Small Business Tax Relief Act of 2007

Floor Speech

SMALL BUSINESS TAX RELIEF ACT OF 2007--Continued -- (Senate - July 31, 2007)

BREAK IN TRANSCRIPT

Mr. DURBIN. Mr. President, what an interesting debate this has been. If you want to know how Congress is likely to react to the fact that we have 47 million uninsured Americans and millions more with health insurance that is almost worthless, if you want to know what Congress is likely to say about the plight of families who struggle each year with premiums rising and coverage falling, you should listen to this debate. Because my friends on the Republican side of the aisle--not all of them, but a number of them--want to argue for the proposition that we ought to be careful we don't insure too many people in America.

It is an easy thing for a Member of the Senate to argue. We are some of the luckiest people in America. We are covered by the Federal Employees
Health Benefit Program. That may be the sweetest deal in terms of health insurance anyone can dream of. It covers 8 million Federal employees, including Congressmen, Senators, and their families, and it allows us--if you can believe it, those watching this debate across America--it allows us once each year to decide if we want to change companies. If we don't like the way we were treated last year, if a particular company didn't cover something important to our family, we can say: That is it, we are buying a new product. It is like shopping for a car and we are in the driver's seat because we have options.

In my State of Illinois, my wife and I can choose from nine different health insurance plans. If we want to get more coverage, we can have more taken out of my check; less coverage, a lower amount. Our choice. Real consumers. Boy, there aren't very many Americans who can say that, are there? How few Americans can stand up and say: If I don't like my health insurance company, I will buy another. But we can do it. The Senators coming to the floor today arguing against children's health insurance being extended to too many people have that luxury. They are part of the Federal Employees Health Benefit Program.

Most of us here in the Senate bring our life experience to the floor. In this bill, there are two life experiences I have been through that come to mind. The first relates to the way we pay for children's health insurance, and that is with the tobacco tax. Well, tobacco has been a big issue in my congressional career. It was 20 years ago that I decided to introduce a bill to ban smoking on airplanes. It was considered a radical idea, that we would have no smoking on airplanes. Back in those days, they split the plane up, smoking and nonsmoking, and argued if you sat in the nonsmoking section that you were protected. Everybody knew better, but nobody questioned it. So I introduced a bill to take smoking off airplanes. My interest in that went beyond the fact that I was a frequent flyer, as most Members of Congress are. It even went beyond the fact that I had read the statistics about secondhand smoke and the damage it had caused to so many innocent people. It went to a personal life experience. My father smoked two packs of Camels a day. He was an addicted smoker for as long as I knew him, and I didn't know him very long. When I was 14, he died. He was 53 years old, and he died of lung cancer. I stood by his bed and watched as he took his last breath on November 13, 1959, at noon. I didn't swear then and there that I would get even with tobacco companies. But looking back, and as a young boy, I never got it out of my mind that that product, that tobacco product, had taken his life and taken him from me.

I remembered it whenever I would fight the tobacco companies, and I have quite a few times. I would think about all the other young people, men and women across America whose lives had been touched by tobacco disease.

My dad started smoking when he was a kid--most people do. So how do we stop kids from making that terrible choice in their lives? There is a simple way--raise the cost of the product. The more expensive a pack of cigarettes is, the less likely a younger child will start smoking and the less likely they will be addicted. That is simple economics. We have proven that over and over again.

We have these charts here that show U.S. cigarette prices versus consumption. As the price goes up, the consumption goes down. It is that basic. So we pay for this bill for children's health insurance across America by imposing a higher tax on tobacco products and cigarettes. It is no surprise that my Senate colleagues from tobacco-producing States don't like the idea at all. For years, they have come to the floor of the House and Senate and argued against tobacco taxes for a variety of different reasons, but they can't argue against this reality. The higher the cost, the lower the consumption. Certainly among children it is even more dramatic.

So for many who have come to argue against our approach to expanding children's health insurance, saying it is not fiscally responsible, it is as responsible as you can ask for. We are going to pay for it, and we pay for it with a tax on a product that claims over half a million American lives each year. Tobacco is still the No. 1 preventable cause of death and disease in America. Sparing a child from addiction to tobacco is sparing them the 1-in-3 likelihood that they will die from that addiction.

