[Congressional Record (Bound Edition), Volume 153 (2007), Part 16]
[Senate]
[Pages 21615-21622]
[From the U.S. Government Publishing Office, www.gpo.gov]




            SMALL BUSINESS TAX RELIEF ACT OF 2007--Continued

  Ms. KLOBUCHAR. Mr. President, I am here today to talk about health 
care. Today, 45 million Americans are living without access to 
affordable health care. In a nation of such tremendous wealth and 
opportunity, with such a strong belief in science and research and 
medical advancement--we certainly have that in our State, the State of 
Minnesota--one wonders how so many of our fellow citizens can be 
burdened with the daily worry of what to do should a health disaster 
strike themselves or a loved one.
  Health insurance premiums have skyrocketed into orbits unreachable by 
an increasing number of middle-class families. We have seen this in our 
State, where we actually have a fairly high level of people covered. 
But health care premiums for the middle class are so many times out of 
reach. We have seen nearly a 100-percent increase in the last few years 
in our State.
  The foundations of employer-based health insurance are buckling under 
enormous cost pressures. The result is that ever more Americans are 
squeezed by health care costs and face awful decisions about delaying 
or forgoing needed medical treatment and care.
  I, in fact, woke up this morning trying to decide when my daughter 
would get her braces because of the health insurance policy we got that 
makes you wait 2 years to get that kind of care. Well, we are lucky to 
be able to even have that insurance because so many kids in this 
country do not have it.
  In fact, nearly 9 million of the uninsured in America are children. 
Kids without access to health care are at an

[[Page 21616]]

enormous disadvantage as they grow up and start to make their life in 
this world. Children without health coverage are less likely to get 
basic preventive care, less likely to see a doctor regularly, and less 
likely to perform well in school. Children without health coverage are 
also more likely to show up at the hospital sicker and more likely to 
develop costly chronic diseases.
  Currently covering 6 million children, the Children's Health 
Insurance Program succeeded in improving their lives by giving them 
access to the health care services they need. It is a successful 
program that deserves to reach even more children. This is important 
because, first of all, it is the decent thing to do for America's 
children who, through no fault of their own, are growing up in families 
that cannot otherwise get affordable health insurance. But this is also 
important because it is something that is good for all of us.
  That is because insuring our children is a smart investment. It is a 
smart investment to make sure America's children get preventive medical 
care. It is a smart investment to help America's children grow up as 
healthy as they can be. It is a smart investment to have America's 
children in school focused on learning rather than distracted by a 
sickness or an injury that has gone untreated. It is a smart investment 
to have America's children get medical care through a sensible system 
of health insurance rather than having them end up in a hospital 
emergency room as their health care provider of last resort, increasing 
the bill for the rest of us.
  I have seen the direct impact at the local level. For 8 years, I was 
the county attorney. As county attorney, my office represented the 
largest safety net hospital in Minnesota. That is the Hennepin County 
Medical Center in Minneapolis. It is one of the Nation's premier public 
teaching and research hospitals. It has a nationally recognized level 1 
trauma center with the largest emergency room in our State.
  The hospital serves patients regardless of their ability to pay. As a 
result, in 2006, the Hennepin County Medical Center's level of 
uncompensated care added up to $38 million--almost double what it was 
in the year 2000. That is because the emergency room was these people's 
doctor. People say: Well, they do not have insurance. They cannot get a 
doctor. Well, they have a doctor. It is the emergency room. The 
taxpayers are paying for it, and it is the most expensive place to get 
health care. It is the clinic of last resort for the uninsured, whether 
it is for minor illnesses or for more serious conditions that went 
untreated or could have been prevented.
  Both in the short run and over the long term, expanding health 
insurance coverage offers a better deal for our Nation's health and for 
our continued prosperity. The people of my State have recognized this 
for a long time. Back in 1992, the leaders in my State voted to 
establish MinnesotaCare to provide children and their families with a 
new opportunity to secure health coverage.
  The initiative was created with bipartisan support in our State 
legislature, and it was signed into law by Republican Governor Arne 
Carlson.
  Within a decade--and thanks to the Children's Health Insurance 
Program--MinnesotaCare had grown to cover more than 150,000 Minnesotans 
and helped to make my State No. 1 in the Nation for the percentage of 
residents with health coverage.
  But we are now losing the high ground we worked so hard to gain, as a 
growing number of Minnesotans, especially children, go without health 
coverage. Uncompensated health care costs for Minnesota's urban and 
rural hospitals have jumped substantially in recent years. Much of this 
increase in uncompensated care is due to a decline in health care 
coverage in our State.
  For example, between 2001 and 2004, the proportion of Minnesotans who 
had health coverage through their employers declined from more than 68 
percent to less than 63 percent. During the same period, the proportion 
of Minnesota children covered through their parents' employer also 
declined from roughly 77 percent to 69 percent.
  Not surprisingly, the number of Minnesota children lacking health 
coverage increased significantly. Today, an estimated 82,000 Minnesota 
children are without health coverage.
  At the time when thousands of Minnesotans are losing coverage from 
their employers, or they are being priced out of the insurance market 
by ever-higher premiums, MinnesotaCare's funding has also been scaled 
back.
  In Congress, we have the opportunity to do something about this--
starting with the reauthorization of the Children's Health Insurance 
Program.
  Recently, the Senate Finance Committee approved bipartisan 
legislation to reauthorize the Children's Health Insurance Program. 
Although I believe it could be even stronger, this compromise 
legislation authorizes $35 billion over 5 years to expand the 
Children's Health Insurance Program and extend quality health insurance 
to an additional 3.2 million children who currently lack coverage.
  This legislation provides much needed funding for States to maintain 
and expand their programs and ensure that States that have suffered 
Federal funding shortfalls, including Minnesota, will now experience a 
stable level of Federal dollars.
  As a State-Federal partnership, Children's Health Insurance Program 
has granted States the ability to tailor their programs to meet the 
needs of their residents. Some States increased eligibility levels for 
children. Other States allowed pregnant women to be covered under the 
program.
  With MinnesotaCare, my State was an early leader in covering children 
from working families who had incomes above the Federal poverty level 
but still could not afford health insurance. In 2001, Minnesota was 
granted a waiver to extend the coverage to parents with incomes up to 
twice the Federal poverty line.
  I would like to make one point clear. In no way is Minnesota covering 
parents at the expense of children. When the Children's Health 
Insurance Program was established in 1997, Minnesota already had one of 
the highest levels of covering children. So why did Minnesota include 
low-income working parents? The reason is simple. Ample research shows 
that when parents have coverage, children also get coverage, and they 
are more likely to actually receive medical care.
  I have to point out the Bush administration agrees--or at least at 
one time it did. Here is a quote from Health and Human Services 
Secretary Tommy Thompson in June of 2001, when his Department approved 
Minnesota's waiver. He said:

