[Congressional Record (Bound Edition), Volume 153 (2007), Part 20]
[Senate]
[Pages 27374-27376]
[From the U.S. Government Publishing Office, www.gpo.gov]




                  CHILDREN'S HEALTH INSURANCE PROGRAM

  Mr. LOTT. Mr. President, a lot of discussion has been going on today, 
this week, and over the last few weeks about a very important program; 
we call it SCHIP. That is Washingtonspeak for health care for children, 
which has a very important role for the States to administer this 
program. This week, the House will be voting on the President's veto of 
this issue. That is the way things work in Washington. It is not very 
pretty. I am not proud of the whole process we have gone through on 
this issue.
  First of all, I have a message for everybody involved. Let's put low-
income, poor kids first. Let's figure out how we deal with their needs. 
That is

[[Page 27375]]

what caused this program to begin with.
  I had the pleasure of being the majority leader in the Senate in the 
1990s when this program was created. I remember the debate. It was 
pretty hot. Phil Gramm of Texas was saying: Wait a minute, we need to 
put protections in here, and Senator Kennedy and Senator Hatch were 
very much involved. But then a bipartisan agreement broke out, the way 
we used to have happen around here occasionally. We created a program, 
well-intentioned, that was targeted for low-income children, to make 
sure they had insurance coverage. It was not a massive number; I guess 
we were thinking in terms of 6 million, with the idea that might go up 
as time went by and more people or parents were made aware of the 
program and information was gotten to them and they could come onto the 
program. I think it has worked well. It has been successful. It covered 
a lot of low-income children who would not have been covered otherwise.
  Now, of course, we come to a period where we have to extend the 
program, and it has been very difficult. I acknowledge right up front 
that Senator Grassley tried to find a way to work through this issue 
and get a proper result. He and Senator Baucus, the chairman of the 
Finance Committee, wound up coming together and getting an agreement. I 
also acknowledge that a lot of the problems have been exacerbated by 
the previous administration and this one because they kept granting 
waivers to States to go above the 200 percent of poverty, up to as high 
as 350 percent of poverty, making not just low-income, poor children 
eligible but children of families making up to--I don't know the exact 
number--$62,000 or $63,000, and some States were applying to go to 400 
percent of poverty, which would go as high as an $80,000 income for 
families. That was not our intent. Plus, adults have been added. Only 
in Washington can you get confused about a program that is for kids and 
then start putting adults on it. But States started doing that and 
waivers were requested, and the administration, unfortunately, for a 
while granted those waivers. I think we should put limits on those 
waivers. Thank goodness, finally the administration turned down the 
most recent application for going up to 400 percent of poverty.
  So here we are. Some of us on the Finance Committee said: Look, we 
want this program extended. The President recommended that it be 
increased by $5 billion, which is about $1 billion a year. Some of us 
on the Finance Committee realized that probably was not enough to cover 
the children now on the program plus to get more low-income children 
who should be eligible and should be covered, covered. So we were 
looking at going above the $5 billion increase the President originally 
suggested. How much? That is what the legislative process is about. Is 
it perhaps $9 billion instead of $5 billion or maybe $12 billion? I 
wasn't wedded to a number; I was wedded to a concept and a program to 
make sure we cover those now on the program. Some should not now be on 
the program. But we wanted to make sure low-income children are covered 
first.
  The administration, to its credit, did put in place a provision that 
would say you cannot start insuring middle-income children until you 
have insured 95 percent of low-income children. This bill which has 
been vetoed by the President would knock that out. What? If our goal is 
to insure low-income children, why would we not require that? But the 
compromise that was worked out went to $35 billion. It would allow for 
kids who are not in the low-income category to be covered.
  The President vetoed it. I think he should. Now the House is going to 
