[Congressional Record (Bound Edition), Volume 150 (2004), Part 15]
[Senate]
[Pages 20421-20423]
[From the U.S. Government Publishing Office, www.gpo.gov]




        CHILDREN'S HEALTH PROTECTION AND IMPROVEMENT ACT OF 2004

  Mr. ROCKEFELLER. Mr. President, yesterday marked a critical juncture 
in the fight to provide comprehensive and affordable health care 
coverage for our Nation's children. Congress had a tremendous 
opportunity to improve the quality of life for hundreds of thousands of 
children, not just for the foreseeable future, but also over the long 
term. September 30, 2004, should have gone down in history as the day 
Congress set aside partisan politics and took a stand for children. 
Unfortunately, yesterday will be remembered as the day Congress chose 
political rhetoric over action and failed to protect health care 
coverage for children in working families.
  Some of my colleagues will argue that September 30 only marked a 
statutory deadline and didn't really matter in terms of coverage for 
kids. I strongly disagree. Yesterday's deadline was about keeping our 
promise to America's working families that their children will have 
access to comprehensive, affordable, and reliable health care coverage. 
We in Congress have broken that promise, and it is unconscionable to 
think that Members would go home to campaign while the health care of 
some of most vulnerable children hangs in the balance.
  We must act now to preserve health care coverage for children 
enrolled in the Children's Health Insurance Program, CHIP. This is too 
important an issue to delay even a day. Senators Chafee, Kennedy, 
Snowe, and I, along with Congressmen Barton and Dingell, have a 
bipartisan, bicameral bill on the table right now that will protect 
coverage for America's children. The Children's Health Protection and 
Improvement Act has the support of 48 bipartisan cosponsors in the 
House of Representatives and 33 bipartisan cosponsors in the Senate. 
Our legislation has been endorsed by over 100 local, state, and 
national organizations including the National Governors Association, 
the American Academy of Pediatrics, the American Hospital Association, 
the National Association of Children's Hospitals, the Catholic Health 
Association, Families USA, the Children's Defense Fund, and the