       I am thrilled today to extend the promise of health care 
     insurance to parents. We know there is a greater likelihood 
     that kids will stay insured if their parents also have 
     coverage.

  Agreeing with Secretary Thompson was Mark McClellan, the 
Administrator for the Centers for Medicare and Medicaid Services. 
Testifying in 2006 before the Finance Committee about the virtues of 
parent coverage, he said:

       Extending coverage to parents and caregivers may also 
     increase the likelihood that their children remain enrolled 
     in SCHIP.

  So as recently as last year, top officials in the Bush administration 
were on record affirming the strong evidence of the role of parental 
coverage in the health care and well-being of children. Now the 
President and his allies have backtracked and would prefer to take 
coverage away from American families, including 34,000 parents in 
Minnesota alone.
  I will tell my colleagues what seems odd to me. Both the President 
and the Vice President were recently in hospitals, and they were 
covered. That is good. But why would they want to deny millions of kids 
in this country the same right? Why would they want to deny 34,000 
parents in Minnesota the same right?
  As Congressional Budget Office Director Peter Orszag stated during a 
Finance Committee markup of this bill:

       When you remove parents from health coverage, you end up 
     removing kids too.

  It doesn't make sense. Our goal must be to secure health care access 
for more--not fewer--Americans.

[[Page 21617]]

  The White House is living in the past instead of looking to the 
future. Leaders at the State level, including many Republican 
Governors, have already moved well beyond the President's constricted 
position and are committed to trying to expand health coverage to their 
residents.
  Minnesota's Republican Governor, Gov. Tim Pawlenty, currently the 
chair of the National Governors Association, recently signed a letter 
to congressional leadership asking them to reauthorize the Children's 
Health Insurance Program. I have this letter in front of me and I wish 
to quote from it:

       The Nation's governors call on Congress and the 
     administration to reauthorize the State Children's Health 
     Insurance Program prior to September 30, 2007.

  They talk about how the authorization is critical for the safety net.
  Then they go on to say:

       While we have not taken a position on the actual overall 
     funding amount or the sources of revenue used as offsets, we 
     are encouraged by the Senate Finance Committee's efforts to 
     move a bipartisan reauthorization bill that provides 
     increased funding and reflects the general philosophy that 
     State flexibility and options and incentives for States are 
     preferable to mandates.

  Not only did Gov. Tim Pawlenty sign this, I know the Governor of the 
Presiding Officer's home State of Ohio signed it. I also see that 
Governor Schwarzenegger of California signed this. There are dozens and 
dozens of signatures of the Nation's Governors.
  I ask unanimous consent to have printed in the Record this letter 
from the National Governors Association, Gov. Tim Pawlenty, Chair.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                    Washington, DC, July 24, 2007.
     Hon. Harry Reid,
     Majority Leader, U.S. Senate, Washington, DC.
     Hon. Mitch McConnell,
     Minority Leader, U.S. Senate, Washington, DC.
     Hon. Nancy Pelosi,
     Speaker, U.S. House of Representatives, Washington, DC.
     Hon. John Boehner,
     Minority Leader, U.S. House of Representatives, Washington, 
         DC.
       Dear Senator Reid, Senator McConnell, Speaker Pelosi and 
     Representative Boehner: The nation's governors call on 
     Congress and the Administration to reauthorize the State 
     Children's Health Insurance Program (SCHIP) prior to 
     September 30, 2007. The authorization for this critical 
     safety net program will soon expire and urgent action is 
     needed to ensure its continued success for the next five 
     years. For many reasons, defaulting to a series of temporary 
     extensions of the program would be untenable for states and 
     the millions of children who rely upon the program.
       While we have not taken a position on the actual overall 
     funding amount or the sources of revenue used as offsets, we 
     are encouraged by the Senate Finance Committee's efforts to 
     move a bipartisan reauthorization bill that provides 
     increased funding and reflects the general philosophy that 
     state flexibility and options and incentives for states are 
     preferable to mandates. Our recently enacted policy on SCHIP 
     and a series of letters we have sent since February outline 
     our positions on these issues in more detail.
       We look forward to working with all of you to ensure that a 
     sensible bipartisan SCHIP reauthorization can be signed into 
     law in a timely and certain manner.
           Sincerely,
         Governor Tim Pawlenty; Governor James H. Douglas, Chair, 
           Health and Human Services Committee; Governor Edward G. 
           Rendell; Governor Jon S. Corzine, Vice Chair, Health 
           and Human Services Committee; Governor Janet 
           Napolitano, Arizona; Governor Ruth Ann Minner, 
           Delaware; Governor M. Jodi Rell, Connecticut; Governor 
           Mike Beebe, Arkansas; Governor M. Michael Rounds, South 
           Dakota; Governor John Baldacci, Maine; Governor Martin 
           O'Malley, Maryland; Governor Rod Blagojevich, Illinois; 
           Governor Christine O. Gregoire, Washington; Governor 
           Deval Patrick, Massachusetts; Governor Jennifer M. 
           Granholm, Michigan; Governor Brian Schweitzer, Montana; 
           Governor Kathleen Babineaux Blanco, Louisiana; Governor 
           Bill Ritter, Colorado; Governor Brad Henry, Oklahoma; 
           Governor Benigno Fitial, Northern Mariana Islands; 
           Governor Felix Perez Camacho, Guam; Governor Eliot 
           Spitzer, New York; Governor Jim Doyle, Wisconsin; 
           Governor Chester J. Culver, Iowa; Governor Jon M. 
           Huntsman, Jr., Utah; Governor Kathleen Sebelius, 
           Kansas; Governor Timothy M. Kaine, Virginia; Governor 
           Ted Strickland, Ohio; Governor Don Carcieri, Rhode 
           Island; Governor John Lynch, New Hamsphire; Governor 
           Ernie Fletcher, Kentucky; Governor Sony Perdue, 
           Georgia; Governor Bill Richardson, New Mexico; Governor 
           Arnold Schwarzenegger, California; Governor Dave 
           Heineman, Nebraska; Governor Michael F. Easley, North 
           Carolina; Governor Jim Gibbons, Nevada; Governor Linda 
           Lingle, Hawaii; Governor Theodore Kulongoski, Oregon; 
           Governor Phil Bredesen, Tennessee; Governor Sarah 
           Palin, Alaska; Governor Dave Freudenthal, Wyoming; 
           Governor John Hoeven, North Dakota.