The second life experience that brings me to this issue goes back to my time in law school here in Washington at Georgetown Law Center. My wife and I were married after my first year in law school, and a baby came along rather quickly. Our daughter was born at the end of my second year, and I didn't have health insurance. I was a law student. We were happy to have our little girl, but a little surprised and unprepared. So we had to save up the money to pay for her delivery. Luckily, in those days, it wasn't as expensive as today, but for a law student it was still a lot of money. My wife worked during the pregnancy, I tried to save a few dollars, and we had enough money to pay the obstetrician and pay the hospital for my daughter's delivery while I was still in law school. But something happened 30 days after that which made a big difference. My daughter was diagnosed with a serious illness. Still, we had no health insurance. I found out what it was like to be the parent of a child and to have no health insurance. It was a humbling experience. I used to leave law school and drive over to Children's Hospital here in Washington, DC, pick up my wife and baby, drive over there and sit in the clinic. The clinic was, I guess, the place for those of us who didn't have health insurance, and we would wait our turns. There were a lot of people in that clinic, and it meant waiting a long time. I was glad to wait, because I wanted some doctor, some competent physician, to come see my daughter.

Well, we usually ended up with a resident who took the history, which we gave over and over and over again. But that is the price you pay when you don't have a regular doctor and a regular appointment. So the chart of my daughter's background grew and grew, and I sat there with my wife time after time waiting for a doctor to examine my baby. It wasn't a reassuring feeling for a father, because you want to believe that the doctor who is going to be there for your baby is the best. If you don't have health insurance, you may be tossing the dice. I learned what it was like. It was a humbling experience. I have never forgotten it, and I never will.

We are talking about children across America now who have no health insurance. Of the 47 million who are uninsured in America, about 9 million are children. We decided about 10 years ago to create a special program to provide uninsured kids with healthcare coverage. It worked. It worked very well. Over 6 million kids across America today have health insurance because of this program, and it is a program that people like because Governors and others can work to make it fit into their State, to fit their needs. There are Government guidelines, but there is flexibility through waivers that are offered. So a lot of States are trying different ways to bring more children in and cover more uninsured people. I think that is a good thing. I hope that whoever the next President of the United States may be--and we all have our favorites in this Chamber--whoever it may be, they will start their administration by saying they are going to challenge America to eliminate the uninsured over a specific period of time. And wouldn't they start with the kids?

The bill that came out of the Finance Committee is a bipartisan bill. I want to salute not only Senator Baucus of Montana, the chairman, but Senator Grassley of Iowa, the ranking minority member, and others, Senator Hatch of Utah, Senator Rockefeller of West Virginia, and Senator Snowe of Maine, who have all made a real bipartisan effort. What we are trying to do is to take this bill and reauthorize this Children's Health Insurance Program so that we cover even more children. In fact, we have the opportunity to add another 3.2 million to the 6.6 currently covered. That is almost 10 million kids who will have health insurance, if we are successful. It will still leave almost 6 million uninsured. That is still too many, as far as I am concerned.

But we are moving forward. We are dealing with political realities and budget realities and doing the best we can under these circumstances.

But Senator McConnell, the Republican leader, is going to come to the floor and suggest spending dramatically less money on this program. The net result of it is that Senator McConnell and others are going to argue let's not increase the number of uninsured kids covered by this program. At the end of the day it is going to mean that just about 9 million kids in America will be uninsured instead of the 6 million that will remain if we pass this proposal. Senator McConnell has made a calculation that he is willing to leave millions of uninsured kids behind.

He doesn't like the tobacco tax. Being from Kentucky, I am not surprised. But for many of us it is a small price to pay, increasing the cost of tobacco products so that kids have more health insurance. The important thing about this debate is it is a precursor of a much bigger debate that is to come over whether America is going to get serious about the shortcomings when it comes to health insurance.

I know there are a lot of people with a lot of different theories. I see my friend from Oklahoma, a medical doctor. He and I have talked about this. He has a much different view about this issue than I do. I hope his approach, if it is ever tested, works. But I believe this approach will work because what we are doing is taking those who have been unfortunate enough not to have health insurance and giving them a chance for coverage.

We know the poorest kids in America are eligible for Medicaid, a program that we share with the States all across the Nation. We know that the kids from wealthier families usually have health insurance through some worker in the household. But what about the kids caught in the middle? What about the kids where the parents do go to work but don't make enough money? What about the kids from families who, because of an existing medical condition or some other complication, can't afford health insurance, can't buy health insurance? That is what this program is all about.