sustain that veto. My question is, Now what? We have made our positions 
clear. We have had a grand old time playing politics with kids. Let's 
get over it. We need to get a result. That is the way it works. 
Somebody was saying in that very chair last night that the Congress has 
a role to play. Yes, and so does the President. Some people say: Look, 
there was a bipartisan compromise worked out. Yes, but some of us who 
would like to have been involved, who were there when the program was 
created, didn't get involved. We just thought we would do what we want 
and shove it over to the President and say: Take this. But he doesn't 
take it. So now we sit down and work it out.
  What is the plan of the Democrats? To let the program just collapse? 
That is unacceptable. Nobody is going to stand for that. Then I hear: 
Well, the plan is to keep extending it in increments--maybe 30 days, 
maybe 90 days. We want to keep it alive until next fall. Look, we can 
play politics and partisan politics, but do we have to use kids in the 
process? I don't think we should do that. We need to make sure we have 
a program that works.
  One of my big problems about the plan we have is that it would put 2 
million kids who now have private insurance on the Government rolls. 
That is part of the plan. The plan is to get them off of the private 
plan, which the families can afford; they could not get on Medicaid, so 
we will get them on the SCHIP program. I think that is a mistake. Of 
course, I think there is phony budgeting in the bill the President 
vetoed. I think the funding is not reliable.
  Now, at least the Senate came up with something that was a little 
more defensible than what the House was working on. They said: We want 
to take money from Medicare Advantage, elderly people in rural areas, 
and use that savings to pay for the children's health program. That was 
a total nonstarter with the Senate, thank goodness.
  What did we come up with? Cigarette taxes. Who wants to stand up here 
and defend tobacco? I will. I smoke a pipe. I don't do it in public. My 
mother wouldn't approve of me doing that. By George, I make that 
choice. I don't apologize for it. But, oh, it is a part of the 
politically correct position now: Let's make everybody quit smoking 
cigarettes. There are no good tobacco products.
  This is still America. We do still have choices. And by the way, 
let's assume it works. If we jack the price of a package of cigarettes 
a buck a package, which is what this would do, it is going to 
eventually, I guess, discourage people and low-income, poor working 
families: Gosh, we can't afford cigarettes; maybe we will quit. Good, 
that is great. I don't deny it is not good for your health. Maybe they 
will quit.
  This is the problem: If they do quit, we would not get the money to 
pay for the SCHIP program. Think about that. We are do-gooders here, we 
are going to raise taxes on tobacco products to pay for the Children's 
Health Insurance Program. That way we will make them quit smoking. And, 
oh, you mean then we would not have the money? Yes. You can't have it 
both ways. It is the kind of stuff we do around here. It is ridiculous.
  So the money would not be there. The program is not going to be 
funded. We all know better than that; it is going to be funded. At some 
point, if the tobacco money doesn't come in, which I assume it would 
not because we have gone crazy trying to tax it out of existence--by 
the way, this is an area States usually handle. But, no, we are going 
to put a 61-cent Federal tax on cigarettes and that will further block 
what the States might do to raise revenue for their programs. By the 
way, they do a better job of running the health programs than we do 
anyway. It is part of the inconsistency here.
  There are many problems with this bill. I have always said, OK, let's 
have our political debates. Let's stake out our partisan positions and 
then let's sit down and work something out. Is that what the people 
expect us to do? That is what the legislative process is all about.
  I don't have the Holy Grail in this area. I realize it would be a 
give and take. I believe Senator Grassley and I and representatives 
from the administration and Democrats can work out this legislation. 
The President said: Let's negotiate. Yes, I think he ought to send his 
top people down here and humbly say to the leaders in the Congress, 
Republicans and Democrats in the House and Senate: What can we do to 
work through this bill now and get

