[Congressional Record (Bound Edition), Volume 153 (2007), Part 18]
[Senate]
[Pages 25828-25859]
[From the U.S. Government Publishing Office, www.gpo.gov]




    CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT OF 2007

  The PRESIDING OFFICER. Under the previous order, there will now be 2 
minutes of debate equally divided prior

[[Page 25829]]

to a vote on the motion to invoke cloture on the motion to concur in 
the House amendments to the Senate amendments to H.R. 976, the 
Children's Health Insurance Act of 2007.
  Pending:

       Reid motion to concur in the amendments of the House to the 
     amendments of the Senate to the bill.
       Reid Amendment No. 3071 (to the House amendment to Senate 
     amendment to the text of H.R. 976), to change the enactment 
     date.
       Reid Amendment No. 3072 (to Amendment No. 3071), of a 
     perfecting nature.

  The PRESIDING OFFICER. Who yields time?
  Mr. ALLARD. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. REID. 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the quorum call be rescinded.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. REID. Mr. President, what is the matter before the Senate?
  The PRESIDING OFFICER. Each side has 1 minute of debate on the 
children's health insurance amendment.
  Mr. REID. Mr. President, we yield back the remainder of our time.
  The PRESIDING OFFICER. Who yields time?
  Mr. GRASSLEY. We yield back the remainder of our time.


                             Cloture Motion

  The PRESIDING OFFICER. Under the previous order and pursuant to rule 
XXII, the Chair lays before the Senate the pending cloture motion, 
which the clerk will state.
  The legislative clerk read as follows:

                             Cloture Motion

       We, the undersigned Senators, in accordance with the 
     provisions of rule XXII of the Standing Rules of the Senate, 
     do hereby move to bring to a close debate on the motion to 
     concur in the House amendments to the Senate amendments to 
     H.R. 976, SCHIP.
         Max Baucus, Ted Kennedy, Jeff Bingaman, Patty Murray, 
           Barbara Boxer, Tom Carper, Patrick J. Leahy, Charles 
           Schumer, Maria Cantwell, Dick Durbin, Blanche L. 
           Lincoln, Robert P. Casey, Jr., Debbie Stabenow, Jack 
           Reed, B.A. Mikulski, Tom Harkin, Harry Reid.

  The PRESIDING OFFICER. By unanimous consent, the mandatory quorum 
call has been waived.
  The question is, Is it the sense of the Senate that the debate on the 
motion of the Senator from Nevada, Mr. Reid, to concur in the House 
amendment to H.R. 976, the Children's Health Insurance Act of 2007, 
shall be brought to a close?
  The yeas and nays are mandatory under the rule.
  The clerk will call the roll.
  The bill clerk called the roll.
  Mr. LOTT. The following Senator is necessarily absent: The Senator 
from Arizona (Mr. McCain).
  The PRESIDING OFFICER (Mr. Tester). Are there any other Senators in 
the Chamber desiring to vote?
  The result was announced--yeas 69, nays 30, as follows:

                      [Rollcall Vote No. 352 Leg.]

                                YEAS--69

     Akaka
     Alexander
     Baucus
     Bayh
     Biden
     Bingaman
     Bond
     Boxer
     Brown
     Byrd
     Cantwell
     Cardin
     Carper
     Casey
     Clinton
     Coleman
     Collins
     Conrad
     Corker
     Dodd
     Domenici
     Dorgan
     Durbin
     Feingold
     Feinstein
     Grassley
     Harkin
     Hatch
     Hutchison
     Inouye
     Johnson
     Kennedy
     Kerry
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     McCaskill
     Menendez
     Mikulski
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Obama
     Pryor
     Reed
     Reid
     Roberts
     Rockefeller
     Salazar
     Sanders
     Schumer
     Smith
     Snowe
     Specter
     Stabenow
     Stevens
     Sununu
     Tester
     Warner
     Webb
     Whitehouse
     Wyden

                                NAYS--30

     Allard
     Barrasso
     Bennett
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cochran
     Cornyn
     Craig
     Crapo
     DeMint
     Dole
     Ensign
     Enzi
     Graham
     Gregg
     Hagel
     Inhofe
     Isakson
     Kyl
     Lott
     Martinez
     McConnell
     Sessions
     Shelby
     Thune
     Vitter
     Voinovich

                             NOT VOTING--1

       
     McCain
       
  The PRESIDING OFFICER. On this vote, the yeas are 69, the nays are 
30. Three-fifths of the Senators duly chosen and sworn having voted in 
the affirmative, the motion is agreed to.
  The PRESIDING OFFICER. The Senator from Nevada is recognized.


                       Unanimous Consent Request

  Mr. ENSIGN. Mr. President, I ask unanimous consent to be recognized 
for 5 minutes to make a quick statement, and then I will make a 
unanimous consent request, to which there will be an objection on the 
other side.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The Senator from Nevada is recognized.
  Mr. ENSIGN. Mr. President, let me make it clear. I support the 
electronic filing by Senators in the underlying bill that Senator 
Feinstein brought forward. There is an issue I want to raise on an 
amendment I wish to add to the bill.
  We have a problem going on in the Senate where there are anonymous 
outside groups who are filing ethics complaints, and they are doing it 
for purely political reasons. As often is the case, this can be fixed 
with transparency.
  If someone files an ethics complaint against a Senator from the 
outside, then they would have to disclose their donors under my 
amendment. Right now in the Senate, there is no such requirement for 
filing a complaint. The complaints do not have to be sworn, signed, or 
even identified, and they can be submitted by a person or an unnamed 
group no one will ever know.
  The complaints do not have to be submitted in a formal manner. They 
can be on a beverage napkin or written in crayon. However, this is not 
the case in the other Chamber. In the House of Representatives, they 
have very formal, rigorous requirements to file complaints. The 
complaints must be sworn to and filed by a Member of Congress. With no 
requirements in the Senate, the result is that people create shell 
organizations in order to register purely political complaints.
  Some say my amendment will prevent people from filing complaints. 
This is simply not true. My amendment will make the complaint process 
transparent and similar to the FEC process. Has there ever been a 
shortage of complaints at the FEC?
  If these complaints are being filed purely for political reasons, 
then we will find that out because we can see who the donors are. We 
need to protect this institution. We need to protect individual 
Senators from purely politically motivated ethics complaints that come 
against us.
  If it is done purely for partisan reasons, we need to know that, and 
transparency is, once again, the best way to find that out. All I am 
asking is for an up-or-down vote so the Senate can decide if it wants 
transparency. It has been said that this bill is unrelated to the 
electronic filing bill. I disagree. They are both about transparency. 
They are both about the political process. We need to have this 
amendment agreed to.
  I ask unanimous consent that at a time to be determined by the 
majority leader, in consultation with the Republican leader, the Senate 
proceed to Calendar No. 96, S. 223, under the following limitations: 
that the committee-reported amendment be agreed to, and that the only 
other amendment in order be an Ensign amendment related to transparency 
and disclosure, with 20 minutes of debate equally divided in the usual 
form on the bill and the amendment to run concurrently, and that 
following the use or yielding back of time, that the Senate proceed to 
vote in relation to the Ensign amendment, and that the bill, as 
amended, be read a third time and the Senate proceed to a vote on 
passage of the bill, with no intervening action or debate.
  The PRESIDING OFFICER (Mrs. McCaskill). Is there objection?
  Mr. BAUCUS. I object.
  Mr. ENSIGN. Madam President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Madam President, what is the regular order?

[[Page 25830]]

  The PRESIDING OFFICER. The regular order is the motion to concur with 
the House amendments to the Senate amendments on SCHIP.
  Mr. BAUCUS. Madam President, we are awaiting the arrival of the 
Senator from Kentucky. I do not see him yet so I will begin.
  Nearly every American schoolchild knows the story told in Parson 
Weems' 1800 biography ``The Life of Washington.'' That is our first 
President. According to Weems, young George used his new hatchet to 
chop down his father's cherry tree. His father asked George what 
happened. George was tempted to make up a story, but then in Weems' 
famous account, young George ``bravely cried out, `I cannot tell a lie. 
I did cut it with my hatchet.'''
  I wish all public servants kept the same standard of truthfulness, 
especially in this debate. Regrettably, many of today's public servants 
appear all too tempted to make up a story. Many are failing to tell the 
truth about the Children's Health Insurance Program.
  Let me set the record straight.
  President Bush has said that our bill ``would result in taking a 
program meant to help poor children and turning it into one that covers 
children in households with incomes of up to $83,000 a year.'' That is 
what our President said. That is not true. There is nothing in the 
Children's Health Insurance Program bill that would change current law 
and allow States to cover children in families making $83,000 a year. 
There is nothing in the current bill that would let that happen. 
Nothing in current law; nothing.
  On income eligibility levels, the bill maintains current law. It 
doesn't change current law, it maintains current law on income 
eligibility levels. Current law limits CHIP to the higher of 200 
percent of poverty or 50 percent above the State's prior Medicaid 
levels. Any State that wants to increase eligibility for CHIP above 
those levels has to get approval from the Secretary of Health and Human 
Services. That is current law, and that is the law under the CHIP bill 
before us today. It is unchanged.
  In fact, our bill actually includes new policies to discourage States 
from increasing eligibility for kids above 300 percent of poverty. 
Under our bill, States that increase eligibility above 300 percent--
again, they have to get approval from HHS to get a waiver--under our 
bill, those States that increase eligibility, if they get a waiver 
granted by the Bush administration or not, would get the lower Medicaid 
Federal match payment for higher income children. Our bill would 
decrease the incentive to cover higher income children relative to 
current law. It decreases incentives relative to current law.
  Our bill also includes new policies requiring any States covering 
children above 300 percent to meet a target enrollment level for 
covering their lowest income children below 200 percent of poverty. 
That is new. States that don't meet the target by 2010 risk losing all 
Federal reimbursement for their higher income children. So our bill has 
an even greater focus on low-income kids compared with current law.
  Our bill will benefit low-income children. The Urban Institute found 
that 70 to 80 percent of children helped by our bill are low-income 
children with family incomes below 200 percent of poverty. Our bill is 
targeted to help exactly the low-income children for which we created 
the CHIP program in the first place. Our bill continues that mission 
for the next 5 years.
  The administration has also said our bill would move too many 
children from private insurance into CHIP. Once again, that is not 
true. According to Congressional Budget Office Director Peter Orszag--
he is the top person in the independent Congressional Budget Office. 
His job is to independently assess what we do. There is no partisanship 
at all. He said there is always some ``crowdout'' or substitution of 
public coverage for private coverage whenever we create a new 
Government subsidy to help people. It always happens to some degree.
  A few years ago--this is important for everybody to remember, 
especially the President--when we considered the Medicare prescription 
drug bill, the so-called MMA, CBO then said about two-thirds of those 
getting the new Government help would already have private coverage. 
Two-thirds already had private coverage. I don't remember the 
administration complaining about the crowdout then, complaining about 
people who might leave private coverage to go to Medicare Part D.
  When we enacted the CHIP program 10 years ago, the Congressional 
Budget Office projected there would be about a 40-percent crowdout 
rate, not two-thirds as the case in the Medicare Part D but about 40 
percent. What happened? Our bill has a lower crowdout. It is about 40 
percent lower than CBO projected would happen in the program 10 years 
ago.
  In fact, CBO Director Orszag said this year's Senate bill, which is 
very similar to the final bill we are considering, was ``pretty much as 
efficient as you can possibly get for new dollar spent to get a 
reduction of roughly 4 million uninsured children.''
  We went to CBO and said we want to reduce the so-called crowdout as 
much as we can; how do we do it. We talked back and forth. And his 
assessment is the final bill is ``pretty much as efficient as you can 
possibly get,'' lower than any other major crowdout results.
  The President also said he has a better plan to help uninsured 
children. If he does, he is keeping it under wraps.
  The President talked about both his plan to reauthorize CHIP and his 
plan to promote private coverage through tax credits. But independent 
analyses of both plans suggest that under them, American children would 
fare far worse.
  For the Children's Health Insurance Program, the President is 
proposing a $5 billion increase in Federal funds over the next 5 years. 
That is his proposal. The President says that will be enough. The 
Congressional Budget Office disagrees. The analysis of the 
Congressional Budget Office, again, an independent analysis of the 
President's plans, indicates it would not even maintain coverage for 
children currently enrolled in CHIP today. it would not even maintain 
it. In fact, CBO projects that under the President's plan, 1.4 million 
children would actually lose coverage.
  The President's tax credit plan does not do much better. The 
Congressional Budget Office has estimated only about 500,000 children 
will gain new coverage under that plan. If we take CBO's estimates for 
these plans together, over 5 years, there would still be a net loss 
coverage for a million children--a net loss coverage for a million 
children compared with current law.
  Causing a million children to lose health insurance is not a better 
plan to help uninsured children--not in my book, and I don't think it 
is in anybody else's book either.
  I am not the only one who thinks what the administration is saying is 
essentially not true--in fact, not at all true. Go to the Annenberg 
Political Fact Check, a nonprofit media accuracy organization funded by 
the Annenberg Political Fund. Go to their Web site: www.factcheck.org.
  At the end of the day, our current President named George has a 
simple choice. He can bring health coverage to 3.8 million low-income 
uninsured children who have no insurance today or he can cut it with 
his hatchet, cutting coverage for at least a million children who would 
otherwise get the doctor visits and medicines they need through CHIP.
  The right choice is to stand bravely with America's children.
  I urge my colleagues to join me in making the right choice. Support 
the CHIP program. Call on the President to sign this important 
legislation.
  Support the CHIP bill because the truth is our bill focuses benefits 
on low-income children. It is that simple. That is what the bill is, no 
more. The truth is, in terms of preserving private coverage, our bill 
is ``pretty much as efficient as you can possibly get.'' And the truth 
is, the administration does not have a credible alternative.
  I urge my colleagues to join me in making the right choice because in 
the end, this bill is about helping those who can least afford health 
insurance

[[Page 25831]]

now. This bill is about helping Americas parents who truly want the 
best for their children. And as much as some may be tempted to make up 
a story to say it is about something else, the truth is, this bill is 
about kids.
  I yield to the Senator from Kansas.
  Mr. ROBERTS. I asked for 20 minutes. I thought the leader was going 
to come down and propose a unanimous consent request to lock in time. 
He agreed to provide me 20 minutes.
  Mr. BAUCUS. There is no time limit. We have 6 hours allocated 
generally to this bill. The Senator can seek recognition.
  Mr. ROBERTS. Madam President, I ask to be recognized for 20 minutes.
  The PRESIDING OFFICER. The Senator from Kansas.
  Mr. ROBERTS. Madam President, I rise today to express my support for 
the SCHIP compromise bill. I believe this agreement represents a good 
balance and continues the historic bipartisan support for this program.
  On Tuesday, the House passed this bill with wide bipartisan support, 
and I expect the Senate to do the same. I also rise today, Madam 
President, to ask and to strongly recommend that the administration 
rethink the threat to veto this important legislation. Simply put, this 
bill should not be vetoed.
  Here in Washington, we often talk about the programs that directly 
affect our constituents back home. The State Children's Health 
Insurance Program, or SCHIP is the acronym, is truly one of those 
programs. SCHIP has long enjoyed bipartisan support, and I am glad we 
have come to a strong bipartisan agreement on a program that is 
critical for our low-income children.
  In Kansas, our SCHIP is called HealthWave, and it supports over 
35,000 Kansas children. It is a critical tool for our hard-working 
families who would otherwise struggle to provide health care for their 
children. Renewing this program has been a top priority of mine for the 
110th Congress. While our Kansas HealthWave Program has made great 
strides in providing health care to low-income children, unfortunately 
we still have 50,000 uninsured children in Kansas--50,000. There are 
35,000 now covered by the program but 50,000 who are not covered.
  Many of these children are currently eligible for SCHIP but are not 
enrolled because of the lack of resources in the program. We can 
clearly do better. The bill before us would provide the necessary 
resources to Kansas and other States in order to reach these low-income 
children and finally provide them with the health care coverage they 
need.
  Unfortunately, instead of talking about achieving rare bipartisan 
progress for these hard-working families and their children, this bill 
and this debate has turned into a political showdown. And, 
unfortunately, low-income children will be the ones to ultimately pay 
the price.
  I am very disappointed that before the administration even received 
the final language their minds were apparently made up, and a line was 
drawn in the sand opposing this compromise. Again, this was even before 
the final language was in their hands. And, to my knowledge, there has 
been little, if any, willingness to come to the negotiating table to 
find the solution. I think this is unfortunate, and I think this is 
irresponsible.
  The administration is now threatening to veto this bill because of 
``excessive spending'' and their belief this bill is a step toward 
federalization of health care. Now, I agree with those concerns. I 
agree with those concerns. I am not for excessive spending, and I 
strongly oppose the federalization of health care. And if the 
administration's concerns with this bill were accurate, I would support 
a veto. But, bluntly put, they are not.
  I do not believe the bill we are debating represents irresponsible 
spending. Instead, this bill provides necessary funding to States to 
cover children who should already be covered under the program. And I 
know there are some who believe this bill is too expensive, but there 
are also others who believe this bill doesn't go far enough. Many of my 
friends on the other side of the aisle wanted a $50 billion to $75 
billion expansion of SCHIP. Many in my caucus would have preferred a $5 
billion increase. As a result, we had to try to find middle ground, and 
we did just that. What we are debating today is something that is often 
hard to come by these days in Washington. It is called a bipartisan, 
bicameral compromise.
  Now, the agreement provides $35 billion in new funding for SCHIP and 
targets the program back to its original focus--low-income children. 
Let me repeat that. This bill targets the program back to its original 
focus--low-income children. We should all understand that despite the 
partisan bickering and the rhetoric that has poisoned the Halls of both 
the House and Senate, bipartisanship and compromise are absolutely 
necessary to achieve--to achieve--good policy. And I know President 
Bush understands this. In fact, the administration has been successful 
in working with my friends on the other side of the aisle on many 
issues during these two terms to achieve good legislation. One good 
example is the historic tax relief we were able to achieve. Obviously, 
that final compromise required give and take from both sides of the 
aisle, and this tax relief is now putting money back into the 
pocketbooks of our constituents back home.
  I was a conferee on the No Child Left Behind legislation and know how 
closely the administration and Senator Kennedy and Congressman Miller 
and others had to work to find any common ground. That bill was 
certainly a great testament to bipartisanship, and we are trying to fix 
some of the problems in that bill on a bipartisan basis.
  The SCHIP bill is yet another example of hard work to come together 
and find common ground. Of course, I am not pleased with everything in 
the bill, and I know my colleagues on both sides of the aisle feel the 
same. However, this bill represents a good bipartisan compromise, with 
the ultimate goal of providing health care coverage to low-income 
children. The alternative that is proposed by the administration is 
threatening a veto and insisting upon a larger health care reform 
debate.
  I appreciate the administration's passion and persistence on having a 
broader health care debate. However, holding a children's health 
insurance bill hostage is not the right way to achieve this goal. I 
support the goals of reforming the Tax Code to promote the purchase of 
private health insurance. Let me repeat that, Madam President. I 
support the goals of reforming the Tax Code to promote the purchase of 
private health insurance. But I have yet to see a plan from the 
administration that can actually pass the Congress.
  In fact, I have yet to see an actual plan from the administration. I 
have yet to see bullet points from the administration. I have yet to 
see any plan that can be articulated in some fashion to sell to the 
American public or to the Members of this body. We don't even have an 
acronym for this plan. My word, you can't do anything around here 
without an acronym.
  The administration has also raised concerns that this bill is a march 
toward the federalization of health care. I would argue that is simply 
not true. I would never support a bill to federalize health care. I 
remember that battle a decade ago. There is no way I want to go down 
that road again.
  I think it is important to point out what I think is a paradox of 
enormous irony in regard to the claim that this bill is a step toward 
the federalization of health care. In reality, this administration has 
approved waivers--approved waivers--to cover adults under a children's 
health care insurance program. Let me repeat that. Under this 
administration's watch, we now have 14 States covering adults under the 
Children's Health Insurance Program.
  Now, this administration and others expressed grave concern that 
SCHIP is the next step to universal health care. Yet this very same 
administration is approving waivers to cover adults under a children's 
health program. And, unfortunately, a number of these States are 
covering more adults through their SCHIP program than they do children, 
even while high rates of uninsured children still remain. This

[[Page 25832]]

is not fair. This is not right. It is wrong.
  I don't mean to pick on other States, but let's take a look at a few 
examples. New Jersey now covers individuals up to 350 percent of the 
Federal poverty level and spends over 40 percent of its SCHIP funds on 
adults. This is even while over 100,000 low-income children in the 
State remain uninsured. This isn't right.
  Earlier this year, Congress had to pass a stopgap funding measure to 
plug 14 State SCHIP shortfalls. Of the 14 States that got this 
emergency funding, five--five--cover adults. One of these States was 
Illinois, which spends over 50 percent of its SCHIP funds on adults. 
Wisconsin covers more adults than children under SCHIP--75 percent to 
be exact. And the administration just approved an extension of their 
waiver to cover adults. Minnesota covers more adults on their SCHIP 
program than they do children. The same is true for Michigan, and the 
same is true for Arizona.
  Now, I am not trying to pick on these States. I can go on and on 
because, again, there are currently 14 that cover adults on a program 
that was meant for children. And how are these States able to cover 
adults under the Children's Health Insurance Program? Again, through 
waivers approved by this administration. This is certainly not fair to 
States such as Kansas that have been playing by the rules and targeting 
our programs to low-income children. I am beginning to wonder if we 
have the wrong name for the State Children's Health Insurance Program. 
I don't think it was intended to be the adult health care insurance 
program.
  The greatest paradox of enormous irony, however, is that this bill 
actually stops the waivers this administration has been so generously 
granting to States to cover adults by not allowing more adult waivers 
to be approved. Let me say that again. The greatest paradox of enormous 
irony is that this bill actually stops the waivers this administration 
has been so generously granting the States to cover adults by not 
allowing more adult waivers to be approved. This means future 
administrations that may want to use SCHIP as a means to expand 
government health care to adults will be prevented by law from doing 
so. As a result, this bill ensures that the Children's Health Insurance 
Program remains just that--a program for low-income children.
  This bill also phases out childless adults currently being covered 
with SCHIP funds and lowers the Federal matching rate for States that 
currently have waivers to cover parents and now must meet certain 
benchmarks in covering low-income children. As a result, this bill 
brings excessive spending on adult populations in check.
  The Congressional Budget Office has estimated that spending on adults 
would be over $1 billion higher under current law over the next 5 years 
than it would be under this compromise. This bill is more fiscally 
responsible than the administration's approach or an extension of this 
program by $1 billion.
  Most importantly, this bill ensures that we are putting kids first 
and returns the program to its original purpose--providing health care 
coverage to low-income children.
  Now, on the income eligibility front, the administration 
unfortunately is claiming this bill does things that the bill simply 
does not do. It is sort of an ``SCHIP In Wonderland.'' For example, the 
President claimed in a speech last week that this bill expands SCHIP 
coverage to families making over $80,000 a year.
  I just have to ask the speech writer for the President, are you 
reading the same bill I am reading? Are you reading the same bill that 
we are discussing on the floor of the Senate? You can twist the facts, 
but facts are stubborn things, Madam President.
  In fact, this bill reduces the matching payment incentives that 
States have had for so long to cover individuals at higher income 
levels. In addition, by the year 2010, this bill--this bill--denies 
Federal matching payments to States that cover children above 300 
percent of the poverty level if the State cannot meet a certain target 
in covering low-income children in either public or private insurance 
plans. And let me emphasize private insurance plans.
  I think it is important to remind the administration that a State can 
only cover children above 200 percent of the poverty level if the 
administration approves the State's application or waiver. I repeat: A 
State can only cover children above 200 percent of the poverty level if 
the administration or any administration approves that State's 
application or waiver. This is current law and this bill does not 
change that.
  More importantly, this bill actually provides incentives and bonus 
payments for States to cover children under 200 percent of the poverty 
level in order to truly put the focus of this program back on low-
income children.
  The bill also addresses the importance of including the private 
market in the SCHIP program. Let me repeat that for all those who want 
a private approach in regard to private markets, in regard to 
insurance: The bill addresses the importance of including the private 
market in the SCHIP program. In fact, the American Health Insurance 
Plans, also known as AHIP--that is their acronym--on Monday announced 
their support for this compromise bill. AHIP is the national trade 
organization which represents over 1,300 private health insurance 
companies.
  The compromise makes it easier for States to provide premium 
assistance for children to get health care coverage through the private 
market--that is the goal of the administration and that should be our 
goal as well--rather than relying on SCHIP. That is in this bill. This 
is an important choice for families who would prefer a private choice 
in health care.
  This bill also requires the GAO and the Institute of Medicine to 
produce analyses in the most accurate and reliable way to measure the 
rate of public and private insurance coverage and on best practices for 
States in addressing the issue of something called ``crowdout.'' That 
means children switching from private health insurance to SCHIP. So we 
have a study to determine exactly how we fix that.
  In the ultimate paradox of enormous irony, it seems the 
administration is threatening to veto a bill which does exactly what 
they want us to do in focusing SCHIP on low-income children and making 
sure the program does not become the vehicle for universal health care.
  This bill gets adults off the program. It targets it to low-income 
children. It ensures appropriate steps are taken to discourage crowdout 
and it encourages private market participation.
  I am proud to support this important bill, and I hope those who have 
concerns can instead focus on the positive benefits this bill will 
bring our low-income children and their hard-working families. I 
especially thank our chairman, Chairman Baucus, Ranking Member 
Grassley, Senator Hatch, all of our House colleagues for their tireless 
work on getting this bill together.
  At the start of these negotiations I made a commitment to work with 
my colleagues to find a bipartisan solution to renew this important 
program. I am holding to that commitment today and am pleased to 
support this bill.
  I also state to the administration I will lend my support to override 
the President's veto if he chooses to wield his veto pen. However, I 
hope--I hope--I hope the President heeds our advice and makes the right 
decision for our children by signing this bill into law.
  I yield the remainder of my time.
  The PRESIDING OFFICER. The Senator from Montana is recognized.
  Mr. BAUCUS. I ask unanimous consent that following the cloture vote 
on the motion to concur in the House amendments to the Senate 
amendments to H.R. 976, there be 6 hours 10 minutes for debate with 
respect to that motion and that the time so far consumed, frankly, be 
taken out of that total time; the time divided and controlled as 
follows: 2 hours under the control of Senator Baucus or his designee, 
and 4 hours 10 minutes under the control of Senator Grassley or his 
designee; that upon the use or yielding back of time, the matter be 
temporarily set aside and the Senate then proceed to the consideration 
of H.J.

