Children's Helath Insurance
Floor Speech
CHILDREN'S HEALTH INSURANCE -- (House of Representatives - July 16, 2007)
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Mr. PALLONE. I'd be very pleased to do that. And if I could, maybe I'll talk; first of all, let me thank you for doing this hour tonight and for everyone who's joining you, because it is really important. And maybe I'll talk about three things, and then I'll turn it back; and that is, one, how we came about with the SCHIP program because I think that relates to the whole bipartisan nature of it, which is what you stressed and is so important. And then maybe I can talk a little bit about the preventative nature of it because you talked about the emergency room and the President's comments about using the emergency room. And then I'll give you my one story.
I'm glad you're here, in part because last week we had some of my Republican colleagues, including some on the Health Subcommittee that I chair, who were talking about this program as if it was an entitlement, as if it was almost socialism, you know, sort of raising the specter that we wanted the government to run the health care system. And nothing could be further from the truth. I mean, first of all, you know they neglected to mention that this was bipartisan. And remember, when we're talking 10 years ago, this was the Gingrich Congress. This was the Republican majority that hadn't been the majority for very long. I mean, they were on the crest of this conservative right wing wave and in the midst of that were willing to adopt this bipartisan measure.
And the reason was because, in fact it wasn't an entitlement; it wasn't government control. It was just a practical solution to the problems that we faced at the time and still face. I mean, we all know that if people are very poor and likely not working, then they're eligible for Medicaid. And we have a lot of kids, and we have a lot of adults and, you know, people who find themselves because they're not working and their income is very low, having to use the Medicaid program, which is a very legitimate program and covers a lot of people very successfully.
But what we found 10 years ago was that there were a lot of other people who, because they were working, for the most part, were above the Medicaid guidelines. Their income was too high. But what were they making? Maybe 20,000 a year, 30,000, in some cases maybe 40,000 a year and they still had kids. And because they were working in jobs where there wasn't a health insurance option available to them, the employer just didn't offer it, or when they went out in the private market, you know, the costs were so prohibitive for them to buy insurance on the private market, which, you know, in New Jersey you might be paying $12,000 if you want to go out and buy insurance on the private market for a family of four, today that they simply couldn't get health insurance.
And so there wasn't any ideology involved here. In fact, it was a block grant. It was set up as a block grant which, I don't know if you guys remember because you haven't been here as long as me, but that was like the Republican mantra at the time; that everything should be block granted, all Federal Government programs should be block granted; this shouldn't be an entitlement. And that's what we did. We said, okay, fine. You want to make it a block grant. You know, President Clinton was the President, so we had a divided Congress, and we said, that's fine. Send the money to the States. We'll set up certain guidelines that, you know, you had to be up to 200 percent of poverty. And then if the States wanted to, they could go get waivers and go to 300 percent or higher.
And we will give the money to the States. They will match it, and we will cover these kids.
Now, the second point I wanted to make is this is a preventative measure, as you pointed out. For President Bush to say people can always use the emergency, that's not the point. The point is we want people to have health insurance so that they go to the doctor on a regular basis, so they take preventative measures, and they don't get so sick, particularly if they are kids, that they have to go to an emergency room to get care. As you said, that is not the way to operate. So we save money because through prevention, and everyone will tell you, any doctor or medical professional will tell you, that the most important thing for a person is to get health care in those first 4 or 5 years of their life. If they are properly cared for and they have the type of preventative care and regular doctor care and dental care that you mentioned in those formative years, then they are likely to be healthy for the rest of their life because that is the most important time. So it makes sense; right?
And then I will tell you my story. My story is that before this was enacted, about maybe 11 years ago, I don't go there as much anymore, but I used to go to a luncheon place that was like a diner, but not a New Jersey, but more of a luncheonette, we used to call it then. It is like an old-fashioned word, I guess. And there was a waitress there who I knew for a long time, and she had young children. And she would always say that her husband worked and she worked as a waitress but she was never able to afford health insurance for her kids. She wasn't eligible for Medicaid. She and her husband were both working. I don't know how much they made. But she had tried repeatedly and asked me about getting private insurance. I even gave her some ideas about how whom to contact. And they couldn't afford it.
The day that we passed SCHIP, I went back there. I forget how long it was going to be enacted, maybe a couple months from then, and the President signed it. And I said, We are going to have this program now. You can go sign up for it. I went back there whenever it went into effect, and she had signed up her children, and it was the nicest thing that could ever happen.
You know how we always say we want to do things for people but a lot of times we are not able to? For me to be able to go back there and have lunch and have her say, Well, now my kids are covered through this program, it was such a wonderful thing.
And I think the gentleman from Pennsylvania said that right now there are about 6.7 million kids that are covered by SCHIP. There are about 6 million that are eligible and not enrolled. And the reason they are not enrolled, in part, is because the States have run out of money. Some of them ran out of money in March of this year, and we had to do a supplemental appropriation. So we are not talking about all this extra money in a vacuum. We are talking about needing it in order to try to cover as many of these kids as possible. And our reauthorization will not only include more money but also ways of getting them enrolled. One stop so that they sign up for one Federal program. They can get this so that they don't get dropped. This is a streamlined application. These are all the things that we are doing in addition to the dollars in order to try to cover as many kids as possible.
I am staying but I will yield back to the gentlewoman.
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Mr. PALLONE. You know, when you relate your own experiences, I can relate so much to it myself.
