two, 
low income; number three, American; and, number four, children. 
Uninsured, low-income American children. That's what the program was 
supposed to do. And I don't believe there is one Member of this body on 
either side of the aisle who wouldn't vote to reauthorize this program 
today for uninsured, low-income American children. Even though I am a 
fiscal conservative, I would vote to appropriate more money to ensure 
that eligible children can be a part of this program.
  But, unfortunately, our friends on the other side of the aisle have 
discovered some new poll or focus group results that say we have this 
great bumper sticker slogan, and maybe we can somehow put people in a 
box, maybe we can fool the American people as to what this is all 
about.
  Well, Mr. Speaker, occasionally it is helpful to have the facts. 
Again, this is a program that was designed for people up to 200 percent 
of the poverty level, presently $40,000. Yet loopholes and exemptions 
allow families up to $83,000. I am not sure anybody is going to call 
that the working poor in America. It is not the working poor in the 
Fifth Congressional District of Texas. But loopholes and exemptions 
allow people making up to $83,000 to get these benefits. What the 
Democrats are doing, they are doing nothing about the loopholes and 
exemptions; and they are expressly taking the program to 300 percent of 
the poverty level when there are still eligible children that haven't 
been enrolled.
  So a program designed for the working poor, the Democrats are trying 
to transform to people making $83,000. And that is not right. It is not 
right at all.
  Second of all, this was a program designed for children. It is called 
the State Children's Health Insurance Program. And yet we have 13 
States that are insuring adults while 800,000 eligible kids aren't 
enrolled. What does the Democrat plan do? Well, bring on more adults. 
We have three States covering more adults than children already. So we 
have precious resources of our Nation instead going to adults, and the 
Democrats say let's insure more adults. Republicans say let's put the 
children first. Let's put the children first.
  This was a program that was also designed for American children. 
American children. Now if anybody walks into any emergency room in any 
hospital in America and they have an emergency, I want them to be 
treated. We are all God's children. But to have illegal immigrants use 
emergency rooms and be able to access our health care system for their 
everyday health care when they are in this Nation illegally, while we 
still have 800,000 eligible children not enrolled, that is just a 
tragedy. That is a travesty. That is crazy.
  Yet under the Democrat plan, what they do is they claim this isn't 
for illegal immigrants. Then I ask them why did they take away the 
proof of citizenship requirements? I mean, your words say something, 
but your actions are even louder than your words. When you take the 
proof of citizenship requirement out of the bill, you are de facto 
allowing more illegal immigrants to access this program.
  Mr. SHADEGG. I think the gentleman has made some strong points, and I 
would like to draw them out.
  One of the ones that gets missed so often is we talk about this being 
a program for poor children. I noticed that the gentleman in his 
remarks made the point that it really isn't a program for poor 
children. We have a program for poor children, and that is called 
Medicaid. That is already in existence. That is one of the points that 
you made.
  Mr. HENSARLING. That's correct. The American people shouldn't be 
fooled. Those at the poverty level in our Nation are covered by 
Medicaid.
  Mr. SHADEGG. So Medicaid covers poor children, and this program was 
designed to cover the near-poor or the working poor.

  Mr. HENSARLING. It was designed for the working poor up to 200 
percent of the poverty level.
  Mr. SHADEGG. And now it has been expanded to?

[[Page H12217]]

