[Congressional Record (Bound Edition), Volume 150 (2004), Part 7]
[Senate]
[Pages 9368-9370]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        COVER THE UNINSURED WEEK

  Mr. KOHL. Mr. President, today I rise to address the growing problem 
of the uninsured in America. This week is Cover the Uninsured Week. It 
is not only appropriate but necessary that we take this time to 
acknowledge the tragedy of American families living without health 
insurance, and often, as a result, without adequate health care. 
Solving this problem is going to take a lot more than talk; it is going 
to take decisive action by the Congress and, very importantly, by the 
administration.
  The number of Americans without health insurance continues to grow. 
In 2002, 15 percent of our population--over 43 million Americans--were 
uninsured. Since the year 2000, 3.8 million more Americans have become 
uninsured. While Wisconsin is doing better than the national average, 
we still had nearly 474,000 people uninsured in 2002--almost 10 percent 
of our population.
  More than half of the nonelderly uninsured are full-time workers or 
their spouses and children. It makes no sense to blame this staggering 
figure just on business. Good businesspeople want to provide health 
insurance to their employees. They know the value of a workforce that 
is receiving necessary preventive health care. They know the bottom-
line productivity losses that occur when workers have to struggle with 
the costs of a serious illness in their families, and they are, in 
great part, family members themselves, often relying on the same 
insurance coverages as their employees, never wanting to see someone 
they work with suffer because they cannot afford adequate health care.
  Businesses want to offer solid, affordable health insurance to their 
employees, but it is getting harder to find every year.
  As premiums increase at double-digit rates every year, employers are 
forced to drop coverage or pass on more costs to their workers in the 
form of higher cost sharing, deductibles, and copays. Too often 
employees' wage increases are more than consumed by the higher health 
care costs they face.
  This crisis affects everyone. A recent study by the Kaiser Commission 
estimates the United States could spend

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$41 billion for uncompensated care for the uninsured in 2004. Eighty-
five percent of that will be paid by Federal, State, and local 
governments using taxpayer funds. This issue has reached a crisis 
point. Yet it has been 8 years since Congress enacted meaningful health 
insurance reform. Further, this is not a partisan crisis. It is a 
national crisis. It will take a national solution, bipartisan and 
resolute, ambitious and courageous. That means we will need to reorder 
pet projects and other priorities in order to devote significant new 
resources to covering the uninsured. That means we need to give up 
political rivalries and partisanship in order to consider any good 
idea, regardless from which side of the aisle it comes. It means we 
need decisive leadership and commitment from the top; namely, from the 
President himself.
  So far we haven't seen much of that. The proposals the President has 
put forward would barely scratch the surface and some would create more 
problems than they solve. With over 43 million Americans uninsured, 
less than 3 million will be covered by his proposals, and they offer 
nothing to stem the rising health care cost problems we face. The 
American people deserve a more serious effort.
  When the President makes something a priority, we see action. When 
the President wanted tax cuts, he pushed two massive bills through 
Congress. When the President wanted authorization for war in Iraq, he 
successfully argued long and hard, not only here but all over the 
world, for the authority he needed. If the President wants to make the 
uninsured a priority, he has the influence, the control, and the 
position to make it happen.
  I know there is no silver bullet for dealing with the cost of health 
care. It will take a variety of solutions to expand coverage to the 
uninsured and help reign in the skyrocketing cost of health care. And 
it will take a combination of market and government-based solutions. We 
should look at proposals like tax credits to help small businesses 
afford health insurance, expansion of Government programs that work, 
like Medicaid and the State Children's Health Insurance Program, 
increased funding for community health centers, encouraging more 
purchasing pools, and the greater use of technology to improve quality 
and cut costs.
  Whatever the combinations are, it is time to have this debate. This 
administration needs to step up and provide leadership. We cannot 
ignore the crisis or wish it away. We cannot waste more time on sound-
bite solutions that do nothing to solve the problem. We need to fight 
the plague of the uninsured the way we have fought other threats to our 
way of life and our basic values. This fight we desperately need to 
win.
  I yield the floor.
  The PRESIDING OFFICER (Ms. Murkowski). The Senator from New Jersey.
  Mr. CORZINE. Madam President, I compliment the Senator from Wisconsin 
for his remarks. I will be giving a similar presentation, but I think 
there is not a more important domestic issue, one that is impacting the 
quality of life for middle-income and moderate-income Americans more 
than almost anything in their private financial affairs. Obviously, it 
is having a major impact on business and the quality of our economy. I 
don't think there is a more important issue for us to debate and to 
achieve those necessary elements that will change the terms and 
conditions so we can address the 44 million uninsured, but also provide 
the kind of underlying support for the quality of life for Americans we 
have come to expect. This is the priority domestic issue.