[[Page 25833]]

Res. 43, the debt limit increase; that be 90 minutes of debate equally 
divided and controlled between the leaders or their designees, with no 
amendment in order; and upon the use or yielding back of time, the 
joint resolution be read a third time and set aside; and that the 
Senate then resume the message on H.R. 976; that the motion to concur 
with amendments be withdrawn, and without further intervening action or 
debate, the Senate proceed to vote on the motion to concur; that upon 
disposition of H.R. 976, the Senate resume H.J. Res. 43 and vote on 
passage of the joint resolution, without intervening action; and that 
upon the conclusion of that vote, the motion to reconsider be 
considered made and laid upon the table, and the Senate then proceed to 
H.J. Res. 52, the continuing resolution; that no amendments be in 
order, the joint resolution be read a third time, and the Senate, 
without intervening action or debate, proceed to vote on passage of the 
joint resolution; that upon passage, the motion to reconsider be 
considered made and laid upon the table; that after the first vote in 
this sequence, the vote time be limited to 10 minutes.
  I also ask consent that the ``without intervening action or debate'' 
be stricken.
  The PRESIDING OFFICER. Is there objection?
  Mr. McCONNELL. Reserving the right to object, and I am not going to 
object, I wish further to lock in the time to each Senator on my side 
within the Republican time designated in the consent agreement the 
distinguished chairman of the Finance Committee has just propounded, as 
follows: Senator DeMint, 10 minutes; Senator Bunning, 15 minutes; 
Senator Lott, 10 minutes; Senator Grassley, 45 minutes--it is my 
understanding the Roberts time under the consent agreement would 
already be counted. I will leave that out--Senator Hatch, 30 minutes; 
Senator Vitter, 10 minutes; Senator Coburn, 15 minutes; Senator Corker, 
10 minutes; Senator Smith, 10 minutes; Senator Snowe, 15 minutes; 
Senator Murkowski, 15 minutes; Senator Burr, 10 minutes; Senator Thune, 
10; and Senator Cornyn, 10.
  The PRESIDING OFFICER. Is there objection to the request as modified?
  Mr. BAUCUS. I ask the distinguished Senator from Kentucky, I assume 
that is all within the time allocated.
  Mr. McCONNELL. I confidently assure my friend that is my desire and I 
think I expressed that to the Chair.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The minority leader is recognized.
  Mr. McCONNELL. Madam President, I am going to proceed in my leader 
time to speak on the SCHIP bill.
  The PRESIDING OFFICER. The minority leader is recognized.
  Mr. McCONNELL. Madam President, 10 years ago a Republican Congress 
created a program that had a worthy and straightforward goal: health 
insurance for kids whose parents made too little to afford private 
coverage but too much to qualify for Government help. Millions of 
children were caught between rich and poor, we wanted to help, and 
thanks to the State Children's Health Insurance Program, we did.
  The program has been a success. Since SCHIP's creation, the uninsured 
rate for children in families earning between about $20,000 and $40,000 
a year has dropped by 25 percent. Last year it covered more than 6\1/2\ 
million kids. Today the number of uninsured children within the income 
group we originally targeted is down to about one million nationwide.
  Republicans were ready to finish the good work we started with SCHIP, 
and we approached its reauthorization this year as an opportunity to do 
just that, to reach out to the kids in our original target area who 
should be covered by SCHIP but weren't.
  Meanwhile, our friends on the other side had another idea: following 
the lead of a number of State Governors, they decided to expand SCHIP 
beyond its original mandate and bring us down the path of Government-
run healthcare for everyone.
  These Governors started with adults and children from middle and 
upper middle-income families. Taking SCHIP funds that were originally 
meant for children from poor families, they spent it on these other 
populations instead. Then they turned around and said they didn't have 
enough money to cover the poor children in their States. Which is 
absurd. This is a capped entitlement. The dollar amount is fixed. If 
you are spending it on adults, you have already decided not to spend it 
on the children who need it most. And that is wrong.
  New Jersey, under the leadership of one of our former Senate 
colleagues, helped lead the way. Rejecting a rule that limits SCHIP 
funds to the poor children, New Jersey now uses SCHIP for adults, and 
for children in families that earn as much as $72,275 a year.
  For millions of hard-working Americans who have to pay for their 
insurance, it doesn't seem right that they should have to subsidize the 
families in New Jersey who can and should be paying for their own. And 
a lot of poor families in New Jersey are also right to wonder why 
Trenton is suddenly enrolling middle-class families for SCHIP when 
their kids still lack coverage--about 120,000 of them by one count.
  This is the kind of SCHIP expansion that Democrats want in all 50 
States. They want to continue to expand it, pulling more and more 
middle-income children and adults off the private market and onto 
public coverage, driving private insurance costs up, driving the 
overall quality of health care down.
  Not every State is abusing the rules. Kentucky runs its version of 
SCHIP, KCHIP, in a financially responsible way. We even have money left 
over from years past. But under the Democrats' reauthorization plan, 
Washington would take those extra funds and send them to States like 
New York and New Jersey that spend more than they get. As a result, 
even the expanded SCHIP program would leave Kentuckians with less SCHIP 
funding in the coming fiscal year.
  Kentuckians don't want the money they have targeted for poor children 
going to adults and middle-class families in other states that can 
afford insurance on its own. KCHIP's money goes where it should be 
going: to low-income kids who need it most.
  Right now, KCHIP serves about 50,000 kids in Kentucky, but there are 
a lot more who could be covered and aren't. We need to focus on them 
before expanding SCHIP program to new populations. And the Republican 
proposal I cosponsored with the other Republican leaders would do just 
that.
  Until this year, SCHIP had been a bipartisan program and a bipartisan 
success. But in yet another sign that no good deed goes unpoliticized 
by Democrats in the 110th Congress, our Democratic friends accuse 
Republicans who want to reauthorize SCHIP of shortchanging it, of 
shortchanging children. Which is also absurd. We want to improve the 
program we have got, not expand it into areas it was never meant to go.
  Of course some of the news organizations are running with the story. 
They seem to have forgotten that basic rule of politics that anytime 
somebody accuses you of opposing children they've either run out of 
arguments or they are trying to distract you from what they are really 
up to. And what our friends on the others side are up to is clear: they 
have taken SCHIP hostage, and what they want in exchange is Republican 
support for Government-run healthcare courtesy of Washington.
  They tried that about 15 years ago, the American people loudly 
rejected it when they realized it would nationalize about a seventh of 
the economy, and they don't like Government health care any better now.
  The first priority for Senate Republicans is reauthorizing SCHIP for 
the kids who need it. And we have demonstrated that commitment. Early 
last month, the Republican leadership proposed the Kids First Act, 
which allocates new funds for outreach and enrollment so SCHIP can 
reach 1.3 million more children than it already does. Our bill also 
pays for this outreach, without gimmicks and without raising taxes.
  When Democrats rejected Kids First, Republicans introduced a bill to 
extend the current program to cover kids at risk of losing coverage 
until the debate over its future is resolved. While our friends on the 
other side were issuing

[[Page 25834]]

press releases and playing politics, Republicans were looking for ways 
to make sure SCHIP funds didn't run out.
  When this bill is vetoed, no one should feign surprise. They have 
known since July the President would veto any proposal that shifted 
SCHIP's original purpose of targeting health care dollars to low-income 
children who need them most.
  Our Democratic colleagues have no excuse for bringing us to this 
point. But then again, this is the game they have played all year: 
neglect the real business of Government in favor of the political shot. 
Dozens of votes on Iraq that everyone knows won't lead to a change in 
policy. Three hundred investigations into the executive branch. And 
what is the result? We have less than 100 hours left in the current 
fiscal year, and Democrats haven't sent a single appropriations bill to 
the President's desk. This ought to put the 110th Congress into the Do-
Nothing Hall of Fame.
  Less than 100 hours before a health insurance program for poor 
children expires, and Democrats are counting down the hours so they can 
tee up the election ads saying Republicans don't like kids. Meanwhile, 
they are using SCHIP as a Trojan horse to sneak Government-run health 
care into the States.
  This isn't just a Republican hunch. According to the nonpartisan 
Congressional Budget Office, families that have private insurance are 
switching over to SCHIP in States that allow it. The junior Senator 
from New York has proposed a plan that would raise the eligibility rate 
to families of four that earn $82,600 a year--this, despite the fact 
that roughly nine out of ten children in these families have private 
health insurance already.
  But of course that is not the point. The point is pursuit of a 
nationalized Government-run health care controlled by a Washington 
bureaucracy. Some Democrats have admitted what this is all about. The 
chairman of the Finance Committee recently put it this way: ``We're the 
only country in the industrialized world that does not have universal 
coverage,'' he said. ``I think the Children's Health Insurance Program 
is another step to move toward universal coverage.''
  While Democrats are busy looking for ways to shift this program away 
from its original target, the deadline for reauthorization looms. 
Republicans have made this reauthorization a top priority. If Democrats 
want to expand Government-run health care, they should do it in the 
light of day, without seeking cover under a bill that was meant for 
poor children, and without the politics. Republicans can take the 
shots. But the poor kids who we were originally trying to help 
shouldn't be caught in the middle.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Madam President, I have a couple of points. I don't want 
to prolong the debate. My good friend from Kentucky made a couple 
points I wish to clarify.
  I did say I think our country should move toward universal health 
coverage. I think we should. In fact, our President, President Bush, 
has said the same thing. He said we should have universal coverage of 
health care in America. I think most Americans think we should have 
universal coverage. What does that mean? That means everyone should 
have health insurance. I did not say and do not mean we should have a 
single-payer system like Canada. I think we should have universal 
coverage with an appropriate mix of public and private coverage so that 
every American has coverage.
  So I think for the Senator from Kentucky to make a charge that we are 
for universal coverage, I am, as is our President. Most Americans want 
universal coverage. My point is, what form and what way?
  I think it is important to remember one thing. What does this CHIP 
bill do compared to current law? The charge is that it expands 
eligibility, it goes to upper income kids, and so on and so forth, it 
is another step in Government health care. That is the charge.
  That is not the fact. This bill is more restrictive than current 
law--more restrictive than current law. Essentially, eligibility is, 
under current law, determined by States and the Federal Government. 
States determine eligibility--that is current law--and the 
administration either does or does not grant a waiver. This Republican 
administration has granted several waivers. In fact, one was to the 
Republican Governor of New Jersey, Christine Todd Whitman, when a major 
waiver was granted. So this bill does not change current law. 
Basically, it provides and uses the purse to discourage States from 
going to higher coverage by lowering the match rate. Nothing in this 
bill expands eligibility--nothing. So the charge that this is 
increasing eligibility to people other than children is just not 
accurate.
  Madam President, I yield the floor.
  I see the Senator from West Virginia is seeking recognition.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mr. ROCKEFELLER. I thank the chairman of the Finance Committee. I am 
very happy that the chairman of the Finance Committee made the comments 
he just did because I was absolutely bowled over by the comments which 
preceded him from the other side of the aisle. It is sort of basic when 
you say the word ``universal.'' It means everybody, but it does not 
necessarily mean it has to be run by the Federal Government, and 
anybody who makes that kind of an error is either really playing 
politics or really needs to go to grad school.
  In any event, this program is totally optional. And there is nothing 
about it which--in fact, several of the previous speakers said that 
States could do this and States could do that, but on the other hand it 
was all Government run, so therefore how could the States do it on 
their own? It is sort of a sad argument.
  Several months ago, four Senators--two Republicans and two 
Democrats--stood in a room, shook hands, and made a promise to each 
other. It was a wonderful moment. It was a wonderful moment. We vowed 
not only to reauthorize the Children's Health Insurance Program for 
millions of kids who rely on it for basic medical care but also to 
reach out to millions more children. Today, these many months later, we 
are one step closer to making the promise into a reality for nearly 10 
million children. I am very proud to be working with those Senators, 
grandfathers and fathers themselves, Senators Baucus, Grassley, Hatch, 
and others, and what they have accomplished in the Senate on the CHIP 
bill.
  The legislation before us today is the result of months of some of 
the most bipartisan working by both the Senators and the staff of the 
Senators that I have ever seen. It went on for months, night and day. 
Every day, the four Senators involved in this met for 2 hours so that 
we could work out differences and make sure it was bipartisan, and I am 
so happy to say that it is.
  Many Members of the House and Senate had hoped for something 
different in this bill. Obviously, some wanted more, some wanted less. 
Some wanted to simply reauthorize the status quo, some wanted to even 
decrease the children's health insurance funding, and others wanted to 
add benefits. That is not necessarily evil. Because you did something 
10 years ago does not mean it has to stand written in stone forever, 
such as eye exams. Some wanted to restore coverage to the children of 
legal immigrants. Some wanted to increase funding to $50 billion.
  Individually, we all believed what we proposed was the right thing to 
do, but ultimately we did not do those things because we compromised 
because we were determined to be bipartisan and we wanted this bill to 
pass for the sake of 10 million children. So the promise of the 
handshake brought us back to the table each and every time and to the 
common ground we walk today.
  Each of us knows the statistics in our own State. I am proud that 
nearly 40,000 West Virginians were enrolled in our Children's Health 
Insurance Program last year. These kids can see a doctor when they get 
sick, they can receive necessary immunizations, and they can get 
preventive screenings. In

[[Page 25835]]

fact, at the very beginning, it was very hard to get preventive 
screenings. Now they can. They will be able to, so they can get a 
healthy start in life because of this important program. The passage of 
this bill means thousands more of West Virginia's children will have 
affordable and stable health insurance, including access to basic care.
  A personal comment. This is all incredibly important to me. Four 
decades ago, or more, I came to West Virginia as a VISTA volunteer. I 
did not plan to stay; went to a community where nobody had any health 
insurance, any job, any water, any sewer, any schoolbus. That was an 
experience which turned me around, gave meaning to my life. It was a 
small mining community in southern West Virginia where I learned just 
exactly how important health care can be in the lives of people who 
work hard every day to raise a family and to do right by their children 
and how painful it is when they don't have it. That experience has had 
a profound influence on me, has influenced me every day of my public 
service career since.
  Providing children, especially those who are in the grips of poverty, 
with health care is moral. It is a moral obligation. It speaks to our 
deepest humanity and to the better angels of our Nation's character. It 
was a promise that got started, in fact, with the recommendations of 
the National Commission on Children, which I was proud to chair and 
have since worked to implement its recommendations, many of which, 
including the earned-income tax credit and others, are in effect.
  It was, as some remember, a very different time in 1997 when this 
CHIP program was begun. A decade ago when the debates on CHIP took 
place, there was a genuine frustration that we could not solve broader 
problems plaguing America's health care system. We were, in fact, the 
wisdom was, at the breaking point. That is when a bipartisan group of 
equally committed Senators at that time were in the finance executive 
room with no staff and worked long into the morning to develop a CHIP 
program. It was one of the most glorious moments I can remember. People 
who had never spoken about children suddenly rose, because we were all 
by ourselves around a table, and spoke about the importance of doing 
health insurance for children. It was moving. Some people actually 
stood as they spoke. We were all around a table and there was no need 
to stand, but their feelings were so deep and they poured forth because 
there we were, by ourselves, with our consciences, with the future of 
children in our hands. We knew we could not solve the entire problem, 
but we committed to trying to do our best by putting children first. 
The time has come for Congress once again to put our children first, 
and the bill before us today does exactly that.
  So having said what it exactly does, I want to say what it exactly 
does not do, this bill.
  To start with, we keep our promise that all those currently enrolled 
will keep their health insurance by investing $35 billion over the next 
5 years.
  We give States the resources to reach out and enroll millions more 
kids, which, in fact, sounds very easy, but in rural areas--and I 
think, of course, of Appalachia--it is a very hard thing to do where, 
in fact, many parents of children, and therefore the children 
themselves, are scared of health care, scared of doctors, scared of 
clinics, scared of hospitals, and want to stay as far away from health 
care as possible. So it is a very difficult thing to get them to join, 
but we are determined to do that.
  We have included, yes, expanded access to dentists and mental health 
counselors. All of the history of health care shows those things are 
incredibly important for children. In fact, even as baby teeth come in, 
they determine what mature teeth will be, and if you do not tend to 
them early, the children are in for terrible problems. I have seen so 
much of that.
  We have made it easier for States to identify those children who are 
eligible but not enrolled in CHIP by reviewing food stamp records, 
school lunch programs, WIC programs, and all kinds of things that 
States will decide to do, every State being different, parts of States 
being different. So there are people--the Governors and those running 
these programs as they do, not the Federal Government, but the 
Governors of the States will decide how to do this.
  We have maintained the unique public-private partnership that has 
been the hallmark of the CHIP program which has been universally 
recognized as the most cost-effective and efficient way of reaching all 
those children who desperately need access to something sacred called 
basic medical care.
  Most importantly, we have preserved the State flexibility, so the 
program fits the needs in every State--different in one State as 
opposed to another.
  Now, let me be equally clear about what the bill does not do. It does 
not raise eligibility limits to families making $83,000 dollars a year. 
It simply does not do that. I challenge anybody to come on the floor 
and say otherwise. Our bill does not encourage people to give up 
private insurance to enroll in CHIP. It does not do that. It does not 
unfairly raise taxes on the poor and middle class to pay for CHIP. In 
fact, throughout, both looking backward and looking forward to the 
passage of this bill and hopefully the signing of this bill, 91 percent 
of all the children who are covered by the Children's Health Insurance 
Program will be at 200 percent of poverty or below. That is not wealth. 
They go out in the private market, and in some places it can be $12,000 
dollars, and in others, $9,000. Families cannot afford that. This bill 
is incredibly important to them.
  This bill does not cover illegal immigrants. It does not expand 
coverage to adults. In fact, it cuts adults off the program over the 
next several years. It does not turn CHIP into some massive Government-
run health care program. The President knows this. He should know this. 
He is a former Governor. And he has spoken about this favorably. So he 
should understand this.
  So what is the President's plan for children's health care? For 
starters, provide a bare minimum of Federal funding to keep CHIP on 
life support and at the same time throw 1.6 million kids currently in 
the program out of the program. And what is his answer to those kids 
and the 721,000 who joined the ranks of the uninsured last year? Go to 
the emergency room. That is the worst increase of health care known in 
this country. So sit for hours to see a doctor, only to be prescribed 
medicine that your parents cannot afford. It is not American. That is 
not American.
  Adding to the Nation's growing health care crisis is not a solution. 
If anything, it would lead to the one thing the President is accusing 
us of: shifting the burden of paying for health care to taxpayers. We 
do not do that.
  Threatening to veto our bill is a mistake. The majority of Americans 
believe we need to live up to our obligations to provide children with 
health care.
  How many people wandering around the streets of Washington or any 
other place in this country would ask: Don't you agree with me that 
children shouldn't have health care, children who can't afford it, that 
only the rich should have it? You wouldn't get any takers on that. 
People care about children. They know they are the future. They want 
them to have health care. So it is a moral obligation for our children, 
and the President is squarely on the wrong side of the issue.
  All of us here, I know, will do the right thing by our Nation's 
children. I sincerely hope the President will look deep into his heart 
and do the same.
  I yield the floor and thank the Chair.
  The PRESIDING OFFICER. The Senator from Maine.
  Ms. SNOWE. Madam President, I rise today to voice my strong support 
for the reauthorization of the State Children's Health Insurance 
Program. I want to extend my heartfelt congratulations to Chairman 
Baucus and Ranking Member Grassley as well as to the chairman and 
ranking member of the Health Subcommittee, Senators Rockefeller and 
Hatch, for their vital and resolute spirit of bipartisan cooperation 
and tireless perseverance in crafting an agreement with House 
negotiators that will maintain health insurance coverage for 6 million 
children and reach nearly four million

