[Congressional Record (Bound Edition), Volume 155 (2009), Part 11]
[Senate]
[Pages 14725-14727]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Mr. CASEY. Mr. President, I rise this afternoon to speak of a subject 
that is on the minds of so many Americans. It is also the subject of a 
lot of attention and work here in Washington, and that issue is health 
care. I won't try today to cover every aspect of it and to cover all of 
the details that are being debated here in Washington, but I rise to 
begin a series of speeches that I and others will be giving on this 
topic.
  I don't think I need to recite the challenge the people of 
Pennsylvania and America face when it comes to their health care. I do 
believe there is some consensus, not only here in Washington but around 
the country, about what we have to do. We have to take action, and as 
we take action, we have to be very clear about what we tell people and 
what is in the legislation: that if you like the health care you have, 
you can keep it; if you don't like what you have or you don't have any 
health care, we are going to put a bill in front of the American 
people--in front of the Senate and the House, and then legislation 
before the American people--which will allow that kind of choice.
  I believe there is consensus about that. There is consensus about 
some fundamental keys to reform. No. 1 is the question of cost 
reduction. We can't get through this process and not get a handle on 
costs, especially for the future. No. 2: I think there is a great 
consensus about choice, preserving the kinds of choices people have now 
and in fact enhancing the choices that people have in their health care 
decisions. No. 3: To ensure quality, affordable health care for all 
Americans. The nature of that issue is that we can build on our current 
system, but that we have too many people--as many as almost 50 
million--who are uninsured.
  There are a lot of people to thank here in Washington for the work 
that has been done already. I know we are a long way off. We have a lot 
more to do. There are weeks and weeks of work still ahead of us, but a 
few bear mentioning. Obviously, the President of the United States, 
President Obama, has made this a central issue of his Presidency and 
has worked very hard and has continued to make this a priority. We want 
to commend his leadership. It is essential. We cannot move this 
legislation without his help.
  Senator Kennedy, who has worked on this issue for more than four 
decades, I guess, now, has given tremendous leadership and inspiration. 
Whether he is here physically or whether he is not, he is providing 
that and has provided that for the American people for a generation on 
health care.
  Senator Baucus, the head of the Finance Committee, has worked not 
just months but years on this. Especially in the last year, in the last 
6 months, he has been working very hard to get it right on that 
essential committee.
  Senator Dodd has stepped into the Health, Education, Labor and 
Pensions Committee leadership role because Senator Kennedy hasn't 
always been able to be here because of his own health challenges.
  I also wish to commend the bipartisan spirit that I think is evident 
on both sides of the aisle. People want to get this done, and they want 
to get it done in a bipartisan manner.
  What I will speak about today is an aspect of this challenge which I 
think is not getting enough attention and enough focus and, therefore, 
may not get enough resolution in the legislation, and that is the issue 
of what happens to our children, especially children who are poor or 
those with disabilities, those with special needs. I believe the 
theme--not just the theme and not just the goal but the ironclad 
promise that we should make when we talk about reforming health care 
and getting legislation passed--the ironclad promise should be as 
follows: No child worse off. No child in America should be worse off at 
the end of this process, especially poor children and especially those 
who have special needs, those with a disability.
  Despite all of the great work--and I could cite a long list of people 
to thank for children's health insurance--the legislation that was 
passed in the 1990s and the reauthorization is great news: 6 million 
kids covered, plus 4 million more who will be covered, so almost 10 
million--almost 11 million, actually--more than 10 million children are 
covered by that. That is wonderful. We

[[Page 14726]]

should be happy about that. We got that done this year. Here is the 
problem: There are still 5 million more who are not covered. So I rise 
today to speak about coverage and a focus on those children.
  Here is what I believe when it comes to children in our society. I 
believe every child born in America is born with a light inside them. 
For some children, the reach of that light will be boundless. It will 
be scintillating. You won't be able to see it, it will be so bright, 
because of that child's potential or because of his or her 
circumstances, but their potential and, therefore, the light within 
them is boundless. For some other children, that light will be a little 
more limited because of circumstance, or because of other limitations 
they may have. No matter what the situation that child is in, no matter 
how brightly or not so brightly that light is shining, we have to make 
sure we are there for them, especially when it comes to health care. So 
I believe that light has to continue to shine, and one of the reasons I 
am so grateful for the work that has been done already is that in our 
committee, we have made children a priority.
  The Health, Education, Labor and Pensions Committee has not only 
produced a bill already--it is from one side of the aisle, the 
Democratic side; we are working with our Republican colleagues now--but 
the Affordable Health Choices Act is now on the table for debate. We 
are working on it today, hours and hours yesterday and today, and we 
will continue that with our Republican colleagues.
  There are a number of provisions in there for children that speak 
directly to this concern I have. Senator Dodd has shown tremendous 
leadership on this issue of helping our children through this 
legislation. But I believe we have to focus the attention of the 
country on the challenge, and that is why I have introduced S. Res. 
170.
  I ask unanimous consent that the entire resolution be printed in the 
Record as a part of my remarks.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                              S. Res. 170