There has been a lot of criticism of this program--I have heard it on the Senate floor today repeatedly--that it just covers too many children. We really ought to cut back on the number of kids covered. That really betrays an approach to this issue which I think we will hear more of. There are some people who, for a variety of reasons, philosophical and economic, would leave a lot of kids and a lot of uninsured Americans behind and say: That's life.

I don't accept that. I don't think that should be life in America. We live in a much better nation than that. Our values are stronger than that. We exalt family in America. We say that is the strength of our Nation. How can you exalt families and say that you want to make them stronger and not provide one of the basics in life--health insurance?

I know what it is like sitting in that waiting room, worrying about my own daughter's care, with no health insurance. I try to think of millions of other families who face that every single day. We were lucky. We got through it. My daughter is 39 years old now and has her own family. We were blessed in many ways.

But it was a tough experience I wouldn't wish on anybody. Those who vote against this proposal are wishing it on millions of Americans. In fact, they know millions of Americans will continue to have no health insurance and they accept it.

There is a young teenager in Naperville, IL, I am honored to represent. His name is Michael, and he is 17 years old. When he was in the fourth grade, he was friends with a young boy named Joey. He used to talk about Joey as his friend with the megawatt smile. They shared lunch together and kept their secrets safe for one another. But, unfortunately, Joey complained a lot about just not feeling right. He missed a lot of school. He was tired, his knees hurt, he bruised easily.

It came as a shock one day when Michael was told that Joey had been diagnosed with acute lymphocytic leukemia, a devastating, life-threatening disease. Then they learned another piece of alarming news: Joey's dad, who was a house painter, was self-employed and like millions of other self-employed Americans, was uninsured.

In the 4 years that followed, Joey with leukemia, would come to school when he could. He lost his hair with the treatment he received. He was frail, and he wore his Cubs cap to cover his bald head. Sometimes he only stayed for a couple of hours, but all the kids remember they were good hours. They were happy to see him.

Then, on January 8, 2003, the school counselor came in and told Michael and his class that Joey was not going to return. That is not an unusual story in America--but it should be.

What does this say about America, that 9 million children do not have the most basic health protection in our country? We are so proud of so many achievements that we have registered in the course of our history. We are so proud of the opportunities in our country. But how would we explain to future generations that we would just walk away from those kids and this opportunity to provide them with coverage? If Senator McConnell's alternative prevails, we will walk away from 9 million uninsured children. If the committee proposal prevails, we at least will take care of about 3.2 million of those kids. I wish we would take care of more.

We also know that if kids don't receive basic health care, a lot of simple things can become complicated; a lot of things that can be treated successfully will be ignored and unfortunately become worse. As Michael puts it, how many Joeys could be saved if only affordable health insurance was available to all children?

What do Americans think about this general concept of helping States cover more uninsured children? In a country that is sharply divided along political lines on so many issues, this is one that is overwhelmingly popular. Ninety-one percent of the American people get it. They think this is the right thing to do, to cover more children. Eighty-four percent specifically support covering all uninsured children with the Children's Health Insurance Program. It is hard to believe that number exists, when you hear some of the speeches against this program from the other side of the aisle. With this program we have reduced the number of uninsured children in America by a third.

States have worked to design programs that work best for them. My State is one of them. Illinois now provides coverage to over 130,000 parents under CHIP, and because of the increased outreach and enrollment, 250,000 more parents than it did prior to receiving a waiver from our Government to offer that coverage.

You say to yourself, if this is a children's program, why are you covering parents? They found the vast majority of parents had no health insurance or couldn't afford the health insurance they had, and by offering them insurance, it brought their children into coverage as well. Some will say it is not what the program is about; it is the children's health insurance program. But for these people, they consider it somehow a violation of trust that we would expand the program to bring in uninsured parents. To me, it is striving to reach a national goal, where every American, regardless of their economic situation, has health insurance. That is something I support and most Americans support, and something this program tries to achieve.

We give the States such as New Jersey and Illinois and many others the option to cover more parents. What is striking is, during the same time period that the state covered these parents, Illinois has added more than 360,00 children to Medicaid and CHIP coverage, so this program has worked. It has become an outreach program to let parents know they have an option. They may qualify for Medicaid. They may qualify for the Children's Health Insurance Program. It is a 38-percent increase in the number of kids covered by health insurance in my State. Is that working, a 38-percent increase? I think, frankly, the figures are obvious.

Just last week, Illinois State officials hosted delegations from around the country, briefing them on how our program works and maybe exchanging some ideas on how to make it better in their States and ours as well. Illinois was telling other states how to do it because Illinois has a successful model.