[[Page 25836]]

more. Their work demonstrates what we can accomplish when we set aside 
philosophical differences in order to do the right thing for children 
and their families. I am pleased that we reached a veto-proof majority 
with the previous cloture vote, which shows strong support for 
extending and building upon this landmark legislation.
  As we all know, the problem of the uninsured touches communities all 
across our country. Thankfully, we have made tremendous strides in 
dramatically lowering the number of uninsured children through SCHIP 
which, time and again, has proved to be both a successful program and a 
saving grace for millions of American families who otherwise simply 
could not afford to pay for their children's health care. The stakes 
could not be more monumental. The quality of the health care that one 
receives as a child can have dramatic implications later in life. And 
there is not a family in America who does not want to provide the most 
comprehensive health coverage possible for its children.
  While some may mistakenly characterize SCHIP coverage as a welfare 
benefit, what they may not realize is that nearly 90 percent of 
uninsured children come from families where at least one parent is 
working. Today, fewer than half of parents in families earning less 
than $40,000 a year are offered health insurance through their 
employer--a 9 percent drop since 1997. And for many working families 
struggling to obtain health care, if benefits are even accessible to 
them, the costs continue to rise, moving further out of their reach. In 
my own State of Maine, a family of four can expect to pay $24,000 on 
the individual market for its coverage. For most families, taking this 
path is unrealistic and unworkable, especially when factoring the cost 
of mortgages, heating bills, and myriad other financial pressures.
  That is why I am pleased that the compromise provides a significant 
increase in federal commitment into the SCHIP program. With lives 
literally hanging in the balance, we ought to be building on what 
works. As we move to reauthorize the SCHIP program, states not only 
require sufficient Federal funding to ensure that children currently 
enrolled in SCHIP do not lose coverage and become uninsured, they also 
require additional funding to enroll more uninsured children--
particularly the 11,000 children in Maine who are eligible but 
unenrolled.
  I am particularly heartened that the House and Senate negotiators 
recognized that dental care is not a ``luxury'' benefit--but one that 
is paramount to the healthy development of children. A guaranteed 
dental benefit was included in S. 1224, the Children's Health Insurance 
Program Reauthorization Act, legislation I introduced with Senator 
Rockefeller in April.
  In addition, as members of the Finance Committee, Senator Jeff 
Bingaman and I sought to improve the quality of dental care through the 
provision of an assured dental benefit for all SCHIP-covered children 
during the committee process. Chairman Baucus was instrumental in the 
inclusion of a $200 million dental grant program as a first step 
towards meeting our goal during the Finance Committee process. And I am 
pleased that we were ultimately able to see such a strong dental 
benefit in the package we are considering today.
  Most dental disease is preventable with proper care up front, but 
when a parent cannot access routine care for a child, taking that child 
to the emergency room is often their only recourse. Yet that option 
costs at least four times as much as seeing a dentist. Plus, the health 
care a child receives in the emergency room does not even resolve the 
underlying problem--they generally provide only pain relief and 
antibiotics for infection. The bill before us today provides States the 
choice to either provide a dental benefit as contained in the SCHIP 
statute or choose among three other coverage options--dental coverage 
equivalent to the coverage offered by the Federal Employee Health 
Benefit Plan, FEHBP, dental option--the largest dental plan in the 
State--or the State employees dental plan with the largest enrollment 
of children.
  The compromise package also replaces the policy announced by the 
Centers for Medicare and Medicaid Services last month that would 
essentially prevent state SCHIP programs from enrolling uninsured 
children from families with household incomes above 250 percent of the 
federal poverty level. To put this into better perspective, 250 percent 
of the federal poverty level for a family of four is $51,625. As I 
illustrated before, families in Maine faced with purchasing a policy on 
the individual market could face a cost well in excess of $24,000 a 
year. If States such as mine were prevented from expanding eligibility 
over 250 percent of poverty, families with a clear, demonstrable need 
could be shut out.
  Families could potentially spend nearly half their income on health 
coverage yet still not qualify for assistance. That's why 2 weeks ago, 
Senators Kennedy, Smith, Rockefeller, and I introduced legislation to 
nullify these new restrictions. This compromise will rightfully block 
efforts to impose onerous and unreasonable restrictions on the States' 
efforts to reach every child requiring assistance--while at the same 
time making sure States with more generous income-eligibility levels 
are meeting their commitment to lower income children.
  I also want to speak briefly about the offset contained in this bill. 
Though some may vigorously disagree, I find that an increase in the 
tobacco tax is an appropriate avenue to help finance health coverage 
for low-income children. The health complications caused by smoking--
for instance, the increased risk of lung cancer and heart disease as 
well as the clear relationship between the number of cigarettes smoked 
during pregnancy and low birth weight babies--could not be more 
evident. It is clear to me that investing in children's health, while 
at the same time discouraging children from starting to smoke in the 
first place, is the best form of cost-effective, preventative medicine.
  Regrettably, this week we will hear a litany of reasons why we 
shouldn't cover more children through SCHIP. Some will express concerns 
about the size and cost of the package. I would respond that it should 
inject a dose of reality on the magnitude of the problem. States have 
responded to the call of families who are struggling every day with the 
cost of health insurance and are assuming a tremendous burden in the 
absence of Federal action.
  In addition, we should bear in mind that this bill is $15 billion 
below the amount we provided for in the budget resolution. Again, this 
bill is the product of compromise. Some of us wanted to go further. 
Senator Rockefeller and I introduced legislation to reauthorize the 
program at the full $50 billion--a bill that garnered 22 bipartisan 
cosponsors.
  Although there were compromises made along the way on various policy 
positions, one point is not up for discussion--simply maintaining the 
status quo of current levels of coverage is unacceptable. And while the 
Congress and the White House argue over philosophical differences, 
children are either going without coverage, or their parents are 
financing their care on credit cards, hoping they can stay on top of 
their debt.
  We are the wealthiest Nation on earth, and if we are unable to 
provide health insurance and medical care to our young people, then 
what does that say about our values? Some of my colleagues will contend 
that the SCHIP reauthorization we are considering is the first step 
toward government-run health care and that we will substitute public 
coverage for private insurance. The fact is that this SCHIP program 
came into being ten years ago. We haven't seen that evolve from the 
SCHIP program. We didn't see it materializing into a government-run 
health care program, as many have alleged here today. It absolutely 
hasn't happened. What we did was identify a need and address it in a 
bipartisan manner.
  These claims ignore the fact that today, 73 percent of the children 
enrolled in Medicaid received most or all of their health care services 
through a managed care plan. In fact, America's Health Insurance Plans, 
AHIP, a national association representing nearly

[[Page 25837]]

1,300 member companies, has recently endorsed this legislation, stating 
``it repairs the safety net and is a major movement toward addressing 
the problems that States and Governors have been trying to address, 
which is how to get access for children.'' The bill also helps shore up 
employer-based coverage by granting states the option to subsidize 
employer-sponsored group health coverage for families that find the 
coverage beyond their financial means.
  Some have argued that SCHIP should reduce coverage for adults, 
especially childless adults. While I believe that coverage for adults 
can have a clear benefit for children, both in terms of enrollment of 
children as well as the simple fact that health problems for a working 
parent can lead to economic insecurity for the family, this approach 
represents an area where we had to compromise. But I find it 
contradictory that the administration, which has been so vocal in its 
opposition to the cost and scope of the compromise package, granted the 
majority of the 14 adult coverage waivers granted over the past ten 
years and renewed a waiver for adult coverage in May!
  Some will argue that reauthorization should be attached to a larger 
initiative on the uninsured. We must acknowledge forthrightly that 
working families are having a difficult, if not wrenching, time finding 
affordable, meaningful coverage--coverage not just in name only. Access 
to affordable, quality health care is the No. 1 one domestic priority 
of Americans, and the public will hold us all--Republicans and 
Democrats alike--accountable on delivering that goal. That is why I 
have been engaged with my colleagues in an effort to address the 
critical issues of extending coverage, reducing costs, and 
revolutionizing care delivery. But while I agree with many of my 
colleagues that legislative action to solve the problem of the 
uninsured is long-overdue, children should not be kept waiting. We 
cannot defer the urgency of providing health insurance for our children 
while we continue to procrastinate on the issue of the uninsured.
  Frankly, I am outraged by the news that the President is considering 
a veto of this legislation. I believe this seriously misjudges the 
genuine concern Americans have about access to care, particularly for 
children. In a March New York Times/CBS News poll, 84 percent of those 
polled said they supported expanding SCHIP to cover all uninsured 
children. A similar majority said they thought the lack of health 
insurance for many children was a ``very serious'' problem for the 
country.
  SCHIP has been the most significant achievement of the Congress over 
the past decade in legislative efforts to assure access to affordable 
health coverage to every American. Today, as we consider this 
reauthorization, we must not undermine the demonstrated success of this 
program over the past decade. Compromise on both sides of the aisle 
helped us create this program ten years ago and hopefully a renewed 
sense bipartisan commitment will help us successfully reauthorize this 
vital program.
  I would strongly encourage the President to reconsider his short-
sighted veto threat and work hand-in-hand with Congress to extend 
health insurance to countless, deserving children. I urge my colleagues 
to support this legislation.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Florida.
  Mr. NELSON of Florida. Madam President, on behalf of Senator Baucus, 
I yield myself 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. NELSON of Florida. Madam President, this Children's Health 
Insurance Program is universally acknowledged as having reduced the 
number of uninsured children in America. As the Senator from Maine has 
just said, we can be very proud we have seen a landmark compromise 
between Republicans and Democrats. With the talks going on between the 
House and the Senate, this compromise legislation is going to allow us 
to continue coverage for millions of low-income children and to expand 
the coverage to millions more.
  It is so popular because if we can attack poor health at a child's 
age, ultimately, not only is it going to benefit the quality of life of 
that individual, but it is going to be less of a cost to society in the 
long run, if you can get at their root problems of health while they 
are young. This is a simple economic fact, preventive health care.
  In my previous life as the elected State treasurer and insurance 
commissioner in Florida, I chaired the board of directors of the 
Healthy Kids Corporation. It was Florida's pioneering effort to insure 
low-income children well before this Children's Health Insurance 
Program started at the Federal level. We did it through the schools. We 
had tremendous success. It works.
  So there is a collective sigh of disappointment that the President is 
going to refuse to accept this compromise, which is what reflects the 
general will, as expressed by that tremendous vote we just had a few 
minutes ago, allowing the bill to continue to go forward in this 
legislative process. The President's looming veto threat calls into 
sharp relief all of those who stand to lose in the absence of fully 
reauthorizing and expanding this CHIP program.
  Think back 10 years ago and what has happened since. The number of 
uninsured adults has increased, while the rate of low-income, uninsured 
children has decreased, and decreased not by a little but by a third 
largely due to this program we are going to pass today.
  These children have been afforded better access to primary and 
preventive care and a better quality of care. This reauthorization is 
going to provide $35 billion of additional funding over the next 5 
years.
  Now, of course, that is a bone of contention for some people. If you 
are going out and finding $35 billion extra to fund something--at a 
time there is not that money out there, particularly when we are going 
to have a supplemental request for Iraq of some $200 billion--under 
that circumstance, that context, where are you going to get 35 billion 
new dollars over 5 years to fund a program such as this? The tobacco 
tax.
  There are those who do not want to tax tobacco. But where else would 
you like to get it? You cannot make it up. You cannot go and print the 
money. You have to get it from some legitimate place. This is the place 
that can withstand that additional tax. So there will be some who will 
vote against this program because they do not want to tax tobacco. 
Well, let their record be clear why they oppose this popular program.
  The added investment in children's health is not only necessary, it 
is fruitful. It is common sense. Healthy children are more likely to 
stay healthy as they move into adulthood. Certainly, if they are 
healthy, they are going to have more productive lives. On top of all 
this, don't we have a moral imperative to ensure that children, 
regardless of their parents' income, are able to have a healthy life?
  I think that is what makes up our moral fiber, our fabric, all of our 
teachings, our traditions. Our values say we want to have health care 
for children regardless of their parents' ability to pay.
  The President has argued that this expansion is going to take the 
CHIP program beyond its original intent of just helping poor children. 
Some people say it is going to be helping adults. Do I think that 
pregnant women--pregnant adult women--ought to be helped? I would think 
common sense would say yes.
  I believe this program would deepen and expand that initial promise 
which is helping those American families that struggle with those 
health care costs that are rising much faster than their wages.
  Can you imagine being a parent and watching your child have a health 
problem and you cannot do anything about it because you do not have the 
financial means to take away the pain of that health problem of your 
own child? Parents would get out and scrap and scrape, they would dig 
ditches, they would clean latrines, they would do anything for their 
child. But, sadly, because of the low income of some families, those 
children do not have that

[[Page 25838]]

health care. Well, we can address that and correct that today.
  The President has also said this expansion is going to bring us down 
a path toward the federalization of health care. Well, that is simply 
not so. There is wide latitude in this law to give that latitude to the 
States. I believe, simply, children are too precious to be held hostage 
to an ideological debate. This program is more important than the 
rhetoric about government-run health care.
  By virtue of me telling you my background, obviously, this bill is 
very important for my State of Florida, where over 700,000 children 
alone are uninsured. This legislation is the best opportunity to expand 
that coverage to a significant portion of those 700,000 children and 
certainly across the land to millions of children.
  We have seen the success. We are aware of how many more children need 
to participate. I humbly urge the President to reconsider his veto 
threat. It is rare we have a chance to pass legislation that is so 
overwhelmingly positive, so completely necessary, and so morally 
unquestionable.
  I am certainly going to cast my vote in favor. I hope a resounding 
percentage of this Senate will do likewise so we can send a very strong 
message of support.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Salazar). The Senator from Ohio.
  Mr. BROWN. Mr. President, I would like to follow on the comments of 
my colleague from Florida, Senator Nelson, in support of the Children's 
Health Insurance Program bill.
  This week, the House of Representatives passed the bill 
overwhelmingly, 265 to 159. Of my 18 Ohio House colleagues, about two-
thirds of them voted for this bill. It is clearly something we know 
works in my State.
  The Children's Health Insurance Program was passed 10 years ago in 
the House of Representatives and the Senate. It was established. 
President Clinton, a Democrat, with a Republican House and a Republican 
Senate, supported that issue, and it has clearly worked.
  We have some 6 million children in this country now who benefit from 
the Children's Health Insurance Program. In my State, it is around 
200,000 children. We also know this legislation will mean about 4 
million more children in the United States will benefit from this 
health care program.
  These are sons and daughters of working families. These are not 
people living in the lap of luxury. They are families making $20,000, 
$30,000, and $40,000 a year. They are families where they are working 
hard, playing by the rules, but they are not making enough money to buy 
insurance. Their employers do not offer insurance. So this is what we 
need to do.
  Now, the President says he plans to veto this bill for two reasons 
that I can understand. One of them, he said, is the cost. This is $35 
billion over 5 years; $7 billion a year. But just make the contrast: We 
are spending $2.5 billion a week--$2.5 billion a week--on the war in 
Iraq. Yet the President does not want to spend $7 billion a year to 
insure 4 million children. That is his first reason--the cost.
  The second reason, the President says: I want private insurance to 
take care of these children. Well, so do I. So does Senator Grassley, 
who has been a major leader on this issue in the Senate on the other 
side of the aisle. We all do. But the fact is, private insurance is not 
taking care of these children. Again, they are sons and daughters of 
people with jobs paying $20,000, $30,000, $40,000, $50,000 a year, 
people without insurance and without the financial wherewithal to be 
able to take care of these children.
  The President came to Cleveland a few months ago and said everybody 
has health care in this country. They can get it at the emergency room. 
I want children in this country to get preventive care in their family 
doctor's office, not acute care in the emergency room.
  Before the President makes his decision, I would like him to meet 
three families in Ohio, people who really speak to this whole issue.
  I want him to know about Dawn and Glenn Snyder and their son Cody, 
living in Bloomingdale, near Steubenville, near the Ohio River in 
eastern Ohio. Dawn works in a doctor's office, and Glenn works 
temporary jobs. Cody is 3 years old and has cerebral palsy. Until he 
was a year old, Cody had bleeding in his brain and seizures. Sometimes 
Glenn has insurance and sometimes he doesn't. It depends on where he is 
working. Dawn is going to lose the coverage for her family that she has 
gotten because they can no longer afford to buy it.
  So even though Cody needs regular medical care from a neurologist and 
an eye doctor, as well as routine preventive care that all children 
need, he is in danger of having no access to health insurance. However, 
the Snyders will have coverage if this bill is signed into law.
  If this bill passes, Cody will likely qualify for care under Ohio's 
new Children's Health Insurance Program. I would add also, on a 
bipartisan note, Governor Strickland, the new Governor of Ohio, with a 
resounding bipartisan vote out of the legislature, moved the 
eligibility to 300 percent of poverty so families making up to about 
$50,000 or $55,000 a year will have coverage.
  If this bill passes, it means the Snyders will have a safety net for 
Cody's coverage and will be able to live with the security of knowing 
their son will receive the care he needs.
  Then there is the story of Evan Brannon. Evan is a 1-year-old from 
Dayton in southwest Ohio. His dad Kenneth is currently not working, 
after losing his job as a repairman for a telephone company. Angela, 
Evan's mother, stays at home with him and has a baby on the way.
  Evan was diagnosed with a congenital hernia of his diaphragm and is 
on a feeding tube, and he also receives medicine through a tube. He 
receives physical, occupational, and speech therapy. His parents looked 
into private coverage and learned they would never qualify for it 
because of Evan's preexisting condition. The family is faced with 
$5,000 to $6,000 a month in medical expenses. Angela can't go back to 
work. Kenneth is looking for a job but can't get a position over a 
certain income level or Evan will lose medical coverage. How is this 
family ever supposed to get ahead if they have to make sure not to make 
too much money out of fear of losing health insurance for their 
children? What kind of incentive is that to build into the system?
  Passing this bill will fix that. This is just one way in which 
America's families' opportunities are limited by our country's 
inability to provide the insurance the children's health insurance will 
provide.
  One more story. David Kelley is a 13-year-old living in Erie County, 
right next door to where I live. He lives with his mother Heather and 
his stepfather Timothy. David has been diagnosed as bipolar, mildly 
autistic, and suffers from Asperger's syndrome. He also has a rare form 
of asthma. David was born 2 months premature. His doctors believe that 
a lack of oxygen and other complications may have caused the conditions 
he has coped with daily for 13 years, although the causes are not 
completely known.
  David's health conditions require him to regularly visit a 
psychiatrist, a psychologist, and a primary care physician. His 
medications cost $2,000 each month, and Medicaid covers it. His mother 
Heather has said her greatest fear in life is of David losing his 
medical coverage. She herself has multiple sclerosis and is unable to 
work. No private insurance plan will ever cover David because of those 
preexisting conditions. Heather has made navigating the Medicaid and 
social service systems a nearly full-time job just to maintain David's 
benefits. Here is another family in need of help from the Senate.
  I hope our President will not leave the Kelleys, the Brannons, or the 
Snyders behind, without the health coverage their children so 
desperately need. I hope he can have compassion for those families 
struggling so hard to make ends meet and whose greatest wish is to 
provide the most basic of needs for their children: housing, food, and 
health care. I hope the President can see what a sound investment this

[[Page 25839]]

is. This isn't spending $7 billion a year; this is investing $7 billion 
a year in the future of our families, the future of our children, and 
the future of our country. Four million American children will receive 
health insurance if the President signs this bill. He must sign it into 
law. Too many people are counting on it.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Texas is recognized.
  Mr. CORNYN. Mr. President, there is no doubt in anyone's mind that 
the SCHIP program will continue. That is a certainty, as certain as 
anything can be. The question is whether the SCHIP program, the State 
children's insurance program, will remain true to its targeted 
population which was contemplated by Congress in 1997 when it passed 
with strong bipartisan support or whether it will expand into a new 
burgeoning Federal program that has lost sight of its original mission 
and which, in the minds of some, represents another incremental step 
toward a Federal Government takeover of our health care system in 
America.
  Let there be no doubt about it, a Federal, Washington-run health care 
system would be bad for the children and the people of this country. 
There are at least three things you can guarantee if Washington takes 
control of our health care. One is it will be incredibly expensive. In 
other words, taxes will have to go up to pay for it. Two, it will be 
incredibly bureaucratic, and some bureaucrat with a green eyeshade will 
decide what kind of health care you or your family gets. Three, there 
will be rationing of health care. That same Government bureaucrat will 
decide whether you get a diagnostic test, whether you can be scheduled 
for an operation when you need it, or what other kinds of health care 
decisions you can make. In fact, the choices will be taken from 
individuals and be given to the Government. That is a bad idea, 
although there are some who have advocated this for many years, 
including the leading Democratic contender for President of the United 
States, who has advocated a government-run health care system since the 
early 1990s.
  This cannot be an expansion of a wildly successful program that has 
lost its focus on the poor children of America, and how in the world 
could I possibly say that? Well, this bill we are debating now raises 
spending by 140 percent--140 percent--at a time when my constituents 
tell me they are very concerned that the Federal Government has lost 
its way when it comes to spending and are worried that they will see 
consequential increases in their tax burden as a result of out-of-
control Federal spending.
  Along with virtually everyone else in Congress, I strongly believe 
the SCHIP program should be renewed, and it will be renewed. I voted 
for a renewal bill called Kids First that provided $10 billion in 
addition to the $35 billion over 5 years and which would enroll 1.3 
million new children in SCHIP. But the majority has rejected that as 
too miserly.
  Whom do they want to cover with the State Children's Health Insurance 
Program? Well, No. 1, they want to cover adults in 14 States, and in 
New York City they want to be able to cover up to 400 percent of 
poverty. A family making $82,000 a year would be--half of whom would be 
displaced from their private health insurance to get government-funded 
health insurance at the courtesy of the beleaguered American taxpayer. 
That is wrong.
  The other inadvertent consequence of this will be because government 
doesn't know how to control health care costs except to ration access 
to health care, we are going to see more and more people now who will 
be displaced from private health insurance to go on to government 
insurance who will find low reimbursement rates--close the doors to 
access to health care providers. In the city of Austin recently, there 
was a story written that said only 18 percent of physicians accept new 
Medicare patients--18 percent. The question was, Why? Well, the Federal 
Government Medicare reimbursement rate is so low, doctors can't 
continue to accept new Medicare patients and keep their doors open. In 
a similar fashion, the SCHIP rate is regulated by the Federal 
Government, as is the Medicaid rate. The only way many physicians and 
health care providers keep their doors open is to have a mix of 
government-subsidized health coverage and private health insurance. We 
all know private health insurance carries the cost to allow many health 
care providers to keep their doors open.
  It is not conspiracy theories, it is not an exaggeration to say this 
is an incremental step toward that single-payer, Washington-controlled 
health care system. Right now, the Federal Government pays 50 percent 
of the health care costs in America today.
  I think it is a bad idea to lose sight of the original target for 
SCHIP, which is children whose families make up to 200 percent of the 
poverty level, who have more money than they can make and still qualify 
for Medicaid. But we should do everything in our power to recommit to 
those children that we are going to make sure the money Congress 
appropriates, takes out of the pocket of the taxpayer and provides in 
terms of health benefits to them, is true to the vision Congress 
originally intended and that that money which could go to expanding 
health care coverage to these kids who come from relatively modest 
incomes is not taken and provided for adult coverage or middle-income 
coverage in places such as New York for up to 400 percent of the 
poverty level.
  So there is a lot of misinformation and, indeed, downright 
demagoguery going on in the media and elsewhere with regard to what is 
happening here. I hope we will make one thing clear: that every Member 
of the Congress--certainly this Senator--supports a continuation and 
reauthorization of SCHIP. It is a canard to suggest that anyone is 
denying access to health care to the children who have benefited 
historically and should benefit from SCHIP. But it is simply a Trojan 
horse to suggest that we are merely reauthorizing this legislation 
because what is happening is we are seeing a dramatic expansion of 
Federal spending, losing sight of the targeted population, and taking 
another incremental step toward a disastrous Washington-controlled and 
-run health care system which will be expensive to the American 
taxpayer, which will be incredibly bureaucratic, and which will result 
in rationing of health care, which is something that is not in the best 
interest of the American people.
  I thank the Chair, and I yield the floor.
  The PRESIDING OFFICER. The Senator from Tennessee is recognized for 
10 minutes.
  Mr. CORKER. Mr. President, I thank the Chair. I will try to use less 
time. I know we have a lot of business today. I rise also to talk about 
the SCHIP bill we just voted on for cloture, and hopefully, later this 
evening, we will have the opportunity to vote on final passage.
  I have been here a short amount of time, and I continue to be amazed 
at some of the rhetoric that ends up circling much of the legislation 
we discuss in the Senate. I do not think the SCHIP bill is perfect. I 
am going to vote for the SCHIP bill. I haven't been in the Senate long 
enough in 8\1/2\ months to have actually ever voted for a perfect bill. 
Chances are I may never vote for a perfect bill in the Senate. I know 
this bill has been threatened to be vetoed. Again, I think about the 
irony of a bill such as this being vetoed by the administration.
  The most recent health care legislation that I remember passing out 
of this body that was a large bill was Medicare Part D. As I remember, 
that was a bill where nothing was paid for. We added $700 billion to 
$800 billion in deficits. There was no attempt whatsoever for that to 
be paid for. It also created coverage for individuals who did not need 
coverage. It didn't matter. We passed a massive bill. I was not here 
during that time, but it passed several years ago.
  The uniqueness of this bill is that there has been an attempt to 
actually pay for it--something unique in recent times as it relates to 
health care coverage. Secondly, it actually is health care for people 
who need it, which is also very different from some of the

