Mr. President, let me compliment my friend, Senator Hatch, for his longstanding work on behalf of the Children's Health Insurance Program. He points out--and rightly so--that this legislation was developed in a bipartisan manner, where…
Mr. President, let me compliment my friend, Senator Hatch, for his longstanding work on behalf of the Children's Health Insurance Program. He points out--and rightly so--that this legislation was developed in a bipartisan manner, where Democrats and Republicans worked together to establish a Federal program that allowed our States to use their mechanism to cover children. That is where our difference might be now. We are looking
at reauthorization legislation. We are looking at how we can make this program more effective, covering more children, giving States the tools they need so children can be covered under the CHIP program. The concerns my friend from Utah raises basically would impede on State discretion. We have a national program that is built upon allowing the States to implement and cover children. Each State is different. The priorities among States are certainly different. We need to give the States the tools they need so children actually are covered effectively by this program.
The amendment my friend from Utah has offered would prohibit States from covering legal immigrants and pregnant women. These are, in many cases, people who have been here for a long time, hard-working, tax- paying families, and they are playing according to the rules.
This restriction was imposed in 1996 by Congress. Since that time, many of the restrictions that have been placed upon legal immigrants have been removed. In this instance, what the committee is recommending is to give the States the option of covering legal immigrants without the 5-year wait period. It is not mandating it. It gives all States the option, if they so desire, to cover. Currently, 23 States want to cover these children.
The last time an amendment was offered and we tried to do away with the prohibition on States, our Republican colleagues said: This shouldn't be done as an independent issue. Why don't we take it up when we reauthorize the Children's Health Insurance Program. That is where it should come up. It should not come up on an unrelated bill. That is exactly what we are doing.
This is the reauthorization bill for the Children's Health Insurance Program. This is the time to correct what was done in 1996, in haste, that in many other Federal programs we have already changed. This allows the States to do it.
Many other issues my friend from Utah raised, I assume, will have individual amendments to deal with them. But in most cases, it is the issue of whether we are going to trust our States to run the program. That was the compromise reached between Democrats and Republicans. Quite frankly, there are more people on the Democratic side of the aisle who wanted a stronger Federal presence. But our Republican colleagues said: Let's build upon the State programs. That is what we did in the compromise. That is why the Children's Health Insurance Program has truly been a bipartisan bill.
The bill reported out by the committee is a bipartisan bill. So let me talk for a few minutes about the importance of S. 275, the Children's Health Insurance Program Reauthorization Act of 2009. For millions of children across America who are waiting for the comprehensive health care coverage they need, this week could not have come soon enough. There is a crisis in health care in this country. The United States spends far more per capita than any other nation on health care services. Yet our health status lags in many areas, especially in preventable diseases. This is primarily because we have so many Americans who lack coverage and a fragmented, inefficient health care system that shifts costs onto those who are covered. This is no longer a matter of whether we take action to achieve universal health insurance but how.
We can begin, in the 111th Congress, by guaranteeing children access to the care they need to grow into healthy adults. We can make great strides by reauthorizing CHIP and covering millions of uninsured children now.
Most uninsured Americans belong to working families. It is the CHIP program, first established 12 years ago, that can provide children in these families with affordable health insurance. As a Member of the House, I voted for the bill that created CHIP. At the time, 37 million Americans were uninsured. At the time, I did so with the hope that CHIP would be the first step toward universal health coverage. Although we did not reach the goal then, I believe we are on track to achieve it this year. In the years since, more employers have dropped their coverage. The number of uninsured has increased. Today the number stands at 46 million and growing. I say ``growing'' because today's headlines contain more grim news for our workforce. The New York Times reported a staggering list of companies that announced job cuts on Monday: Caterpillar, 20,000 jobs; Sprint-Nextel, 8,000 jobs; Home Depot, 7,000 jobs; General Motors, 2,000 jobs; Texas Instruments, 3,400 jobs; Philips Electronics, 6,000 jobs.
