[Congressional Record (Bound Edition), Volume 151 (2005), Part 21]
[Senate]
[Page 27952]
[From the U.S. Government Publishing Office, www.gpo.gov]




                                MEDICAID

  Mr. BINGAMAN. Mr. President, I rise to speak briefly in support of 
the motion that I understand is to be made by the Senator from Montana, 
Mr. Baucus, who is here on the floor, to instruct conferees with 
respect to the Medicaid Program.
  The motion to instruct conferees on the Medicaid Program highlights 
one of the many ways in which the House of Representatives budget 
reconciliation bill radically departs from the Senate bill. Let me 
spend a very few minutes highlighting the differences between the House 
and Senate packages on Medicaid, particularly with regard to the health 
of children.
  The contrast between the two bills could not be more stark. The 
Senate bill arguably improves coverage of children through the 
inclusion of the Family Opportunity Act that provides a State option to 
expand Medicaid coverage to children with disabilities and through 
inclusion of outreach and enrollment funding based on legislation that 
Senator Frist and I introduced earlier this year.
  In sharp contrast, however, according to the Congressional Budget 
Office, the House budget reconciliation package imposes increased cost 
sharing on low-income Medicaid beneficiaries and reduces health 
services by $6.5 billion over 5 years and by $30.1 billion over 10 
years.
  For children, the impact of the House bill would be devastating. 
Medicaid covers more than 27 million children, almost one in four in 
this country. Medicaid also covers more than a third of all the births 
and health care costs of newborns in the United States each year.
  In spite of the importance of Medicaid for children, the House budget 
package increases cost sharing for all children who rely on it for 
prescription drugs or for emergency room services. The bill also allows 
States to impose premiums for the first time under Medicaid for 
children's coverage and to deny children coverage even if their family 
cannot afford to pay the premium or other cost sharing.
  The House budget bill also allows States to eliminate the early and 
periodic screening diagnosis and treatment benefit rules that are so 
critical to the health of children with special health care needs and 
disabilities. Benefits that could be lost include comprehensive 
developmental assessments, assessment and treatment for elevated blood 
lead levels, eyeglasses, dental care, hearing aids, wheelchairs and 
crutches, respiratory treatment, comprehensive mental health services, 
prescription drugs and speech and therapy services. In short, three-
fourths of the savings in the House bill come at the expense of low-
income Medicaid beneficiaries. By CBO's estimate, half of the 
beneficiaries affected by the increased cost-sharing provisions in the 
House package are imposed on children, and half of those who will lose 
Medicaid benefits would be children.
  In CBO's own words:

       We estimate that the number of affected enrollees [due to 
     increased cost-sharing requirements] would increase from 7 
     million in 2010 to 11 million in 2015, and that about half of 
     those enrollees would be children.

  CBO adds that, due to added premiums, ``about 70,000 enrollees would 
lose coverage in fiscal year 2010 and 110,000 would lose coverage in 
fiscal year 2015 because of the imposition of premiums.''
  Furthermore, CBO estimates that the flexibility in the House bill to 
reduce benefits will also heavily impact children. CBO estimates that 
``benefit reductions would affect an estimated 2.5 million Medicaid 
enrollees in 2010 and about 5 million enrollees by 2015--about 8 
percent of the Medicaid population--and that about one-half of those 
receiving alternative [or reduced] benefit packages would be 
children.''
  Without the Medicaid Program, the number of children without health 
insurance, which was 8.3 million in 2004, would be substantially 
higher. In fact, the number of uninsured children has dropped by over 
300,000 over the past 4 years due in large part to Medicaid and the 
SCHIP Program. We should not at this time be taking steps backward by 
reducing coverage for low-income and vulnerable populations that 
primarily include the children I have been referring to.
  I urge that colleagues support the Baucus motion to instruct 
conferees on Medicaid. We are coming into the holiday season. This is 
not a time when we, the wealthiest Nation in the world, should be 
cutting health care assistance to the low-income children of this 
country. I did not support the Senate budget reconciliation bill for a 
variety of reasons, but even with the imperfections that were in that 
bill, it was far superior to the House budget package. For one thing, 
it does not contain the type of cuts for children's health that are 
included in the House bill.
  I urge my colleagues to recognize how much better the Senate bill is 
for the health and well-being of our Nation's children. I urge my 
colleagues to vote to instruct conferees to support the Senate's 
approach over that of the House of Representatives.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Montana.

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