[[Page 25840]]

things we have focused on in the past. So I find it very ironic that 
this administration has chosen this bill to veto.
  I have heard a lot of comments about the frailties of this, and one 
of the most recent red herrings regarding this bill was that it would 
allow illegal immigrants to receive health care. That is absolutely not 
true. But based on the standard of this argument that was put forth 
recently, we certainly need to ensure that immediately we would do away 
with Social Security, Medicare, and Medicaid because they would be 
held, of course, to a standard that cannot be met. That is an argument 
which obviously is not true.
  I also heard that this bill had earmarks in it. I have looked and I 
can't find any earmarks in this bill. There is a hospital in Tennessee, 
down on the Mississippi-Arkansas border, and it happens to deal with 
low-income citizens who come there from Mississippi and Arkansas. So 
this bill allows that hospital to be paid Medicaid reimbursement for 
the patients it sees from Mississippi and Arkansas. If that is the new 
standard for earmarks in this body, then I suppose every comment or 
statement we make will now become an earmark.
  I have also heard the comment that this is the backdoor to socialized 
medicine. I really think that one is maybe the most humorous I have 
heard. I do wish to bring this body's attention to the fact that the 
Bush administration--the Bush administration--since it has been in 
office has approved these waivers and state plan amendments: in June of 
2004 to California, allowing them to go to 300 percent of poverty, 
again above the intent of the original SCHIP bill; in Hawaii, in 
January of 2006, allowed the State, through executive prerogative, to 
go to 300 percent; in Massachusetts, in July of 2006, this 
administration allowed that State to go to 300 percent; in Missouri, in 
August of 2003, this administration allowed them to go to 300 percent; 
in New York, in July of 2001, this administration allowed them to go to 
250 percent; in Pennsylvania, in February of 2007, just a few months 
ago, to 300 percent; in West Virginia, in December of 2006, to 220 
percent. But the one I have left is the one that is most recent.
  This administration, without any legislative involvement, in March of 
2007--a few months ago--agreed to let the District of Columbia go to 
300 percent of the poverty level. So for those people to say this bill 
is a back door to socialized medicine, it seems to me they have not 
taken into account the front door of the Bush administration, which all 
along has allowed nine states to expand their programs beyond the 
original intent of the SCHIP program. This bill actually causes this 
out-of-control process that has been ongoing during the Bush 
administration to actually be reformed. It actually causes reforms to 
take place so this bill will more fully embrace its original intent.
  So I rise to say there is a lot of rhetoric that is being used in 
this SCHIP bill. This bill is not perfect. I know my colleagues on the 
other side of the aisle would like to see changes in this bill. I would 
like to see changes in this bill. I think it could have had a more 
credible debate had the administration initially funded this in their 
budget with an appropriate amount of money to even allow the program as 
it is to continue.
  I will vote for this bill. I am not going to argue to any of my 
colleagues as to what they should do. I will vote for this bill because 
I believe it focuses on those most in need--children--mostly poor 
children in our country.
  What is actually moving our country toward socialized medicine is the 
fact that none of us in this body have yet taken the steps to make sure 
that those most in need have access to private, affordable health care. 
I know there are a number of bills that have looked at that. I have 
offered a bill--again, it is not perfect--and I hope Members of this 
body will actually cause it to be improved by adding amendments. But 
the fact of the matter is, what will move our country toward socialized 
medicine is not this SCHIP bill, which focuses on poor children in 
America, but it will be the lack of action in this body to create 
methodologies, which we could do, to allow people in need to have 
access to private, affordable health care.
  Ms. STABENOW. Will my colleague yield for a question?
  Mr. CORKER. Yes.
  Ms. STABENOW. First, I thank the Senator for his comments on the 
floor of the Senate, debunking what has been inaccurate statements that 
have been made and also for laying out the realities of what is true 
about this proposal. I think the Senator has done it in a wonderful 
way. I appreciate the Senator's willingness to stand up and talk about 
what is real, important, and the fact that this is such a strong 
bipartisan bill.
  I wonder if the Senator might comment on the fact that aren't we 
talking about working families, low-income working families, trying 
every day to keep things together for their family, and they want to 
know that the children have health care? Isn't that what this is all 
about?
  Mr. CORKER. That is exactly what the bill is about. There is no 
doubt--and I think we should all acknowledge this--that there are some 
cases in some States where there has been an aggressiveness to actually 
cause some adults to be covered who should not be covered. In this 
bill, focusing toward 2010, there is an effort to reform that, to cause 
the focus to return back to children.
  Also, there is no question that this administration, which offers the 
fact that they are going to veto this bill, has done more to change the 
dynamics of SCHIP than any legislation that we could pass.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon is recognized.
  Mr. SMITH. Mr. President, today is a momentous day. We have the 
opportunity to extend health insurance coverage to 10 million low-
income children, 4 million of whom, without this bill, simply would 
continue to be a statistic in the ranks of the uninsured. In Oregon 
alone, we estimate that at least 60,000 new young people will receive 
health insurance and possibly even more.
  Because of the outstanding work of my colleagues, Senators Baucus, 
Grassley, Hatch, and Rockefeller, and because of their work, we have 
before us a proposal that will garner wide, bipartisan support. I 
commend them for their efforts and thank them for their willingness to 
work with me to incorporate a number of important policies not only to 
Oregon but to millions of young Americans across this country.
  When I first arrived in the Senate in 1997, I had the opportunity to 
learn about an outstanding idea launched by two great colleagues, 
Senators Kennedy and Hatch. That idea was known as the State Children's 
Health Insurance Program. When they described the details to me, I 
recognized in it many of the features I had worked on as an Oregon 
State Senator in the development of the Oregon health plan. I told them 
to sign me up and let me know how a junior Senator on the Budget 
Committee could help them. It was my privilege to do that with an 
amendment on that year's budget.
  But here we are, 11 years later; now I serve on the Finance 
Committee, and I have had the opportunity to help craft a bill that 
will provide the authority and funding needed to continue SCHIP for 
another 5 years. It is a responsibility I took seriously then and 
still. I am pleased to have an opportunity today to renew it and 
improve it.
  As I think of the work we have done to advance this bill, I wish to 
take a moment to highlight a number of critical policies I have worked 
hard to advance and which are now included in the bill before us.
  First, and perhaps most important, I am pleased we will continue to 
utilize a 60 cent increase in the tobacco products excise tax to pay 
for SCHIP reauthorization. Looking back on the debate over the budget 
this past March, I didn't know, but I hoped at the time, my amendment 
to do this would garner the support necessary. It has done so. That 
support has held, and it is now the funding source for keeping the 
promise of SCHIP.
  However, in my opinion, there is no better means to provide funding 
for

[[Page 25841]]

children's health care. I know some don't like this. It is, frankly, 
the only tax increase I enthusiastically support and for which I have 
ever consciously voted. Not only can we extend health insurance to 10 
million low-income children, we can do so while discouraging other 
young people from smoking. Studies show America's youth is strongly 
discouraged from smoking if the price of the tobacco product is 
increased. I am hopeful we will discourage thousands of kids from 
smoking, which will improve and perhaps save their lives. I see it as a 
``twofer,'' to discourage smoking, and you can connect the habit of 
tobacco with all the public health care costs it imposes. It is a sad 
statistic that 20 percent of Oregonians who die each year die from 
tobacco-related illnesses.
  I am also pleased to have been able to secure mental health parity in 
SCHIP. According to a report by the Urban Institute entitled ``Access 
to Children's Mental Health Services Under Medicaid and SCHIP,'' the 
highest prevalence of mental health problems among all children, ages 6 
to 17, is observed among Medicaid and SCHIP-eligible children at a rate 
significantly higher than for other insured children and uninsured 
children. Now, today, the Senate has taken a remarkable step forward to 
ensuring that SCHIP treats ailments of the mind on the same level as it 
treats ailments of the body. That is a notable achievement.
  We are, as a Senate body, advancing the cause of mental health care 
as it has needed to be for some time but now hopefully soon. In this 
bill, and in the mental health parity bill earlier passed, we put 
mental health on parity with physical health.
  This bill also reverses the harmful policy recently implemented by 
the administration. While I understand the President has some authority 
to help guide the development of Federal programs, in this instance, 
the policy released by the Centers for Medicare and Medicaid Services 
to restrict coverage of children with incomes over 250 percent of 
poverty simply goes too far.
  Therefore, I strongly support the language in the bill that 
reinforces the Senate's position that States will be allowed to cover 
children with family incomes up to 300 percent of poverty. I also 
support the proposal to create a tracking system to more accurately 
determine who does and doesn't have insurance. This is vital as we 
continue to work to extend health insurance to all Americans.
  Finally, I wish to note how pleased I am to see that States will be 
able to extend coverage to pregnant women through SCHIP. This makes 
sense. Prenatal care, when you are talking about children, is truly the 
point at which they can get the healthier start. Their mothers deserve 
this if we are serious about the children they bear. According to the 
National Committee for Quality Assurance, every dollar spent on 
prenatal care results in a 300-percent savings in postnatal care costs 
and an almost 500-percent savings in long-term morbidity costs. This is 
an investment we need to make, and it is well worth making.
  Ten years after SCHIP became law, we now have a chance to support a 
bill that will cover 4 million new children who are already eligible 
for this program. This is not an expansion, though. This is simply 
keeping the promise of SCHIP with those children who are currently 
eligible but for whom we have not had the resources, the dollars, to 
fully fund this program.
  While some have alleged we are expanding the program, expanding 
government-run health care, that rhetoric could not be further from the 
truth. We are not expanding the program, we are simply putting our 
money where our mouths have been. We are taking a step forward to give 
States the money they need to cover the children who already are 
qualified for SCHIP but, for one reason or another, are not enrolled. 
We also are not expanding government-run health care. SCHIP is a 
program that is delivered by private insurance companies. It is a 
program that requires families to pay premiums and copayments based on 
their income levels. It is for these reasons that SCHIP will garner 
strong, bipartisan support today.
  In closing, I know there has been a great deal of rhetoric back and 
forth between the White House and the Hill. In this instance, with 
health care for millions of American children on the line, I urge my 
friend, President Bush, to take a fresh look at the details of this 
package and realize it is worthy of his support. I urge him to put 
aside the differences of this debate and sign this bill into law for 
the sake of our children, America's children.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Louisiana. The Senator is 
recognized for 10 minutes.
  Mr. VITTER. Mr. President, I rise today to speak about a very 
important amendment I have filed to the SCHIP legislation that passed 
the House and was sent back to the Senate. Unfortunately, the majority 
leader has decided not to allow any Republican amendments to this very 
important legislation. But I wish to take the opportunity, 
nevertheless, to discuss my amendment which is filed which is at the 
desk. It is very straightforward.
  It simply says American citizens only are eligible for SCHIP and that 
no funds will be used to expand health care benefits in SCHIP to 
illegal immigrants and others.
  The legislation we are considering, as written, will do just that. It 
will expand the program enormously without any regard for focusing on 
American citizens, and it is very clear that in that expansion, the 
benefit would go to many illegal aliens because of glaring loopholes 
that exist in present law and in this legislation.
  Congressman Jim McCrery of Louisiana has been looking into this issue 
for several weeks. On September 21, he wrote the Commissioner of the 
Social Security Administration.
  Mr. President, I ask unanimous consent to have printed in the Record 
Congressman McCrery's letter to the Social Security Administration.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                         House of Representatives,


                                  Committee on Ways and Means,

                               Washington, DC, September 21, 2007.
     Commissioner Michael J. Astrue,
     Social Security Administration, Office of the Commissioner, 
         Baltimore, MD.
       Dear Commissioner Astrue: As Congress prepares to debate 
     the reauthorization of the State Children's Health Insurance 
     Program (SCHIP), I am writing to request your assistance in 
     clarifying an issue raised by a provision in the Senate 
     passed bill. Specifically, I would request that the Social 
     Security Administration provide technical assistance to 
     explain the impact of Section 301 of H.R. 976, which was 
     passed by the Senate on August 2, 2007.
       Concerns have been raised that the implementation of this 
     provision could make it easier for illegal aliens to qualify 
     for government funded healthcare programs including SCHIP and 
     Medicaid. In order to better assess the accuracy of these 
     claims, I would request that you provide answers to the 
     following questions by no later than the evening of Monday, 
     September 24, 2007.
       1. If implemented as written, would the name and Social 
     Security number verification process in section 301 of the 
     Senate SCHIP bill allow the Social Security Administration 
     (SSA) to verify whether someone is a naturalized citizen?
       2. Would Section 301 require SSA to perform any 
     verification of a person's status as a naturalized citizen?
       3. Would the implementation of this provision detect and/or 
     prevent a legal alien who is not a naturalized citizen (and 
     therefore generally ineligible for Medicaid), from receiving 
     Medicaid?
       4. Would the name and Social Security number verification 
     system in Section 301 verify that the person submitting the 
     name and Social Security number is who they say they are?
       5. Would the name and Social Security number verification 
     system in Section 301 prevent an illegal alien from 
     fraudulently using another person's valid name and matching 
     Social Security number to obtain Medicaid or SCHIP benefits?
       6. Would the name and Social Security number verification 
     system in Section 301 prevent an individual who has illegally 
     overstayed a work visa permit from qualifying for Medicaid or 
     SCHIP?
       7. Based on the accuracy of your database, please comment 
     as to the volume of false positives or false negatives that 
     could occur under the Social Security number verification 
     process in section 301 of the Senate SCHIP bill.
       Thank you for your prompt attention to this matter. If you 
     should have questions about any of the requests in this 
     letter,

[[Page 25842]]

     please contact Chuck Clapton of the Ways and Means Committee 
     Republican staff.
           Sincerely,
                                                      Jim McCrery,
                                                   Ranking Member.


  Mr. VITTER. Mr. President, Congressman McCrery laid out seven very 
simple and straightforward questions that go exactly to this point: Is 
there any reliable way to ensure that this program is reserved for 
American citizens, not illegal aliens in the country?
  Unfortunately, the answers--all seven of them--came back: No, no, no, 
no, no, no, no.
  Mr. President, I ask unanimous consent to have printed in the Record 
the Administrator's responses.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

       If implemented as written, would the name and Social 
     Security number verification process in Section 301 of the 
     Senate SCHIP bill allow SSA to verify whether someone is a 
     naturalized citizen?
       No, the name/SSN verification process only indicates 
     whether this information matches SSA's records. Our 
     understanding of Section 301 is that it would provide States 
     with the option of using a match as a conclusive presumption 
     that someone is a citizen, whether naturalized or not. Since 
     we have no data specific to this particular population, we 
     have no basis for estimating how many noncitizens would match 
     if this language were passed by Congress.
       2. Would Section 301 require SSA to perform any 
     verification of a person's status as a naturalized citizen?
       Section 301 would not provide for verification of 
     citizenship but would create a conclusive presumption based 
     on less reliable data that a person is a citizen. As we read 
     Section 301, it would not require use of DHS data to make a 
     verification of citizenship.
       3. Would the implementation of this provision detect and/or 
     prevent a legal alien who is not a naturalized citizen (and 
     therefore generally ineligible for Medicaid), from receiving 
     Medicaid?
       No. Our current name/SSN verification procedures will not 
     detect legal aliens who are not naturalized citizens.
       4. Would the name and Social Security number verification 
     system in Section 301 verify that the person submitting the 
     name and Social Security number is who they say they are?
       No.
       5. Would the name and Social Security Number verification 
     system in Section 301 prevent an illegal alien from 
     fraudulently using another person's valid name and matching 
     SSN to obtain Medicaid or SCHIP benefits?
       No.
       6. Would the name and Social Security number verification 
     system in Section 301 prevent an individual who has illegally 
     overstayed a work visa permit from qualifying for Medicaid or 
     SCHIP?
       The name/SSN verification system in Section 301 would not 
     identify individuals who have illegally overstayed a work 
     visa permit.
       7. Based on the accuracy of your database, please comment 
     as to the volume of false positives or false negatives that 
     could occur under the Social Security number verification 
     process in section 301 of the Senate SCHIP bill.
       Due to a lack of data specific to this particular 
     population defined in section 301, we have no basis for 
     projecting how many ``false negatives'' or ``false 
     positives'' would be produced by enactment of Section 301, 
     but they will occur.

  Mr. VITTER. Mr. President, the responses are very clear:

       . . . we have no basis for estimating how many noncitizens 
     would match if this language were passed by Congress.
       Section 301 would not provide for verification of 
     citizenship. . . .
       Our current name/SSN verification procedures will not 
     detect legal aliens who are not naturalized citizens.

  They will not detect illegal aliens who have gotten Social Security 
numbers fraudulently.

       The . . . verification system in Section 301 would not 
     identify individuals who have illegally overstayed a work 
     Visa permit,

  And on and on.
  The record is perfectly clear, including from the Social Security 
Administration Commissioner, that there is nothing in the SCHIP 
legislation to prevent this fraud, to prevent these very significant 
costly benefits coming from the Federal taxpayers from going to illegal 
aliens in the country.
  Again, this is a glaring problem with this legislation. It is a 
glaring problem with many existing Federal benefits that we should 
address head on. Absent a solution to look at this carefully in the 
context of this legislation, I do not think it should move forward.
  Again, it is truly unfortunate that we have no ability to vote on 
this amendment on the Senate floor. This is a significant issue, this 
is a significant bill, and yet no Republican amendments, either this 
amendment or any other, can be considered on the Senate floor given the 
procedures the majority leader has used to shut out debate, shut out 
amendments, move forward, ignore a very serious concern of the American 
people. I think that is unfortunate. I also think it is reason not to 
move forward in passing this SCHIP legislation--one significant reason 
among others.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mrs. CLINTON. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mrs. CLINTON. Mr. President, today, in this Chamber, we are 
considering three critical issues that go to the heart of values we 
have as a nation, three pieces of legislation that seek to honor these 
values by putting them into action. We have passed and I am proud to 
support a bill to strengthen our capacity to stop hate crimes by 
supporting local law enforcement. We will be passing the largest 
expansion of health care for children since we created the Children's 
Health Insurance Program during the Clinton administration. Finally, 
included in this Children's Health Insurance Program legislation is a 
provision I sponsored and authored with Senator Dodd to support injured 
servicemembers by giving their families more time off under the Family 
and Medical Leave Act. This is a banner day for the Senate and the 
Congress, and I am proud to join a bipartisan coalition in tackling 
these challenges, from children without health insurance to military 
families without the support they need.
  We will pass the CHIP legislation by a wide margin, and so the choice 
will then fall squarely on the shoulders of the President. Will he join 
us in helping injured servicemembers and in providing health care to 
3.8 million children who right now don't have it or will he put 
ideology ahead of military families and vulnerable children? We in this 
Chamber know what the right choice is. The American people also know 
what the right choice is. I hope our President will put progress over 
partisanship and join the bipartisan majority and the vast majority of 
Americans in believing we can no longer treat these challenges and the 
people who face them as though they were invisible.
  I believe every child deserves health care. Yet far too many children 
in our Nation--more than 9 million--do not have access to quality, 
affordable health care. That is a moral crisis which should be 
impelling us to act, and this Congress has done so.
  A few weeks ago, I met Amy McCutchin, who was struggling to find 
health insurance for her 2-year-old daughter Pascale--a healthy, lively 
2\1/2\ year old. Amy works as a contractor while also going to school 
for her master's degree. She is divorced. She lost her insurance 
because of the divorce. She is not offered insurance through her 
employer because she does freelance work. Unfortunately, Pascale and 
her mom are among the millions for whom the Children's Health Insurance 
Program is currently unavailable.
  When I met Amy, she stressed she is trying to do the right thing. She 
works hard. She is what we would call barely middle class. In fact, she 
can't miss a day of work or she doesn't get paid. But she is also going 
to school full time, and she has to balance that with her work and the 
care of her daughter. She is falling through the cracks, and so is 
little Pascale.
  This is a story which is being told 9 million times every day by the 
parents of the children without health insurance. Today, we can tell a 
different story and create a different outcome.
  I was proud to help create the State Children's Health Insurance 
Program during the Clinton administration. I worked on that legislation 
during my

[[Page 25843]]

time as First Lady. In fact, after the bill was passed into law--a 
bipartisan majority in this Congress made that happen--I helped to get 
the word out to tell parents that help was on the way and to sign up 
children for the program in the first few years. In the Senate, I have 
continued that effort, fighting to ensure health care for children has 
the priority in our budget it deserves, and I am proud of the progress 
we have made.
  The CHIP program provides health insurance for 6 million children. In 
New York alone, almost 400,000 kids benefit from CHIP every month. With 
this strong bipartisan, bicameral agreement, hammered out in this 
Chamber by Chairman Baucus and Senators Grassley, Rockefeller, and 
Hatch, an additional 72,000 children in New York will have access to 
health care coverage.
  It will also help enroll many of the almost 300,000 children in New 
York who live in families who are already eligible for CHIP or for 
Medicaid because they make less than $52,000 a year, which is 250 
percent of the poverty level for a family of four. Now, I know that 
sounds like a lot of money to some people around the country, but it 
doesn't go very far in New York, and it is one of the reasons why so 
many children in New York don't have access to health care and why we 
are fighting so hard in New York to extend health care to those who 
need it and can't yet afford it.
  According to the Congressional Budget Office, 3.8 million children 
who are uninsured nationwide will gain coverage. That will reduce the 
number of uninsured children by one-third over the next 5 years. Now, 
if we can afford tax breaks for companies that ship jobs overseas and 
tax cuts for oil companies making record profits, I think we ought to 
be able to find it in our hearts and in our budget to cover the 
millions of children who deserve a healthy start.
  I want to be very clear. If the President vetoes this bill, as he has 
threatened, he will be vetoing health care for almost 4 million 
children and he will be putting ideology, not children, first.
  Earlier this year, I was proud to introduce legislation with Chairman 
John Dingell from the House of Representatives to reauthorize and 
expand CHIP, and I am very pleased that a number of the ideas in our 
bill are included in this legislation, such as cutting the redtape and 
bolstering incentives to get eligible children into the program. The 
legislation also improves access to private coverage and expands access 
to benefits such as mental health and dental coverage.
  Some of my colleagues have heard me tell the story about the young 
boy living in Maryland whose mother wasn't on Medicaid, wasn't on CHIP, 
and was struggling to get some kind of health care coverage for her 
children when her 12-year-old son came down with a toothache. Medicaid 
and CHIP don't cover dental care in many cases, anyway, so even though 
she eventually got coverage, she couldn't find a dentist who was 
available to actually provide the dental care. Her son continued to 
complain, the toothache turned into an abscess, the abscess broke, and 
the next thing you know, the little boy is in the emergency room and 
being admitted to the hospital. But because the poison had already 
spread into his bloodstream, he had to be put on life support, and 
Demonte didn't make it. So for the lack of a visit to a dentist, which 
might have cost $80, $85, a little boy lost his life. And this is why 
expanding access to mental health and dental coverage is absolutely 
critical.
  I also commend the authors of this bipartisan agreement for their 
work and for bringing forward a practical, fiscally responsible 
compromise. It represents the culmination of a lot of hard work. I see 
some of the staff from the Finance Committee here on the floor, and I 
thank them because I know how much they did to make this possible.
  I am also pleased that the conference report includes the support for 
the Injured Service Members Act of 2007, legislation Senator Dodd and I 
introduced to provide up to 6 months of job-protected leave for 
spouses, children, parents, or next of kin of service members who 
suffer from combat-related injuries or illness.
  This amendment implements a key recommendation of the Dole-Shalala 
Commission, chaired by former Senator Dole, who served with great 
distinction in this Chamber, and Secretary Shalala, who served for 8 
years under the Clinton administration as the Secretary of Health and 
Human Services. Their Commission on Care for America's Returning 
Wounded Warriors came up with a number of recommendations, and those 
recommendations are supported by a broad bipartisan coalition in 
Congress.
  The families of our service men and women face extraordinary demands 
in caring for loved ones who are injured while serving our Nation. 
Currently, the spouses, parents, and children receive only the 12 weeks 
of unpaid leave under the Family and Medical Leave Act. But, as the 
Dole-Shalala Commission found, all too often that is just not enough 
time. An injured servicemember usually grapples with not only the 
physical injuries but having been, just a few weeks or months before, a 
healthy, fit young person and now, with the loss of a limb or being 
blinded or burned, having to come to grips with all of that. That takes 
time as well as medical care.
  These new injuries our service members are suffering--the traumatic 
brain injuries--that we are only now focusing on are especially 
difficult.
  I remember being at Walter Reed a few months ago, and I met a young 
Army captain who had been in a convoy hit by one of those improvised 
explosive devices, resulting in the loss of his right arm and the ring 
finger on his left hand because he had his wedding band on his finger 
and the explosion had caused his wedding band to melt into his finger, 
unfortunately causing him to lose that finger.
  I asked him: Captain, how are you doing?
  He said: Oh, Senator, I am making progress. Folks are helping me get 
used to the prosthetic, and I am learning how to use it. But where do I 
go to get my brain back? I never had to ask people for help before. Now 
my wife has to make a list for me, telling me where I have to go to 
meet my appointments and what I have to do when I am there. Where do I 
go to get my brain back?
  Well, these wounds--some that you can see, some that you can't--are 
extremely serious and require family members to be available. The 
language included in the bill expands leave to 6 months. It is a step 
we can take immediately that will make a real difference in the lives 
of these wounded warriors and their families, and I hope the President 
will think about that before he vetoes this bill.
  Now, I am disappointed that the CHIP bill doesn't include the Legal 
Immigrant Children's Health Improvement Act, which I introduced with 
Senator Snowe and have been working on with her for a number of years. 
This bipartisan bill would give States the flexibility to provide 
Medicaid and CHIP coverage to low-income legal immigrant children and 
pregnant women. I want to underscore that. We are talking about legal 
immigrant children and pregnant women.
  The current restrictions prevent thousands of legal immigrant 
children and pregnant women from receiving preventive health services 
and treatment for minor illnesses before they become serious. Families 
who are unable to access care for their children have little choice but 
to turn to emergency rooms. This hurts children, plain and simple, and 
I think it costs us money. A legal pregnant woman who cannot get 
prenatal care may have a premature baby, who ends up in a neonatal 
intensive care unit, which ends up costing us hundreds of thousands of 
dollars. So I hope we are going to be able to lift this ban and make it 
possible for States to access Medicaid and CHIP for legal immigrant 
children and pregnant women.
  But I could not be more proud that the Senate is voting on expanding 
health care to 3.8 million children. There is no debating the 
importance of this and the way the Senate has come together in order to 
produce this result.
  Finally, I am proud to support the bipartisan legislation which we 
have