  Ms. KLOBUCHAR. Mr. President, here is one more indicator of broad-
based support for this insurance. A few days ago, a group of law 
enforcement leaders in my State came together to express their support 
for expanding the Children's Health Insurance Program. They included 
Minneapolis Police Chief Tim Dolan, my former colleague Dakota County 
Attorney Jim Backstrom, and Hennepin County Sheriff Rich Stanek, who 
also happens to be a former Republican State legislator. They believe 
that investing in health insurance for kids and their families is one 
of the best things we can do to fight crime and ensure safe, prosperous 
communities.
  The time to act is now. In a few months, the Children's Health 
Insurance Program will expire. If that happens, our children will 
suffer. The President should reconsider his threat to veto. My Senate 
colleagues who say they are against this bipartisan compromise 
legislation should reconsider their opposition.
  I thank the Finance Committee for its efforts to bring this bill to 
the floor and to expand this important and successful initiative. It is 
not only good for American kids, it is good for our families and for 
our local communities, and it is good for all of us, because it 
improves our Nation's health and prosperity.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The junior Senator from Tennessee is 
recognized.
  Mr. CORKER. Mr. President, I rise this evening at this late hour to 
again talk about the SCHIP bill before us, but even talk a little 
further about health care for all Americans. I don't think there is 
anybody in this body who believes that at some point we are not going 
to extend children's health care coverage. I think everybody in this 
body realizes what we are doing right now is talking about how, in 
fact, that is going to be done. Even if the President were to veto this 
bill, I think all of us realize that again, in some form or fashion, we 
are going to come back together and we are going to make sure the 
children of America benefit from the SCHIP program that has been in 
place now since 1997. I think as we look at the issues we are dealing 
with on this SCHIP bill, as we look at the many issues we are dealing 
with involving Medicaid and Medicare, I know of no other moment for us 
to more fully be able to debate the future of health care in our 
country in general.
  I think all of us know, as the Senator from Minnesota said and many 
Senators before her have said, there are 45 million Americans today who 
at some point in time during the year did not have health insurance. In 
my own State of Tennessee, we have 800,000 people in the State who do 
not have health insurance. The toll is enormous. I think all of us can 
tell a story about a friend or a neighbor or somebody we have seen in 
our cities as we go back into the States who does not have health care 
coverage and the insecurities they feel. We are having one of the most 
dynamic growths in markets in U.S. history, and yet so many people in 
America feel insecure. I am convinced one of the main reasons is 
because so many people feel insecure about their health care coverage.
  I know that throughout the campaign, in the 95 counties of our State 
that I visited, I met so many Tennesseans who were concerned about the 
financial health of their family because they did not have health 
insurance, and about whether their husbands who might have had seizures 
would be able to get the proper care they might need. So I believe it 
is a moral obligation for us here in the Senate and for those in the 
Congress to deal with this issue in a much broader way even than as we 
are talking about during this SCHIP debate. I also believe as this 
Presidential race unfolds, almost every

[[Page 21618]]