  Mr. HENSARLING. Under the Democrat bill, they expressly take it from 
200 percent to 300 percent. Yet, you have to read the fine print 
because even today there are so many exemptions and so many loopholes 
that there are States that are insuring people up to $82,000 income for 
a family of four, and they do nothing to bring this back to the working 
poor.
  Mr. SHADEGG. The gentleman's remarks remind me of something I think 
we already know, and that is certainly with legislation the adage that 
the devil is in the details is pretty important. I think a lot of our 
Democrat colleagues, a lot of the majority, think we will put up a 
picture of a child, we will call it the State Children's Health 
Insurance Program, and no one can vote against it. And you know what, 
if it were the State Children's Health Insurance Program for children 
of the working poor who are uninsured, I would be all for it. But when 
you get into the details, it ain't quite so.
  Mr. HENSARLING. If the gentleman would yield, I have no doubt that 99 
percent of this body, Democrat and Republican, today, this moment, this 
moment would vote to reauthorize a SCHIP program which provides health 
insurance benefits to the uninsured, to the working poor, to Americans, 
and finally to children. That's what the debate is about today. That is 
the main debate we are having today.
  Mr. SHADEGG. I think that is an important note. We care about the 
structure of the bill. My main concern is patient choice. I believe 
creating government programs and forcing people into those programs is 
not the preferable way to care for people or to help them. I personally 
think we would be doing better to give people choice, give them in my 
case a refundable tax credit and let them buy a health care plan that 
suits their needs, not to be forced into a government-controlled, 
government-run bureaucratic, rationed-care program, but give them 
choice.
  I was talking with one of the doctors in our conference earlier 
today, and he pointed out that the reimbursement rates under SCHIP, 
because it is a government program, are dramatically lower than under 
many private programs. So kids who do drop their private health 
insurance and go on a government-run SCHIP program will actually get 
worst care.
  I know that the gentleman is an expert on budget and finance, and I 
think that chart demonstrates, and I don't know whether you want to 
call it hypocrisy or whether you want to call it trickery or whatever 
you want to call it, it is playing fast and loose with the budget facts 
on this bill. Maybe the gentleman would like to direct his remarks to 
that in light of the fact that the cigarette tax, and I have tried to 
make a big point out of this tonight, that the cigarette tax in the 
bill isn't enough to fund the bill. It is kind of a scam. It is kind of 
a scheme.
  The cigarette tax in the bill would only fund the bill if 22 million 
new nonsmokers took up the habit and started smoking. So for a graphic, 
we got 22 cartons of cigarettes, each carton representing another 
million Americans who would have to start smoking. I thought it would 
be helpful if the gentleman addressed those issues as well.
  Mr. HENSARLING. I thank the gentleman for his insight. And looking at 
all of the cigarette cartons in front of you, as somebody who used to 
serve on the board of directors in Dallas, Texas, of the American 
Cancer Society, I know how seriously devastating the habit of smoking 
can be to families. I have seen a lot of cancer in the families of 
friends, something I take very, very seriously.
  And to think that now we are going to have a health insurance program 
ostensibly counting on 22 million more Americans to take up smoking is 
frankly beyond insulting. It is beyond ludicrous. For the life of me I 
cannot fathom why any type of system would be created, and then as an 
irony, and I make this point as an aside, the tax would go mainly to 
those who are making less than 200 percent of poverty level, the same 
people that ostensibly this program is due to help. Fifty-four percent 
of all smokers are in families making less than $42,000 a year.
  Mr. SHADEGG. We have this chart which makes the point that the 
gentleman just brought up. The burden of tobacco taxes falls largely on 
poor Americans. As a matter of fact, 28 percent of the people who smoke 
are considered poor. They make less than 100 percent of the poverty 
level. And 26 percent of the people who smoke are near-poor. They are 
in that 100 to 200 percent. And for the not-poor, that is only 18 
percent of Americans. So this tobacco tax that is supposed to pay for 
the bill, but it is not enough money to pay for the bill unless 
millions of Americans, 22 million, take up smoking, post the burden of 
this legislation on the people who can least afford to pay it.
  Mr. HENSARLING. Essentially, under the Democrat plan, you will be 
taxing people making less than $42,000 a year in order to give 
subsidies to those making up to $83,000.
  Mr. SHADEGG. Wait, wait, wait. I want you to repeat that point 
because I think it is important.
  Mr. HENSARLING. Well, 54 percent of the smokers are in families 
making less than $42,000 a year. That is 200 percent of the poverty 
level in 2007. So under the Democrat plan, you would tax people making 
less than 200 percent of poverty in order to extend subsidies to 
families making up to $83,000 a year.
  Mr. SHADEGG. I think that reason alone, the fact that it is funded by 
a mechanism that imposes a tax on the poorest Americans to pay for a 
subsidy to people making over $60,000, and in some instances over 
$80,000 a year, is reason enough for the President to have vetoed the 
bill.