[[Page 25844]]

passed to strengthen our tools against crimes motivated by hate on the 
basis of a victim's race, ethnic background, religion, gender, sexual 
orientation, disability, and gender identity. These are crimes not just 
against an individual but against a community. What we have done by 
moving this legislation forward means we are taking a stand on behalf 
of those individuals and communities affected.
  Hate crimes are an affront to the core values that bind us one to the 
other in our country. We should dedicate the resources needed to 
prosecute these crimes to the fullest extent of the law. I am very 
proud of our country. I think we rightly hold ourselves up as a model 
for the ideals of equality, tolerance, and mutual understanding. But we 
cannot rest. We have to continue to fight hate-motivated violence in 
America. With today's vote, the Senate is proclaiming loudly that the 
American people will not tolerate crimes motivated by bigotry and 
hatred, that we will punish such crimes and the bigotry they represent.
  I commend Judy and Dennis Shepherd for their extraordinary dedication 
and leadership when it comes to the prosecution of hate crimes. The 
murder of their son Matthew was a tragic event for a family, but a 
motivating cause was created. No parent should ever have to bear what 
the Shepards have borne, but their grace and their grit in going 
forward is inspirational. The Matthew Shepard Local Law Enforcement 
Hate Crimes Prevention Act is a step toward honoring their son's 
memory, and honoring everyone who has ever been afflicted by hate-
motivated violence and harassment.
  I commend my colleague Senator Kennedy for his long-time leadership 
on this important matter.
  The Matthew Shepard Law Enforcement Hate Crimes Prevention Act 
condemns the abhorrent practice of victimizing people and authorizes 
the Justice Department to help State and local governments investigate 
and prosecute these appalling offenses. I commend my colleague and 
friend Senator Hatch.
  Today is a good day for the Senate. We are doing good work. It may be 
at a glacial pace in the eyes of some of us, but I have faith in our 
system and I have the utmost respect for this body. It is an honor to 
be part of it, especially on a day such as today when we make progress 
on behalf of the values America stands for.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Utah.
  Mr. HATCH. Mr. President, I remember it so vividly.
  I remember it as if it were yesterday.
  But it was 10 years ago that Senator Kennedy and I stood outside this 
great building, we stood on the Capitol lawn under a great oak tree, 
and announced final passage of the Children's Health Insurance Program 
legislation.
  History was made that day, and it has been made every day since.
  A true, bipartisan partnership--forged on the strength of good 
intentions, motivated by a simple desire to help our country's most 
vulnerable citizens, and nurtured in a politics-free atmosphere--led to 
enactment of CHIP, arguably the most significant advancement in 
children's health in this modern era.
  Ten years ago, Senator John Chafee and Senator Rockefeller, Senator 
Kennedy and I, began a partnership that led to the Children's Health 
Insurance Program. That legislation, enacted in under 5 months--to show 
you its potency--was founded on a very basic premise: that we needed to 
provide incentives to States to help them design plans to provide 
health insurance to the poorest of the poor families not eligible for 
Medicaid.
  Senators Rockefeller and Chafee argued for a Medicaid expansion. 
Senator Kennedy and I argued for a State-directed block grant. The 
final law was an innovative, workable blend of the two.
  Since that time, almost 6 million children have become insured under 
CHIP. They are leading healthier, more productive lives.
  Their parents can sleep at night, resting easy that their children 
will be taken care of if they become ill.
  That peace of mind, that giant step toward a healthier population, is 
the mark of a compassionate, caring Congress. It was a mark toward 
reassuring the American people that the Government hears their concerns 
loud and clear and stands ready to act.
  Let us hear that same message today and let us provide our 
constituents with that same measure of reassurance as we consider this 
bipartisan agreement to extend CHIP for another 5 years.
  This year, as Finance Committee Chairman Max Baucus, Ranking 
Republican Chuck Grassley, Subcommittee Chairman Jay Rockefeller, HELP 
Committee Chairman Kennedy, and I began our discussions of the Child 
Health Insurance Program Reauthorization Act--or CHIPRA--we agreed 
there were several key principles that must be embodied in any 
extension of the original act.
  The bill we consider today is built on those principles.
  First, we agreed that the proposal must be fully financed or else it 
would be irresponsible for us to legislate.
  Next, it must retain the original character of CHIP--that is, it must 
be a flexible, State-directed program. Senator Kennedy talked about 
that this morning.
  We worked to see the budget resolution provide $25 billion in its 
baseline to extend the current levels of coverage, and up to $50 
billion more if it were fully financed.
  Indeed, this bill is fully financed.
  The costs above the budget baseline have been certified by Joint Tax 
to be covered by an increase in the tobacco excise tax.
  We agreed that we wanted to continue coverage for those who are 
currently eligible, but also to conduct extensive outreach to enroll 
those who may be eligible but aren't enrolled.
  Our bill provides health coverage to almost 4 million low-income, 
uninsured children through incentives to states to enroll these 
uninsured children in their programs.
  We agreed that coverage of childless adults--a policy Senator Kennedy 
and I never intended nor envisioned when we wrote our original 
proposal--we agreed that policy needed to stop.
  Under our bill, childless adults currently covered under CHIP will be 
phased out of the program and transitioned into Medicaid.
  I cannot emphasize this enough. Today, 6 million children receive 
health care through the CHIP program--25,095 of these children are from 
Utah.
  That would not have happened absent congressional action in 1997.
  In addition, there are an added 6 million children in families with 
income under 200 percent of the Federal poverty level--or FPL--who are 
uninsured and eligible for either CHIP or Medicaid.
  According to the Congressional Budget Office, the bipartisan, 
compromise bill covers close to 4 million of these children--3.7 
million to be precise--a significant step by any measure. This is a 
crucial, crucial part of the bill, an achievement that, while 
expensive, really goes to the heart of what we are trying to achieve 
with the original CHIP, and now CHIPRA.
  For several weeks now, we have heard a crescendo of opposition to our 
legislation from officials at the White House, and most recently, our 
President.
  Needless to say, this is disheartening for me. It is difficult for me 
to be against a man I care for, my own personal President, on such an 
important bill. I have been and will continue to be one of the 
President's strongest supporters in the Congress. He is a good man. He 
means well, but he does have to listen to his staff--or at least does 
listen to his staff, and I believe he has listened to them in a way 
that throws barriers up to this bill.
  I wish I had had an opportunity to persuade him on the merits of this 
bill before he issued a veto threat. I did send messages down there, 
talked to top people in the administration, but I wish I had had a 
greater opportunity.
  Indeed, I am sympathetic to many of the concerns he raises.
  When he says that we need to be careful about creating a one-size-
fits-

[[Page 25845]]

all health plan for our children, I believe he is right. When we wrote 
this program in 1997, we wrote it based on the foundation of giving 
States the flexibility to design their own CHIP programs. Each State is 
different--what is good for Utah may not be good for California or 
Massachusetts.
  It is important for States, not the Federal Government, to determine 
which benefits should be covered. After all, CHIP is a State block 
grant program, not a Federal entitlement. That is why we are debating 
its reauthorization today.
  The President has also raised concerns about the Federal dollars that 
our bill spends on the CHIP program over the next 5 years.
  I agree that $60 billion is a lot of money. But in comparison to what 
the House passed bill proposed earlier this year--they started at $100 
billion and came down to $75 billion--it is much more reasonable.
  And, as the Congressional Budget Office has told us, it is relatively 
more expensive to find and cover the low-income children who still do 
not have health coverage compared to those who are enrolled today.
  That is why I was able to agree with the Senate number of $35 
billion, in addition to the $25 billion already built in the budget 
baseline for CHIP--although, to be fair, it is higher than I would have 
liked. But this is a classic compromise and friends in the House wanted 
more. Some of them.
  It is unfortunate that the President has chosen to be on what--to 
me--is clearly the wrong side of the issue.
  Indeed, this is not the bill I would have written if I had full 
license to draft. That is true for the original SCHIP law as well.
  But, it is hard to envision any major law being written by one person 
and enacted without change. That is not how good legislation is made.
  Indeed, 10 years ago, Senator Kennedy and I spent many, many hours 
proposing, arguing, compromising, and refining, in drafting session 
after drafting session.
  Some days it seemed we disagreed more than we agreed.
  It was hard, hard work.
  But it was a labor of love.
  We had a full discussion. We explored all the issues together.
  We found compromises where we needed to.
  That is how good legislation is made. Sometimes even bad legislation, 
but this is good legislation.
  It pains me that we did not have this full discourse with the 
administration on CHIPRA.
  It pains me that some have been slow to recognize the realities of 
this new Congress.
  Indeed, what some political pundits termed The Trifecta--a Republican 
House, Senate, and Presidency, is no more.
  I thought I should point out this fact for those in this body who may 
not have noticed.
  And so it is no secret, no surprise, that a Democrat-led Congress 
would seek a more expansive program.
  Yet it is to the great credit of our Democratic leaders that they 
recognize our country's fiscal realities and that they held the line at 
the additional $35 billion figure.
  To be sure, I would have been comfortable with a lower number, just 
as Speaker Pelosi and Chairman Rangel and Chairman Dingell and Chairman 
Baucus and Chairman Rockefeller advocated for a much higher number.
  So, again, we have that spirit of compromise which was the hallmark 
of CHIP in 1997.
  I must say it has also been difficult to conflict with my good friend 
from Utah, Health and Human Services Secretary Mike Leavitt.
  He was an expert in health care policy when he was Governor of Utah, 
and he is even more of a leader on the national level now.
  I know the concerns he expressed to me about the CHIP bill in 1997.
  I recall our many conversations when he advocated for a greater 
Federal role in health coverage for needy children. And I also recall 
his admonitions that we could do better by the children and their 
parents if we were to provide the States with much-needed flexibility.
  The final CHIP block grant reflected that flexibility I believe, and 
Mike Leavitt's good counsel helped us improve the law. I hear Secretary 
Leavitt's concerns when he says that he is concerned about paying for 
the reauthorization of this program through tobacco taxes. I am not 
comfortable with raising taxes either. However, when we first created 
the CHIP program in 1997, we believed that it was entirely fitting that 
the bill be funded through incentives to decrease the use of tobacco, a 
leading killer of Americans young and old. And, therefore, I am 
comfortable with raising tobacco taxes to pay for our CHIP program.
  I understand his concerns about crowd-out and higher income children 
dropping their private health coverage in order to be covered through 
CHIP when CHIP was created to provide health care for low-income 
children.
  And I agree with him 100 percent when he says that we are only fixing 
part of the problem by reauthorizing CHIP and not addressing what's 
wrong with the entire health care system.
  He and I have visited on several occasions on these issues. I have 
benefited by that guidance, and I sincerely regret that ultimately we 
disagree on this bill. But I am willing to work with him to try to come 
up with an overall health care plan that will work.
  I might add that I believe we have had an honest misunderstanding 
which has not only been raised by Secretary Leavitt but the President 
as well. They say that our legislation allows families with annual 
incomes of $83,000 to be covered under a State CHIP plan.
  Let me be clear. Our legislation does not permit a State to cover 
these families unless the Secretary of Health and Human Services 
approves the State's application to cover individuals at that income 
level.
  We do not change current law and put Congress in charge. We leave 
that decision in the hands of the Secretary.
  We do not take away the Secretary's authority to make that decision.
  I hope that point is clear.
  At this point, it may be helpful for me to outline for my colleagues 
exactly what this bill does.
  As I stated earlier, CHIPRA is a 5-year reauthorization which spends 
an additional $35 billion in Federal dollars on the CHIP program, in 
addition to the $25 billion in Federal dollars already built into the 
budget baseline.
  So, in total, we are spending $60 billion in Federal dollars over the 
next 5 years on the CHIP program.
  And I know that sounds very expensive, especially to my Republican 
colleagues. In contrast, the bill passed by the House in August would 
have spent an additional $50 billion on CHIP on top of the $25 billion 
in the budget baseline for a grand total of $75 billion.
  As this chart indicates, we spend far more Federal money on Federal 
health programs then we are suggesting that we spend on the CHIP 
program over the next 5 years.
  This chart compares projected spending in Medicare, Medicaid and the 
National Institutes of Health to the spending that we authorize for the 
CHIP program from fiscal year 2008 to fiscal year 2012.
  For the Medicare Program, CBO projects that the Federal Government 
will spend $2.6 trillion, yes, trillion dollars over the next 5 years.
  For the Medicaid Program, CBO projects that the Federal Government 
will spend $1.22 trillion over the next 5 years.
  For the NIH, we project that the Federal Government will spend 
approximately $150 billion over the next 5 years.
  In contrast, our bill authorizes $60 billion over the next 5 years. I 
think these numbers speak for themselves. We can spend billions, even 
trillions of dollars on programs for the elderly, disabled, very poor 
and for medical research but spending $60 billion to provide health 
care for the children of the working poor causes the President to issue 
a veto threat? Something here just doesn't add up, especially when you 
look at these numbers on this chart. The spending for the CHIP program 
hardly shows up on this chart compared to the other three programs.
  Let me remind my colleagues that this legislation is built on 
compromise.

[[Page 25846]]

  Is it perfect?
  Far from it.
  But does it cover more CHIP-eligible kids, our ultimate goal? 
Absolutely.
  And that's why I am a strong advocate for this bill and urge my 
colleagues to support it.
  This is a good compromise.
  It is a $35 billion bill--not a $50 billion bill. The House 
ultimately agreed with the Senate on this issue. I do not blame them. 
They are very sincere in thinking you can just throw money at these 
things and you will do more good.
  It does not include Medicare provisions. The House also dropped its 
insistence on this issue, even though there was tremendous pressure to 
include Medicare provisions such as a fix for the sustainable growth 
rate formula flaw, which is the physician reimbursement rate, in 2008.
  But let me be clear, all of us agree that these important Medicare 
issues must be addressed by the end of this year. Just not in this 
bill.
  Before I continue, I would like to note that both the $35 billion 
limit and agreement not to include Medicare provisions were huge 
concessions by the House of Representatives.
  Honestly, I never thought that the House leadership would agree to 
those terms; and, trust me, those were the two conditions that were 
nonnegotiable as far as I was concerned.
  The moderation on the part of House leaders is a true indication that 
they are serious about getting a bipartisan CHIP reauthorization bill 
signed into law.
  Key provisions of this legislation are the tools and resources it 
provides to enroll more of the CHIP-eligible children. As I previously 
stated, in addition to the 6 million children already covered by CHIP, 
this bipartisan compromise bill would provide coverage to almost 4 
million more uninsured, low-income children.
  The bill no longer allows new State waivers for adults to receive 
their health care through CHIP. Childless adults will be phased out of 
CHIP and will be covered through Medicaid.
  States that currently cover parents may continue to do so; but after 
a transition period, States will no longer receive the enhanced CHIP 
match rate for covering parents.
  The legislation rewards States for covering more low-income children 
by establishing a CHIP performance bonus payment for States that exceed 
their child enrollment targets.
  We worked hard to make certain there will be no funding shortfalls 
with this legislation.
  The bill provides States adequate money in their CHIP allotments so 
they will not experience funding shortfalls in their CHIP program.
  As a safeguard, we created a Child enrollment contingency fund for 
States that experience a funding shortfall as a result of enrolling 
more low-income children.
  Shortfalls have been a serious problem. They are something we want to 
avoid.
  In addition, the proposal clarifies that States will only have 2 
years to spend their CHIP allotments. Today, States have 3 years to 
spend their CHIP allotments.
  It gives States a new option to provide coverage to pregnant women. 
Today, pregnant women are only covered in CHIP if the State has been 
granted a waiver to cover pregnant women or through the 
Administration's unborn child policy.
  This is a proposal Senator Kennedy and I seriously considered 
including in 1997. We ultimately concluded that the cost of childbirth 
hospitalization was so expensive, then, about $4,000 a birth, that the 
greater public good could be achieved if we focused those resources on 
providing more insurance policies to needy children.
  It was not a policy we undertook with great comfort. Indeed, Senator 
Kennedy argued strongly for coverage of pregnant women. But ultimately, 
we chose to advocate for the policy that covered the most children.
  Today, we are both satisfied that the bill embodies the correct 
policy, if I may speak for the Senator from Massachusetts on this 
point.
  CHIPRA provides beneficiaries and their families with coverage 
choices. If the State provides premium assistance through its CHIP 
program, CHIP beneficiaries may choose to be covered through the State 
CHIP program or receive premium assistance to receive health care 
through a private health plan. And States like Utah that already have 
premium assistance programs for their CHIP beneficiaries would have 
their programs grandfathered in, in other words, their programs would 
continue to exist.
  It also provides CHIP beneficiaries with dental benefits, states will 
have a choice of four dental benchmark plans to provide to their CHIP 
beneficiaries, the dental benefits included in the House-passed bill; a 
benefit package equivalent to the federal employee health plan dental 
benefit that covers the most children; a benefit package equivalent to 
the State employee dental plan that covers the most children; or a 
benefit package equivalent to the most popular commercial dental plan 
that covers the most children.
  As my colleagues are aware, I have a long record of advocating for 
better dental care for children. It alleviates so many health problems 
in the future.
  In fact, in 2000, I introduced the Early Childhood Oral Health 
Improvement Act, which created grant programs to improve the oral 
health of children under 6 years of age. This bill was included in the 
Children's Health Act which was signed into law on October 17, 2000.
  So, I know how important dental health is for children.
  At the same time, it is fair to say that I have been concerned about 
mandating that States provide dental coverage for two basic reasons.
  First, the inherent nature of CHIP, and a primary reason it could be 
enacted in a Republican-led Congress, is that it was a State block 
grant.
  Mandates move us away from that important framework.
  Second, the dental coverage that some advocated be included in this 
bill is more generous than most private-sector policies. Thus, 
including such coverage would be a giant incentive for crowd-out, that 
is, dropping private coverage in order to seek a more generous public 
coverage.
  Ten years ago we called it substitution. Today, we call it crowd out. 
But it is the same thing.
  I will not sugar coat it. It is a problem. It is a concern. And, we 
should take every step we can to keep it from occurring.
  I think the dental policy we adopted was a good compromise, and I 
appreciate my colleagues agreeing to my suggestion for this coverage.
  Our legislation also limits the Federal matching rate that States 
will receive for covering individuals with family incomes over 300 
percent of FPL in their CHIP plans.
  It clarifies the Administration's policy on crowd-out and provides 
States with guidance on how to ensure that their low-income children 
are covered through the CHIP plan before expanding coverage to higher 
income children.
  Another key element of this bill is that it provides States with 
funds for outreach and enrollment.
  It gives States a time-limited option to speed up enrollment in CHIP 
and Medicaid by using eligibility information from designated express 
lane agencies.
  The bill gives States the option of verifying citizenship for both 
Medicaid and CHIP by submitting names and Social Security numbers to 
the Commissioner of Social Security.
  It creates a new quality initiative through the Secretary of Health 
and Human Services, in consultation with the States, to develop 
evidence-based pediatric quality measures in order to evaluate the 
quality of care for children.
  I introduced legislation to develop pediatric quality measures with 
Senators Bayh and Lincoln and much of our bill is incorporated in this 
bipartisan compromise legislation.
  The proposal includes mental health parity in the state CHIP programs 
so that if a State offers mental health coverage in its CHIP plan, it 
must be on par with limits for medical and surgical services.

[[Page 25847]]

  Senator Gordon Smith has done a stellar job bringing awareness about 
the need for mental health benefits for children and this provision is 
modeled after legislation that he introduced with Senator John Kerry of 
Massachusetts.
  At this point, I would also like to refute some of the inaccurate 
statements that I have heard the last few days regarding our bill.
  First, some have alleged that our bill allows the Federal Government 
to continue covering childless adults and parents through CHIP.
  Our bill puts the emphasis back on low-income, uninsured children. 
Simply put, our bill puts an immediate stop to States being granted 
future waivers to cover nonpregnant adults. In fact, the provisions 
included in the Senate-passed CHIP bill were included in the 
compromise, bipartisan CHIP bill.
  At the beginning of fiscal year 2009, States will receive lower 
Federal matching rates for childless adults and in fiscal year 2010, 
childless adults will not be covered under CHIP, they will be 
transitioned into Medicaid.
  At the beginning of fiscal year 2010, only States with significant 
outreach efforts for low-income uninsured children will receive 
enhanced match rates for parents; others will receive the lower 
Medicaid match rate FMAP for adults.
  Starting in fiscal year 2011, all States will receive a lower Federal 
match rate for parents. Those States covering more lower income kids or 
with significant outreach efforts will receive a Federal matching rate 
for parents covered under CHIP which is a midpoint between the Federal 
CHIP matching rate and the lower Medicaid matching rate. Other States 
will receive the lower Medicaid Federal matching rate, known as FMAP, 
for CHIP parents. Simply put, beginning in fiscal year 2011, States 
will no longer receive the higher CHIP matching rate for covering 
parents.
  Second, some criticize our bill and say it allows higher income 
children to be covered under the CHIP program.
  Today, States may receive an enhanced Federal matching rate for their 
CHIP program through waivers for all income levels. Our bill 
discourages States from covering higher income individuals in the CHIP 
program.
  After enactment of our bill, States with new waivers approved to 
cover those with family incomes over 300 percent of FPL would only 
receive the lower FMAP payment for these higher income individuals.
  In addition, States that cover individuals with incomes over 300 
percent of FPL in their CHIP plans will have to submit a State plan to 
the HHS Secretary to show how it is addressing crowd-out for higher 
income children covered under CHIP.
  The State plan must be approved by the HHS Secretary before October 
1, 2010; otherwise, the State will no longer receive Federal matching 
dollars for covering those over 300 percent of FPL in their CHIP plans.
  Third, some say our bill makes CHIP an entitlement program and almost 
doubles the Federal dollars spent on CHIP over the last 10 years.
  CHIP is not an entitlement program, it is a capped, block grant 
program, where States are given flexibility to cover their low-income, 
uninsured children.
  I admit that it works so well, nobody wants to abolish it, including 
the President and most everyone in this body. As to its cost, as I 
noted earlier, the 6 million children who are already covered by CHIP 
were easier to find that the current 6 million, low-income, uninsured 
children under 200 percent of FPL.
  CBO has explained it is much more expensive to find these uncovered 
children. That is why our bill gives States bonus payments for 
enrolling them. I hope their prediction does not prove true. If it 
doesn't, we will save money in the program. But if their prediction 
does prove true, there is still no excuse for enrolling these kids.
  I also believe it is important to note that, according to the Centers 
for Medicare and Medicaid Services, in 2005, we spent a total $1.98 
trillion on our Nation's health care system.
  Private expenditures were $1.08 trillion and Federal spending was 
$900 billion.
  Total Medicare spending was $342 billion in 2005 and Medicaid was 
$177 billion in Federal dollars.
  Our bill today funds CHIP at $60 billion over five years--a fraction 
of the cost to provide care for low-income, uninsured children. 
Covering these children is worth every cent.
  Another common criticism is the myth that our bill allows States to 
cover children from families with annual incomes of $83,000.
  I have addressed this before, but it bears repeating.
  Our bill neither prevents, nor requires, States' coverage of families 
at higher income levels. Only the Secretary of Health and Human 
Services decides whether a State may cover families with incomes up to 
$83,000 per year under their State CHIP program, not Congress.
  Many have suggested, in error, that our bill allows illegal 
immigrants to be covered under CHIP.
  In fact, during the House debate, I heard some state incorrectly that 
our bill provides benefits to illegal immigrants and opens the door for 
CHIP and Medicaid benefits for illegal immigrants by substantially 
weakening a requirement that persons applying for such services show 
proof of citizenship.
  Nothing could be further from the truth.
  In fact, our legislation has specific language stating that no 
illegal immigrants will be covered under CHIP.
  For those who still don't believe me, it can be found under section 
605, entitled No Federal Funding for Illegal Aliens.
  Let me just read what it says: ``Nothing in this Act allows Federal 
payment for individuals who are not legal residents.''
  Finally, much has been said about the Centers for Medicare and 
Medicaid Services' recent guidance on crowd out.
  I will include for the Record a letter dated August 17, 2007, to the 
State Medicaid Directors from Dennis Smith, the director of the Center 
for Medicaid and State Operations for CMS.
  The purpose of this letter was to give the State Medicaid Directors 
guidance on how CMS will review state plan amendments or waivers to 
raise income eligibility limits under the CHIP program in the future.
  In this letter, CMS made it perfectly clear that the agency was very 
concerned about crowd-out and wanted States to target low-income, 
uninsured children under 200 percent of poverty before covering higher 
income children under CHIP.
  So in order for States to cover higher income children, CMS made it 
clear that States must cover 95 percent of their children under 200 
percent of poverty before expanding coverage to higher income children.
  While I agree with the thrust of what the administration intended to 
achieve, I am not certain what Mr. Smith asks the States to do can be 
achieved.
  States have told us it is virtually impossible for them to determine 
how many of those low-income children are currently covered.
  Currently, good, solid data on the uninsured simply do not exist. So 
it is almost impossible to find good, solid numbers on the uninsured. 
On top of that, currently, States do not have to report income data to 
CMS.
  Therefore, we knew that it would be impossible for States to 
determine how many low-income, uninsured children live in their States 
and whether or not those children were receiving health coverage.
  We heard the States and we addressed their valid concerns in the bill 
by requiring that two studies will be conducted to study crowdout and 
figure out what States are doing to successfully cover low-income, 
uninsured children. Once the data are available, States covering 
individuals over 300 percent of poverty in their CHIP plans must submit 
to the HHS Secretary their plans for covering low-income children and 
reducing crowdout. If its plan is not approved by a certain date, a 
state would no longer receive CHIP money for covering those over 300 
percent FPL with limited exception. To