Presidential candidate will have to face Americans and talk about how 
they plan to deal with the fact that Americans today do not have the 
health insurance coverage they need.
  That is why today I rise to join the Senator from North Carolina, 
Senator Burr, with Senate bill 1886, which is the Every American 
Insured Health Act. Americans want to control their own destiny. They 
don't like the fact that an employer might decide what kind of coverage 
they have, or if they have coverage at all. They don't like the fact 
that some bureaucrat in Washington may decide that they have coverage 
or not. Americans like to know they have their destiny in their own 
hands. There is something about American psyches that is grounded in 
that particular issue.
  So what we propose through the Every American Insured Health Act is 
that every individual in America--every individual in America--who is 
not now covered by some existing governmental program would receive a 
$2,160 tax credit, and every family would receive $5,400. This is very 
different than many proposals in the past where we talked about a tax 
deduction. One of the things I think we all know we can talk about 
which are niceties--things that are decent--are health savings 
accounts. We can talk about other things that sort of nibble at the 
edges, if you will, as they relate to health care, but the only thing 
that allows people to own their own health insurance is the money to 
pay for it. So we, through what is called a refundable tax credit in 
this bill, caused that to be the case.
  Unlike the other bills that are being discussed today, and unlike so 
many other health care acts we discussed, this actually is revenue 
neutral. This is one of those things that allows every American to be 
covered with health insurance, yet does not pile on a deficit, if you 
will, for the children of our future to have to deal with. It is 
absolutely revenue neutral.
  Let me tell my colleagues how it works. A lot of people, such as we 
here in the Senate, receive our health insurance through our employer--
the Federal Government. A lot of people receive health insurance 
through the employer they work for back in our home States. Let me give 
a little example. For an individual in Tennessee who might make $40,000 
and receive a $5,000 health benefit, whereas now that is not taxable, 
in the future, if this bill were to be enacted, they would have to 
actually pay tax on that and their tax bill would be about $1,250. 
Under the provisions of this act, what we would propose is that every 
individual would receive $2,160, so they could pay their tax bill, and 
then have money left over to deal with whatever other health issues 
they might have.
  The most important aspect of this, though, is it means that so many 
Americans today--Tennesseans, Ohioans, Minnesotans--who don't have 
health insurance, through this proposal would actually have the money, 
the money timed in a fashion to actually allow them to purchase health 
insurance. This would mean that virtually everybody in America, through 
this plan, would have the opportunity to own their own health insurance 
plan and they themselves would decide who the carrier would be. This 
would do something that was discussed by Dr. Coburn from Oklahoma. It 
would do away with what we call cost shifting.
  Obviously, the 45 million citizens, as the Senator from Minnesota 
mentioned, get health care; they just happen to get it at the emergency 
room. Who pays for that? Well, all of those people who go out and buy 
private health plans or employers who buy those, actually pay for that, 
because all of those costs are shifted to the other plans. What the 
Every American Insured Health Act would do is do away totally with cost 
shifting, because everybody in America would own their own plan and 
those plans would be paying for their health coverage.
  This obviously includes a few other attributes. It includes reforms 
for States so that States can set up pools, so that individuals today 
who don't have access to other pools of insurance at lesser expensive 
rates, it allows the States to set up pools so that individuals can buy 
their insurance through those pools. It also incentivizes States to set 
up high-risk pools. There are obviously many people, by the grace of 
God, by the genes they are created from, who have health issues that 
some of us don't have to deal with, so their health care costs are 
higher, if you will, than other Americans. This would provide 
incentives for States to set up high-risk pools so that those people 
could benefit from the opportunity of being grouped with others.
  One other attribute and incentive of this is it causes States to 
actually set up a plan--a plan in their State--that has of the cost 6 
percent of the median income of the population of that State, so that 
you create a basic plan that certainly almost everyone--everyone in 
their State certainly, by virtue of the plan we are laying out, would 
obviously be able to afford. This obviously, as I mentioned, would 
reduce the cost to people around our country who are trying to do the 
right thing by their employees. It obviously gives people the 
opportunity--every American--to determine their own destiny as it 
relates to health care.
  I know this bill is not perfect; no bill is. I want to say in closing 
that the reason I have joined Senator Burr and others to offer this 
bill is I do believe this country continues and continues and continues 
to have a debate about the fringes, if you will. We talk about 
children. We talk about other populations. We offer in many ways what I 
think is empty rhetoric around the issue of health care. This is a 
solution. It may not be a perfect solution. But I ask my colleagues to 
please join the debate about health care in a way that ensures that 
every American has access to health care.
  We are very fortunate in this body. We have health care. All of us 
know of people who truly are concerned about the next day and the next 
day and the next day, about how they are going to survive because a 
loved one in their family has health care issues that are not covered. 
So I ask my colleagues, please, don't turn away from this plan. Join 
the debate and let's make sure that this body puts forth an act, a 
bill, a solution, if you will, to make sure that every American--every 
American--has the same benefit we here in the Senate have.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Whitehouse). The Senator from Ohio is 
recognized.
  Mr. BROWN. Mr. President, the Children's Health Insurance Program is 
a success story. It was created in 1996 during my second term in the 
House of Representatives under a Republican-controlled Congress and 
signed into law by President Clinton. It was exactly what voters sent 
people to Washington to do. It was bipartisan, with a Democratic 
President working with a Republican Congress, with wide support within 
Congress from large numbers of both Democrats and Republicans.
  Since then, the program has reduced the number of uninsured children 
in working families by one-third; 6.6 million children are covered 
nationally. More than 218,000 children are covered in my State of Ohio, 
from Galion to Gallipolis, from Mansfield to Middletown, from Xenia to 
Zanesville. These children now get care in their doctors' offices but 
not, as the President suggests, in the emergency rooms. Their care is 
delivered when it is needed, not when it is too late. They go to their 
family physician with an ear infection, and they get an antibiotic that 
may cost $50 or $75 or $100. The child gets sent home with his or her 
mother or father, and the child is cured instead of the ear ache 
getting so bad for a child whose parent has no insurance, and the 
parent waiting and hoping it gets better. The child goes to the 
emergency room at the cost of several hundred dollars, and the child 
may have a permanent hearing loss as a result, with what that does to 
the child's future in school and to the child's future later in getting 
a job.
  These children under the CHIP program have good, reliable health 
coverage. The Children's Health Insurance Program, in short, works. It 
works for our Ohio children, our Ohio parents, and for Ohio 
communities. But it does not work as well as it could.

