[Congressional Record (Bound Edition), Volume 155 (2009), Part 23]
[Senate]
[Pages 31454-31455]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. CASEY. Mr. President, I rise this morning to speak about health 
care and our children and the health care reform, the Patient 
Protection and Affordable Care Act, as relates to our children.
  The chart on my left makes a couple of fundamental points.
  For children, health care reform must follow one simple principle, 
and I also say it is only four words: No child

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worse off. When I say ``no child,'' of course I am speaking of children 
who do not often have a voice. Obviously, if they are children from a 
family that is very wealthy, I think they will be just fine no matter 
what happens here. But children who are poor and children who 
experience and have to live with special needs are the ones I am 
talking about when I say ``no child worse off.''
  I filed many weeks ago--actually, months ago now--a joint resolution, 
No. 170. I was joined in that resolution by Senator Dodd, Senator 
Rockefeller, Senator Brown, Senator Whitehouse, and Senator Sanders. We 
filed that resolution just to make this point with a couple more words 
than ``no child worse off,'' but that was the fundamental point to 
guide us through this process because sometimes in a debate on 
something that is this significant, and parts of it are complicated to 
be enacted into law--it is a challenge to pass health care reform. I 
think we will. I think we must. But we do need guiding principles, and 
I believe one of these should be ``no child worse off'' for special 
needs children.
  A lot of the child advocates across America have told us, for many 
years, something so simple but something very meaningful in terms of 
providing further guidance for this debate. Children are not small 
adults. That does not sound so profound, but it really matters when it 
comes to health care. We can't just say: If you have a health care plan 
for adults, it will work for kids, do not worry about it. 
Unfortunately, that is not the case.
  If we do not do the right thing, we could lose our way on that basic 
principle. We have to get it right, and we have to give poor and 
special needs children a voice in this debate. I do not think there is 
any question that Senators on this side of the aisle are guided by that 
basic principle.
  I want to next turn to the bill, the Patient Protection and 
Affordable Care Act, and walk through some of the provisions. There are 
many good provisions in the bill for children, but I want to walk 
through a couple.
  How does it help children? That is a fundamental question. You cannot 
escape the basic implications of that. First, the bill eliminates 
preexisting condition exclusions. That is in the first couple pages of 
the bill. Obviously, it has an enormously positive impact for adults. 
We have heard story after story of literally millions of Americans 
denied coverage year after year because of the problem of preexisting 
conditions. It has special meaning when it comes to children.
  No. 2, the bill ensures that benefits packages include oral and 
vision care. We know what that means for children, and in particular we 
are thinking about the horrific, tragic, and preventable death recently 
of Deamonte Driver of Maryland, a young boy who lost his life because 
his family did not have the coverage for an infected tooth--an infected 
tooth, not something that is complicated to deal with. His family 
couldn't afford the care. A child in America died from an infected 
tooth that would have cost $80 to treat.
  So when we talk about insuring benefit packages that include oral and 
vision care, that doesn't say it too well until you connect it to the 
life and the death--the tragic death--of a young child not too far from 
Washington, DC.
  Thirdly, the Patient Protection and Affordable Care Act will mandate 
prevention and screenings for children. This is so important. We know 
our poorest children, who have the benefit of being covered by 
Medicaid, get these kinds of services so we can prevent a child from 
getting sicker or prevent a disease or a condition or a problem from 
becoming that much worse for that child.
  As I said before, children are not small adults, so we have to make 
sure we have strategies and procedures in place that deal with the 
special needs and the special challenges that children face in our 
health care system.
  Finally, the act has increasing access to immunizations. I don't 
think I have to explain to any American how important immunizations 
are. The Centers for Disease Control will provide grants to improve 
immunizations for children, adolescents, and adults.
  Let me move to the third chart. The third chart outlines some other 
provisions for children. Here are three more ways the Patient 
Protection and Affordable Care Act helps children, among many others. 
It creates pediatric medical homes. People may say: What is a medical 
home? What does that mean? Well, I need simplicity just like anyone 
does. This is my best summary of a medical home.
  A medical home obviously isn't a place. It is treating people in the 
way they ought to be treated in our health care system. The ideal--and 
I think this bill gets us very close to meeting this goal--is that 
every American should have a primary care physician and then be 
surrounded by the expertise of our health care system. Children 
especially need that kind of help. So we want to make sure every child 
not only has a primary care physician--in this case a pediatrician--but 
also has access to all of the expertise that pediatricians and our 
system can give them access to.
  Next, the act strengthens the pediatric workforce. We can't just say 
we want children to have access to pediatric care. We have to make sure 
we have the workforce in America to provide that kind of care.
  Thirdly, the act expands drug discounts to children's hospitals. 
Before this act, before the act that we are debating, children's 
hospitals did not have access to a program that provides discounts on 
the drugs they need for sick children. Now children will benefit from 
the discounted prices that result from the passage of this act. This is 
vitally important.
  Let me go to one more chart.
  Parliamentary inquiry, Mr. President: How much time do I have 
remaining?
  The ACTING PRESIDENT pro tempore. Two minutes.
  Mr. CASEY. Two minutes. I will just do one chart and then we will 
move quickly.
  This chart makes a very fundamental point. At a time in our history 
when over the course of a year the national poverty rate went up by 
800,000, and the number of people without insurance is going up--and in 
the midst of a recession, you would understand and expect that--the one 
thing we don't focus on is that because of the effectiveness of the 
Children's Health Insurance Program, there is one number on this chart 
that is going down--and we hope it keeps going down--and that is the 
number of uninsured children.
  It is interesting that on this chart between 2007-2008, as the child 
poverty rate went up by 800,000 children, the number of children 
without insurance is down by that same number--800,000. It shows the 
Children's Health Insurance Program is working, even in the midst of a 
recession. So I have an amendment that strengthens the Children's 
Health Insurance Program in the bill.
  I know I am out of time, Mr. President, and I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Illinois.
  Mr. DURBIN. Mr. President, it is my understanding that we have gone 
over the original allocation of time, and Senator McCain is coming to 
the floor. We will, of course, offer to the minority side whatever 
extra time we will use so that there will be a like amount available to 
them, and I will make every effort to shorten my remarks.
  The ACTING PRESIDENT pro tempore. The majority has not exceeded its 
time. There is 12 minutes remaining on the clock.
  Mr. DURBIN. Sorry, I was misinformed. But whatever we promised the 
minority side, they will receive like treatment on whatever time we 
use.

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