Over the past year, more than 12.5 million Americans have lost their jobs. Our unemployment rate is now 7.2 percent, the highest in 16 years. As President Obama said yesterday:
These are not just numbers. These are working men and women
whose families have been disrupted and whose dreams have been
put on hold.
Whenever we have a family who loses their job, in many cases, they lose their health insurance. If they lose their health insurance, in many cases, they lose their access to quality health care. The numbers are increasing. In many cases, we have two working families. One person loses their job which may cover the family, the other spouse has only single coverage and can't get family coverage or doesn't have the money to afford family coverage. This disrupts a family's ability to take care of their own health care needs. We know CHIP works. Studies have shown and proved that enrollment in CHIP improves the health care of children. When previously uninsured children sign up for CHIP, they are far more likely to get regular primary medical and dental care. They are less likely to visit the emergency room for services that could be rendered in a doctor's office. That saves us health care dollars. They are more likely to receive immunizations and other services they need to stay healthy and lead to healthier schools and communities. They are more likely to get the prescription drugs they need to recover from illness.
The best evidence of the program's success doesn't rest in studies or surveys. It rests in the families themselves. The Bedford family from Baltimore is a success story, one of millions of families in CHIP. Craig and Kim Lee Bedford and their five children have testified on Capitol Hill about the difference the Maryland CHIP program has made in their lives. Mrs. Bedford said:
Perhaps the greatest impact the Maryland Children's Health
Insurance Program has had on our family is that we no longer
have to make impossible health choices based on a financial
perspective. We no longer have to decide whether a child is
really sick enough to warrant a doctor's visit. We no longer
have to decide whether a child really needs a certain
medication prescribed by his pediatrician.
Mr. Bedford said:
The face of CHIP is families such as ours, families that
work hard, play by the rules, trying to live the American
dream.
So for the Bedford family and millions more, CHIP has been a success. But there are still millions of children who have not enrolled in the program offered by their States. Our State is making progress, simplifying their enrollment procedures, expanding outreach efforts and using joint applications for Medicaid and CHIP so families can enroll together. The States are making progress, but as we reauthorize the Children's Health Insurance Program, let's make sure we make real progress.
Our bill will extend the program for 4.5 years and allow an additional 4.1 million children nationwide to enroll. We have to get this bill done.
I wish to talk about the MCHIP program, the Maryland State program. It has one of the highest income eligibility thresholds in the Nation. I know my colleagues have talked about this. This is needed because of the high cost of living in our State. Eligibility is 300 percent of the Federal poverty level, not because our Governor wants to move people from private insurance to public insurance plans. It is at 300 percent because working families at this income level do not have access to affordable health insurance. That is the statistics in my State. Those families need CHIP. This is a State option.
As to one point my friend from Utah mentioned, I don't think the Federal Government should be prescriptive. Allow the States to figure out what program works best. There are incentives to cover low-income families. There are higher matches from the Federal Government, as it should be. We should make sure the lower income families are covered first, and we do under CHIP. Children under the age of 19 may be eligible for MCHIP, if their
family income is at or below 200 percent of the Federal poverty level or up to $34,000 for a family of three. Our program has been a true success. Enrollment has grown from about 38,000 enrollees in 1999 to more than 100,000 today. In Maryland, the need has always exceeded available funds. We actually spend more money than the Federal Government will give us. The Federal match through the CHIP formula established in 1997 is not enough to meet all the costs of the MCHIP program. Some States do not use their entire allotment, while other States, such as Maryland, have expenditures that exceed their allotment. Congress has addressed this problem by redistributing the excesses of the States that have them to States that have shortfalls. Now we must move forward for future years.