I have to say, I was thinking back about 10 years ago when we first started the program. Of course, my wife and I were just starting to have kids. My oldest daughter now is 13, so she was three at the time. And I guess I had my son at the time, he was only one. And we were starting to realize at the time about the fact that, first of all, as parents, the idea of kids not having health insurance, you know, young kids at that age was really an awful thing. And that's why we got involved. I say ``we'' because my wife got involved in the whole issue as well. And to think about the fact that you have children and they can't have health insurance or you have to take them to an emergency room is just an awful thing.
I worry myself even now because a lot of times your health insurance doesn't cover everything. Like I was faced with the orthodontist bill a couple years ago. And I suddenly realized our insurance doesn't cover orthodontistry. And that was upsetting, but to think of parents that can't even take their kids to the doctor is just an awful thing.
One of the things that my wife would always say to me that she observed was that many times government officials, and I don't want to speak about ourselves because I don't want to be critical, but a lot of times politicians don't think about kids because of the fact that they don't vote. And I would almost kind of differ with the gentleman from Maine when he says that, you know, one of the things that we found and one of the reasons why States like Connecticut and New Jersey have covered some of the parents is because they have noticed that a lot of times the parents wouldn't enroll the kids unless they were eligible themselves to be enrolled in the program. And I again go back to, this is really a very practical thing. If some States have found that the parents won't enroll the kids unless they're enrolled, they actually allow the parents to enroll as an incentive to get the kids enrolled.
Because you can be cynical. I mean, you have to say that unfortunately sometimes parents don't care or sometimes politicians don't care. And the fact that we were able to do this and basically do a kids' health initiative program and get the political support for it in some ways was an amazing thing. You would say, well, gee, that's a basic thing, why wouldn't that happen? But it wasn't that easy. And we're going to have to continue to fight to expand it today.
I just wanted to answer your question, because I know that the gentleman from Maine did, but you said, what would happen if we don't reauthorize?
Well, I will just say, first of all, essentially this has happened in some fashion in the last few years. States have run out of money because there wasn't enough money as early as March in a given calendar year. Georgia ran out of money this March. And my own State started to run out of money by May. So we had to actually do a supplemental appropriation. The world knows it as the ``Iraq supplemental,'' but actually it was the supplemental that included the funding for Iraq, and it included about $750 million for SCHIP because States, in fact, were running out of money.
In my own State of New Jersey a couple of years had to cut back on the program and actually lower the eligibility and eliminate parents because of the fact that they started to run out of money. So we have experience of what actually happens if we don't provide the additional funds.
The other thing, too, is that until last year, every year for the first 9 years of the program, the number of uninsured kids in the country was going down. But last year, for the first time, the number of uninsured kids went up. So this is a crisis. I mean, if we're going to get to those extra kids, we really have to do something.
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Mr. PALLONE. If I could point out one thing, too, because I know there is some debate about this. The
States don't get any more money because they cover kids at a higher percentage of poverty or because they cover the adults, and I think there has been some debate about that. Remember, as I said before, this is a block grant, and the money that goes to the States is dependent upon the number of children that they have. So the fact of the matter is that if a State decides, like Connecticut did, that they're going to cover the adults, they just have to stretch out the Federal funds and contribute more State dollars to pay for it. They don't get additional money. I know that this sounds like such a bureaucratic comment, but some Members are worried, well, is my State going to get more because they cover kids at a higher level of poverty or another State covers adults. They don't. It's just a question of usually they're providing more State dollars and having the flexibility to include the parents so that they can cover the kids.
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Mr. PALLONE. I just think the President has been very inconsistent. You talk about his experience as governor of Texas. But keep in mind that for the last 6 or 7 years, he has actually been granting the waivers. For example, right now the law says 200 percent of poverty, is what the law says in terms of eligibility. But it allows for waivers, and he has given waivers for so many States, I think as many as around 15 States, to go to 300 percent of poverty, to allow adults in some cases. His administration had to approve all those.
So I was very surprised in the early part of this year when he said that he wanted to keep it at 200 percent, he didn't want to cover any of the adults, because he has allowed that flexibility during his administration.
One of the things that the National Governors Association said unanimously was that they wanted States to have the flexibility. Again, I point out, this is a block grant. The States don't get any more money because they cover adults or go to higher levels of poverty or lesser levels. There is also flexibility, and some States don't count assets in determining that 100 percent or the 300 percent.
I think it really makes sense, and the National Governors Association said it makes sense to leave it to the States to have that flexibility, and the President historically has been in favor of that kind of flexibility. So I really don't understand where he is coming from.
The other thing I wanted to mention is we were talking about alternatives. When I listened last week to our colleagues on the other side of the aisle, some of them were saying, well, people can go to community health centers. That was another thing that I heard. Well, the President talked about emergency rooms and some of our colleagues on the Republican said, well, they can go to community health centers.
Well, I am all in favor of expanding community health centers, but in my district I think we have maybe four Federally sponsored, maybe 5, community health centers. There is absolutely no way that the kids and the parents are going to line up. They don't have the ability to handle all the kids.
So what you said is true. They are going to end up being in an emergency room. They are part of charity care whose responsibility is on the rest of the taxpayers.
Then I heard another one of our Republican colleagues say, well, what we really need is, and I wrote it down, competition in the marketplace. And I was saying, what are we talking about here? Again, this is people who are working, who can't afford health insurance. What competition? They can't go out and buy it on the individual market.
So we hear a lot of inconsistencies. I don't want to be so critical of our Republican colleagues, because I want them to join us on this. But some of the statements that have been made by the President in the last few days.
I would point out in the Senate, as you know, the Republicans and Democrats came together and they are about to pass a bipartisan SCHIP expansion. So the Republicans in the Senate hopefully can talk to the President and the Republicans in the House and say, what are you doing? We want to continue with this on a bipartisan basis.
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