Children's Health Insurance Program Reauthorization Act Of 2009

Floor Speech

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Mr. DURBIN. Will the Senator yield for a question?

Mr. HATCH. Sure.

Mr. DURBIN. I know he has an amendment pending relative to taking care of providing prenatal care to make certain that children are born healthy in the United States. I would like to ask the Senator if he is arguing now that we should not provide maternal care for pregnant women who are legal immigrants to the United States with the full knowledge that the lack of that care may mean the child will be born sick and the child will be a citizen of the United States?

Mr. HATCH. Heavens no.

Mr. DURBIN. Is the Senator arguing we should not provide obstetrical care to pregnant legal immigrant women?

Mr. HATCH. Certainly not. And as the Senator knows, many States today provide that care to legal immigrants through CHIP or otherwise. And let me emphasize that all expenses are supposed to be provided by the sponsoring families for 5 years. If that was the wrong time or it should have been shortened, I would have worked with the distinguished Senator to do that. But that was the deal. That was the rule. That was what we worked on. That is what we thought would work. That is what we thought was fair.

What I don't want to do is have our own children who are U.S. citizens be without care while we cover those who were supposed to be covered by their sponsor families who brought them to the United States.

Mr. DURBIN. If the Senator will yield, if a person is here legally though not a citizen, is a legal immigrant mother, is it not true that her child born here will be a legal citizen?

Mr. HATCH. Yes, it is true. And they would be covered by CHIP.

Mr. DURBIN. Then if we deny care----

Mr. HATCH. What about those who were brought in who are not legal citizens? I am not against helping them.

Mr. DURBIN. I don't think there should be a provision for undocumented illegals.

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Mr. DURBIN. Mr. President, I would like to speak to the pending matter before us.

Mr. HATCH. Will the Senator yield?

Mr. DURBIN. I am happy to yield to the Senator from Utah.

Mr. HATCH. I don't think I answered the question as well as I would like to. The question was, Do we want any children of pregnant women, legal immigrant children, not to be helped? Twenty-one States already pay for that. I think most of the others do through emergency rooms. They don't go without health care. But what is happening here is that we are taking what 21 States are actually doing and we are basically just alleviating them from having to do that, that which they are capable of doing and wanted to do, and just taking it over by the Federal Government when, in fact, these problems were solved in a way that was reasonable, with not only families taking care of people they brought into this country for 5 years under their obligation but also because the States would take care of them with State money. I wanted to make that clear. I do appreciate working with my colleagues on the other side, but I am a little disappointed that it has turned out this way.

Mr. DURBIN. Mr. President, let me preface my remarks by saying a word of tribute to the Senator from Utah. I hope he doesn't leave the floor because this may be historic, but I thank him personally for his support of this SCHIP bill through the years. I know it has not always been easy. Sometimes he has been a lone voice. And though we may disagree about one aspect or another, I greatly admire the fact that he has stood up and supported this. I hope at the end of the day he will continue to because bipartisan support for this program is very important. I salute him.

Mr. HATCH. If the Senator will yield, I thank him for his gracious comments. He knows our friendship means a great deal, and also with the distinguished chairman of the committee. I think he is a very fine man who has done a very good job on this committee. But I am going to have a difficult time supporting this bill without some bipartisan approach that would work a lot better than this is going to work. But I thank the Senator again.

Mr. DURBIN. Mr. President, I thank the Senator from Utah.

I want to try to bring this down to the bottom line. This really is a debate about children's health coverage. This is not a debate about immigration. I hope my colleagues will be willing to have that debate about immigration, and soon, because it is long overdue in this country.

Much of this debate is focused on the idea that this provision in the bill would call on undocumented immigrants to abuse the system and that our financially strapped system would be run down by an influx of these undocumented immigrants jumping onboard.

Let me make it clear: Undocumented immigrants have never been eligible for the major benefit programs in America, and this law does not change that. We are talking about legal immigrants, people who are in the United States legally, people who are working and paying taxes, people who are more than likely to become tomorrow's citizens.