[[Page 21619]]

  Today we have the opportunity to make the Children's Health Insurance 
Program what it should be. Sadly, we all know millions of American 
children--far too many children in Dayton and Columbus and Toledo and 
Cleveland and Akron and Canton and Youngstown and Cincinnati--remain 
without health insurance, even though the law states they are eligible 
for it.
  Eleven years ago, in 1996, Congress made a promise to America's 
children. Right now, today, this week, in the Senate and in the House, 
we have the opportunity to live up to that promise. We can pass this 
bill to provide health insurance to 3.2 million more children, children 
who have missed out on our promise--not their fault, ours--so far.
  This is a bipartisan effort and bill, just like the original was a 
decade ago. That is because this legislation is about children, not 
politics. This bill is about helping children.
  Let me tell a story about how the Children's Health Insurance Program 
has helped one family in Ohio. Seth Novak is a 3-year-old boy who lives 
in Lebanon, OH, in Warren County, outside Cincinnati, the southwestern 
part of the State. This is a picture of Seth. His dad is self-employed. 
He helps churches with their construction projects.
  The family buys private health insurance for $444 a month that covers 
the parents and Seth's two older siblings. But Seth has Down Syndrome 
and other health problems. In addition, in an attempt to get health 
insurance for her son, Seth's mom checked with six different insurance 
companies. She was quoted rates from $1,200 to $1,800 per month for 
private insurance--just for Seth, not for Mr. and Mrs. Novak or the two 
older children.
  The Novaks are a hard-working family, but they simply cannot afford 
$14,400 a year for a policy covering only one of their children, not to 
mention their own insurance, another $444. They cannot afford a policy 
of $14,000 a year for one of their children, which would cover only 
part of the cost, frankly, for only some of the care Seth needs.
  Just this week, the Novak family learned that Seth's eligibility for 
Medicaid/SCHIP has been denied effective August 31. That is why we have 
work to do. Where will Seth go for medical care? What if something 
happens?
  There is hope for Seth, though. In Ohio, Governor Strickland and 
legislative leadership--again, in Ohio, it is a bipartisan effort--by 
increasing eligibility for the Children's Health Insurance Program to 
children up to 300 percent of the Federal poverty level. As Assistant 
Majority Leader Durbin pointed out about an hour and a half ago, these 
are not people living in the lap of luxury when you say 300 percent of 
the poverty level. These are middle-class families with significant 
health problems, who simply cannot afford, on their middle-class 
salaries and wages, their health insurance.
  In January, the legislature and the Governor, understanding the 
plight that families like Seth's find themselves in, when the new 
eligibility for the program goes into effect, the Novaks of Lebanon, 
OH, will be able to restore his health insurance and still pay their 
bills and take care of their family.
  Ohio's leaders have taken care of Seth and thousands like him. They 
need Congress and the President this week to do the same.
  I have a picture of another Ohio family--a success story--who can 
attest to how the Children's Health Insurance Program helped them. This 
is Latonya Shoulders of Kent, OH, and her son Phillip Grant, Jr.
  In 1996, Latonya was a pregnant, full-time student at Kent State 
University, my wife's alma mater. She didn't have health insurance or 
the resources to afford medical care. She enrolled in Ohio's Medicaid 
Program about halfway through her pregnancy. Her son had Medicaid/SCHIP 
coverage until he was 5 years old. That is when she finished her 
bachelor's degree and got a job as a nurse with insurance benefits.
  The Children's Health Insurance Program was there for Phillip in the 
first years of his life. The program provided for him in several 
medical emergencies. At 2 years old, he was bitten by another child at 
daycare and developed acute cellulitis. He spent 2 days in the 
hospital. When he was about 4, he cut his arm and had a recurrence of 
cellulitis. This required two surgeries, both inpatient and outpatient 
treatment.
  As any parent knows, raising children means all too many visits to 
the hospital. These hospital stays could have devastated this family's 
finances and so much that went with it, right when Latonya was working 
so hard to get her nursing degree and to get ahead. Latonya is proud 
that she no longer needs Medicaid/Children's Health Insurance Program 
coverage for her son.
  As I said, she is now a nurse and has health insurance. The program 
helped Latonya when she and Phillip needed it. Today she is a 
productive taxpaying citizen, and he is a healthy boy. The goal now is 
to let other families experience the same benefit.
  President Bush came to Cleveland recently--about 25, 20 miles from my 
home--and told an audience of Ohioans:

       People have access to health care in America. After all, 
     you just go to an emergency room.

  The President doesn't seem to realize that is exactly the problem. We 
all know emergency care is much more expensive than a scheduled visit 
to a doctor or a clinic. When people go to emergency rooms and 
hospitals, they end up with large costs which insurance companies bear 
and then raise their premiums, or the hospital eats the cost. It is a 
huge burden on hospitals, especially hospitals in places such as rural 
Appalachia, in southeast Ohio, and places such as Zanesville and Morgan 
County and Athens and Gallia County and Lawrence County. It is a burden 
on hospitals such as Metro in Cleveland, which serves our community so 
well, or Akron General or the Summa or Lorain's community health 
center. These hard-working families cannot afford health insurance for 
children, much less if the child has a serious health issue.
  I want to make sure children like Seth Novak and Phillip Grant 
receive the care they need. This is a picture of Seth playing on a 
slide. I want him to be strong and healthy so he can continue playing 
and getting his exercise and enjoying his childhood, with health 
insurance; or this picture of Phillip with his mother at her 
graduation. I want him to grow up healthy so he can pursue a bachelor's 
degree just like his mom did. I want every child in Ohio to thrive and 
develop to his or her full potential.
  Ohio families should be able to take care of their bills without 
worrying about whether they will get their most basic health care needs 
met. Every eligible child should be able to benefit from the Children's 
Health Insurance Program--every eligible child in this country. That 
requires the additional $35 billion that this bill authorizes. That is 
about how many weeks in Iraq? We spend $2.5 billion a week in Iraq, and 
here we are asking for $35 billion over 5 years. That requires that 
additional $35 billion.
  I want our President to see past relying on emergency rooms, thinking 
that is the best option to provide the basic medical care that our low-
income families need, and instead, to provide it through an insurance 
program so a mother can take her child to a family practitioner and get 
the kind of preventive care that my friend from Oklahoma, Senator 
Coburn, talked about. Even though he doesn't agree with this 
legislation, he talked about getting the care that these children need 
that only health insurance--not emergency room treatment--will get 
them.
  This bill is about children, not about politics. It needs to pass.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  (Mr. Brown assumed the Chair.)
  Mr. WHITEHOUSE. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WHITEHOUSE. Mr. President, I speak today in support of the 
Children's Health Insurance Program. I

