[Congressional Record (Bound Edition), Volume 149 (2003), Part 5]
[Senate]
[Pages 5743-5744]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        COVER THE UNINSURED WEEK

  Mr. JOHNSON. Mr. President, in recognition of Cover the Uninsured 
Week, March 10th through the 16th, I want to address a very serious 
issue that our country is facing on the domestic front. It is a problem 
that can be found in every State and encompasses a staggering 41 
million Americans, a number that is only due to increase if we do not 
take immediate efforts to remedy the problem. I am referring to the 
number of people in this country who lack health insurance. Let me also 
take this opportunity to acknowledge the effort that is being put forth 
this week by numerous individuals, organizations, and businesses alike 
who have been instrumental in arranging Cover the Uninsured Week. This 
event will highlight the degree to which the issue affects our society 
and will serve as a venue bringing communities, professionals, 
educators, faith groups, legislators, businesses, and those directly 
affected to find solutions.
  There are 41 million Americans who lack health insurance, 75,000 of 
whom are South Dakotans. In 2001, 41.2 million people or 14.6 percent 
of the U.S. population were uninsured, which was

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an increase of 1.4 million from the previous year. This is most likely 
a result of the continued increase in the unemployment rate. These 
factors, coupled with State budgets that are strapped thin, are what 
many analysts predict is the making of a ``perfect storm'' in the wake 
of health care today. South Dakota is facing a $54 million shortfall 
this year alone.
  Every year, South Dakota continues to lose access to health insurance 
companies. Currently, there are only three health insurance carriers 
offering individual coverage in this State. This is compounded with the 
continued increase of yearly premiums, which have left many individuals 
and families having to choose either between coverage and financial 
insecurity or joining the ranks of the uninsured and watching the 
possible deterioration of their health. Nationally, 8 out of 10 or the 
uninsured are in working families that cannot afford health insurance 
and are not eligible for public programs. In South Dakota, 84 percent 
of the uninsured live in a family headed by a working adult. The Center 
for Studying Health System Change found that health care costs for 
privately insured Americans jumped 10 percent in 2001. In 2002, 
premiums for employer-sponsored health coverage increased 12.7 percent. 
As many as 40 percent of small businesses in South Dakota that have 
provided workers a health benefit say that they may have to eliminate 
it. In addition, children are seriously affected by this decrease in 
health insurance coverage. While South Dakota has done very well at 
enrolling eligible children in the State Children's Health Insurance 
Program SCHIP, according to a January 2003 report by the Children's 
Defense Fund the State ranks 16th in the Nation in percent of uninsured 
children. A recent report showed that 19,000 South Dakota children 
under age of 19 are uninsured. These statistics on both the South 
Dakota level, as well as national level, only reconfirm the seriousness 
of the problem.
  It goes without saying that the uninsured often face greater 
challenges and run a higher risk of developing chronic illness because 
seeking treatment or even preventative care is fiscally out of the 
question. A third of uninsured South Dakotans report needing to see a 
doctor but not going because of cost concerns. National studies have 
shown that the uninsured are four times more likely to experience an 
avoidable hospital or emergency room visit or stay. For those who 
experience these types of visits, medical costs can be too substantial 
to pay. Outstanding medical bills are a leading cause of bankruptcy and 
have been cited as a reason for half of all personal bankruptcy 
filings. It is troubling to know that a large number of Americans are 
placed in a position to gamble with their health and be faced with 
possible financial ruin if they seek care for minor or major ailments.
  With these staggering statistics, we need to take initiatives, as 
well as employ current resources, that will prevent this problem from 
becoming even worse. I support the establishment of full deductibility 
of health insurance premiums for the self-employed. I feel strongly 
that we need to make additional funding available to community health 
centers and other public health programs, which are the main source of 
care for the uninsured. As well, I look forward to further movement on 
such legislative initiatives as the Family Opportunity Act, which would 
give States the option of allowing families of disabled children to 
purchase Medicaid coverage for them, and would provide for treatment of 
inpatient psychiatric hospital services for individuals under age 21 by 
allowing for payment of part or all of the cost of home or community-
based services. While all of these initiatives are important steps 
forward, more needs to be done.
  It is also important as we move forward with these initiatives, that 
we make sure to take precautions on other levels, so as not to 
exacerbate this problem any further. It is for this reason that I am 
concerned with the administration's Medicaid reform proposal. With 
States facing the most serious fiscal shortfalls to date, it is 
imperative to see that such programs as Medicaid be adequately funded. 
In previous years we have seen how Federal assistance has helped to 
expand this program, and in many ways been able to pick up where 
Medicare has left off. The Medicaid program has proved instrumental in 
providing health care coverage for many who would otherwise fall into 
the growing ranks of the uninsured.
  Currently, there are 91,531 Medicaid-eligible recipients in South 
Dakota and the States' Medicaid expenditures are in excess of $450 
million. This includes both State and Federal dollars. It is projected 
that the South Dakota Medicaid Program will spend over $70 million on 
prescription drugs alone in fiscal year 2003. The President's proposal 
would for the most part cease future Federal assistance, which has been 
instrumental in funding this program, and leave States having to pay 
back any Federal assistance they receive in a decade from now. This is 
not a solution, but a reshuffling of responsibility and liability from 
Federal and State to just States. This proposed reform could leave 
thousands of additional South Dakotans uninsured.
  As you can see, the high volume of the uninsured is a serious 
situation in South Dakota, as well as the Nation at large. This problem 
needs to be remedied before any further erosion of our health care 
system commences. I look forward to the progress that will arise this 
week from the numerous presentations and discussions that will take 
place. However, it is my hope these discussions do not stop here. The 
ultimate goal of covering the uninsured can be reached as long as we 
work in a bipartisan fashion on both the Federal and State levels to 
make health care more affordable and accessible to all Americans.

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