It is a different group. These are not those hiding in the shadows because they are here illegally. These are people who have legal documentation as to their presence in the United States. They can go to work. They pay taxes. What we are talking about is making certain the children of these legal immigrants have a chance to be healthy. It is likely many of those children are already U.S. citizens, and many will become U.S. citizens. Their being
unhealthy does not make sense for that family, and it certainly does not make sense for our Nation.

Legal immigrants were able to get some assistance, but the 1996 Federal welfare law restricted those benefits by enacting a 5-year waiting period. This was during the Gingrich era. The policy was instated over 10 years ago, and almost immediately we started changing it, realizing it really did not work as well as planned. Congress and many States recognized we had gone too far and we were causing serious harm to seniors and persons with disabilities and vulnerable families throughout the country.

Over time, and with the support of Presidents from both political parties--President Clinton and President George W. Bush--Congress restored eligibility to many but not all lawfully residing immigrants who needed Social Security assistance or food stamps. We have not yet restored health care services to these individuals and families. We have attempted to do so in the past.

During the debate on Medicare Part D prescription drugs for seniors, the Senate version of the Medicare bill included this same language. We all know how successful the effort was. It passed this Chamber with a strong bipartisan vote of 76 to 21. When there was an attempt to change it, water it down, it was rejected by the Senate by a vote of 65 to 33--a strong bipartisan vote.

In addition to longstanding support from Republicans, Democrats, and Independents, the removal of legal immigrant barriers to health care is also backed by diverse stakeholders. The National Governors Association and the National Conference of State Legislatures are on record supporting the approach of this bill.

In addition, the bipartisan U.S. Commission on Immigration Reform called for lifting restrictions on legal immigrants' eligibility for public benefits shortly after the 1996 restrictions went into place. The arguments for such a policy are overwhelming.

According to a 2003 factsheet from Families USA, extending health insurance to this population actually saves the health care system of America a lot of money. Covering uninsured children and pregnant women through Medicaid can reduce unnecessary hospitalizations by 22 percent. Preventing unnecessary hospital visits results in substantial savings in uncompensated care. Women without access to prenatal care are four times more likely to deliver low birth weight babies and seven times more likely to deliver prematurely with complications.

Avoiding these pregnancy complications is not only the humane thing to do, it is the economic thing to do. It produces great savings to the system. Like all of us, when immigrant kids are insured--legal immigrant kids are insured--their families make better decisions when it comes to the use of health care. They are twice as likely to have seen a primary care doctor in the last year as those who are uninsured. They are three times more likely to have preventive well-child visits. They are more likely to get a flu shot.

In contrast, uninsured immigrant children are four times as likely to have used an emergency room more than once as immigrant children who are covered. ER care is expensive, sometimes unnecessary. We can avoid it by doing the smart thing in providing health insurance for the children of these legal immigrants.

So I say this: There is a lot of debate in this Chamber, and has been over the last several days, about families, family values, life, respecting life. Those are all valuable concepts and principles. But isn't that the bottom line in this debate? If you really do respect families and family values, if you really do respect life and children, why would you deny basic health insurance to these children? They are the children of legal residents of the United States, people paying their taxes, who want the best for their kids, like we all do.

That is why this is so important. We have come at this in the last couple days--and I salute the chairman of the Finance Committee for his patience. We have come at this from 10 different directions. It is still the bottom line. The bottom line is, if you value these kids, if you want them to be healthy, if you want to give them a fighting chance for a good life so they can be happy, healthy, and good citizens of the United States, don't deny them this health care.

No child should have to wait 5 years for health care. Five years is a lifetime to a child with a medical problem. Many of these conditions have long consequences if we do not treat them early. So let's make sure we do the right thing. As someone said in some of the debate the other day, children are contagious. You cannot say, well, we are going to put in a classroom those citizen kids with those legal resident kids, and the legal resident kids do not get to go to the doctor. They have to wait until they are really sick or the parent, in desperation, has to take them to an emergency room, and it does not affect the whole classroom. It does.

We are literally in this together. Our children and grandchildren are in this together. Our country can do better. I hope we defeat these amendments and stick with this basic bill.

Mr. President, I yield the floor.

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