[Congressional Record (Bound Edition), Volume 146 (2000), Part 10]
[Senate]
[Pages 14432-14433]
[From the U.S. Government Publishing Office, www.gpo.gov]



                            FAMILY CARE ACT

  Mr. ROCKEFELLER. Mr. President, I rise to comment on the bill Senator 
Kennedy and others have worked on which is formally called the 
Medicaid/CHIP Family Improvement Act, but I will simply refer to it as 
the Family Care Act.
  Most of the people in this country who are uninsured work. A lot of 
Americans assume that if somebody does not have health insurance, there 
is lack of merit or effort on their part. Most of the people who do not 
have health insurance are, in fact, working every single day. They are 
working, and many happen to be the working poor.
  The whole philosophy of the earned-income tax credit, which President 
Reagan started and a lot of people continued, is that if people are 
poor and are working, we say: Good, you have taken a job; as a result 
of taking a job, you have given up your Medicaid health care benefits, 
and in America we respect that you are taking a risk by going out into 
the marketplace. You are probably not getting health insurance because 
of the low wages you are being paid but, nevertheless, you value work 
and you are going ahead with it.
  This is the same spirit we are talking about in the Family Care Act. 
We value people who work. We value people who work for low wages, and 
we want to help them and their families.
  Essentially through the Family Care Act, not only do we have the CHIP 
program, with which we are all familiar, which was started in 1996, 
which has been moderately successful for 2 million out of the 11 
million children in this country, but we expand that. We say: Let your 
parents be included in this, too, because you are all part of the same 
family.
  The Senator from Alabama was just talking about the importance of 
protecting the family. This is an example of how to do that. The parent 
of the child receiving the Children's Health Insurance Program is 
probably without health insurance, so why not expand that to include 
that parent, which brings the family together on health insurance. It 
is sensible.
  We also provide some money because it is very hard in places such as 
West Virginia and, I suspect, Alabama, both of which are essentially 
rural States, and most States in this country have very rural aspects 
to them--it is very hard to reach out and find the children. We go 
through the School Lunch Program, but not everybody wants to admit they 
are on Medicaid or they are available for the CHIP program. It is hard 
to reach out, so we provide more money to the States to do that in ways 
the States believe are appropriate.
  We also provide States some money for other ways they might think of 
to do innovative planning to include parents and expand those who are 
uninsured.
  It is interesting to me because we are talking a lot about health 
care but not doing very much about it. I remember when President 
Clinton was elected. Although his health care bill did not succeed, 
there was a lot of energy around here. The energy did not start out to 
be partisan. It started out that he was elected to do universal health 
care, and there was a lot of talk.
  At that time, the only industrialized countries in the world that did 
not have universal health insurance were the United States and South 
Africa. South Africa now has universal health insurance, and the United 
States is still the only country which does not.
  Of course, we are in a massively successful economic situation with a 
lot of people working and a lot of opportunities to make these changes. 
What I worry about and why I care about the Family Care Act is that we 
have tended more away from the fundamentals of health care towards what 
I call political posturing. I do not want to get into who is doing it 
and to what extent, but I think most people will agree there is a lot 
of political posturing occurring.
  I am hopeful we will pass a prescription drug benefit. I am not sure 
we will. I am hopeful we will pass Medicare reform. I do not think we 
will. I spent a year with the Medicare Reform Commission. It was quite 
an exercise in futility. There were a lot of negative feelings going 
back and forth. It was not the kind of commission or work with which 
one really wanted to be associated in terms of expanding health care.
  This bill is not about posturing; it is about trying to eliminate the 
number of uninsured as much as we possibly can.
  I still very much have on my mind the concept of universal health 
care. I understand that is not the top subject of the moment. We are at 
an incremental stage. If I can do things incrementally, then I will do 
that. If I have to wait some years for universal health care, then I 
will have to do that. I will always be pushing for universal health 
care, but I will take steps as we can take them, and this Family Care 
Act is a splendid way to do that.
  One of the problems is that since President Clinton's health care 
bill did not pass--and I will not comment on that--there were 36 or 37 
million people uninsured in the country, and there was disagreement as 
to the number. That is a lot of people. Now there are about 43 million 
to 44 million uninsured. One can extrapolate from that that we have 
been talking but not doing much about it. There have been a couple of 
instances where there has been bipartisan legislation which has passed 
and has helped, but nothing really substantial, and it has been very 
sporadic.
  We are looking at a situation where, over the next 3 years, 
approximately 30 percent of the population, or about 81 million 
Americans, can expect to have no health insurance for at least 1 month 
out of a year. Who is to say when a problem might occur, when a leg 
might be broken, when a cancer may be discovered or when some other 
problem might arise? Basically, that to me is uninsurance.

[[Page 14433]]

  Business people like to have predictability, and individuals like to 
have a sense of predictability: I have it; I am safe. That is why it is 
called the Health Security Act. Security is very important in health 
care.
  Others would say let the market do that. The market has worked 
wonderfully in many ways in our country. It has had a lot to do with 
the success of our economy. It probably has had more to do with the 
success of our economy than the very Chairman of the Federal Reserve 
the Senator from Alabama was talking about a few moments ago. We are an 
entrepreneurial country, but we carry entrepreneurship to those places 
where we are quite certain it is going to work.
  There are those who take risks, but basically Americans, when it 
comes to something such as health care, are rather risk averse, and 
therefore the whole concept of predictability and security once again 
becomes particularly important.
  I am very unhappy when I think of 81 million Americans having at 
least 1 month out of the year without health insurance. I do not 
suspect the market is going to turn that around because it declined to. 
The Health Insurance Association of America, which is not a 
particularly aggressive group on health care, would agree with that 
statement. They do not want to get into that business of doing that 
kind of insurance.
  The Family Care Act is a sensible Government approach in which we 
simply take the CHIP program, which is beginning to work now at a 
rapidly increasing rate as States grow more comfortable with it, and 
say let's extend that to the parents. That is called incrementalism. It 
is sensible. It fits within a pattern. It is logical, and it also helps 
those who tend to be from the working poor. I think we should do all we 
can to help people who are poor and who work and who choose not to go 
on welfare.
  I think it is time to act. The family care amendment is not in any 
way political. It is not even large scale. But it does help. It is 
something that we will be voting on next week. With a strong degree of 
intensity, I encourage my colleagues to vote for it.
  I thank the Presiding Officer and yield the floor.
  The PRESIDING OFFICER (Mr. Sessions). The Senator from Kentucky.

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