  I compliment the distinguished Senator for his remarks. I hope I can 
be as eloquent.
  I do want to make sure I speak out on this issue. I have been talking 
consistently about the state of our economy, particularly the squeeze 
middle-class Americans have. Health care costs are absolutely at the 
top of that list, but we see it in tuition costs at colleges and 
universities, property taxes, gasoline prices, and energy prices. There 
are a number of things that are impinging the ability of middle-income 
and moderate-income families to navigate the American economy. But none 
of those is more troubling than both the access and the affordability 
of health care.
  Today there are roughly 44 million Americans without health coverage. 
Those who do have health coverage are seeing increases in their costs. 
Particularly those who are part of group programs see that costs rise 
exponentially. We are seeing that carry through into the challenges in 
our budgetary policies in Washington with regard to Medicare and 
Medicaid. Costs are truly phenomenal.
  The average cost of a family health insurance policy today is roughly 
$10,000 a year. A study released this week by the Kerry campaign shows 
there has been a $2,700 increase in the average annual family premium 
per year over the last 3 years for those who have insurance, 4 times 
the rate at which family income has grown in the last 4 years.
  I have to say this is a particularly troubling issue for those folks 
in the State of New Jersey, because we have had the highest rate of 
premium increase of any State in the Nation. I am hearing a lot of 
complaints back home. This is unsustainable and needs to be addressed. 
For the Senate, representing the people of our States, to not have a 
serious debate about the uninsured, with all of the pressures on the 
middle class, is hard for me to understand.
  We used to take for granted that if you had a good job, guaranteed 
health benefits came along with the job. This is not the way it is 
today. In fact, you would usually be able to count on those health 
insurance benefits through retirement. That is no longer a certainty. 
Employers, on the other hand, have seen their costs rising 10 or 15 
percent. We have a chart that shows how, over the period of time from 
1996 to 2003, we have seen a surge in health care costs. For the third 
year in a row we have had double-digit increases in the cost of 
premiums for health care insurance. When employers have seen their 
costs rise, they have taken an obvious strategic step and shifted the 
cost to their employees, eliminated coverage for retirees, or 
eliminated coverage altogether for employees, or had all kinds of cost-
sharing arrangements. It is amazing how the burden has shifted 
increasingly to working families.
  Eighty-one percent of the uninsured, those 44 million, are actually 
people who are working. A lot of times you think it is folks who are 
unemployed or somehow are not connected to the economy. Eighty-one 
percent of the uninsured are in working families, people who have jobs.
  Competitive pressure among employers to drop coverage is growing 
because it is such an important cost element in their overall means of 
doing business. We have to take steps to address the health care 
coverage and affordability crisis. Fewer and fewer people can afford to 
maintain the coverage they have; fewer and fewer businesses can afford 
to. It is time we actually get on with it.
  To give you one example, the average annual premium for a standard 
plan for a healthy, nonsmoking 25-year-old in New Jersey is almost 
$5,000.
  That is the average--$5,000 for a single individual. Just to contrast 
that with some of the initiatives we see out of the administration, 
which I find remarkably unacceptable and limited to addressing this 
problem, President Bush has proposed giving a $1,000 to $3,000 tax 
credit to low to moderate income-tax paying individuals and families. A 
$1,000 tax credit for a single individual earning $15,000 a year would 
leave that single 25-year-old I just mentioned paying 30 percent of the 
gross income to purchase coverage.
  How does that work? What kind of help is that? A $5,000 premium, you 
get a $1,000 tax credit, and you make $10,000, $15,000, $20,000, and 30 
percent of the income pays for coverage. This is the kind of problem 
with which individuals are dealing. You can do that across the income 
and age spectrum, and it is an enormous issue.
  The President's tax credit proposal simply falls far short of 
offering the whole health care coverage for 44 million Americans. In 
fact, an independent

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study by Ken Thorpe of Emory University finds that the President's 
proposal would provide coverage to only 2.1 million of that 44 million 
uninsured. That is over 10 years, by the way. So we are making no dent 
whatsoever. It would not even cover the 3.8 million who lost coverage 
since President Bush came into office.
  Furthermore, the CBO determined the President's associated health 
plan proposal would actually increase health care premiums for a 
majority of employees working in small firms and would cause about 
10,000 individuals to lose their coverage. So the second element of the 
President's proposal, beyond the tax credit, is going to actually 
increase the uninsured and increase premiums. It is hard to see how 
that will be helpful in this overall health care crisis.