[[Page 25848]]

me, that sends a very clear message to all 50 States about the 
intention of the CHIP program--to cover low-income, uninsured children.
  Let me conclude by emphasizing to my colleagues that passing this 
legislation is the right thing to do.
  When we first wrote CHIP in 1997, our goal was to cover the several 
million children who had no health insurance coverage. These children 
were in a no-win situation--their family incomes were too high to 
qualify for Medicaid, but their families did not have enough money to 
purchase private health insurance.
  When Senator Kennedy, Senator Chafee, Senator Rockefeller and I 
worked on the original legislation in 1997, our goal was to cover the 
several million children who had no health insurance.
  Coverage of these uninsured children is still our top priority, and I 
believe our bipartisan CHIP bill will make a dramatic difference by 
covering almost 4 million additional low-income children.
  The bill we are considering is very similar to the Senate-passed CHIP 
bill and captures the true essence of the 1997 law.
  It is the true essence of bipartisan compromise.
  To be fair, it does not make any of us Republicans comfortable to 
face a veto threat from our President.
  It does not make me comfortable to face a veto threat issued by my 
colleague and good friend from Utah, Secretary Leavitt.
  However, as Senator Kennedy and I have been fond of saying to each 
other over the years, if neither side is totally comfortable, we must 
have done a good job.
  This is a good bill. It accomplishes what we have set out to do--to 
cover low-income children without health coverage.
  Yes, I admit, it is expensive. However, this is necessary spending 
when I think of the 6 million American children who are leading 
healthier lives because of our vision and commitment.
  And when I compare $60 billion to the trillions of dollars our 
Government will spend on health care, I believe it is a worthwhile 
benefit.
  We should not let the opportunity pass us by to build on that solid 
foundation and do even better for the children, our future.
  I will add one more point that I want my Republican colleagues to 
take to heart. This is a bipartisan compromise bill. It is not the 
House-passed CHIP bill that would spend $75 billion over the next 5 
years on CHIP.
  In my opinion, the $50 billion CHIP legislation before the Senate is 
the better deal for the low-income children and the American people. It 
is my hope that my colleagues who disagree with me will take one more 
look at this legislation.
  On the House side, I would like to recognize the hard work of my 
House colleagues: Energy and Commerce Committee Chairman John Dingell; 
House Energy and Commerce Health Subcommittee Chairman Frank Pallone; 
House Ways and Means Committee Chairman Charlie Rangel; House Committee 
on Oversight and Reform Chairman Henry Waxman; and of course, the 
Speaker of the House, Nancy Pelosi.
  I also want to commend my Utah Governor, Jon Huntsman, Jr., for his 
continued support of legislation to reauthorize the CHIP program. In 
April, Governor Huntsman presented me with a proclamation expressing 
his and the Utah State Legislature's strong support for the CHIP 
program, which I greatly appreciated. In fact, Governor Huntsman and 
his staff have provided me with invaluable advice throughout this 
process. Utah's program, which covers 25,095 children, provides well-
child exams; immunizations; doctor visits; hospital and emergency care; 
prescriptions; hearing and eye exams; mental health services; and 
dental care.
  Finally, I must commend my good friends and colleagues from the 
Senate: Finance Committee Chairman Max Baucus; Ranking Republican 
Member Chuck Grassley; Finance Health Subcommittee Chairman Jay 
Rockefeller; and the Senate Majority Leader Harry Reid.
  I would also like to mention all of the staff who put many hours into 
this bill and gave up time with their families to work on this bill--
Pattie DeLoatche, Patricia Knight, Karen LaMontagne, Peter Carr, Jared 
Whitley, Hanns Kuttner, Becky Shipp, Rodney Whitlock, Mark Hayes, Alice 
Weiss, Michelle Easton, David Schwartz, Jocelyn Moore, Ellen Doneski, 
Ruth Ernst, Kate Leone, Bridgett Taylor, Amy Hall, Bobby Clark, Karen 
Nelson, Andy Schneider, Wendell Primus, Ed Grossman and Jessica 
Shapiro.
  I would be remiss if I didn't mention some of the staff who laid the 
groundwork on the original CHIP law in 1997, particularly Patricia 
Knight, Rob Foreman, Bruce Artim, Nick Littlefield, David Nexon, Laurie 
Rubiner, Lisa Layman, Michael Iskowitz, Cybele Bjorklund and Mary Ella 
Payne.
  Mr. President, I remember so vividly 10 years ago when Senator 
Kennedy and I stood on this floor to argue for enactment of SCHIP. We 
had two posters.
  We had one of a little boy named Joey.
  And we had one of Joe Camel, the mascot for one manufacturer of 
cigarettes.
  We asked our colleagues, whom do you support? Joe Camel or Joey?
  It is somewhat ironic, even amazing, or even more--a reflection of 
history repeating itself--that I stand here today to pose the same 
question to my colleagues.
  Whom do you support: Joe Camel or Joey?
  Joey? He's now almost 20.
  The Camel? Haven't seen him for a while, have we?
  So, we are making progress.
  But there is much to do.
  This bill represents the congressional commitment to one of the most 
important goals we can strive for: a healthy population.
  We must start with the kids, and that is what H.R. 976 does.
  I would like to close by reading an excerpt from a letter written by 
Karen Henage, the parent of children are covered by the Utah CHIP 
program. Kim Henage writes, ``I firmly believe the CHIP Program gave 
our family the financial assistance and more so the emotional security 
(peace of mind) to survive our new start, so that we were able to make 
it make it through. We are a success story because of this assistance. 
I cannot express in mere words how much this meant to us. When we 
needed it, it was there for us. I wholeheartedly request your support 
of the continuation of this valuable program, that other families might 
survive as we did.''
  I think Kim's letter says it all--we must pass this bill today so 
more families without health insurance will be able to become a CHIP 
success story like the Henages.
  I ask unanimous consent to print the above-referenced letter from CMS 
in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                            Department of Health &


                                               Human Services,

                                   Baltimore, MD, August 17, 2007.

       Dear State Health Official: This letter clarifies how the 
     Centers for Medicare & Medicaid Services (CMS) applies 
     existing statutory and regulatory requirements in reviewing 
     State requests to extend eligibility under the State 
     Children's Health Insurance Program (SCHIP) to children in 
     families with effective family income levels above 250 
     percent of the Federal poverty level (FPL). These 
     requirements ensure that extension of eligibility to children 
     at these higher effective income levels do not interfere with 
     the effective and efficient provision of child health 
     assistance coordinated with other sources of health benefits 
     coverage to the core SCHIP population of uninsured targeted 
     low income children.
       Section 2101(a) of the Social Security Act describes the 
     purpose of the SCHIP statute ``to initiate and expand the 
     provision of child health assistance to uninsured, low-income 
     children in an effective and efficient manner that is 
     coordinated with other sources of health benefits coverage.'' 
     Section 2102(b)(3)(C) of the Act, and implementing 
     regulations at 42 CFR Part 457, Subpart H, require that State 
     child health plans include procedures to ensure that SCHIP 
     coverage does not substitute for coverage under group health 
     plans (known as ``crowd-out'' procedures). In addition 
     section 2102(c) of the Act

[[Page 25849]]

     requires that State child health plans include procedures for 
     outreach and coordination with other public and private 
     health insurance programs.
       Existing regulations at 42 CFR. 457.805 provide that States 
     must have ``reasonable procedures'' to prevent substitution 
     of public SCHIP coverage for private coverage. In issuing 
     these regulations, CMS indicated that, for States that expand 
     eligibility above an effective level of 250 percent of the 
     FPL, these reasonable crowd-out procedures would include 
     identifying specific strategies to prevent substitution. Over 
     time, States have adopted one or more of the following five 
     crowd-out strategies: Imposing waiting periods between 
     dropping private coverage and enrollment; imposing cost 
     sharing in approximation to the cost of private coverage; 
     monitoring health insurance status at time of application; 
     verifying family insurance status through insurance 
     databases; and/or preventing employers from changing 
     dependent coverage policies that would favor a shift to 
     public coverage.
       As CMS has developed more experience and information from 
     the operation of SCHIP programs, it has become clear that the 
     potential for crowd-out is greater for higher income 
     beneficiaries. Therefore, we are clarifying that the 
     reasonable procedures adopted by States to prevent crowd-out 
     pursuant to 42 CFR. 457.805 should include the above five 
     general crowd-out strategies with certain important 
     components. As a result, we will expect that, for States that 
     expand eligibility above an effective level of 250 percent of 
     the FPL, the specific crowd-out strategies identified in the 
     State child health plan to include all five of the above 
     crowd-out strategies, which incorporate the following 
     components as part of those strategies: The cost sharing 
     requirement under the State plan compared to the cost sharing 
     required by competing private plans must not be more 
     favorable to the public plan by more than one percent of the 
     family income, unless the public plan's cost sharing is set 
     at the five percent family cap; the State must establish a 
     minimum of a one year period of uninsurance for individuals 
     prior to receiving coverage; and monitoring and verification 
     must include information regarding coverage provided by a 
     noncustodial parent.
       In addition, to ensure that expansion to higher income 
     populations does not interfere with the effective and 
     efficient provision of child health assistance coordinated 
     with other sources of health benefits coverage, and to 
     prevent substitution of SCHIP coverage for coverage under 
     group health plans, we will ask for such a State to make the 
     following assurances: Assurance that the State has enrolled 
     at least 95 percent of the children in the State below 200 
     percent of the FPL who are eligible for either SCHIP or 
     Medicaid (including a description of the steps the State 
     takes to enroll these eligible children); assurance that the 
     number of children in the target population insured through 
     private employers has not decreased by more than two 
     percentage points over the prior five year period; and 
     assurance that the State is current with all reporting 
     requirements in SCHIP and Medicaid and reports on a monthly 
     basis data relating to the crowd-out requirements.
       We will continue to review all State monitoring plans, 
     including those States whose upper eligibility levels are 
     below an effective level of 250 percent of the FPL, to 
     determine whether the monitoring plans are being followed and 
     whether the crowd-out procedures specified in the SCHIP state 
     plans are reasonable and effective in preventing crowd-out.
       CMS will apply this review strategy to SCHIP state plans 
     and section 1115 demonstration waivers that include SCHIP 
     populations, and will work with States that currently provide 
     services to children with effective family incomes over 250 
     percent of the FPL. We expect affected States to amend their 
     SCHIP state plan (or 1115 demonstration) in accordance with 
     this review strategy within 12 months, or CMS may pursue 
     corrective action. We would not expect any effect on current 
     enrollees from this review strategy, and anticipate that the 
     entire program will be strengthened by the focus on effective 
     and efficient operation of the program for the core uninsured 
     targeted low-income population. We appreciate your efforts 
     and share your goal of providing health care to low-income, 
     uninsured children through title XXI.
       If you have questions regarding this guidance, please 
     contact Ms. Jean Sheil, Director, Family and Children's 
     Health Programs.
           Sincerely,

                                              Dennis G. Smith,

                                     Director, Center for Medicaid
                                             and State Operations.

  Mr. HATCH. I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. CASEY. Mr. President, I commend the Senator from Utah for his 
remarks today, for his work on this bill, his work many months ago when 
this work began in the Senate, and for his leadership 10 years ago in 
1997, when at that time, as today, we had bipartisan agreement on 
children's health insurance. I commend him and his colleague, Senator 
Grassley.
  On the Democratic side we have a lot of great leaders: Senator Jay 
Rockefeller and Senator Max Baucus, working mightily with Senator 
Kennedy and so many others to get this done. We still have a long way 
to go. We know we had a resounding 69 votes in the Senate today, but we 
still have one impediment to getting this done. That impediment is the 
President of the United States.
  I want to talk about some numbers today, but I want to focus 
initially on the benefits of this program. We are going to continue to 
have debates within this body and with the President about this issue. 
I will get to that. But let's step back for a minute and think about 
what this program means to one single child or what it means to one 
single family. Here is what it means. I come from Pennsylvania. We have 
some big cities in Pennsylvania: obviously, Pittsburgh and 
Philadelphia. But what if this child is born in a rural area. I come 
from a State where a huge percentage of our population is, in 
statistical categories, considered rural. The breadth of Pennsylvania, 
right through the middle of the State, out toward western Pennsylvania, 
we have a lot of people who live in rural areas. We know the benefits 
of this program help a lot of our children in cities and towns and also 
in rural areas. In fact, one-third of rural children get their health 
care from Medicaid or the Children's Health Insurance Program.
  We also know a lot of African-American and Latino children have 
benefited tremendously in the 10 years this has been part of our law. 
Let's think about those children. No matter where they live, let's 
think about what this means to them. It means they can get well-child 
visits to the doctor during a year. The experts tell us you need at 
least six of those in your first year of life to be healthy. We ought 
to make sure every child in America can have six well-child visits in a 
year, but millions don't get that.
  What happens to that child? That child would not grow. Their brains 
and cognitive development would not proceed as it should. They can't 
learn as fast. They can't read as quickly. They don't do as well in 
school. Down the road when they become part of the workforce, they have 
been shortchanged, if we don't do our job. It also means immunizations 
in the dawn of their lives and all of the preventative care a child 
should receive.
  We should be doing everything we can in this body, not just with 
children's health insurance but with early learning opportunities and 
other programs we have to help our children to do a number of things, 
but principally to make sure children are healthy enough to learn. We 
know if they learn more in the dawn of their lives, they will earn more 
down the road. We have to make those investments. I don't see this as 
just a program, something that we are giving to people.
  That is not what it is. The distinguished Senator from Utah said a 
couple moments ago, this is a capped block grant program and a good 
investment in that child and his or her future. But it is also an 
investment in our economic future. We can do a lot with this program to 
help families. But let's think about a mother. What does every mother 
want for their child, especially when they are very young? They want to 
nurture the child. They want to make sure the child has some kind of 
health care, has nutrition, and they want to shower that child with all 
the love and care a mother can provide.
  One of the benefits to reauthorizing this program and getting the job 
done is that we can help a mother as she is trying to provide 
everything she can for her child, whether she lives in a farming 
community in central Pennsylvania or whether she lives in one of our 
towns in Pennsylvania or across the country or whether she lives in the 
inner city. Make no mistake, this comes down to a very simple 
question--maybe a couple, but one basic question--which is, does the 
President want to cover 10 million American children? There is only one 
answer to that question, only one answer we can justify. There is only 
one answer for

[[Page 25850]]

which we can go back to our States and say we did the right thing. That 
answer is, absolutely, the President should want to cover 10 million 
American children because if he vetoes this and his point of view 
prevails, 10 million children will not have health insurance. By 
signing this legislation we are about to send to him, he can make sure 
10 million American children have health insurance.
  What upsets me about the President--I have been very critical of him, 
and I will continue to be so when it is warranted--is not just his 
position on this issue, not just his threat of a veto--that is bad 
enough. What upsets me and a lot of Americans, frankly, is the 
President had month after month after month to come to the Congress and 
say: I think we should have a $5 billion increase over 5 years. That is 
what he says. There is an overwhelming consensus now in the Congress 
that it should be a $35 billion increase. When you consider it over 5 
years, that is only a billion a year. We spend $7 billion a year on a 
lot of things. But let's consider what he said. If he was going to take 
that position all those months ago, why didn't he come to the Congress? 
If health care for children is such a priority, why didn't he come to 
the Congress and say: We are far apart. The Congress is at $35 billion, 
and I am at $5 billion. We will work together.
  He didn't do that. He just laid down his number and then he began, 
frankly, to misrepresent the facts. That has made this argument an 
unfortunate episode in the debate.
  I have another question for the President. The question about 10 
million children is very important, but I have a question for the 
President. What is the choice you are making? You are saying on the one 
hand, Mr. President, that 10 million American children should not have 
health insurance at the same time that in 2000 we will give away $100 
billion to wealthy Americans. Is that right? I don't think so. That is 
immoral in my judgment, to give $100 billion to wealthy Americans and 
say children who could benefit from this program, 4 million more, that 
they don't get health insurance.
  It is equally immoral when the President of the United States and 
every Senator and every House Member gets their health insurance paid 
for. Yet some people say: No, we are going to wait on those children. 
Those 4 million children will have to wait, even though every Senator 
gets health care and this President gets health care every day of the 
week. I think that is immoral. He should recognize that.
  This is about numbers and budgets and a program. We will talk about 
that a lot. That is important. I can justify every one of those 
numbers. OK. I know a lot about cutting out waste and fraud. I did that 
for 10 years in State government. I know that subject very well.
  But this is a program that works. We have had a 10-year experiment 
with it, and it works, and everyone here knows that. It works very well 
to make sure we cover our children. All these other arguments about why 
we should not do it comes down to politics. The people who are 
supporting the President on this should answer the questions I posed.
  Why shouldn't 10 million children get health care? Why do you get 
health care in the Senate and those children do not get health care, 
according to your point of view? They should answer that question when 
they are supporting this President. Why should every Member of the 
Senate get health care and these 4 million children--plus the 6.5 
million or so we can cover--why shouldn't they get health care? Why 
should millionaires and multimillionaires and billionaires get tax cuts 
in 2008 and 2009 and on into the future and these children should not 
have health insurance?
  So when you come to the floor to talk about this program, and when 
the President goes on television and preaches to us about why we should 
not do that, I hope you would be honest enough--I hope the President 
and every Member of this body would have the integrity to stand up and 
justify why 10 million kids should not have health insurance, why they, 
as a Member of the Senate, should have their health care paid for, and 
why all those wealthy Americans should get their tax cut--tens of 
billions this year--and these kids should not have health insurance.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Salazar). The Senator from Oklahoma.
  Mr. COBURN. Mr. President, I thank the leaders of this bill for the 
time to speak.
  I am kind of flabbergasted at the last talk. I am one of the 
physicians in this country who has cared for kids on Medicaid. I have 
actually delivered over 2,000 babies on Medicaid. I have actually done 
well-child exams.
  We have the Senate lecturing the President, and we should be 
lecturing ourselves. The debate on this bill is not about children. 
There is not anybody in the Senate who does not want to cover and 
continue the present SCHIP.
  What this debate is about is how do we move toward national health 
care. That is what this debate is. So immoral? Is it immoral to spend 
$3,000 to buy $1,500 worth of care, like we are going to do in this 
bill? Is it immoral for the Senate to say it only costs $35 billion and 
then totally take a program that is costing $12 billion a year 5 years 
from now and cut it down to $700 million and say we met the budget 
rules, when in fact we did not? That is immoral. What about the 
children who are going to pay for the deficit associated with this 
bill?
  I have actually cared for these kids. My practice has been a 
Medicaid-based practice and a SCHIP-based practice. The holier-than-
thou attitude that if you oppose this bill, you do not care about 
children is completely disrespectful to those of us who happen to 
disagree, who maybe think a better way to cover children would be the 
Burr-Corker bill, which gives a tax credit to every kid in this country 
that covers enough to give them insurance and takes that Medicaid stamp 
off their head, since only 40 percent of the doctors in this country 
will cover SCHIP kids and Medicaid kids.
  So the debate is not about the President being immoral. It is not 
about tax cuts. The real immoral fact of this bill is we are winking 
and nodding again to the American people that we are going to spend 
$121 billion over the next 10 years--not $60 billion over the next 5 
years--$121 billion, and we have no way to pay for that. We had a $444 
billion deficit last year. We could have paid for the war and decreased 
the deficit if this body would have had the courage to eliminate 
duplicative and fraudulent programs. There is no holier-than-thou 
attitude to go after those programs because they have an interest. As 
politicians, we do not want to upset anybody.
  So it is easy--the greatest pleasure in the world is to spend 
somebody else's money and to claim it is in the name of children. I 
have been on the ground with children. I have taken care of the poorest 
of the poor. We have a pregnancy component in this bill. Title 19 now 
is at 300 percent of the poverty level in this country. We have people 
dropping their insurance to qualify for title 19. We do not need 
pregnancy covered in the SCHIP bill. It is already covered. But we 
claim that to rationalize to make the bill better.
  I have no disrespect for people in this body who claim they want 
national health care, government-run national health care. Well, 
American public--guess what--if you think health care is expensive now, 
wait till it is free. Wait till it is free. That is exactly what we are 
doing with this bill.
  We can reauthorize SCHIP, and we can make it higher than a $5 billion 
increase to truly cover those kids who need it. This body rejected an 
insurance contribution component amendment I offered that would 
actually expand further the number of kids.
  The other point that is not being made is, for every kid you cover 
who does not have health insurance today, you are going to drop another 
kid from health insurance that is being paid for by their parents, and 
they are getting no benefit in terms of a reduction of their health 
insurance. So what we are doing is shifting taxes to those same parents 
to pay for a program, twice as