This is not a perfect piece of legislation. I wish it were larger. I would spend more than $35 billion. I would raise the tobacco taxes higher, if necessary. I would find other ways to offset the cost because I think we should be striving
great day that would be. What a celebration it would be for us to be able to say, on a bipartisan basis, Republicans and Democrats have reached that goal.

This bill doesn't quite reach the goal. But let's celebrate what it does. It moves us forward. It preserves a program which would expire on September 30, and it expands it. With these new funds and an accurate formula, combined with the incentive bonuses proposed, Illinois could cover as many as 123,400 children who are uninsured today over the next 5 years. That is a dramatic expansion. It is one which I would be happy to vote for and will vote for.

The Finance Committee bill increases eligibility levels for children covered under this Children's Health Insurance Program to 300 percent of Federal poverty. Some people on the floor have talked about 300 percent of Federal poverty level as a higher income. Do you know what it means to have a family of four and be at 300 percent of poverty? It means an income of $62,000 a year. That is a little over $1,000 a week. That is maybe a little more than $5,000 a month. It is hard to imagine people are living in the lap of luxury, after they pay their taxes and their basic expenses, paying for the higher price of gasoline and utility bills, paying for whatever it takes to have a safe and sound place to live in.

I think most of us who are blessed with a lot more income should reflect on a family of four struggling with $62,000 a year. I don't think there are many vacations or trips to the movies with that kind of income. For the State of Illinois, this change in eligibility level would bring in an additional $26.5 million to cover thousands of additional kids, which is certainly a positive step forward.

I can tell you that Senator McConnell, who is offering a Republican alternative--as I mentioned earlier, is not offering an alternative embraced by all Republicans. Many support the bipartisan bill that came out of the committee and see it as strengthening a successful bipartisan program. Senator McConnell sees it as a slippery slope to universal coverage.

The Republican leader yesterday invoked all the right words when he described his Republican alternative: low-income children, fiscally responsible, providing a safety net. He criticized the bill from the committee as a ``dramatic departure from current SCHIP law.''

What he failed to mention is his alternative is the dramatic departure. It includes a bare reauthorization of the program and adds in small business health plans and health savings account reform. Incidentally, the health savings account is the refuge for all of my friends on the Republican side of the aisle. When they can't think of anything to say about covering more people with health insurance, they come in with these health savings accounts--an idea once waltzed out by Speaker Gingrich that has gone around the track many times and has not shown the success that they promised.

Here it is again--no surprise. The Republican proposal by Senator McConnell would likely cause hundreds of thousands of people to lose coverage.

I am encouraged that the reauthorization bill before us has sparked a national conversation, not only about the kids who are uninsured but others as well. My counterparts on the other side of the aisle have not always been open to that conversation, but that is not what is before us. The bill we are considering will reauthorize the Children's Health Insurance Program before it expires on September 30.

This is not the time or vehicle to try to add all kinds of health care proposals, but that day should come. This is the time to take care of our nation's children and we will pay for it as we go. As I said earlier, this new tobacco tax is a smart thing from a health point of view. In a poll conducted by the Campaign for Tobacco Free Kids, two-thirds, 67 percent, of those interviewed favored such a tax increase. Only 28 percent opposed it. Moreover nearly half, 49 percent, strongly favored it. Only 20 percent strongly opposed it. It is the right thing to do. We know what tobacco does to the health of America. Discouraging its use is a move in the right direction.

This is an historic debate, one that is long overdue. We know health care is the most important issue to Americans next to the war in Iraq, and very rarely if ever do we seriously address it. We know the business community is begging us to move forward and expand health insurance coverage in this country to help them find a way to move to universal coverage which will not be at the expense of competitiveness. We know that working families, those in labor unions and those who are not, all understand the cost of health insurance and its value to every family, and we know from our own personal experiences and the people we meet in our States that this is long overdue. It is about time we opened up this discussion.

I am heartened by the work of the Finance Committee. The fact they brought this bill to us with strong bipartisan support on the floor of the Senate is an indication that there is some promise to this debate. I thank my colleagues who worked so hard on the committee to bring this bill forward. I hope we can build on it, cover more uninsured children, and move to the day that every single American, regardless of their income, has basic health insurance coverage so that every American has peace of mind when it comes to their health and the health of their family, so that no American, whether a law student or someone who has a low-income job, has to wait and pray that there will be good professional health care for their children.

I yield the floor.

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