[Congressional Record (Bound Edition), Volume 152 (2006), Part 12]
[Senate]
[Pages 15921-15922]
[From the U.S. Government Publishing Office, www.gpo.gov]




               SCHIP AT 10: A DECADE OF COVERING CHILDREN

  Mr. CHAFEE. Mr. President, I am pleased to commend the Finance 
Committee and Senators Hatch and Rockefeller for holding a hearing on 
the State Children's Health Insurance Program, SCHIP. This program has 
meant a decade of health care coverage for millions of low-income 
children who would otherwise be uninsured.
  My interest and commitment to the success of the SCHIP program goes 
back to its inception. My father, the late Senator John H. Chafee, 
along with Senator Rockefeller, designed and introduced S. 674, the 
Children's Health Insurance Provides Security, CHIPS, Act on April 30, 
1997. With help from a bipartisan coalition of Members, including 
Senators Hatch and Kennedy, this effort came to fruition later that 
year when Congress approved the State Children's Health Insurance 
Program, SCHIP.
  When SCHIP was introduced there were 10 million uninsured children in 
the United States including 3 million who were eligible for Medicaid 
but were not enrolled. The SCHIP program sought to alleviate this unmet 
need by offering States additional Federal funds if they provided 
Medicaid coverage to children from families whose income was under 150 
percent of the Federal poverty level. This would mean coverage for a 
family of four earning $30,000 per year. The bill also provided grant 
funds for States to reach out and enroll eligible children.
  Although some States were slow to implement their programs, to date 
all 50 States, the District of Columbia, and the 5 territories have 
SCHIP programs in operation. The SCHIP program has been a tremendous 
success; the share of uninsured children has dropped from 23 percent to 
15 percent of the population since 1997. Today, more than 4 million 
low-income children who would otherwise be uninsured have access to 
doctors, immunizations, and preventative health care through SCHIP. 
Since 1997, enrollment has steadily increased to the point that 6.2 
million children are currently covered.
  Rhode Island's program has also been a success story. Since the 
program began on October 1, 1997, that State has enrolled 25,573 
uninsured children. The State has also expanded its income eligibility 
requirement to cover additional low-income families. One reason for 
this great success is the SCHIP program's flexibility in benefit 
structure and design. States are allowed to expand eligibility levels, 
cover parents of children on SCHIP, and in some cases childless adults. 
Rhode Island has utilized this flexibility to develop innovative 
strategies to address its uninsured.
  One example of this innovation was Rhode Island's recognition of the 
importance of covering families. Studies cited by the Kaiser Commission 
on Medicaid and the Uninsured show that parents are more likely to 
enroll their children in SCHIP if the entire family is covered. Parents 
who have the proper health care coverage are more likely to stay 
healthy and avoid missed days at work. The same is true of their 
children; preventative screenings and immunizations will allow them to 
remain healthy, avoid expensive hospitalizations, and stay in school.
  States may appeal to the Secretary of Health and Human Services for 
waivers to expand their program beyond current law requirements. Along 
with 15 other States, Rhode Island has a waiver that allows it to use 
SCHIP funds to cope with the growing number of uninsured. States such 
as Arizona, Idaho, Oregon, Minnesota, New Mexico, and Virginia have 
similar waivers.
  We have a growing crisis with the number of uninsured in this 
country. Estimates place the number of uninsured at 45 million, up from 
41 million a few years ago. We should reward States that use innovative 
approaches with their SCHIP programs to expand coverage. Until 
comprehensive solutions are found to help States fill the coverage 
gaps, we should not penalize them for taking advantage of existing 
resources and programs.
  To this end, I have been proud to support legislation that maintained 
funding for the SCHIP program and reallocated funding to coverage-
expanding States. In 2003 I was the lead Republican on legislation 
introduced by Senator Rockefeller to keep $2.7 billion in the program 
until the end of fiscal year 2004 and reallocate funds to other States 
through fiscal year 2005. This bill also included a provision I fought 
for that is important to States like Rhode Island. It allows States 
with expansive Medicaid Programs that covered uninsured children prior 
to SCHIP's enactment to use 20 percent of SCHIP funds to cover these 
children. This is significant since SCHIP provides a higher Federal 
match than Medicaid. States that did the right thing by covering pre-
SCHIP children were being penalized by not receiving the higher match.

[[Page 15922]]

  In closing, I thank Senators Rockefeller and Hatch for holding a 
hearing on SCHIP and honoring its tremendous accomplishments over the 
past 10 years. The SCHIP program has been an integral part of our 
health care safety net. As we turn to reauthorization and the 
challenges facing the program in fiscal year 2007, I look forward to 
working with the bipartisan coalition whose vision created the program. 
We must work together to keep SCHIP strong so that the progress and the 
innovations made with the program will not be lost.

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