This is what we are doing on the floor of the Senate today. I thank Chairman Baucus and Senator Rockefeller for their efforts on this bill. This bill will allow us to continue to cover children and families with incomes up to 300 percent of poverty. Maryland would also have access to contingent funds, if a shortfall arises, and additional funds based on enrollment gains. With this new money, Maryland can cover an estimated 42,800 children who are currently uninsured over the next 5 years.
There is another important part of this bill I wish to talk about for a moment, section 501. It hasn't gotten much attention, but it certainly has received a lot of attention around the country. Section 501 ensures that dental care is a guaranteed benefit under CHIP. I agree with my friend from Utah, we need to set standards at the national level. Dental benefits must be included. According to the American Academy of Pediatric Dentistry, dental decay is the most common chronic childhood disease among children. It affects 1 in 5 children between the ages of 2 and 4 and half of those between the ages of 6 and 8. Children living in poverty suffer twice as much tooth decay as middle- and upper-income children. Nearly 40 percent of Black children have untreated tooth decay in their permanent teeth. More than 10 percent of the Nation's rural population has never visited a dentist. More than 25 million people live in areas that lack adequate dental services.
Next month will mark 2 years since a young man from suburban Maryland named Deamonte Driver passed away. He was 12 years old, when he died in February of 2007 from an untreated tooth abscess. His mother tried to access the system, tried to get him to a dentist. What was needed was an $80 tooth extraction. Because of the failure of the system to cover his services, an inability to get to a dentist, Deamonte ended up in an emergency room. A quarter of a million dollars was spent in emergency surgeries. He lost his life in the United States in 2007.
This bill will do something about it by covering oral health care, as it should. Deamonte's death has shown us that, as C. Everett Koop once said, ``There is no health without oral health.'' No children should ever go without dental care. I have said before, I hoped that Deamonte Driver's death will serve as a wake-up call for Congress. Section 501 of this bill shows that it has. We must never forget that behind all the data about enrollment and behind every CBO estimate, there are real children who need care.
When I spoke about Deamonte Driver after his death, I urged my colleagues to ensure that the CHIP reauthorization bill we send to the President includes guaranteed dental coverage. This bill does include guaranteed dental coverage. It also provides ways in which families will have a better understanding of the need for oral health care. It also provides ways in which families can access dentists who will treat them under either the CHIP program or the Medicaid Program.
This legislation is a major step forward on dental care. We need to do more. I want to acknowledge the work particularly of Senators Bingaman and Snowe on oral health care. They have been real champions in this body in moving forward on these types of legislation.
This bill will also require GAO to study and report on access to dental services by children in underserved areas, access to oral health care through Medicaid and CHIP, and how we can use midlevel dental health providers in coordination with dentists to improve access to dental care for children. The results of this study will give us the information we need to further improve coverage.
We still have to raise reimbursement for dental providers, and send grants to the States to allow them to offer wraparound coverage for those who have basic health insurance but no dental insurance. But these provisions are an excellent start.
After two vetoes of a bipartisan CHIP bill by the former President, I am so pleased to stand here today on the floor of the Senate and express my strong support for S. 275. This is the week in which we can make progress in covering people in this country, particularly our children, with health insurance. One week after the inauguration of President Obama, we are poised to move this bill through the Congress and to his desk so it can finally become law.
I urge all my colleagues to vote in favor of this legislation, as we start down the path to universal health coverage for all Americans.
With that, Mr. President, I yield the floor.
Mr. President, I do object. The reason, quite frankly, is that we have worked out with the Republican leader that we would have three amendments pending. We have those three amendments pending. I think it is important we have an opportunity to act on those three amendments. We certainly look forward to other opportunities where my colleague will be able to offer the amendment, but at this point I object.
Mr. President, if my colleague will yield?
We would be pleased to allow the Senator to call up amendment No. 43 but not the entire list of amendments the Senator sought.
To point out to my friend, we already have three amendments that are pending, and we are hoping to make progress, and we want to get votes on these amendments. I will not raise an objection to setting aside the amendment for the sole purpose of offering amendment No. 43.