  We could begin to address these difficult issues by acting on health 
care in the way that a number of people put forward and, most 
particularly, Senator Kerry has put forward. His plan would reduce 
health care costs for those with health insurance and expand coverage 
to 27 million Americans who currently lack it. Senator Kerry's 
commonsense proposal builds on existing successful health care programs 
such as SCHIP, State Children's Health Insurance Program; mandates 
coverage for all children; and provides incentives to States to expand 
coverage to uninsured adults. The Kerry plan would not only expand 
access to health coverage, it would reduce premiums by about 10 percent 
for those with insurance. He does this by making the Federal Government 
a secondary insurer, whenever an individual's health care costs exceed 
$50,000 in a year. So it is a catastrophic backstop that the Federal 
Government takes up and covers 75 percent of those costs above that 
level. It would reduce costs by 10 percent for everybody who has 
insurance. It is a very simple but important concept to add to the 
expansion of coverage the Senator has talked about.
  We can provide coverage to more than half of those currently 
uninsured through these steps. I think we must take those programs and 
even expand them to make sure everybody has coverage. Expanding health 
coverage is not cheap, but the cost of refusing to expand access to 
health insurance is enormous as well, and it affects every one of us. 
We all pay more for health care because hospitals and other providers 
are forced to increase prices to compensate for those without coverage 
who use the services. They are mandated to do that at hospitals. We all 
pay higher State and local taxes to compensate providers who provide 
precare to those without coverage. We all know that. Emergency rooms, 
charity care--all of those places where we build up these costs. It is 
important that we understand the cost-benefit of actually having health 
insurance programs that work to take care of that and to eliminate some 
of those costs.
  According to the Kaiser Commission on Medicaid and the Uninsured, we 
spent $41 billion in this Nation last year for uncompensated care for 
the uninsured. We hear about it from our hospitals, local providers. 
They give out care, and the total is $41 billion, according to the 
Kaiser Commission. The annual cost, by the way, of that program I just 
talked about with the Kerry proposal is $35 billion. So you have a 
cost-benefit tradeoff. If you could take care of the uninsured, you 
could take a big bite out of that $41 billion of uncompensated care. We 
would have to spend the money. Some folks would say we don't have the 
budget room. We don't have the budget room to pay for the $41 billion 
that we have. I think we can make major inroads if we work on it.
  There are savings to be had if we are prepared to do it. I think 
making sure that we move on to preventive care, in conjunction with 
health care access, will make a huge difference in making sure that 
people deal with diabetes before it is chronic and critical, deal with 
hypertension before it is chronic and critical. All of these things 
will make a huge difference. People will deal with these in the normal 
course of preventive care as opposed to emergency or critical or 
chronic problems.
  Madam President, there is a lot to be dealt with on this topic of 
access to health care in this country. We need to have that debate. 
Senator Kerry has laid down an incredibly important proposal--one that 
is self-financed by the costs that it would defray from the 
unreimbursed costs going through the system. We need to address these 
44 million Americans and address the pressure that middle-class, 
moderate Americans are feeling every day as they see this 13-percent 
increase in health care.
  I hope we can have a real debate on this floor so that we can move 
forward to take care of those 44 million uninsured and not have 
proposals that are dead on arrival, that have no real impact, maybe 
addressing 2 million of the 44 million and not even dealing with the 
numbers that are increasing. As we sit here and talk about it today, 
3.8 million new Americans have gone on the uninsured rolls since this 
administration has been in office. We need to address that problem and 
the other 40 million that are without health insurance. There are 
proposals that make sense. It is time to address it. I hope we can have 
that debate.
  I yield the floor.
  Mrs. BOXER. Madam President, how much time do we have remaining?
  The PRESIDING OFFICER. There is 17 minutes remaining on your side.
  Mrs. BOXER. Madam President, I come to the floor, first of all, to 
thank my colleagues for pointing out what is happening in every State 
in America today. People are struggling to get health care. My mother 
used to say, ``If you have your health, you have everything.'' I 
thought, as a child, what does she mean? Now, as I get older, I realize 
she is right because when your family gets stricken with a disease, 
with a problem that makes them hurt and unproductive, your world really 
falls apart.
  So, clearly, health care is a very big issue as we go into this 
election season. It should be a big issue every day here. We don't see 
the majority bringing up any kind of legislation to make life easier 
for people, in terms of their health care. We cannot even get enough 
votes to extend unemployment compensation for people who have been 
unemployed. So it is something for the people of America to think 
about.

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