[[Page 21620]]

want to first applaud the Finance Committee for its bipartisan 17-to-4 
vote to approve this bill. I thank Senators Baucus, Rockefeller, 
Grassley, and Hatch, Majority Leader Reid, and also the staff of the 
Finance Committee for all their hard work through the very difficult 
negotiations that made it possible to bring this critical measure so 
strongly to the floor.
  I also recognize Rhode Island's role in this piece of legislation, 
going all the way back to the distinguished Senator John Chafee, one of 
the early bipartisan sponsors of the bill. Now on the floor today, my 
senior Senator, Jack Reed, has been one of the most powerful and 
outstanding advocates for this program in this institution. I am proud 
to join him in supporting this bill and in this fight.
  I am proud also to represent a State with one of the lowest rates of 
uninsured adults and children in the Nation. There is a reason. Rhode 
Island has worked over the past 15 years to achieve this success, 
beginning with the RIteCare program in 1993. In 2001, the creation of 
this Children's Health Insurance Program allowed Rhode Island to 
further reduce the number of uninsured children in the State. I am 
proud to have been part of Gov. Bruce Sundlun's team when he started 
the original RIteCare program in 1993.
  As health care costs skyrocket, and the number of people in this 
country who lack health insurance approaches the staggering number of 
50 million, we in Congress have an obligation to strengthen initiatives 
like RIteCare that make health care more accessible.
  For years, the Children's Health Insurance Program has given millions 
of uninsured American families access to health care for their kids. 
And pretty much everyone has thought this was a good thing. But now, 
setting aside reason, and driven by ideology, President Bush has 
threatened to lift his veto pen for only the fourth time in his 
Presidency to take that security and peace of mind away from these 
children and from their worried moms and dads, from families similar to 
the ones the Senator from Ohio highlighted in his eloquent remarks a 
moment ago.
  The President claims the $35 billion improvement over 5 years is too 
expensive. The President would prefer only the $5 billion he included 
in his budget. But that funding level would result in 1 million 
American children losing their health insurance. We certainly cannot 
look to President Bush for leadership.
  How ironic, after all we have heard from this administration praising 
the State Children's Health Insurance Program and even taking credit 
for expanding coverage, for encouraging State flexibility, and for 
spurring innovation at the State level.
  Listen to what they used to say. In the administration's plan 
outlining the President's second term, their fact sheet boasted:

       The year before President Bush took office, some 3.3 
     million low-income children were enrolled in SCHIP. By 2003, 
     that number had risen to 5.8 million, a 75 percent increase. 
     Over that same period, by working cooperatively with State 
     Governors, the Department of Health and Human Services 
     increased the number of low-income adults on Medicaid by 6.8 
     million.

  That was then, this is now.
  After that, the administration went on to lament the fact that 
``millions of children who are eligible for SCHIP or Medicaid coverage 
are not yet enrolled. Billions in Federal dollars available to the 
States to insure these children remain unspent because these children 
haven't been signed up.''
  Then, at the 2004 Republican National Convention, President Bush 
promised this:

       In a new term, we will lead an aggressive effort to enroll 
     millions of poor children who are eligible but not signed up 
     for the Government's health insurance programs. We will not 
     allow a lack of attention or information to stand between 
     these children and the health care they need.

  But now the same Bush administration, the same President, is 
aggressively planning to deny health insurance to poor children. How 
does this make any sense?
  The President's rationale for this new parsimony was revealed before 
an audience in Cleveland on July 10. Here is the President's approach 
to health insurance for America. You just pointed this out, Mr. 
President:

       I mean, people have access to health care in America; after 
     all, you just go to an emergency room.

  Well, that is a thoughtful approach. Once again, we cannot look to 
our President for any leadership on this issue.
  The administration has also expressed its opposition to the cigarette 
tax that will fund the increases in children's health insurance, 
calling it--get this--among the most regressive revenue-raising 
measures one could propose. That is from a letter from Secretary 
Leavitt to Chairman Baucus and Senator Grassley.
  The irony department is open late in the Bush administration. In 
evaluating their crocodile tears about regressive tax measures, 
consider that this Nation will spend $233 billion in 2008 on the Bush 
tax cuts, 30 percent of which will go to the top 1 percent of income 
earners. From 2008 through 2011, the period we are talking about for 
children's health care, those tax cuts will cost Americans, in lost 
revenue and interest on the debt, nearly $1 trillion, 22 percent of 
which will go to people who earn more than $1 million a year.
  This chart illustrates just how the cost of tax cuts for the top 1 
percent of Americans compares to the cost of expanding health care for 
children in this country. We are spending vastly more each year on tax 
cuts for the Nation's highest income earners than we are fighting for 
in children's health care.
  Here it is, $2.1 billion for children's health care in 2008, $70 
billion for the richest 1 percent; $5 billion in fiscal year 2009 for 
children's health care, $72 billion for the richest 1 percent; and in 
2010, gosh, we go all the way to $7.9 billion for children's health 
care with only $82 billion for the richest 1 percent.
  The Congressional Budget Office estimates that in just this year 
alone--just this year alone--we are paying an extra $46 billion in 
interest, not paying back the debt, just in interest, on the Bush tax 
cuts--$46 billion just in 1 year. And the whole thing we are arguing 
about here is $35 billion over 5 years for children's health care. It 
is truly mind-boggling.
  But it doesn't end there. The President has also threatened to veto 
the bill based on its coverage of adults. This is a policy that the 
administration has previously, explicitly, repeatedly approved. This is 
a sudden ideological U-turn of stunning and deeply hypocritical 
proportions.
  As recently as last summer at a Finance Committee hearing on 
children's health insurance, then CMS Administrator Mark McClellan said 
the following:

       Extending coverage to parents and caretaker relatives not 
     only serves to cover additional insured individuals, but it 
     may also increase the likelihood that they will take the 
     steps necessary to enroll their children. Extending coverage 
     to parents and caretakers may also increase the likelihood 
     that their children remain enrolled in SCHIP.

