Further Changes to S. Con. Res. 21

Floor Speech

FURTHER CHANGES TO S. CON. RES. 21

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Mr. THUNE. Mr. President, I have listened intently to much of the debate today on this SCHIP reauthorization. Let me preface my remarks by saying, first and foremost, I do support children. I like children, contrary to the implication that has come out of this debate that people who are not in favor of this particular piece of legislation are not in favor of the children. I am very much supportive and in favor of helping children. Furthermore, I also support extending the SCHIP program. I would even support increasing funding for the SCHIP program in a way that would cover those children who are eligible but are not currently being covered.

That is a substantial number of children across the country, which is why I think it is essential if we are going to reauthorize this program, if we are going to extend this program, we do it in a way that takes into consideration there are a lot of children in America today who are eligible for the SCHIP program who are not being covered. So, frankly, I support not only extending the program but also increasing funding for the program.

We had a number of amendments that would have done that during the debate in the Senate that would have increased it substantially and, frankly, would have also, according to the CBO, covered more children than this piece of legislation we are going to vote on today.

But I have to say for a lot of us who do support extending the existing program and increasing funding to cover children who are eligible but not currently covered, this is a bridge too far because what this essentially does is, it not only expands the scale of the program, it expands the scope of the program. That is where a lot of us take issue with this legislation.

If you look at what the SCHIP program costs today, it is about $5 billion a year. It has cost us $40 billion over the course of the last 10 years. This legislation today would increase the 5-year cost to $60 billion, the 10-year cost to $121 billion.

So where we are paying $5 billion a year today for the SCHIP program, this increases that to $12 billion a year, $60 billion over 5 years, or a $35 billion increase over the existing program, and $121 billion over 10 years.

Now, that again is an expansion, not just of scale but also of scope, because this covers adults, it increases the income levels that are eligible under the program that the States can incorporate up to 300 percent of the poverty level, and even allows and grandfathers in those States which have asked for waivers to go to 300 percent or 400 percent of the poverty level. So it does substantially increase or expand the scope of the program.

I think the other thing which is important and which is a concern for me in this whole debate is the fact that when you get to the year 2012, it is no longer paid for. Nobody here is disputing that fact. This is funded for the first 5 years or so of this program, but when you get to the last 5 years of the program, there is a cliff, and there isn't funding there to fund the program. In fact, the funding which is provided in the form of a cigarette tax increase actually assumes there are going to be 22 million new smokers over the course of the next 10 years. That would create a substantial number of problems for the health care system in this country and is certainly not something we want to encourage. But the reality is that when you get to 2012, you hit a cliff, and this is not paid for. It is going to have to be paid for in some form or fashion, which we all assume is going to be some substantial tax increase because it is going to be about $60 billion underfunded during the last 5 years of the program.

The other thing I will say which is, again, of great concern to me is this doesn't solve the underlying problem we have in this country. We have a health care problem in this country that needs to be addressed, that Congress needs to address head-on.

There are a lot of wonderful proposals and ideas that have been discussed, some of which have been proposed in the form of legislation, some of which have been voted on, and some of which have been defeated in the Senate.

A small business health plan, something many of us have supported for a long time, going back to my days in the House of Representatives, actually has been defeated on numerous occasions in the Senate. It is a proposal that would allow small businesses to form together, to leverage that group size they have and be able to lower the cost of health insurance coverage.

We heard my colleague from South Carolina talk earlier today about a national market for health care.

We have had suggestions, bipartisan suggestions about allowing a tax deduction that each individual could use in order to buy health insurance.

There is the proposal for a tax credit that has been offered by a couple of my colleagues on this side.

There are a lot of good ideas out there we ought to be adopting, or at least debating, and driving toward health care reform which empowers consumers in this country, which puts more people in charge of their own health care, and which allows them to have access to coverage where they own their own health care coverage and can make better and more informed decisions and get the cost of health care in this country under control. I don't believe this does that because what this legislation does is it increases government-run, Washington-controlled health care. This is an expansion of the government component of health care. It does nothing in the long run to address what is a very serious crisis in this country; that is, the need to bring reforms to our health care system.

The other thing I will say which I, frankly, take issue with as well with regard to this legislation is the fact that low-cost, efficient States such as South Dakota--and we have a 200-percent Federal poverty level in our SCHIP program in South Dakota--end up subsidizing higher costs in inefficient States. We have taxpayers in South Dakota who are covered, as I said, up to 200 percent of the Federal poverty level, or about $41,000 per family, who are going to end up subsidizing States that choose to exercise the option to go to a higher level. Frankly, there is no incentive for States not to go to the higher level, to go to the 300 percent, and those that already have requested waivers to go to 350 or 400, you are already talking about, in the case of 400 percent of the Federal poverty level, over $80,000 a year.

Now, what is ironic about that is the Federal Government is going to be telling people in this country that not only are you poor--in other words, you are eligible for this particular low-income health insurance program--but you are also rich, so rich that you are going to be subject to the alternative minimum tax.

I offered an amendment to the debate we had weeks ago that would have prevented those who are subject to the alternative minimum tax because under the Internal Revenue Code in this country they are considered rich--rich enough to pay the alternative minimum tax--that would have said that people who are subject to the alternative minimum tax cannot at the same time be eligible for a program that is designed to help low-income families and low-income children. That was defeated in the Senate by a vote of 42 to 57.

So there are a lot of issues with regard to this legislation that give me grave concerns, reasons that I can't support it. As I said before, an expansion of a government-run health care program in this country--it is not paid for after the year 2012--leads us toward nationalized, Washington-controlled health care and moves us away from what ultimately ought to be our goal; that is, providing access for more Americans to coverage through our market-based system in this country.

It requires that low-cost, efficient States such as my State of South Dakota are going to be subsidizing high-cost, inefficient States--States such as in the New Jersey, New York area--that are already talking about going to 350 percent or 400 percent of the poverty level, which, as I said earlier, in the case of New York, that would get you up to where you would have those in the income level of over $80,000 a year qualifying and being eligible for a program that is designed to help low-income children and low-income families and, ironically, subjects them to the alternative minimum tax. The alternative minimum tax was a tax put into place in the first place to tax people who are making too much money and not paying enough taxes. That, to me, seems to be a very conflicted message we are sending with this bill.

We need a strong, market-based health care system in this country. We need to start that debate. This debate delays that debate because we are going to be adopting legislation that increases--adds to the government-run component of health care in this country and moves us away from the debate we ought to be having, which is, how can we improve access for more Americans to affordable health care coverage, where they can own their own coverage, where they don't have to rely on a government system that is inefficient, that is Washington-based, and that is controlled by bureaucrats here in Washington, DC?

We want to put people and patients more in control of health care. This particular bill does not do that. I will be voting no, and I urge my colleagues as well to vote no. I hope we can get to the big debate, the debate we ought to be having; that is, how do we reform the health care system in this country?

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