[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.
____________________