  That was then, this is now.
  This administration has approved waivers to cover parents in New 
Mexico, Illinois, Oregon, New Jersey, Michigan, and Wisconsin. Fewer 
than 2 months ago, on May 30 of this year, Leslie Norwalk, who was then 
Acting Administrator of CMS, was ``pleased to inform'' Wisconsin that 
its extension request for what they call BadgerCare--it is equivalent 
to RIteCare in Rhode Island--had been approved through March 31, 2010. 
BadgerCare covers roughly 67,000 parents. Again, this waiver was 
approved by the Bush administration 8 weeks ago, and now he is 
threatening a veto for care that covers adults.
  Here is a copy of the letter that CMS Administrator Mark McClellan 
sent to my home State of Rhode Island on January 13, 2006. It reads:

       We are pleased to inform you that your amendment to the 
     RIteCare section 1115 demonstration, as modified by the 
     Special Terms and Conditions accompanying this award letter, 
     has been approved.

  It also notes:

       Rhode Island's request to renew title XXI, section 1115, 
     demonstration project, dated July 15, 2005, with additional 
     information . . . has also been approved.

  Finally, it notes:


[[Page 21621]]

       Individuals who, at the time of initial application, are 
     custodial parents or relative caretakers of children who are 
     eligible under the title XIX State plan or the title XXI 
     State plan . . .

  Are in the demonstration population and, of course, ``we look forward 
to continuing to work with you and your staff.'' Signed Mark B. 
McClellan, M.D., Ph.D., the Administrator of CMS. This was January of 
2006. This is the Bush administration. This is them signing off on 
adults, custodial parents, or relative caretakers of children being in 
the plan.
  Yet now the President is shocked--shocked--that this program may 
cover some adults. Who didn't send him the memo?
  At the end of May, I spoke on the Senate floor about some of the 
major problems facing health care in this country. I talked about the 
lack of investment in quality improvements, the lack of a national 
information technology infrastructure, and a reimbursement system that 
pays doctors to perform procedures rather than to help patients get 
well. I took these issues to the Senate floor because the structure of 
our system is unsound, its underlying mechanism is broken, its signals 
are misaligned.
  But there are a few shining lights in the American health care 
system, and the Children's Health Insurance Program is among the 
brightest. This program respects State flexibility, it encourages 
responsiveness to local needs, it fertilizes structural creativity in 
the health care arena, it safeguards the vulnerable, it unites 
families, and it invests in the future of our Nation.
  The Children's Health Insurance Program means that children are more 
likely to receive medical care for common conditions such as asthma or 
ear infections. It means that children have higher school attendance 
rates. It means that children have higher academic achievement. It 
means that children have more contact with medical professionals and 
receive more preventive care. It means that children stay out of 
expensive urgent care settings, such as the emergency room.
  We choose now in this bill and in this debate between providing our 
Nation's children with health insurance and not providing our Nation's 
children with health insurance. It is as simple as that. We choose now 
whether every individual in this Nation, regardless of age, gender, 
race, income, or health status deserves the stability and the safety 
that health insurance provides. We choose for millions of American 
families how much they have to worry, how much moms and dads have to 
worry about the health care of their children.
  It is my duty as a representative of the people of Rhode Island, and 
it is our collective duty as representatives of a great Nation to stick 
up for the most vulnerable members of our society and for programs that 
protect those who cannot protect themselves. We must certainly not give 
up in the face of an administration that willingly violates its own 
principles in order to create an issue on which the President can 
deliver a veto as a desperate political stunt in the last bleak 
chapters of his collapsed Presidency--not at the cost of health care 
for children. That would be truly pathetic.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Montana is recognized.
  Mr. TESTER. Mr. President, I rise in strong support of the 
reauthorization of the Children's Health Insurance Program. The 
reauthorization of this highly successful 10-year-old program would 
provide an additional $35 billion over the next 5 years to make sure 
that more of America's neediest children have access to one of their 
most basic needs--health care.
  In fact, 6.6 million of our most vulnerable children--that is an 
increase of 3.2 million children--will be covered by this bill. I 
applaud the efforts of my senior Senator, Max Baucus, for leading the 
charge to cover more children.
  Reauthorizing the Children's Health Insurance Program is the right 
thing to do. Because of Max Baucus and the good work of the Finance 
Committee, almost 12,000 more children in Montana will have coverage 
this year. Montanans know just how well this program works. As 
president of the Montana Senate, I worked to increase the number of 
children eligible for the Children's Health Insurance Program and 
pushed through full State funding of the Children's Health Insurance 
Program for Montana's children, expanding the enrollment from 10,900 to 
13,900 children annually. As of this July, Montana's Children's Health 
Insurance Program is providing insurance for 14,304 children per month 
in the State of Montana.
  It just makes sense. Only children who do not have private insurance 
are eligible. I am going to repeat that because I have heard contrary 
stuff on the floor. Only children who do not have private insurance are 
eligible for this program. No one is double-dipping, no one who has 
insurance can receive this coverage.
  With this reauthorization of the Children's Health Insurance Program, 
we as a country are investing in our most valuable resource--our 
children. If children have regular checkups and receive the preventive 
care they need, they are sick less and in school more, and they grow up 
to be healthy, productive members of our society with less problems in 
middle age and healthier in their elderly years.
  Mr. President, it is tough out there. Millions of children lack 
health insurance despite their parents' hard work and efforts to keep 
their heads above water. Many families cannot afford health insurance 
despite the fact that they have jobs. When it comes time for parents to 
pay the bills, health insurance comes after rent, food, clothing, 
utility bills, and gas for their car. Health insurance shouldn't be 
treated as a luxury, and access to health care shouldn't be a fantasy.
  We must be focused on improving the overall quality of health care 
for low-income children. We know there are more children eligible for 
benefits than are currently enrolled. In order to find and provide 
coverage for those children, States should be able to use the 
information from food stamp programs, free and reduced lunches, and 
other initiatives in place for low-income families. Up to now, these 
programs could not share information, so those with the greatest need 
would have to apply for each program separately.
  This Children's Health Insurance Program before us increases funding 
and outreach and enrollment efforts to find these uninsured kids. This 
is especially critical in rural States--rural States such as Montana. 
Rural children are more likely to be poor and less likely to have 
access to employer-based health plans even though most of their parents 
are employed. Nearly one-third of the kids in rural America rely upon 
CHIP and Medicare. The need is clear: Without children's health 
insurance, they would be uninsured.
  There have been a lot of stories shared today on the floor. I want to 
share another one, of a fellow Montanan. Duran ``Junior'' Caferro from 
Helena, MT, is a boxer and has been fighting for 10 years. He is ranked 
in the 125-pound weight class and will compete in the Olympic trials 
next month in Houston, TX. Duran is also an enrolled member of the 
Northern Cheyenne tribe. His father, who works with at-risk youth, does 
not have health insurance and can't afford coverage for himself or his 
son. Helena has an urban Indian health clinic but not an Indian Health 
Service hospital, so Duran doesn't have access to emergency and 
hospital services with his IHS health benefits.
  CHIP has allowed him to have a choice in where he receives medical 
care, and he recognizes the value of this coverage. When asked about 
CHIP, he said the following:

