[Congressional Record (Bound Edition), Volume 146 (2000), Part 5]
[House]
[Pages 6690-6691]
[From the U.S. Government Publishing Office, www.gpo.gov]



          ENSURING THAT CHILDREN RECEIVE NEEDED IMMUNIZATIONS

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Texas (Mr. Green) is recognized for 5 minutes.
  Mr. GREEN of Texas. Mr. Speaker, most Americans are surprised to 
learn that in some States one in four children are not receiving the 
immunizations they need to prevent disease and death. Yet despite gains 
in recent years, we are still not doing enough to make sure that 
children get the right immunizations when they need them.
  As this chart shows, in some States, like my home State of Texas, 
Michigan, and Nevada one in four children are not receiving one or more 
of the immunizations they need by the time they are 2 years old. In 
Houston, we share seven Members of Congress in Houston, and that is my 
district, over 44 percent of our children do not receive one or more of 
the immunizations. Over 44 percent of the children receive less than 
one or more of their immunizations.
  I am introducing two bills that will help correct this situation. The 
first is the sense of Congress that calls for increase in funding to 
crucial State immunization infrastructure programs. The second bill, 
the Comprehensive Insurance Coverage of Childhood Immunization Act, 
will require health plans to begin providing immunizations to children 
as a covered benefit.
  America's children need our help. In recent months, some have 
questioned why vaccines are needed at all. Some have linked them to 
adverse effects, such as autism. While there is no scientific link 
between immunizations and autism, and I will repeat, no scientific link 
between immunization and autism, I support efforts to completely and 
thoroughly research this issue to put the minds of parents at rest.
  We should not lose our focus, however, on the huge health gains that 
have resulted from immunizations. The Centers for Disease Control list 
vaccinations for children as the number one public health achievement 
of the last century. Before we had the smallpox vaccine, 48,000 
Americans per year had this disease; 1,528 died. Before we had a 
measles vaccine, close to one-half million children a year got this 
disease, and over 400 died. Before we had the mumps vaccine, close to 
150,000 died each year of this disease. Before we had diphtheria 
vaccination, over 175,000 children got sick each year.
  None of these diseases have been eliminated. Only smallpox has been 
eradicated. An epidemic of unvaccinated children is entirely possible, 
as we saw with measles in 1989.
  Children still die of the measles, mumps, rubella, and whooping 
cough. These are dangerous and harmful, painful and sometimes fatal 
diseases. Measles can lead to seizures and death. Mumps can lead to 
deafness. Polio causes paralysis that can lead to permanent disability 
and death. Diphtheria can result in coma and death. Whooping cough can 
result in death for infants.
  Providing access to lifesaving vaccines should be one of our Nation's 
top priorities. Tracking children who have not been vaccinated, in 
order to prevent future outbreaks, should be another priority.
  To meet these goals, the sense of Congress resolution I have 
introduced with my friend and colleague, the gentleman from 
Pennsylvania (Mr. Greenwood), calls for an increase in Federal

[[Page 6691]]

funds to the Public Health Service's Section 317 infrastructure 
program. A similar resolution was approved by the Senate Budget 
Committee in March. These funds are used by States and cities to 
support a complex array of programs and activities, including 
implementation of registries, community outreach, management of 
vaccines, quality assurance services, and surveillance and outbreak 
control.
  As this chart of funds illustrates, infrastructure funds have reduced 
rather dramatically in the last 5 years, from $271 million in 1995, to 
$139 million today. That is a 40 percent decrease in funds for 
infrastructure immunization. Yet the need for outreach and registry and 
infrastructure development is greater today than it was in 1995.
  If you have not heard from your State health director on this issue, 
you will. Cuts in infrastructure funding have meant different things in 
different States. In Florida, for example, the State reports that it 
has reduced surveys on pockets of need and has reduced monitoring due 
to lack of adequate staffing. The State has reduced community outreach 
staffs and reduced the number of reminder cards it sends. Florida has 
also reduced its school-based immunization clinics and has had to cut 
back on efforts at day care centers.
  In California, where infrastructure funds have been reduced from $27 
million in 1997 to $14.9 million in 1999, only 35 percent of children 
have been vaccinated against chicken pox, and the State has no system 
to monitor chicken pox cases.
  In California, a targeted immunization information campaign aimed at 
Latino, African and American Southeast Asian families has been 
eliminated.
  The need for increased infrastructure funding is particularly 
important in light of a recent journal of the American Medical 
Association showing that 50 percent of America's children are either 
over- or under-vaccinated.
  Mr. Speaker, the JAMA study shows that 21% of toddlers received at 
least one extra immunization while 31% missed at least one. In other 
words, over 50% of American children are receiving too few or too many 
vaccinations. We should do a better job of tracking these children.
  A Section 317 funding increase is supported by: the American Academy 
of Family Physicians, the American Academy of Pediatrics, and the 
American Public Health Association.
  The increase is also supported by the Association of Maternal and 
Child Health Programs, Every Child by Two, the Association of State and 
Territorial Health Officials and the Association of County and City 
Health Officials.
  My second legislative initiative, the Comprehensive Insurance 
Coverage of Childhood Immunization Act of 2000, requires all health 
plans governed by the Employee Retirement Income Security Act (ERISA) 
to provide coverage of immunizations for children 18 years old and 
younger.
  The vaccines required to be covered are those recommended by CDC's 
Recommended Childhood Immunization Schedule, issued periodically by the 
CDC's Advisory Committee on Immunization Practices.
  This schedule is approved by the American Academy of Pediatrics and 
others and serves as the standard for immunization in the United 
States. Plans may not charge any payment for the immunizations or 
vaccines. And vaccines must be made available to children as soon as 
they are approved by the Advisory Committee.
  Beginning for plan years in 2001, ERISA governed health plans must 
provide the benefit.
  For plans that are negotiated as part of a collective bargaining 
agreement, the effective date is delayed until plan years following the 
termination date of the current underlying collective bargaining 
agreement.
  The adoption of collectively bargained plan amendments made solely in 
order to comply with the new requirements will not affect the timing of 
the effective date under this special rule.
  Why is federal legislation needed? The federal government gives this 
benefit to its own workers: it requires plans that contract with the 
Office of Personnel Management to provide immunizations for children as 
a covered benefit.
  Many states have recognized the importance of covering vaccines. 
Twenty-four states, including Texas, have enacted laws to require 
state-regulated plans to provide vaccines.
  How big is the problem? A March, 2000 William M. Mercer survey done 
for the non-profit Partnership for Prevention showed that nearly one in 
five employer-sponsored plans do not cover immunizations for infants 
and children.
  Nearly one in four children in Preferred Provider Organizations (PPO) 
and Indemnity plans do not have coverage for immunizations.
  The Comprehensive Insurance Coverage of Childhood Immunization Act of 
2000 is endorsed by the American Medical Association, the American 
Academy of Pediatrics and others.
  It, and our Sense of the Congress resolution, will improve the health 
of millions of American children is a cost-effective manner.
  For each dollar we spend on vaccines we save twenty-four dollars in 
future health costs. That's a good investment.
  I urge my colleagues to support these two bills and I yield back the 
balance of my time.

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