       Whereas Medicaid is a cornerstone of the Nation's health 
     care infrastructure, providing critical health coverage to 
     Americans who have the greatest needs: children and adults 
     whose financial means are very modest and people who are in 
     poorer health compared to the population at-large, including 
     individuals with significant disabilities and those with 
     multiple chronic illnesses;
       Whereas Medicaid provides health coverage to \1/4\ of the 
     Nation's children and more than \1/2\ of all low-income 
     children;
       Whereas because minority children are more likely to be 
     from low-income families, Medicaid has been shown to reduce 
     racial and ethnic disparities in health care, as it provides 
     coverage for 2 out of every 5 African-American and Hispanic 
     children;
       Whereas by limiting cost-sharing and premiums, Medicaid 
     provides a comprehensive benefit package and ensures that 
     children have access to affordable coverage and the health 
     care services they need to stay healthy and meet 
     developmental milestones;
       Whereas Medicaid is designed to meet the complex health 
     care needs of low-income and special needs children by 
     including a wide range of essential and comprehensive 
     services that many private insurers do not cover;
       Whereas Medicaid provides developmental assessments for 
     infants and young children (including well-child visits, 
     vision and hearing services, and access to a wide range of 
     therapies to manage developmental disorders and chronic 
     illnesses) and coverage for in-home support, long-term care 
     for special needs children, and transportation services;
       Whereas Medicaid provides a care coordination benefit that 
     supports at-risk children by coordinating State health 
     services, thereby furthering the ability of States to 
     effectively coordinate medical and social services that are 
     provided by multiple organizations and agencies;
       Whereas administrative spending is lower in Medicaid than 
     through private insurance;
       Whereas Medicaid is critical for ensuring that children 
     have access to safety-net providers in their local 
     communities and for training health care professionals, 
     including pediatricians; and
       Whereas Medicaid provides low-income children with the full 
     complement of services they need to meet their unique health 
     and developmental needs: Now, therefore, be it
       Resolved, That it is the sense of the Senate that--
       (1) Congress should ensure that reform of our Nation's 
     health care system shall benefit all children and that no 
     child shall be worse off, particularly the most vulnerable 
     low-income children and children with disabilities; and
       (2) strengthening our Nation's Medicaid program should be a 
     priority and that low-income children should not be moved 
     into a health care exchange system that could disrupt and 
     diminish their benefits, cost-sharing protections, 
     availability of care standards and protections, and access to 
     supports, services, and safety-net providers.

  Mr. CASEY. S. Res. 170 is cosponsored by Senators Dodd, Rockefeller, 
Brown, Whitehouse, and Sanders. I will highlight some of the features 
of it.
  First, it starts with a recognition that the Medicaid Program is a 
cornerstone of the Nation's health insurance infrastructure. It notes 
in the resolution that Medicaid covers a quarter of all children in the 
country--one-quarter--and half of all poor children. It notes as well 
that Medicaid has been shown to reduce racial and ethnic disparities in 
health care and provides coverage for two out of every five African-
American and Hispanic children.
  Medicaid is a comprehensive benefit package. It provides 
developmental assessments for infants and young children. It has care 
coordination benefits in support of at-risk children, and Medicaid's 
administrative spending is lower than that through private insurance.
  Here is the end of the resolution, and I am summarizing here: It is 
the intent of this resolution to say that the Nation's health care 
system shall benefit all children--all children--and that no child 
shall be worse off at the end of this debate. Low-income children 
should not be moved into a health care exchange system that could 
disrupt and diminish their benefits. That is S. Res. 170.
  I believe it is critically important to emphasize this idea, that no 
child should be worse off as a result of health care reform--not a 
single child--and in particular, those who have special needs or who 
happen to be poor.
  We know from our research that children are not small adults. They 
have different challenges. They have developmental and health care 
needs that are very different from adults. The challenges they have, 
the problems they encounter can be exacerbated if children face 
economic challenges or have any kind of special needs. These needs must 
be met, and if they are not met, the whole trajectory for the future of 
that child will be changed for the worse.
  Let me say in conclusion, we have seen throughout our history that 
there are some people who cannot do something on their own, that they 
need the help of a program, they need the help of a government, and 
thank goodness we made the determination a long time ago that our 
health care system is part of that equation. When I think about health 
care and when we think about the health care of children, no matter 
what income level their family happens to be in, but especially if they 
are poor or have special needs, and you think of the love of a mother, 
with the kind of love that a mother provides to a child, there are so 
many things that one mother can provide for her child. She can help 
with that child's education. She can provide nurturing and care and 
love to make sure that child develops in the way we would hope. She can 
even help somewhat in that child's health care. But no matter how much 
a mother loves her child, no matter how skilled she is, no matter how 
dedicated she is to the welfare of her child, and no matter how much 
she loves that child, she cannot--cannot--provide the kind of 
protections that health insurance provides and the kind of medical 
attention that a good hospital or a good doctor or a good health care 
professional can provide.
  So we have a choice. We can have health reform legislation, and 
everyone will pat each other on the back and we will all be happy we 
got it done. That would be wonderful. But if we get this bill passed 
and we have fallen short with regard to our children, especially those 
who are poor and have special needs, I think we will have failed not 
only those children, of course, but we will have failed the obligation 
we have to make sure that every child comes through this with the kind 
of protections and the kind of help they should have a right to expect, 
and that that

[[Page 14727]]

mother can have a sense that this country, this government has made a 
full commitment--not a partial commitment but a full commitment--to 
children.
  Let us, as we go forward, remember the love that a mother has for her 
child and the limitations--no matter how much that mother loves that 
child and what she is able to do--that we must help her with in this 
debate. Let us not forget, and let us make sure that the legislation we 
pass on health care reform has as one of its ironclad promises: no 
child worse off.
  Mr. President, I yield the floor and would note the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. DODD. 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. DODD. Mr. President, what is the business before the Senate?

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