       It is important that I have Children's Health Insurance 
     Program because I don't have to be afraid to push myself when 
     I'm training or fighting. It gives me one less thing to worry 
     about.

  If Duran wins this tournament in Houston this summer, he will be a 
member of the U.S. Olympic boxing team. He will turn 19 soon and will 
age-out of CHIP. He expects to become uninsured because he and his dad 
are still struggling and can't afford to buy private health insurance.
  Some may doubt the cost-effectiveness of this program, but this bill 
not

[[Page 21622]]

only helps low-income children, it also helps middle America. Why is 
that the case? Because the coverage made available to low-income kids 
lowers the number of emergency room visits of uninsured children. 
Emergency room doctors no longer serve as primary care physicians for 
the uninsured, and that lowers the cost of health care for the rest of 
America--the middle class--who currently cover the cost of the 
uninsured emergency room visits.
  We all know that the middle class is feeling the pinch too. If we can 
lower health costs for them and provide health care to more of our 
kids, it is a win-win.
  The way to ensure the continued strength of our country for future 
generations is to improve the future of our most valuable asset--our 
young people--and this bill which reauthorizes the Children's Health 
Insurance Program does just that.
  Once again, I thank the senior Senator from Montana, Max Baucus, and 
the Finance Committee for championing this bill. They did some 
outstanding work. Hopefully, we will continue that work on the floor 
here tomorrow. We must pass this bill, and I urge my colleagues and the 
President to support it.
  Mrs. BOXER. Mr. President, I rise today to support the 
reauthorization of the Children's Health Insurance Program--an 
essential effort to ensure the health of our Nation's children.
  For the past 10 years, the Children's Health Insurance Program has 
helped provide health care for millions of children from working 
families that do not qualify for Medicaid but can't afford private 
insurance. These are the children of working families whose companies 
do not offer health insurance to their employees.
  As the cost of health insurance rises and an increasing number of 
employers are unable or unwilling to provide health insurance to their 
employees and their families, the number of families who do not have 
health insurance has continued to rise.
  While the number of the uninsured continues to rise, the percentage 
of low-income children without health insurance has dropped more than 
one-third since the creation of the Children's Health Insurance 
Program.
  Currently the Children's Health Insurance Program provides coverage 
for 6.6 million children nationwide. This reauthorization would provide 
health care coverage for an additional 3.2 million children who are 
uninsured today. In California, an estimated 250,000 children will be 
added.
  The Children's Health Insurance Program has always enjoyed the 
bipartisan support of our Congress, our Governors, and our President--
which is why I am shocked by the inadequacy of this administration's 
plan to insure the children of our Nation's working families.
  The President is spending $10 billion each month in Iraq but has 
threatened to veto a bill that will provide 10 million children with 
access to health care. Under the President's proposal, he is willing to 
fund the Children's Health Insurance Program with an increase of $1 
billion a year--the cost of 3 days in Iraq.
  Under the administration's proposal, we end up counting how many 
children will lose health insurance instead of how many we can enroll. 
In the first year, the President's plan would eliminate health care 
insurance for 200,000 children in California alone--and the number of 
uninsured children would continue to climb.
  This shortfall in funding would result in 800,000 children who are 
currently enrolled to lose their coverage. I ask the President, what 
does he propose these children do when they are sick?
  If we fail to renew this program or if the President vetoes this bill 
as he has threatened to do, it is the children who will pay the price.
  There is not a man or woman in this Chamber who wouldn't do 
everything within their power to ensure the health of their own 
children--we should do no less for the children of our Nation.
  The Members of this Congress have overwhelmingly expressed a 
commitment to children's health. Earlier this year, we passed a budget 
resolution which set aside $50 billion for the Children's Health 
Insurance Program, reaffirming our commitment to the continued success 
of this program.
  We can still do more and we will, but this bill is a step forward in 
the right direction.
  I would like to thank Senators Baucus and Rockefeller, Senators 
Grassley and Hatch and the members of the Finance Committee who worked 
so tirelessly to bring this legislation forward in a bipartisan way, 
and keep the focus of this bill where it should be--on the children.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. TESTER. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________