Children's Health Insurance Program Reauthorization Act of 2009

Floor Speech

CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT OF 2009 -- (Senate - January 28, 2009)

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Mr. REED. Madam President, I don't know if we are going back and forth. I know Senator Murkowski is here. I have about 5 or 6 minutes.

I rise in support of the legislation before us to renew and improve the Children's Health Insurance Program. I begin by commending Chairman Baucus for his work on this legislation, not just this year, but so many years before. We brought this bill to the floor in 2007. We have had successful votes, a tribute to the chairman's leadership. I know at the same time he is working on the stimulus package, which is critically important to our economy. I personally thank him and commend him for all his efforts.

This bill is virtually identical to the legislation that I previously voted for on two occasions. Indeed, I voted, along with a large bipartisan majority, for this legislation in 2007. So I am hopeful Congress will act swiftly in a bipartisan manner to present this bill to President Obama for his signature. Uninsured children have already waited for that moment for far too long.

This bill invests $32.8 billion to extend and expand CHIP through fiscal year 2013. According to the Congressional Budget Office, it will preserve coverage for 6.7 million children and expand coverage to an additional 4.1 million uninsured children. In addition, the bill facilitates enrollment and improves benefits by requiring dental coverage and mental health parity.

For my State of Rhode Island, this bill is absolutely critical because it would end the persistent funding shortfalls that have required 11th hour stopgap measures. Over the years, I have been able to secure $77 million in additional funding to cover these shortfalls, but these efforts at the very last minute are not something that can be sustained indefinitely.

This bill allocates funding based on actual spending and provides a contingency fund for shortfalls. As a result, Rhode Island's allotment, the amount of Federal funding available for the State to draw down, will increase from $13.2 million to $69.5 million. This is the highest percentage increase of any State. This will preserve coverage for about 12,500 children enrolled in RIte Care, which is our Children's Health Insurance Program, and allow the State to expand SCHIP coverage.

With the current economic crisis, this bill could not be more timely. As parents lose their jobs, they and their children will lose their health coverage. Nationwide, the rise in unemployment has caused 1.6 million children to lose employer-based health insurance. In Rhode Island, the unemployment rate is now in double digits at 10 percent. Behind this number are real families who are struggling to pay their medical bills and whose children may be forced to forgo doctor visits, medicines, and immunizations they need to lead healthy, productive lives.

Recently, Rhode Island was forced to make the very difficult choice of dropping coverage for 1,300 children who are legally here because there was no Federal match. For many years, the State had provided coverage for these children using State funds alone. This bill could result in expanded coverage by providing Federal funds for these children who are legally here within the United States.

It also includes important provisions to increase enrollment of people who
are eligible for both the CHIP funding and Medicaid funding. The bill allows States to use Social Security numbers to verify citizenship, provides grants to States for outreach activities, and provides bonus payments for the cost of increased enrollment in Medicaid.

However, I must point out, Rhode Island may not be able to fully benefit from these latest provisions as they relate to Medicaid. In the waning hours of the Bush administration, the State agreed to an unprecedented cap on total spending. The cap is based on projections that do not factor in potential increases in Medicaid enrollment resulting from this legislation. As a result, the cap could prevent the State from taking up the option to cover legal immigrant children and pregnant women and could discourage the State from renewing its outreach efforts, even though these were longstanding policies in the State prior to the economic downturn. I have strong concerns about the cap because there are too many unknowns about how it would interact with both this bill and other efforts to expand Medicaid coverage.

States are struggling to grapple with rising health care costs, enrollment is increasing, and indeed the Federal Government, businesses, and families are also burdened by rising costs and the absence of any discernible health care system. It is clear there can be no economic recovery in the long term unless we at last confront the critical challenge of comprehensive health reform. The time has come to guarantee affordable, quality health care to all Americans. This bill is an important step forward and a downpayment on this effort.

Let me finally emphasize how critical this bill is to the children's health care program. It will dramatically increase the share that Rhode Island is entitled to and it will prevent the eleventh-hour scramble to fund shortfalls in the State. On the Medicaid side, I hope the State is able to use these additional authorities to enroll more children who could, in fact, receive help from this bill.

I yield the floor.

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