[[Page 25851]]

much money for the benefit we will get for the kids.
  I am not against well-child exams. I am not against immunizations. I 
give them out of my pocket of my own practice now for free. They cost 
me an average of $146 a kid.
  The claim of superiority that somehow if you do not want to have this 
bill you do not care for children is gobbledygook. What about the kids 
in the future who are going to pay for the mistakes we are making? What 
about the kids who are born today who owe $400,000 on our unfunded 
liabilities? We have done that. If we care so much about kids, why 
aren't we fixing that problem? They are never going to get a college 
education or own a home, and they are never going to have health 
coverage because we will have bankrupt this country by the way we do 
not control how we spend money.
  So to be lectured and lecturing the President because, finally, he is 
exhibiting some fiscal responsibility into the future, and us to play 
games on the true cost of this program, that is what is immoral. It is 
not the President being immoral. The fact is it is not our money, it is 
the money of the people of this country, and we are going to decide we 
are going to spend money and not tell them what it is really going to 
cost because that is what this bill does in the outyears, the 6th 
through the 11th year of this bill if we cut this program to $700 
million a year.
  Now, nobody in their right mind will honestly say we are going to let 
that happen. So if we are not going to let that happen, how about being 
honest with the American people about the true cost of what we are 
doing? It is $121 billion. It is not $60 billion. Even the staff admits 
that. Both the Democratic and Republican staff admit that.
  For us to sit up here and claim it is only a $35 billion increase--
well, only a $35 billion increase is a 120-percent increase in the 
program, just a 120-percent increase in the program.
  We ought to have a debate about national health care and how we solve 
the problems of health care in this country. There is a way to solve 
it. It is to make sure everybody in this country has access and give 
them the freedom and the power to choose what is best for them rather 
than us tell them what they have to have. That is the debate we ought 
to have.
  This is a farce. This debate is a farce. It is a farce about saying 
we want to cover more children, when we are really taking children who 
are already covered and putting them under a government program and 
then charging those children's kids for the cost of the program. That 
is what we are doing. It is not about caring for kids. It is about 
lying to the American public about what this program does.
  So I do not have any hard feelings about the fact that people want to 
have national health care and a government-run program, but let's have 
the debate about what it really is and not have a debate demeaning the 
President when he finally stands up and says we have an obligation, for 
the next few generations, to start doing it right, and finally he is 
starting to do it right. And now we are saying he is immoral. Of the 10 
million kids, 5 million already have coverage. We are going to ask the 
American taxpayer--in spite of what we are doing, in spite of the fact 
we borrowed $434 billion--we are going to load that on them.
  They already have coverage. They already have immunization. They 
already have well-child care, and we are going to add that cost to the 
American taxpayer. Do you know who that taxpayer is? That is that 
child's child because we are not going to pay for it. We are going to 
refuse to be responsible. We played the game of pay-go on this, the 
great pay-go rule, where we now bastardize our own ethics to say we 
paid for something, knowing we did not. Because nobody in this body 
believes this is going to go to $700 million 5 years from now. Nobody 
believes that. Everybody knows that. So everybody knows we are telling 
an untruth to the American people about the true cost of this program.
  I care a ton about my patients. But I also care enough about this 
country to be able to speak the truth about what we are doing. And what 
we are doing is absolutely untruthful in how we characterize the 
spending on this program. You can debate that. I will debate that all 
day with anybody up here. This body knows I know our numbers, and the 
numbers on this bill are untruthful.
  So what we ought to say is, we think we ought to expand the SCHIP 
program, and it costs $121 billion. Let's have a debate about what it 
really costs. That is why the President says we should not do it. And 
we should not go to 300 percent, and we should not have adults on a 
program where in many States it consumes 75 percent of the dollars.
  I will readily grant you, we have a big problem with health care in 
this country. One of the major reasons we have a big problem with 
health care in this country is government-run health care programs that 
drive the cost and the overutilization in many areas where we cannot 
function properly.
  What is happening today in our country with quality of care is 
because we have so much government run. We have physicians trying to 
see too many patients. The one thing we are taught in medical school 
is, if you will listen to your patients, they will tell you what is 
wrong. Right now, 8 percent of the cost of health care in this country 
is associated with tests we order that no patient needs. It is because 
this body will not look at the malpractice situation we have in this 
country and the liability situation and fix it to where it truly 
represents a system where people who are injured are taken care of. 
What we have is a system that games it. So consequently we are all 
paying 8 percent more for health care because providers have to order 
tests to cover their backside.
  The other thing we know is another 3 percent of the cost of health 
care is associated with tests that doctors are ordering because they 
are not listening well--$50 billion worth of tests that people do not 
need because we will not take the time to listen to them.
  I will summarize and finish my point with this: Washington has an 11-
percent approval rating for a very good reason. Because we do not 
deserve to be trusted, because we do exactly what we are doing on this 
bill. We are lying to the American people about what it costs, who it 
will cover, and how it will be delivered.
  Now, some other details of the bill are debatable, but those facts 
are not debatable, and the American people, hopefully soon, are going 
to wake up to the dishonesty and the farce that we perpetrate on them 
as we debate those issues.
  Let's have a debate about national health care. Let's really debate 
it. Let's look at the options. Our bill, in several other places--the 
Burr-Corker bill, the Universal Health Care Choice and Access Act--
gives everybody in this country an equal tax credit. Everybody gets 
treated the same. You want to punish the millionaires? Take away some 
of their tremendous excess tax benefits from health care. But we would 
not do that. We do not have one person who will come forward and say: 
Let's equalize the Tax Code on the other side. Let's equalize the Tax 
Code so everybody has the same shot. Let's let a market help us access 
that. Let's make sure it is 100 percent access. If you do not have 
access, you cannot have care.
  This bill is not going to provide that much access. Fifty percent of 
what it does has to do with people who already have access. Those are 
not my numbers. Those are Congressional Budget Office numbers.
  So let's be honest about what we are doing. Let's talk about health 
care. If we want to go to national health care, if we have the votes to 
do it, then let's do it. But let's do not, under the guise of helping 
children, expand national health care. This Senator will vote to 
reauthorize a higher level of funding for SCHIP to cover kids who are 
truly poor--those who don't have access. I will help anytime, any way 
to do that. That has been my practice. That has been my heritage. That 
has been my history in caring for poor folks in Oklahoma. But I am not 
about to go along with a lie, that what we are doing is something 
different than what we say we are doing.

[[Page 25852]]

  With that, I yield the floor.
  The PRESIDING OFFICER. The Senator from West Virginia is recognized.


                              Veto Threats

  Mr. BYRD. Mr. President, with 3 days to go before the start of the 
new fiscal year, there is much inside-the-beltway chatter about 
continuing resolutions, omnibuses, minibuses, budget showdowns, and 
Government shutdowns.
  Nowhere is that chatter louder than that which is coming from the 
other end of Pennsylvania Avenue. The President has threatened almost 
daily that he will veto any appropriations bill that exceeds his budget 
request. These veto threats include all of the spending bills that 
provide funding for our domestic programs--programs that, in one way or 
another, benefit each American and every American. These bills help to 
educate our children, help to secure our homeland, help to support 
rural America, and help to promote a competitive economy. These 
domestic spending bills provide the essential building blocks for the 
foundation of our great country.
  On the one hand, the President is seeking over $190 billion in 
emergency appropriations to fight the wars in Iraq and Afghanistan. 
That is $190 billion for the cost of the wars for 1 year--1 year--1 
year. At the same time, the President wants to veto critical domestic 
spending bills because they total $22 billion above his, the 
President's, budget request--less than 1 percent of our entire budget, 
and about what we spend in 2 months' time fighting an unpopular war in 
Iraq. All the chatter from the White House even asserts that the $22 
billion for programs here in America means increasing taxes and putting 
America's economic growth at risk.
  This, of course, begs the question of the economic impact of the 
almost $450 billion we have spent on the war in Iraq, a war which I 
oppose.
  The President characterizes the $22 billion above his request as 
``increased'' spending. In fact, $19 billion of the $22 billion 
``increase'' simply represents restorations of the President's--the 
President's--the President's relentless attempts to savage important 
domestic initiatives.
  This week, the FBI announced that violent crime is on the rise for 
the second straight year. Yet the President proposes to cut State and 
local law enforcement funding by $1.5 billion.
  Hurricane Katrina proved that the Government is not prepared to 
handle major disasters, be they natural disasters or terrorist attacks. 
Yet the President--our President--has proposed to cut first responder 
grants by $1.2 billion. Those grants equip and train our police, our 
fire and emergency medical personnel to respond to a disaster.
  The President--our President--proposes over $3 billion in cuts for 
education programs, including special education, safe and drug-free 
schools, and improving teacher quality.
  Despite an aging population in this country, the President proposes a 
cut of $279 million for studying cancer, diabetes, and heart disease at 
the National Institutes of Health. Under the President's budget, the 
National Institutes of Health would have to eliminate 700 research 
grants that could lead to cures for treatments for cancer, diabetes, 
Alzheimer's, and other diseases.
  The President also proposes to cut $2.7 billion for elderly and 
disabled housing and community development grants.
  When the Interstate 35 bridge collapsed into the Mississippi River, 
it focused the Nation on the need to invest in our crumbling 
infrastructure. Yet the President proposes to cut over $3 billion from 
infrastructure programs, such as highway and transit funding, bridge 
repairs, rural wastewater grants, levees and dams, clean water grants, 
and airport safety and improvements. The President--our President--even 
proposes to reduce funding for the highway and transit levels that are 
guaranteed in the highway law that he, the President--our President--
signed in 2005.
  The President proposed cuts of $1 billion from health programs such 
as rural health, preventive health, and mental health grants, as well 
as over $300 million from the Low-Income Home Energy Assistance 
Program.
  Between 1998 and 2004, disease outbreaks in food produce have almost 
doubled. In 2003, there were 870 food inspectors at the FDA. In 2006, 
there were 640. The FDA lost 230 inspectors in less than 4 years. So it 
is no surprise food inspection dropped by nearly half during that time. 
Yet the President--our President--does not propose to restore those 
reductions in the number of inspectors.
  All of these foolish cuts have been restored in the bipartisan bills 
that were approved by the Senate Appropriations Committee by nearly 
unanimous votes and, regrettably, that the President--our President--
has said he will veto. In the 12 bills that have been reported from the 
committee, we have significantly reduced funding used for 
congressionally directed spending, and we have added unprecedented 
transparency and accountability.
  As one can clearly see, this White House standoff is not over some 
irresponsible plan for an expansion of Government or pork-barrel 
projects. Rather, it is the President's--our President's--effort to 
prevent cancellation of his ill-conceived and poorly justified proposed 
budget cuts. Congress wants to support vital core missions of 
Government, such as the Federal Emergency Management Agency, the Food 
and Drug Administration, and the Customs and Border Protection Agency. 
Congress wants to make reasonable choices and set important priorities 
for our Nation.
  There are consequences--yes, consequences--for failing to invest in 
America's safety and in America's future. Hurricane Katrina proved 
that. The collapse of the I-35 bridge proved that. Increases in violent 
crime prove that. Increases in food-borne illnesses prove that. Every 
headline about unsafe products being imported into this country proves 
that.
  Americans rightly expect their Government to work.
  Regrettably, rather than recognizing the consequences of his budget, 
the President--our President--is spoiling for a political fight. He 
refuses to recognize the facts, even as those facts evolve in a 
changing world.
  According to the administration's latest National Intelligence 
Estimate:

       We judge the U.S. homeland will face a persistent and 
     evolving terrorist threat over the next three years. The main 
     threat comes from Islamic terrorist groups and cells, 
     especially al-Qaida, driven by their undiminished intent to 
     attack the United States.

  Yet the President threatens to veto the Homeland Security bill that 
passed the Senate 89 to 4 because it is $2.2 billion above his request, 
with increases for first responder grants, for border security, and for 
enforcing our immigration laws.
  The President--our President--is determined to veto 8 of our 12 
appropriations bills over $22 billion. Some have argued that $22 
billion is not a lot of money. I don't share that view; $22 billion is 
a lot of money. That is why we are fighting for the additional funding 
above the President's inadequate request. This fight is about 
priorities.
  This Congress passed a budget resolution that balances the budget by 
2012 and provides for the increase above the President's request for 
domestic programs.
  Consistent with the budget resolution, the Appropriations Committee 
has reported all 12 bills. Four have passed the Senate, and with 
passage of the continuing resolution, we will continue to press for 
passage of the remaining bills. The President's veto threats 
inevitably--yes, the President's veto threats inevitably slow this 
process.
  In the 12 bills that have been reported by the Appropriations 
Committee, we invest the $22 billion in America's future. By 
comparison:
  In fiscal year 2008, the total cost of President Bush's tax cuts is 
$252 billion--11 times the amount of spending in question.
  In fiscal year 2008, the cost of the tax cuts for the wealthiest 1 
percent of taxpayers is almost $70 billion--three times the amount of 
spending in question.
  In fiscal year 2008, special interest tax expenditures will cost $1 
trillion--

[[Page 25853]]

45 times the amount of spending in question. Corporate tax expenditures 
will cost $91 billion--over four times the amount of spending in 
question.
  So $22 billion is, in fact, a lot of money; money that, if well 
spent, can help to make America be a safer, healthier, more prosperous 
country. We are committed to making those careful choices. We will root 
out waste. We will cut or eliminate ineffective programs. We will make 
careful choices.
  When President Bush came to town almost 7 years ago, he vowed to 
reach across the aisle for the common good of our Nation. Now is his 
chance. This is the President's chance to make good on that pledge. He 
can continue his purely partisan fight over $22 billion in needed 
spending, or the President can work with the Congress to confront 
problems that face Americans here at home.
  It is my fervent hope the President will put away his veto pen so we 
can get on with the business of adequately funding programs that 
contribute to a safe and prosperous United States of America.
  God bless America always.
  The PRESIDING OFFICER. Who yields time?
  The Senator from New Jersey is recognized.
  Mr. MENENDEZ. Mr. President, I rise today, as I did when we started 
this whole debate on children's health insurance, on behalf of the 
Nation's children and working families. I wasn't intending to come to 
the floor, but as I have listened to the debate over the last several 
days, I am amazed we have to defend a program that I cannot believe 
actually needs defending.
  Today, we rise to protect the Nation's children. In this great 
Chamber, I often hear Members say our children are our greatest asset, 
and they most certainly are, but they are also our most fragile asset. 
And nothing is more important in preserving that asset than preserving 
their health so they can fulfill their God-given potential.
  The issue before us today is a matter of values. It is not just about 
a law or about a program, it is also about a matter of values. Do we 
value our children sufficiently to ensure that those who otherwise do 
not have the ability to insure themselves will have the ability to have 
health care coverage so no child in America goes to sleep at night 
worried that they not get ill because their parents cannot afford to 
take care of them? That is the issue before the Senate, the issue 
before the country, and the issue that will be before the President.
  If our values match our action, then this bill needs to be passed by 
the Senate and signed into law by the President.
  This is common sense to me. The bill before us today will keep 6 
million children insured and will cover an additional 4 million 
children who presently go to sleep at night and, because they have no 
health care coverage, their parents worry over them; and if they get 
ill, what happens? They wait longer and their illness gets worse. What 
do they do? They go to an emergency room, which is far more costly to 
their lives, as well as to our collective economic consequence. The 
deal the Senate has before it is to save children's lives and keep 
children healthy. Bottom line: It is a deal that will keep millions of 
American children and families from being pushed into the ranks of the 
uninsured.
  I find it interesting that my colleagues talk about fiscal 
responsibility--now we are going to be fiscally responsible--when we 
have supplementals that keep coming here without payment for them and 
without any limitation whatsoever--a blank check. But now we are going 
to be fiscally responsible on the backs of children.
  I want to take a moment to look at the families who are actually 
affected by the Children's Health Insurance Program. We are not talking 
about the poor, because if you are poor in this country, you get 
Medicaid. If you are wealthy, of course, you have the wherewithal to 
pay for the insurance. We are talking about children whose families 
work in some of the toughest jobs this country has. They work at jobs 
that offer no health care, and they certainly don't make enough money 
to afford private health care coverage. This program is their last 
resort. I have been watching the floor this week and I have noticed 
that my State of New Jersey has quite unfairly become the punching bag 
by some Members of this body for our successful Children's Health 
Insurance Program. On behalf of New Jersey families, I simply cannot 
let that go unnoticed. On behalf of the families that the opponents of 
this legislation say don't deserve to have a doctor or receive medical 
attention, I am insulted. On behalf of children who are asking for an 
eyeglass to see a blackboard or get an immunization shot to ward off 
illness, I am offended.
  I will tell you about one of these families in Keyport, NJ. They earn 
just over $50,000 a year and they have a 16-year-old daughter. They 
cannot afford private health insurance coverage in New Jersey, but 
through the Children's Health Insurance Program they can provide their 
daughter with the much needed health care--health care that protected 
her when she came down with a flu that would not go away, and care that 
provides relief to her parents, who don't have to worry about medical 
bills if their child gets sick.
  Even on New Jersey FamilyCare they pay a premium of $74 a month 
because they are higher on the Federal poverty level. But that is far 
less than private insurance would cost them, which they could not 
possibly afford on that $50,000 income for that family of three.
  Talking about premiums, let me take a moment to talk about families 
at 350 percent of the Federal poverty level in New Jersey, since that 
is a particular point of contention in this debate. Families at 350 
percent of the Federal poverty level in New Jersey earn about $60,000 
for a family of three. These families, under New Jersey FamilyCare, are 
paying $125 each month in premiums and between $5 and $35 in copays. It 
is not a free ride. In fact, most federally elected officials, 
including my colleagues in the Senate, pay about $190 each month in 
premiums for their family coverage and their earnings are well above 
350 percent of the Federal poverty level. It is hard to see how it is 
OK for Members of this body but it is not OK for children in this 
country.
  If the President made the decision, it seems he would say ``tough 
luck'' to these families, ``go ahead and roll the dice on your 
daughter's health care.'' That is not an action that I think is 
dignified by a compassionate conservative. The President doesn't want 
to cover families above 200 percent of the Federal poverty level--this 
child and so many others like her. I believe that is disgraceful and it 
should be embarrassing to even threaten a veto of this bill.
  Here is my question to those who oppose this bill: Is the greatest 
Nation on the Earth going to permit its children to have no health 
coverage?
  The President gets some of the best health care coverage in the 
world, paid by the taxpayers of this country. He can go, as Members of 
this body can, to Bethesda Naval Hospital, or Walter Reed, or, in the 
case of the Members of this body, to the Capitol doctor. That is 
subsidized by the taxpayer. Talk about socialized medicine. It is good 
enough for Members of this Chamber but not for these children. The 
President gets the best health care coverage in the world. He deserves 
to have it, but so do the children of this country.
  When you think about using your veto pen, Mr. President, think about 
your health care coverage that we all pay for as taxpayers. Do these 
children deserve less?
  In New Jersey there are 130,000 children depending on this program 
for their health coverage. They, along with 6 million children 
nationwide, depend on this program to stay healthy and, in some cases, 
stay alive. Proper coverage is often the difference between life and 
death, between health and sickness, between compassion and 
heartlessness.
  I urge my colleagues to act wisely as this is not a political game, 
nor is it time to make a point. This is about one thing only: the 
health of our Nation's children.
  What troubles me is that the President is prepared to turn his back 
and

[[Page 25854]]

close the doors but, simply put, if his priorities were different, we 
could provide health care to all children in this country. If we were 
to take what we spend in Iraq in one day--$300 million--and spend that 
on children's health care, we could cover 245,000 children. In the past 
41 days, we have spent over $12 billion on the war, and what changed in 
Iraq during that time? But I can tell you what we can do in the lives 
of children in this country.
  Finally, I bristle when colleagues come to this floor and still bring 
up the red herring of immigrant children being covered who should not 
have the right. The law has been clear--the law that exists, the law we 
are renewing. Undocumented immigrants have never--I underline 
``never''--been eligible for regular Medicaid or the Children's Health 
Insurance Program. This bill maintains that prohibition. It maintains 
that. So to continue to come to the floor and bring the bogeyman of 
those who are coming because they want the health care coverage that 
this program would provide, it is not permitted under the law, has not 
been, and is not under this law, and won't be under this law.
  I will tell you what is incredibly remarkable. During the immigration 
debate, we heard a great deal that we should differentiate between 
those who follow law and the rules and came here legally, and did the 
right thing and are living legally as permanent residents of the United 
States versus those who do not. Guess what. We don't even cover the 
children of those legal permanent residents of the United States who 
have obeyed the law, followed the rules, and ultimately are working 
hard in our country. Many of them, by the way--over 70,000--are serving 
in the Armed Forces of the United States. So to say that children are 
getting covered who are not legal and who are not permitted under the 
law, that is outrageous. This bill doesn't do it, but we should cover 
those children of legal permanent residents who have obeyed the law and 
the rules and are contributing to our society. But we don't do that 
either. So I hope we stop using children, whether they be those who 
cannot afford, because of their status in life and because of their 
parents' hard work but they don't make enough money, to have insurance 
and ultimately don't get it at their workplace, or those children who, 
through no fault of their own, find themselves in this country but who 
are not covered under this provision anyhow under the law--stop using 
all of these images to try to undermine the very essence of what this 
bill is all about.
  You either stand with children in this country who, through no fault 
of their own, have no health care coverage whatsoever, or you stand 
against them. You stand for the proposition that no child in America 
should go to sleep at night without health care coverage; you stand for 
the proposition that it is in the societal interest of this country to 
ensure that the greatest asset we always talk about, our children--they 
are also the most fragile asset--can be protected; you stand for the 
proposition that in this great country of ours, among the high and 
mighty here, who have great health care coverage, well over 350 percent 
of the Federal poverty level, that we deserve no more than children in 
this country do.
  That is what this debate and vote is all about.
  Before I close, there is one part of this bill that is missing and it 
leaves this entire bill and mission to increase children's health care 
unfulfilled. And that is the lack of language to provide health care 
for legal immigrant children and pregnant women in this bill.
  I am a proud cosponsor of the bipartisan Legal Immigrant Chidren's 
Health Improvement Act, also known as ICHIA, which would have repealed 
the morally objectionable law that prohibits new legal immigrants from 
accessing Medicaid and SCHIP until they have lived in the United States 
for 5 years. This bill today should have included a provision that 
would have given States the flexibility to provide coverage to this 
population.
  I am proud of my home State of New Jersey. They have taken it upon 
themselves to use 100 percent State funds to cover over 8,000 legal 
immigrant pregnant women and children--at a cost of over $22 million. 
My State has temporarily fixed the problem but it is up to Congress to 
pass the solution into law.
  How can you tell a 7-year-old child with an ear infection he has to 
wait 5 years to see a doctor? We cannot bar these families from 
accessing our health care system simply because they haven't lived here 
long enough.
  During the immigration debate, our colleagues emphasized the 
difference between those here legally and those here illegally, so it 
is appalling to me that a legal immigrant child, whose family waited 
their time, came here legally and obeyed the law, are still subject to 
republican criticism and are denied health care.
  These fully legal, taxpaying pregnant women and their children 
deserve to be covered under our children's health program. I am 
disheartened that we could not agree to include this language but you 
have my promise that I will work to pass ICHIA in coming months. This 
is not a question of if but a question of when it will pass.
  In conclusion, a great Republican, Abe Lincoln, once said:

       A child is a person who is going to carry on what you have 
     started. They are going to sit where you are sitting, and 
     when you are gone; attend to those things, which you think 
     are important. The fate of humanity is in their hands. So it 
     might be well to pay them some attention.