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March of Dimes. There is no reason why we cannot pass this legislation 
today.
  If my colleagues were to talk to their Governors about the merits of 
the Children Health Protection and Improvement Act, all 50 Governors 
would say that our legislation addresses the long-term Federal funding 
shortfalls that will occur in SCHIP over the next 3 years.
  If my colleagues were to visit doctors' offices and hospital 
emergency rooms and talk to general practitioners, pediatricians, and 
surgeons, these providers would confirm that our legislation makes it 
easier for children to access health services and reduces our Nation's 
growing uncompensated health care burden.
  Most importantly, if my colleagues were to talk to working families 
in their home states who rely on CHIP, working families would say that 
our legislation guarantees real coverage for their children. Our 
legislation gives working families the peace of mind that comes from 
knowing their children would not just receive health care coverage 
tomorrow, next month, or next year, but for the next several years 
until the CHIP program is reauthorized in fiscal year 2007.
  It seems that some in this body are more concerned with sound bites 
than with actually providing health coverage for children. Of course, 
we can all attest to the success of the Children's Health Insurance 
Program over the years. We can all cite the 5.8 million children who 
were covered last year. But, I ask my colleagues, how are we going to 
do to protect the coverage of those 5.8 million children and ensure 
that even more children are covered?
  While I strongly support greater outreach and enrollment in the CHIP 
program, the bottom line is that outreach is not a solution to States' 
coverage problems. States aren't covering additional children under 
CHIP because they cannot afford to cover the children already enrolled 
in their programs. In fact, according to the Kaiser Commission on 
Medicaid and the Uninsured, states are implementing measures--such as 
enrollment caps, premiums and enrollment fees, eligibility cuts, 
restricted benefits, and increased co-payments to scale back outreach 
and enrollment instead of increase them. The State of Florida is a 
prime example of this. Enrollment in Florida's CHIP program is closed 
for some children who are undeniably eligible. Outreach to more 
children who meet the eligibility requirements for Florida KidCare is 
futile if those kids cannot access actual coverage.
  States are experiencing both State and Federal funding shortfalls 
that prevent them from covering kids. Senator Gordon Smith and I 
offered legislation earlier this year to address State budget 
shortfalls. The State Fiscal Relief Act would extend the federal fiscal 
relief enacted last year to help resolve state budget deficits and 
prevent cuts in critical programs and services, including health care. 
Yet, Congress has yet to consider this important legislation. And now, 
Congress has failed to preserve approximately $1.1 billion in expiring 
CHIP funds for coverage. Our failure to act is sending a very strong 
message to the states that not only is Congress not willing to assist 
with budget shortfalls during an economic downturn, Congress is also 
not willing to uphold the federal guarantee of CHIP coverage.
  CHIP is a Federal entitlement, and the Federal Government has a 
responsibility to make certain the program has the requisite funding to 
insure eligible children. Additional Federal funding for CHIP outreach 
should only be pursued after we have made sure states have the federal 
funding needed to cover the children currently on their rolls. 
Otherwise, outreach efforts will be ineffective because children will 
not have access to actual coverage.
  The Children's Health Protection and Improvement Act would prevent 
nearly $1.1 billion in expiring CHIP funds from reverting to the 
Treasury so that states with unmet needs can use the money to preserve 
coverage for children currently enrolled and higher-spending states can 
cover additional children. Our legislation would also establish 
redistribution rules that will keep CHIP money in the CHIP program 
through fiscal year 2007.
  Some of my colleagues have expressed concerns that our bill would not 
lead to new children being enrolled in CHIP. These concerns are simply 
unfounded. My home State of West Virginia, for example, is looking at 
the feasibility of a CHIP expansion that would cover an additional 4400 
children under 300 percent of poverty. The biggest barrier to West 
Virginia going forward with this expansion is the lack of Federal 
funds. My state and many others are still recovering from the so-called 
``CHIP dip,'' when Federal CHIP funding was $1 billion lower in fiscal 
years 2002-2004 than it was in fiscal year 2001. However, under the 
Children's Health Protection and Improvement Act, WV would qualify for 
redistributed funds which would give the state the ability to proceed 
with the expansion.
  Finally, I respond to the claims made by some that the Secretary of 
Health and Human Services should be allowed to redistribute 
approximately $660 million in unspent fiscal year 2002 funds to the six 
states projected to have shortfalls next year. There are several 
problems with this approach. First, such an approach would concentrate 
the vast majority of the expiring fiscal year 2002 funds in just six 
states, when a total of 30 states would qualify for redistributed 
funds.
  Second, unlike the Rockefeller-Chafee-Kennedy-Snowe bill, this 
approach would not address Federal funding shortfalls in these states 
in fiscal years 2006 and 2007. Moreover, such a proposal is likely to 
open up a larger Federal shortfall in fiscal years 2006 and 2007 for 
the other 12 states projected to have insufficient Federal funding 
before SCHIP is reauthorized in fiscal year 2007. This is because these 
12 states would receive less in redistributed fiscal year 2002 funds 
under such a proposal than they would otherwise receive under our 
legislation.
  Third, and most importantly, the Centers for Medicare and Medicaid 
Services, CMS, has not offered a specific formula for allocating funds 
to states that need them the most in fiscal year 2005, so there is no 
guarantee that CMS would actually do so. Furthermore, it is critical to 
note that Congress acted in both 2000 and 2003 to set a specific 
statutory formula for redistribution and has never allowed the 
administration, neither the previous one nor the current one, decide 
how to reallocate unspent funds. Leadership in both the House and the 
Senate supported these previous redistributions, which have directly 
contributed to the success of the CHIP program in recent years, so it 
is unclear why there seems to be a change in position now.
  In recent days, several new ideas have been proposed for how to deal 
with expiring CHIP funds. Perhaps if it were March or April, and we had 
ample time to analyze these far-reaching proposals, then we could 
adequately consider each one. But, the fact of the matter is that we 
have a strongly bipartisan bill, supported by the Governors of all 50 
States, that is ready to go right now. Our legislation has been 
properly vetted and appropriately scrutinized. The score of our bill is 
relatively small in relation to the number of children who would be 
covered. And, our legislation is the product of a long collaborative 
effort between states, advocacy groups, and Members of Congress 
instrumental in the creation of the CHIP program. I see no reason why 
we cannot pass this legislation now.
  I am encouraged by Chairman Grassley's statement that he wants to 
address the long-term Federal CHIP funding shortfalls. After all, the 
Finance Committee has a history of protecting health care coverage for 
children. It is where the CHIP program was created and where previous 
redistributions were conceived. I cannot imagine that members of the 
Finance Committee would want to jeopardize such a remarkable history by 
failing to protect CHIP coverage for hundreds of thousands of children 
over the next three years. I look forward to working with Chairman 
Grassley and other members of the Finance Committee to pass a unanimous 
consent agreement on CHIP before we go home next week.

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  I also call on the President to take a similar stand for children. 
For reasons that are inconceivable to me, some of my colleagues on the 
other side of the isle have indicated that our legislation is partisan 
or politically motivated. That could not be further from the truth. Our 
legislation has strong bipartisan support in the House and the Senate, 
and all of the cosponsors have worked hard to keep this bill from 
becoming part of election-year politics. There is no reason for 
Congress not to pass our legislation next week and for the President 
not to sign it into law. Our children cannot afford to wait.

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