                              {time}  1830

  Mr. HENSARLING. I thank the gentleman for yielding, and I certainly 
hope that the President would veto the bill.
  And again, our Democrat colleagues know that last month, last week, 
last night, today, tomorrow, this body stands ready to reauthorize the 
SCHIP program, as long as it's really going to help the uninsured, as 
long as it's going to help the working poor, as long as it's going to 
help children, and as long as those children are American children.
  So, a debate is taking place about that, but I'd like to harken back 
to another point that the gentleman made. As important as this debate 
is, we need to keep the focus on ultimately how are we going to get 
affordable health care, accessible health care, health care of high 
quality to all families across America.
  And in many respects, this is not just an economic debate. In many 
respects, we're not debating how much money we're going to spend on 
children's health care in America, but we are debating who's going to 
do the spending.
  So, under the Democrat plan, the Congressional Budget Office says 
that for all intents and purposes over 2 million children will be taken 
off their chosen health insurance plan and shoved into the government 
health insurance plan. And you might have seen in the newspaper ``The 
Politico'' that this was really Senator Hillary Clinton's plan from the 
first, that if she couldn't pass her Canadian-style, socialized health 
care system in one big bite, that she would do it in little bites.
  So there's memos dating back, and I have the document right here, the 
document right here that's referred to in the article. And if I could 
quote from the October 2 issue of ``The Politico,'' ``Back in 1993, 
according to an internal White House staff memo, then-First Lady 
Hillary Rodham Clinton's staff saw Federal coverage of children as a 
precursor to universal coverage.
  ``In a section of the memo titled `Kids First,' Clinton's staff laid 
out backup plans in the event the universal coverage idea failed.''
  And now we're seeing it. That failed, and so this is really the first 
step in taking us down that road in that Canadian-style, socialized 
health care system where ultimately, ultimately mothers in America 
won't be waiting hours to see a doctor to help their sick children. 
They will be waiting days. They may be waiting weeks, and it won't be 
the doctor of their choice. It will be the doctor of some government 
bureaucrat's choice, and I don't plan to stand idly by and allow that 
to happen to my children, much less the children in the Fifth District 
of Texas, much less the children in America.
  Mr. SHADEGG. I think we're about to run out of time. I want to thank 
the gentleman very much for participating in this debate.
  I think there are millions of Americans who don't quite understand 
and who perhaps learned a little more tonight about why the President 
would

[[Page H12218]]

veto this bill and why many of us would vote to sustain that bill, 
about our concern that it is called a program for the near-poor or the 
working-poor uninsured children, and it turns out it's not for the 
near-poor or working-poor uninsured children.
  As we've demonstrated in this discussion tonight, it covers people 
who make up to $60,000 and in some cases $80,000 and more a year. It's 
not for the uninsured because the original study shows 61 percent of 
those who became eligible already had private insurance, and under the 
new bill, one out of every two who become eligible will have already 
had private insurance, and they'll drop that insurance. And when they 
do, the cost of the private insurance for everybody else, everyone else 
who has a child in that private insurance, will go up.
  It turns out so it's not for the poor or the near-poor or the working 
poor. It's not for the uninsured, because we discover it makes 
millions, 2 million by the latest estimate, children who are already 
privately insured eligible to go on this program. Then you think, well, 
the children's health care bill has to be for children and you 
discover, shock of all shock, the children's health care program isn't 
for children; it's for adults.
  I thank the gentleman. I think the 22 million new smokers is a 
stunning fact. I'm sorry we haven't been able to offer amendments on 
the floor. I'm glad this debate gives us a chance to explain to the 
American people what's going on, and that there's more to this bill 
than just the title, and it's important to pay attention to these 
details.

                          ____________________