  I ask my colleagues to now pay attention to our children and support 
this important bill. I ask this for our children, for our families and 
for the well-being of our country.
  The PRESIDING OFFICER. The Senator from Kentucky.
  Mr. BUNNING. Mr. President, I wish to talk about the Children's 
Health Insurance Program, known as SCHIP. In Kentucky, it is known as 
KCHIP.
  Several weeks ago, the Senate debated a bill that would reauthorize 
this program. Now we are debating a bill that looks very much like the 
last bill. I did not support the Senate-passed bill and, unfortunately, 
I cannot support this version presently on the floor.
  The tobacco tax funding mechanism is an irresponsible way to pay for 
children's health care. The increased tax is fundamentally unfair, 
particularly to my State and the States that surround Kentucky.
  It pays for a government program intended for low-income kids--one 
that I support and continue to support--by raising taxes. The bill 
expands its coverage to middle-income adults and some illegal 
immigrants in other States. It redistributes income from low-income 
smokers to States with the highest per capita incomes. It could be 
called Robin Hood in reverse.
  I have a chart that illustrates what this bill really does. It is 
compiled from data drawn from a CDC database on tobacco consumption and 
projections by Family USA concerning SCHIP spending.
  As we can see, the States in red will pay more in tobacco tax over 
the next 5 years than they will receive. In my State of Kentucky, we 
will pay $602 million more in tobacco taxes than we will receive in 
SCHIP money under the same 5 years.
  Virginians, our good friends from Virginia, will pay $576 million 
more, and the citizens of Florida, our good friends down in the 
panhandle, will pay $703 million more than they receive.
  California, our good friends out on the left coast, will receive a 
net benefit--in other words, more than they pay--of $2.5 billion. How 
fair is this?
  New taxes paid by low-income smokers in my State will go to pay for 
an extravagant expansion of SCHIP in California, New York, Texas, and 
all the States in light and dark green, and that includes New Jersey, 
New Mexico, Arizona, California, New York, and many others.
  Many people predict that the new Federal tobacco tax needed to pay 
for this expansion of SCHIP is likely to cause the States to increase 
their own tax cigarette taxes to avoid State revenue shortfalls. This 
will lead to artificially high-priced cigarettes that are irresistible 
targets for foreign cigarette counterfeiters and bootleggers in the 
United States.
  This is not just somebody's dream. There is new evidence of the 
absolute folly of this plan to increase tobacco

[[Page 25855]]

taxes by over 150 percent. We will not see the revenue projected, but 
you can be sure organized crime will profit from this situation.
  In August of this year, the New York Police Department and Federal 
authorities found 600,000 cartons of counterfeit cigarettes made in 
China in a warehouse in Queens. In the same raid, the NYPD found 
125,000 phony revenue stamps. The counterfeiters planned to use these 
phony stamps to evade taxes in Virginia, New York, and Kentucky, 
passing them off as real stamps so that cigarettes can be sold in 
ordinary stores.
  This was not an isolated incident. There are many other similar 
incidents of fake cigarettes in the United States from countries such 
as China and Russia.
  If you are concerned about lead in toys made in China, you should 
also be concerned about this SCHIP bill because it will almost 
certainly expose smokers, including some children, to the toxic 
substance in counterfeit Chinese and Russian cigarettes.
  According to an article last week in the New York Times, chemical 
studies of counterfeit cigarettes have shown that they contain high 
levels of lead. Unlike the lead paint on toys, this lead will certainly 
be consumed by smokers. It is much more dangerous. So much for 
improving health care.
  In addition to all the other problems, this new tax is a poor 
foundation for the proposed expansion of SCHIP. We are matching a 
declining source of revenue with a growing Federal program. It doesn't 
make any fiscal sense.
  If we were honest and truly wanted to fully fund SCHIP spending with 
a tobacco tax, the Federal Government would have to encourage people to 
smoke. As a matter of fact, the Federal Government would possibly need 
an additional 22.4 million smokers by the year 2017 to pay for this 
bill.
  Expanding SCHIP to cover adults, as well as kids, will lead to even 
more tax increases in future years because no one will pay these 
tobacco taxes if smuggled cigarettes and cigarettes from Internet Web 
sites are freely available.
  I also don't believe this bill focuses on those who need health care 
insurance the most. When richer families are made eligible for SCHIP, 
kids will move from private coverage to Government health care. In 
fact, the Congressional Budget Office tells us that this bill will 
result in 2 million children moving off private coverage. It is absurd 
to me that children above the 300 percent poverty level will be added 
to this program.
  New York still has the possibility of covering families that will 
make over $82,000 a year. It is not a fact, it is a possibility. These 
are families paying AMT taxes, a tax which is supposedly only affecting 
the wealthy. This expansion of the bill is a push for Government-funded 
national health care which is not the original intent of SCHIP.
  The way the bill is funded also should raise great concerns to anyone 
if they care about fiscal responsibility. The budget gimmick used to 
fund it is irresponsible. It jeopardizes coverage under the program and 
basically guarantees another tax increase 5 years from today or when we 
pass this bill.
  Under the bill, SCHIP spending from 2008 to 2012 totals over $27 
billion. However, for 2013, spending drops to $2.3 billion and falls to 
negative amounts in each year after that until 2017, representing 
projected cuts--I say that again, projected cuts--to the SCHIP program.
  So what we have here is a 10-year tax for a 5-year program. Does 
anybody really think we will kick millions of kids off this program in 
2013 to accommodate this lowered spending? Of course we won't. However, 
we will have to find a new way to pay for it. If a private company ran 
its books like this, the CEO would be fired or end up in the big house, 
in jail.
  Another stunning example of how this bill undermines the original 
purpose of SCHIP is that it makes it easier for illegal aliens to get 
health care intended for poor children. This bill guts existing 
protections put in place to stop illegal immigrants from getting 
taxpayer-funded SCHIP and Medicaid benefits. Earlier this year, we 
spent nearly a month debating immigration reform. This bill is a step 
backwards, and it certainly sends the wrong message. It takes money 
that is supposed to go to our poor children and gives it to others who 
have come to this country illegally.
  Let me make it clear that I want to see the SCHIP program continued 
as it is, and I want to see it reauthorized. However, I want to see it 
done responsibly. This bill does not do that. So I must oppose it and 
urge my colleagues to do the same.
  I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  The Senator from Pennsylvania.
  Mr. CASEY. Mr. President, I rise for a few moments because I know 
there are other people in this Chamber who have worked for many years 
on this bill who wish to speak. Senator Kennedy is here. I wish to take 
a few moments to rebut what was said about a half an hour ago. Our 
colleague from Oklahoma was making some arguments, and I want to rebut 
some of them. I know this has been a long debate, but it is important.
  He and others have made the claim about government-run health 
insurance over and over, and I think that is a White House talking 
point. I understand where they get the line. This is a program which 
uses private insurance carriers to provide the services especially to 
do the administration. So that argument really does not make a lot of 
sense.
  Secondly, he talked about shifting costs and people paying more 
taxes. It is very clear, just as the argument of our colleague from 
Kentucky made clear, that the increase in this program, the $35 billion 
to cover 4 million more children, comes from tobacco tax increases. We 
can have debates about whether it is right or wrong, but most people in 
America support an increase in the tobacco tax to pay for this 
legislation. We are not talking about an income tax or any other kind 
of tax.
  Thirdly, fiscal responsibility. We heard people talk about that issue 
today. No one on this side of the aisle needs a lecture from that side 
of the aisle or anywhere else about fiscal responsibility. This 
administration is the administration that brought us to a $9 trillion 
debt level and huge deficits. I think that is disingenuous.
  I want to read a quotation from a recognized expert from MIT, 
Professor Jonathan Gruber, on private versus public:

       I have undertaken a number of analyses to compare public 
     sector costs of public sector expansions such as SCHIP to 
     alternatives such as tax credits. I find that the public 
     sector provides much more insurance coverage at a much lower 
     cost under SCHIP than these alternatives. Tax subsidies 
     mostly operate to ``buy out the base'' of insured without 
     providing much new coverage.

  That quote is from a recognized expert.
  We heard discussions about the cost over 5 years. This is a 5-year 
reauthorization. The cost is not, as it was alleged before, some lie. 
The cost over 5 years is very simple: $25 billion is in the program 
now. We want to add $35 billion, so it is a $60 billion cost over 5 
years. It makes all the sense in the world to spend $12 billion a year 
on health insurance when billionaires get $100 million in 1 year, or I 
should say over $200,000 of income. They get $100 million a year if 
they make that kind of money.
  My last point is, he and others talked about this being a debate 
about national health insurance. We can have that debate. We agreed on 
that. That is one thing we all agree on, both sides of the aisle. We 
should have a debate about health insurance. This is not national 
health insurance. This is not the debate about health insurance 
generally. This is a very focused debate about whether the President of 
the United States is in favor of providing health care for 10 million 
children and whether he is going to make that commitment. It is very 
simple. If you are supporting the President, then you are supporting a 
policy which will lead to the failure of this country to provide health 
care for 10 million children, and that would be a terrible mistake for 
those kids, for their communities, but

[[Page 25856]]

especially, over the long term, for our economic future. We can't 
compete around the world unless our kids are healthy and they learn 
more now and earn more in the future.
  Mr. AKAKA. Mr. President, I support the Children's Health Insurance 
Program Reauthorization Act of 2007.
  The Children's Health Insurance Program is a successful program that 
has improved the quality of life for our Nation's children. According 
to the Center on Budget and Policy Priorities, the Children's Health 
Insurance Program has reduced the number of uninsured children by one-
third since its enactment in 1997.
  The Children's Health Insurance Program Reauthorization Act will 
preserve the access of health care for the 6.6 million children 
currently enrolled in the Children's Health Insurance Program. It will 
also expand health care access to an estimated 4 million children.
  An estimated 5 percent of children in Hawaii do not have health 
insurance. This is approximately 16,000 children. My home State of 
Hawaii has continued to develop innovative programs to increase access 
to health insurance. The Hawaii State Legislature established the Keiki 
Care Program this year. The Keiki Care Program is a public-private 
partnership intended to make sure that every child in Hawaii has access 
to health care.
  It would be irresponsible to reduce Federal resources to States for 
children's health care. Without access to insurance, children will not 
be able to learn, be active, and grow into healthy adults.
  I greatly appreciate the inclusion of a provision to restore Medicaid 
disproportionate share hospital, DSH, allotments for Hawaii and 
Tennessee. Medicaid DSH payments are designed to provide additional 
support to hospitals that treat large numbers of Medicaid and uninsured 
patients.
  I developed this provision as an amendment with my colleagues, 
Senators Alexander, Inouye, and Corker. I am proud that we were able to 
have this bipartisan amendment included in the Children's Health 
Insurance Program Reauthorization Act. Hawaii would be provided with a 
$10 million Medicaid DSH allotment for fiscal year 2008. For fiscal 
year 2009 and beyond, Hawaii's allotment would increase with annual 
inflation updates just like other low DSH States.
  We must enact this legislation so that Hawaii and Tennessee can 
receive Medicaid DSH allotments in fiscal year 2008 and beyond. In The 
Tax Relief and Health Care Act of 2006, DSH allotments were provided 
for Hawaii and Tennessee for 2007. The act included $10 million for a 
Hawaii Medicaid DSH allotment. The Hawaii State Legislature enacted 
legislation to provide the necessary matching funds required to utilize 
the Federal resources.
  Hawaii and Tennessee are the only two States that do not have DSH 
allotments. I will explain some of the history behind the lack of the 
DSH allotment for Hawaii and why it is so important that this 
legislation be enacted. The Balanced Budget Act of 1997, BBA, created 
specific DSH allotments for each State based on their actual DSH 
expenditures for fiscal year 1995. In 1994, Hawaii implemented the 
QUEST demonstration program that was designed to reduce the number of 
uninsured and improve access to health care. The prior Medicaid DSH 
program was incorporated into QUEST. As a result of the demonstration 
program, Hawaii did not have DSH expenditures in 1995 and was not 
provided a DSH allotment.
  The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection 
Act of 2000 made further changes to the DSH program, which included the 
establishment of a floor for DSH allotments. However, States without 
allotments were again left out.
  The Medicare Prescription Drug, Improvement, and Modernization Act of 
2003 made additional changes in the DSH program. This included an 
increase in DSH allotments for low DSH States. Again, States without 
allotments were left out.
  Hawaii and Tennessee should be treated like other extremely low DSH 
States and be provided with Medicaid DSH allotments every year. Other 
States that have obtained waivers similar to Hawaii's have retained 
their DSH allotments.
  Hospitals in Hawaii are struggling to meet the elevated demands 
placed on them by the increasing number of uninsured people. DSH 
payments will help Hawaii hospitals meet the rising health care needs 
of our communities and reinforce our health care safety net. All States 
need to have access to resources to ensure that hospitals can continue 
to provide services for uninsured and low-income residents.
  The President's expected veto of this legislation is detrimental to 
the health of our Nation's children. It also will be very harmful to 
Hawaii. The resources necessary to ensure that children have access to 
health care.
  This administration fails to understand the health care needs of the 
country and especially Hawaii. This legislation will help the State of 
Hawaii provide essential health care access to children that currently 
lack health insurance. It will also provide much needed assistance to 
our hospitals that care for Medicaid beneficiaries and uninsured 
patients.
  Mr. LEVIN. Mr. President, I strongly support the Children's Health 
Insurance Program Reauthorization Act of 2007, a bipartisan bill that 
would provide health care insurance to millions of children who are not 
now covered.
  I hope the President will reconsider his position and sign the 
bipartisan compromise when it reaches his desk.
  Currently, 6.6 million children are enrolled in CHIP. There are still 
9 million uninsured children nationwide, 6 million of which are 
eligible for either Medicaid or CHIP. In Michigan, while 55,000 
children are covered under CHIP, 90,000 Michigan children are currently 
eligible for Medicaid or MIChild, Michigan's CHIP program, but are not 
receiving services. In addition, according to the Robert Wood Johnson 
Foundation, the recent decline in employer-sponsored health care 
coverage is threatening the access to private health care coverage for 
many more children. In fact, the Census Bureau has reported that, 
between 2004-2006, the number of uninsured children has increased by 
approximately one million children.
  Although the existing CHIP has been successful, it still fails to 
address the problem fully. Too many children qualify for the program 
but are unable to receive insurance because of inadequate funding.
  Much like the Senate bill to reauthorize this successful children's 
health program, the bill we will pass today will reauthorize CHIP and 
increase funding for the program by $35 billion over 5 years. The 
Children's Health Insurance Program Reauthorization Act of 2007, a 
compromise worked out between the House and Senate, would ensure that 
there is sufficient funding to cover the children currently enrolled 
and to expand the program to additional children in need.
  The Congressional Budget Office estimates that 3.8 million uninsured 
children would gain health coverage under this plan and according to a 
study done by The Urban Institute, 80 percent of the children covered 
under CHIP will come from families under 200 percent of the Federal 
poverty level.
  We have a moral obligation to provide Americans access to affordable 
and high quality health care. No person, young or old, should be denied 
access to adequate health care, and the expanded and improved 
Children's Health Insurance Program is an important step toward 
achieving that goal.
  Mr. DOMENICI. Mr. President, I rise today in support of the 
Children's Health Insurance Program Reauthorization Act of 2007, H.R. 
976. Reauthorizing the State Children's Health Insurance Program, 
SCHIP, before it expires is critical to ensure health care access for 
millions of our Nation's children.
  My home State of New Mexico has a terrible problem with uninsured 
children. Recent reports have New Mexico at the bottom in the Nation 
for coverage of children. In 1997, while I was chairman of the Senate 
Budget Committee, I helped to create SCHIP as part of the Balanced 
Budget Act. The program has been a success. Over the

[[Page 25857]]

past decade, SCHIP has helped reduce the number of children without 
insurance.
  The bill we are voting on today is a compromise. In August, both the 
House and the Senate passed two very different versions of an SCHIP 
reauthorization. At that time, I came down to the floor and I said I 
did not like what the House of Representatives was doing. I did not 
support the massive increases in spending and eligibility proposed by 
the House and I did not want a reauthorization that included revisions 
to the Medicare Program. The conference committee listened to these 
concerns, and I am pleased that the bill before us today closely 
resembles the SCHIP bill passed by the Senate 68-31 in August.
  My comment to children's health care remains firm today. I support 
the passage of the compromise SCHIP reauthorization. It is a good bill. 
It provides $35 billion in new resources to provide health coverage for 
millions more children in working families. It will strengthen outreach 
and enrollment efforts to make sure that all children who are eligible 
for the program get the services they need. It also makes improvements 
to the program by including language on mental health parity and dental 
health coverage.
  Mr. JOHNSON. Mr. President, I rise today to express my support for 
legislation that is critically important to more than 6 million 
children in the United States, including more than 14,000 South Dakota 
children, who are covered by the State Children's Health Insurance 
Program, or CHIP.
  I voted for this program when Congress created it 10 years ago and I 
have watched with great satisfaction as the number of uninsured 
children in our country dropped. More children have health insurance 
coverage today, which ensures that they have every chance to do their 
best in school and live long, healthy, productive lives.
  Congress originally authorized this program for 10 years in order to 
provide an opportunity to evaluate the program and make sure that we 
are doing right by our children. Well, the studies are in with 
impressive results: while the number of uninsured adults has steadily 
risen since CHIP was enacted, the number of uninsured low-income 
children has dropped by nearly one-third.
  Yet there is much more work to do. In my State alone, more than 
12,000 children are eligible for health coverage through either 
Medicaid or CHIP but remain uninsured. These uninsured children don't 
receive their vaccinations, miss screening and other preventive 
measures, and access health care at much later stages of their 
illnesses than insured children. The fact that so many children, 
through no fault of their own, face these struggles with health care is 
something about which our Nation should be ashamed.
  The President says he will veto this bill, which he calls ``an 
incremental step toward the goal of government-run health care for 
every American.'' Nothing could be further from the truth. If the 
President's plan of providing private health insurance worked, we 
wouldn't have 9 million uninsured children in the United States today, 
including 18,000 South Dakota children. But the bottom line, as an 
editorial in one South Dakota newspaper put it, is this:

       The uninsured children of families struggling to get by do 
     not need lectures about the encroachment of socialized 
     medicine or the virtues of personal responsibility. They need 
     health coverage.

  During the past 9 months, I have received a personal lesson in the 
great value of health insurance. Our Nation's children shouldn't have 
to learn this lesson the hard way. I urge my colleagues to support the 
Children's Health Insurance Program Reauthorization Act, and I hope the 
President will do right by our Nation's children and sign this bill 
into law.
  Mrs. BOXER. Mr. President, I rise today to continue my support for 
the reauthorization of the Children's Health Insurance Program--an 
essential effort to ensure the health of our Nation's children. Since 
the inception of this program, I have agreed with the goals of this 
program and strongly believe that it is necessary to meet our 
responsibilities and fulfill our commitment to children.
  Although I wholeheartedly support the compromise agreement on the 
reauthorization of this program, it is exactly that: a compromise.
  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--
and the legislation we are voting on today reflects that spirit of 
cooperation.
  I am glad to see that we have worked with many of our Republican 
colleagues on an issue so critical to the health of children across 
this Nation.
  This bipartisan, bicameral agreement is largely based on the 
legislation passed by the Senate in July, which would fund outreach and 
enrollment efforts, allow States to use information from food stamp 
programs and other initiatives for low-income families to find and 
enroll eligible children, and give States the option to cover pregnant 
women for prenatal care vital to healthy newborn children.
  In desperation and defiance, opponents of the Children's Health 
Insurance Program have made outrageous allegations maligning the 
effectiveness and success of this program.
  Critics have claimed that this program extends to eligibility to 
wealthy families in America--this could not be further from the truth. 
In my own State of California, the average family income of children 
covered by this program is just 163 percent of the Federal poverty 
level--less than $34,000 a year for a family of four.
  There have been claims that Children's Health Insurance funding goes 
to illegal immigrants--this is completely false. The reality is that 
undocumented immigrants have never been eligible for Medicaid or the 
Children's Health Insurance Program. Actually, there are restrictions 
within this program which deny health insurance to low-income children 
who are legal immigrants.
  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.
  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.
  As we near the September 30 deadline to reauthorize this program, I 
strongly urge and implore that the President reconsider his position on 
this bill. The need of children knows no partisan or political 
barriers, and should not have to overcome the obstacles created by the 
President.
  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

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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. FEINGOLD. Mr. President, today we are voting on the 
reauthorization of a program that has wide support in our country and 
that has reduced the number of uninsured children nationwide by over 6 
million. In fact, CHIP has helped lower the rate of noninsurance among 
low-income children by one-third since its enactment in 1997. That is a 
huge accomplishment, and has helped address a problem in our country 
that is unacceptable--the millions of uninsured families.
  In my home State of Wisconsin, CHIP, known as BadgerCare, provides 
health insurance for over 67,000 families. Wisconsin has done an 
incredible job of covering uninsured children as well as their parents, 
and the positive effects of this program are felt at schools, in the 
workforce, and at home. This bill helps support Wisconsin's efforts and 
provides low-income families in my State with better access to 
preventive care, primary care, and affordable care. The end result is 
healthier families. BadgerCare is vital to the well-being of many 
families in Wisconsin and I am very pleased that this bill supports the 
program in my State, including Wisconsin's choice to cover parents of 
CHIP and Medicaid children.
  We know from numerous reports that when we cover parents, we bring 
more uninsured children into the program as well. States like Wisconsin 
have proven time and again that covering parents means covering more 
kids. I worked hard with my colleagues and the Senate Finance Committee 
to make sure that Wisconsin could keep families in the CHIP program, 
and I am very pleased that those efforts have paid off.
  This legislation is not perfect. I would like to be voting on a more 
expansive package today that would offer health care access to more 
children and families. I am very disappointed that this legislation 
does not include language that would allow access to the program for 
legal immigrants. Unfortunately, it appears that, because of Republican 
opposition to this policy, legal immigrant children will continue to 
have to wait five years before they become eligible for CHIP and 
Medicaid. I will do my best to help change the discriminatory policy in 
the future.
  Despite the flaws in this legislation, the CHIP reauthorization bill 
marks an important step forward in getting coverage to those who need 
it. I will support this bill's final passage, and I hope the President 
will reconsider his ill-advised decision to veto it. I look forward to 
the day that everyone in our country has access to the basic right of 
health care.
  Mr. DODD. Mr. President, I rise today in strong support of H.R. 976, 
the Small Business Tax Relief Act. This is a bipartisan agreement to do 
what is right for our nation's children. There are few more important 
issues facing the senate than the health and well-being of our Nation's 
youth. The vote to pass this legislation is a vote for children.
  As the father of two young daughters, I keenly understand how 
important it is to know that if one of them gets sick they have the 
health insurance coverage that will provide for them. For millions of 
parents, every slight sniffle or aching tooth could mean the difference 
between paying the rent and paying for medical care. Today we have an 
opportunity to help give those parents peace of mind about their 
children's health.
  It is our national shame that 9 million children wake up every day 
lacking any form of health insurance. Every day, this means millions of 
regular checkups are sidelined, dental exams go unscheduled, and early 
diagnoses of chronic conditions such as asthma or diabetes are 
postponed. For families, such delays set the stage for children to grow 
up underperforming in school, developing preventable or treatable 
conditions, or worse, permanent disability or even premature death.
  The lack of health insurance causes more than poor health outcomes. 
Access to affordable health care is essential to alleviating child 
poverty. Low-income families without insurance often get stuck in an 
endless cycle of medical debt, a primary cause of bankruptcy filings in 
this country. Parents already struggling to make ends meet should not 
have to choose between providing their children needed medications and 
putting a roof over their heads or food on their table.
  I commend the chairman and ranking member of the Finance Committee 
for working so hard with our colleagues in the House of Representatives 
to put together a bill that will benefit the lives of millions of 
children and their families. Their leadership over the years, and that 
of Senators Hatch, Rockefeller, Kennedy and many others, helped create 
the Children's Health Insurance Program, CHIP, and reduce the number of 
uninsured children by one-third. Their persistence now to expand this 
bill in the face of considerable opposition shows their commitment to 
children's health. This bill is a tremendous investment in the health 
and future of our children.
  Specifically, the bill continues providing coverage for 6.6 million 
children currently enrolled in CHIP and provides coverage for 3.1 
million children who are currently uninsured today. It gives States the 
resources they need to keep up with the growing numbers of uninsured 
children. It provides tools and incentives to cover children who have 
fallen through the cracks of current programs. And it will prevent the 
President from unfairly and shortsightedly limiting States' efforts to 
expand their CHIP programs to cover even more children. All together 
these efforts will reduce the number of uninsured children by one third 
over the next 5 years.
  In my own State of Connecticut, our CHIP program, commonly known as 
HUSKY B, has brought affordable health insurance to more than 130,000 
children in working families since its inception in 1998. H.R. 976 is 
essential to States like Connecticut so that they may continue to 
operate programs like HUSKY B and build on their proven success to 
insure even more children.
  I am additionally very pleased that my Support for Injured 
Servicemembers Act amendment was included in the final SCHIP bill. This 
amendment provides up to 6 months of Family and Medical Leave Act, 
FMLA, leave for family members of military personnel who suffer from a 
combat-related injury or illness. FMLA currently allows three months of 
unpaid leave. Fourteen years ago, FMLA declared the principle that 
workers should never be forced to choose between the jobs they need and 
the families they love.
  If ordinary Americans deserve those rights, how much more do they 
apply to those who risk their lives in the service of our country? 
Soldiers who have been wounded in our service deserve everything 
America can give to speed their recoveries but most of all, they 
deserve the care of their closest loved ones. That is exactly what is 
offered in the Support for Injured Servicemembers Act.
  Senator Bob Dole and former Secretary of Health and Human Services 
Donna Shalala have been instrumental in this effort through the 
President's Commission on Care for America's Returning Wounded 
Warriors. It's not surprising that the Commission found that family 
members play a critical role in the recovery of our wounded 
servicemembers. The commitment shown by the families and friends of our 
troops is truly inspiring. According to the Commission's report, 33 
percent of active duty servicemembers report that a family member or 
close friend relocated for extended periods of time to help their 
recoveries. It also points out that 21 percent of active duty 
servicemembers say that their friends or family members gave up jobs to 
find

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the time. Last week in a hearing of the Subcommittee on Workforce 
Protections, we heard from one of those families and there are 
thousands more to be heard. The House is moving forward with companion 
legislation and I am grateful to my colleagues Congresswoman Woolsey 
and Chairman Miller and their cosponsors.
  I am pleased that Senator Clinton is the lead cosponsor of my 
amendment. In addition, I am pleased that Senators Dole, Graham, 
Kennedy, Chambliss, Reed, Mikulski, Murray, Salazar, Lieberman, 
Menendez, Brown, Nelson of Nebraska, and Cardin are cosponsoring this 
amendment. I thank Senator Baucus and Senator Grassley for accepting 
this important amendment and appreciate the support of all of my 
colleagues in this effort.
  I am troubled by the comments by President Bush and members of his 
administration about this bill. This legislation is vital to the health 
and well being of our children. The CHIP program is a model of success 
and this bill provides sustainable and predictable health care coverage 
for low income children regardless of their health status. It 
represents the hard work and agreement of an overwhelming majority of 
Members on both sides of the aisle. It is a testament to how important 
issues like children's health care can be addressed in a bipartisan 
manner by a united Congress. The President's policy of block and delay 
would mean Connecticut and other States would have to take away 
existing health coverage for hundreds of thousands of children when 
they should be covering more kids.
  But despite the bipartisan agreement of this Congress, the President 
threatens to veto this legislation. If he does, all Americans will know 
whether the President stands for children or would rather stand in the 
way of children's access to critically needed health care.
  I urge my colleagues to support this critical legislation and I urge 
President Bush to do what is right and sign it into law.

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