[Congressional Record (Bound Edition), Volume 155 (2009), Part 1]
[Senate]
[Pages 1445-1447]
[From the U.S. Government Publishing Office, www.gpo.gov]




                         SCHIP REAUTHORIZATION

  Mr. KYL. Madam President, this week the Senate is considering the so-
called SCHIP bill, the State Children's Health Insurance Program, which 
is what SCHIP stands for. It is a program that has been worthwhile to 
take care of kids who are from families of lower income and need help 
with their health insurance. Last year, we attempted to work in a 
bipartisan way to get a reauthorization of the so-called SCHIP bill. 
This year, however, the Democratic majority has decided to work it 
alone, to write a partisan bill without Republican input. In fact, 
every single one of the Republican amendments offered during the 
Finance Committee markup of this bill last week was defeated. There was 
one small amendment that was accepted; otherwise, they were all 
defeated.
  It is my judgment that this is not the best way to start off the 
year--working together, bridging the partisan gap, all of the things 
President Obama talked about, trying to put the old politics behind 
us--if we are simply going to approach something this important on a 
partisan basis.
  I rise to talk about four specific ways in which I hope we can come 
together and work in a more bipartisan way to improve the bill. It 
doesn't put low-income children first, and that should be the whole 
point of the SCHIP bill.
  First, it expands SCHIP to higher income families--in fact, for two 
States and only two States, for families making $88,200 a year. That is 
not for the State of the Presiding Officer or for my State. That is 
only for New York State. People in New York State would be able to make 
$88,000 per year--actually, about $40,000 even above that--and qualify. 
So it is not about helping low-income children.
  Second, it removes about 2.5 million people who are already in 
private insurance programs with their employer. It will result in their 
leaving the employer's health care coverage to come