[[Page 27376]]

this program extended to where it covers genuinely poor kids and get it 
beyond the next election? I urge we do that.
  I don't presume to try to say who would be in the room. Pick anybody. 
But I say this: That is what needs to be done. Let's go ahead and rack 
up the political points and politically let's say this one goes to the 
Democrats. Policywise, I have no qualms about the position I have 
taken. I am perfectly comfortable with it. But also I am prepared to 
say enough is enough, let's move on, let's get a compromise worked out, 
and let's protect this program which is well intentioned but which, for 
good reasons, we have gotten carried away.
  There are some people who might say: Let's cover all children with a 
federally funded health insurance program. Maybe we can raise taxes to 
$5 a package, 10 bucks a cigar. It is ridiculous. There are other ways 
we can get revenue. I hope we will get started on that as soon as the 
House votes. They will sustain the veto, and then we can sit down and 
work this out.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Salazar). The Senator from Iowa.
  Mr. GRASSLEY. Mr. President, I came to the Chamber to speak on an 
oversight issue on which I have been working for well over a year. But 
before I speak on that subject, I wish to take advantage of the 
opportunity to respond to incorrect impressions about the compromise 
State Children's Health Insurance Program bill on which the House is 
going to be voting tomorrow. I am speaking as much to Republicans in 
the House of Representatives as I am responding to some of the points 
Senator Lott has made. These reminded me that regardless of how many 
speeches one gives around here, regardless of how many explanations one 
gives of what our bill does and does not do, nobody listens. We get the 
same wrong statements being made time after time. I wonder, does 
anybody ever listen? Maybe they don't like to have Chuck Grassley say 
it.
  I was a negotiator for the Republicans. I never had a single 
Republican tell me since January that they didn't want the SCHIP 
program reauthorized after a 10-year sunset. I never had one of them 
say it wasn't a program that was serving a good purpose. I had a lot of 
people express faults about what is wrong with the present program. 
Most of those issues have been corrected in the legislation the 
President vetoed.
  I finally got people to realize the $5 billion the President put in 
his budget on top of baseline is not enough to do what we are already 
doing. Even the Republicans on this side offered $14.5 billion over 
baseline, which still is not enough to do what needs to be done to take 
care of the kids we are taking care of now and extend coverage to other 
eligible but uninsured low income children.
  Some people are saying this bill should have been vetoed because 
there are adults in the program. But it was this Administration that 
approved the waivers to cover adults. The bill that the President 
vetoed did away with waivers. What has been in the program for 10 years 
this bill does away with. Childless adults are not going to be on the 
program. New waivers for parents under SCHIP is prohibited. For states 
that currently cover parents, the federal match is reduced. But yet 
people are still saying to me, from the other body, as I talk with 
Republicans over there to vote to override the President's veto: Why 
are we letting all these adults on? The waivers did that, and we do 
away with the waivers.
  Also, in my conversations with people in the other body, as I try to 
convince them they ought to vote to override the veto, this $83,000 
number keeps coming up. There was an inference made to it in the 
previous speech. That is not in our bill, and yet the President in his 
veto message referred to our bill allowing people up to $83,000 to get 
on SCHIP. That is in the law. It has been in the law for 10 years, and 
that can only happen if the President of the United States says a State 
can do that upon that State's request. Only the President can allow 
that to happen. That has been that way for 10 years. So don't tell me 
our bill allows States to go up to $83,000. That has been the law.
  What about the statement of having genuine poor children on this 
program? I agree. Do you know that 92 percent of the kids on the 
program are in families under 200 percent of poverty? Somebody can say: 
What about the other 8 percent? OK, so what do we do about that? 
Because there has been an inference to a State Health Official letter 
to states released on August 17, 2007 that we did away with what would 
have prevented that. But the policies in that letter were flawed and 
unworkable. What we did is we made those policies workable in our 
legislation. So the emphasis on kids under 200 percent of poverty works 
out this way: First, we reduce the Federal match to the Medicaid match 
for any state that wants to go over 300 percent of poverty, beginning 
upon enactment of the bill. Then, by 2010, any State that wants to go 
or to continue to go above 300 percent of poverty for children has to 
demonstrate that they have reached the targets determined by the 10 
best States covering kids under 200 percent of poverty. If they do not 
meet the target, they get no Federal match for kids over 300 percent.
  So don't tell me the bill before us does not have emphasis on low-
income kids. It has emphasis on low-income kids.
  It was not brought up in the previous speech, but in my conversations 
with the House of Representatives, I have had this other smokescreen 
thrown at me: Our bill allows illegal immigrants to get on the program. 
For the first time, we are doing in SCHIP what has never been done 
before, what we have done for Medicaid in the Deficit Reduction Act. We 
are making it so that illegal immigrants cannot get on the SCHIP 
program.
  People are paid to read legislation, and I don't know how the 
President of the United States, who gets paid a heck of a lot more than 
I do and has a lot of advisers who get paid a heck of a lot more than I 
do--I don't know how they can have him put in a speech that this bill 
allows people over $83,000 to get into the program, or there can be 
speeches in the Chamber of the other body saying we are opening the 
door for illegal immigrants to be covered by this program when we are 
doing more than existing law does in that area and where existing law 
already allows, if the President approves it.
  And then this business of adults being in the program--absolutely 
right, three States have more adults on the program than other States. 
How did that happen? This administration gave waivers for that to 
happen. We do away with those waivers. I have heard all the complaints 
from this side of the Senate, the Republican side of the Senate, that 
there is no ``A'' in SCHIP--and I agree, it shouldn't be for adults--
and I even heard Democrats strongly speak to this point. This program 
should never have gone in that direction. We do away with waivers.
  I ask everybody to read the legislation, and particularly Republicans 
in the other body, before they vote tomorrow to override or not 
override because all these inaccurate representations of the compromise 
bill are creating a very bad mistake. It's so bad politically that the 
White House is looking for some way to get out of this situation. 
Probably that some way to get out of it is negotiating another bill 
with us. But it would be smart if the White House would send a signal 
to the House of Representatives: Override our veto; we made a mistake.

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