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to a Government-sponsored program, something called the ``crowd out'' 
effect.
  Third, it is actually not even paid for in the sense that we normally 
treat these authorization bills. We try to make sure that whatever new 
spending we provide is offset by some other spending. But there is a 
budget gimmick that is used to account for the spending in this bill.
  Finally, for the first time it significantly expands the program to 
include not only citizens but legal immigrants, primarily green card 
holders. It eliminates most of the requirement for demonstrating 
eligibility for citizens, which would result in a lot of illegal 
immigrants getting coverage.
  In these four important areas, we ought to work together and find a 
way to amend the bill before we end up voting on it, perhaps at the end 
of the week.
  Let me first turn to the question of the budget gimmick. Sometimes 
you say how much something costs. In the Senate, our scoring always 
requires that we show a 5-year cost and a 10-year cost. That is a good 
thing to do. What they do in this bill is make it work, in effect, for 
about 4.5 years, then they slow the spending way down so that it 
doesn't look as if it is going to cost any more. The result would be 
that we would have to disenroll millions of children. Think about it. 
Are we being honest when we have a level of spending for 4.5 years and 
then it drops off a cliff to virtually nothing? Are we honest to say 
that is the 10-year cost of the bill when we know we would have to 
disenroll kids in order to make it work that way? No. The reality is, 
we are going to continue to keep the level of spending for the entire 
10 years, and the bill, therefore, will cost about twice as much as we 
say it is going to cost. In fact, the Congressional Budget Office, 
which pays attention to these things, says the cost of the bill is 
going to be about $115.2 billion over 10 years, of which only $73.3 
billion is offset. So the net result is a $41.6 billion deficit 
spending bill for fiscal years 2009 through 2019. That is the first 
problem.
  The second problem is that the bill is not limited to low-income 
families. In fact, it is extended to quite high-income families. It 
permits States to cover children from families earning as much as 
$66,150 per year. That is 300 percent of poverty. That is well above 
SCHIP's original intent of 200 percent of poverty. Of course, the more 
you increase the income level, the more likely it is that you are going 
to crowd out people who already have insurance.
  As I mentioned, there is even an exception for New Jersey and New 
York which would allow families in New Jersey earning approximately 
$77,175 per year to qualify, and in New York, $88,200 a year or 400 
percent of poverty. Let me put this in perspective. In Arizona, the 
Arizona KIDS Program covers families earning $44,100 per year or 200 
percent of poverty. That is low-income families. But under this bill, 
Arizona's hard-earned taxpayer funds will be sent to cover families who 
earn twice that much in New York State. That is not fair. It is not 
right.
  To make matters worse, the committee acknowledged that States may 
intentionally disregard tens of thousands of dollars worth of income in 
order to make a child eligible. They could disregard, for example, 
$20,000 a year in housing expenses, $10,000 a year in transportation 
expenses, $10,000 a year for clothing expenses. The net result is that 
if Congress sets this level of $88,200 for New York and then allows 
$40,000 worth of income disregards, children could actually come from 
families earning nearly $130,000 and still be eligible for SCHIP. That 
does not comport with what either Senator Obama said he wanted or what 
most of us think would be fair.
  Third, I talked about the crowd-out effect, especially by extending 
this to higher income families. We are going to replace a lot of 
private insurance with Government insurance. In fact, according to the 
Congressional Budget Office, about 2.5 million individuals will lose 
their private coverage under this bill.
  It is interesting that last year we raised this problem. It was 
considered to be a serious problem. But my amendment to try to deal 
with that failed. Nevertheless, when the Democratic House leaders and 
Democratic Senate committee members got together, they wrote a 
provision to deal with the crowd-out, recognizing that it was a serious 
problem. They passed the bill. This was written in part by the chairman 
of the Finance Committee. That crowd-out provision, however, was 
dropped from this year's version of the bill. There is no crowd-out 
provision. So in the committee, I offered an amendment to insert their 
crowd-out language, the language drafted by the chairman of the 
committee, passed by the House and Senate last year. That amendment 
failed.
  Well, maybe it is premature to deal with the problem of crowd-out. We 
know there is going to be crowd-out. The Congressional Budget Office 
says there will be, and the time to deal with it is before we adopt the 
legislation, not after.
  Finally, let me close with the immigration-related section, section 
214. This eliminates the current 5-year bar allowing Federal coverage 
of Medicaid or SCHIP coverage for legal immigrants. These are primarily 
green card holders. Not even the House bill goes this far. The Senate 
bill actually eliminates the requirement that sponsors of immigrants 
reimburse the Federal Government for immigrants' coverage. This would 
be for the first time since actually 1882--our Federal law dates back 
that far--with regard to immigration.
  We are a nation of immigrants. We invite immigrants to come here. My 
grandparents are immigrants. We want to make sure that when they come 
here, they don't immediately become a public charge or go on welfare. 
That is why, starting as far back as 1882, we said: You need to take 
care of yourself when you come here and not ask the Government to do it 
or at least have your sponsor affirm that he or she will take care of 
you. That was affirmed in 1996 when we updated the legislation.
  This mark would eliminate that requirement, so that from now on legal 
immigrants, primarily green card holders, would be able to avail terms 
of this coverage. It is about 300,000 individuals estimated at a 5-year 
cost of $1.3 billion. I don't have the CBO number for the 10-year cost. 
That number doesn't even begin to take into account people who are here 
illegally but who might actually make legal under some kind of 
immigration reform, if that were to happen. It is also estimated that 
about 100,000 of these 300,000 individuals would be crowded out from 
either private insurance or State insurance coverage. So we continue to 
have the crowd-out effect here.
  The problematic section is section 211. This will likely increase the 
number of illegal immigrants and other ineligible individuals because 
it eliminates the current document verification to demonstrate that you 
are entitled to accept the benefits of the program. What this does is 
to say that all you have to do is provide a Social Security number. In 
my State, all of the illegal immigrants--virtually all of the illegal 
immigrants have Social Security numbers. In fact, they have a lot of 
Social Security numbers sometimes, most of which are probably not 
valid, some of which, however, are valid. So even if they are checked 
through the system, which this bill does not require, you would catch 
them. All you have to do is to say: Here is a Social Security number. 
Now let me avail myself of the benefits. That is the whole point of the 
immigration reform legislation. That Social Security number proves 
nothing with regard to eligibility. That would be substituted for the 
requirements already in the bill.
  Are the requirements already in the bill onerous? I think not. There 
are four different levels of documentation you can provide. The last 
document, tier 4, is when you can't do any of the other things, you can 
simply have two individuals affirm your citizenship. You can do this by 
mail. You don't even have to show up in person. So it is not as if we 
have onerous requirements today to participate in the program.
  Even with the very generous provisions we have, it is my 
understanding

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from a GAO study in 2007 that we think most of the people who are 
eligible are signing up and we are not getting a lot of ineligible 
people signing up. In other words, people are not gaming the system, 
and that is a good thing. But why make it easier to game the system, 
especially to play into the hands of those who are here illegally, who 
use a Social Security number for work purposes and now could use it for 
this purpose, signing up for SCHIP.
  We will have amendments that deal with each of these subjects. The 
bottom line is, we should get back to dealing with this subject in a 
way in which both Democrats and Republicans can have input into the 
bill and actually solve some of the problems. I know some of my 
Democratic colleagues were interested in this eligibility issue because 
they don't want a lot of people getting benefits who aren't entitled. 
It will only hurt those who are entitled. We need to have strong 
eligibility requirements.
  We don't want to begin to expand this program to people who are not 
citizens of the United States and who have a contract with the United 
States when they come here as our guests, either on a temporary basis 
or on a green card. They understand their obligations when they come 
here. One of their responsibilities is not to begin to receive benefits 
of this kind from the taxpaying American citizen.
  For these four reasons, I hope that when this legislation comes 
before us, we are able to not only amend the bill, work to amend the 
bill, but will actually have amendments adopted and that we can improve 
the legislation so that we can all be proud to support it at the end of 
the day. If not, an awful lot of Republicans, including myself, will 
not be able to support the legislation.
  The PRESIDING OFFICER. The Senator from Florida is recognized.

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