Statements On Introduced Bills And Joint Resolutions
Mr. President, I rise today to introduce legislation with Senators Jeffords, Murray, Leahy, and Cantwell entitled the ``Children's Health Equity Act of 2003.'' This bill addresses an inequity that was created during the establishment of…
Mr. President, I rise today to introduce legislation with Senators Jeffords, Murray, Leahy, and Cantwell entitled the ``Children's Health Equity Act of 2003.'' This bill addresses an inequity that was created during the establishment of the State Children's Health Insurance Program, CHIP, that unfairly penalized certain States that had done the right thing and had expanded Medicaid coverage to children prior to the enactment of the bill.
While the Congress recognized this fact for some States and ``grandfathered'' in their expansions so those States could use the new CHIP funding for the children of their respective States, the legislation failed to do so for others, including New Mexico, Vermont, and Washington, among others. This had the effect of penalizing a certain group of States for having done the right thing.
The ``Children's Health Equity Act of 2003'' addresses this inequity by allowing those States, which had expanded coverage to children up to 185 percent of poverty by April 15, 1997, before the enactment of CHIP, to be allowed to also utilize their CHIP allotments for coverage of those children covered by Medicaid above 133 percent of poverty-- putting them on a more level field with all other States in the country.
As you know, in 1997 Congress and President Clinton agreed to establish the State Children's Health Insurance Program, CHIP, and provide $48 billion over ten years as an incentive to States to provide health care coverage to uninsured, low-income children up 200 percent of poverty or beyond.
During the negotiations of the Balanced Budget Act, BBA, of 1997, Congress and the Administration properly recognized that certain States were already undertaking Medicaid or separate State-run expansions of coverage to children up to 185 percent of poverty or above and that they would be allowed to use the new CHIP funding for those purposes. The final bill specifically allowed the States of Florida, New York, and Pennsylvania to convert their separate State-run programs into CHIP expansions and States that had expanded coverage to children through Medicaid after March 31, 1997, were also allowed to use CHIP funding for their expansions.
Unfortunately, New Mexico and other States that had enacted similar expansions prior to March 1997 were denied the use of CHIP funding for their expansions. This created an inequity among the States where some were allowed to have their prior programs ``grandfathered'' into CHIP and others were denied. Therefore, our bill addresses this inequity.
New Mexico has a strong record of attempting to expand coverage to children through the Medicaid program. In 1995, prior to the enactment of CHIP, New Mexico expanded coverage to for all children through age 18 through the Medicaid program up to 185 percent of poverty. After CHIP was passed, New Mexico further expanded its coverage up to 235 percent of poverty--above the level of the vast majority of states across the country.
Due to the inequity caused by CHIP, New Mexico has been allocated $266 million from CHIP between fiscal years 1998 and 2002, and yet, has only been able to spend slightly over $26 million as of the end of last fiscal year. In other words, New Mexico has been allowed to spend less than 10 percent of its federal CHIP allocations.
New Mexico is unable to spend its funding because it had enacted its expansion of coverage to children up to 185 percent of poverty prior to the enactment of CHIP and our State was not ``grandfathered'' into CHIP as other comparable states were.
The consequences for the children of New Mexico are enormous. According to the Census Bureau, New Mexico has an estimated 114,000 uninsured children. In other words, almost 21 percent of all the children in New Mexico are uninsured, despite the fact the State has expanded coverage up to 235 percent of poverty. This is the second highest rate of uninsured children in the country.
This is a result of the fact that an estimated 80 percent of the uninsured children in New Mexico are below 200 percent of poverty. These children are, consequently, often eligible for Medicaid but currently unenrolled. With the exception of those few children between 185 and 200 percent of poverty who are eligible for CHIP funding, all of the remaining uninsured children below 185 percent of poverty in New Mexico are denied CHIP funding despite their need.
Exacerbating this inequity is the fact that many States are accessing their CHIP allotments to cover kids at poverty levels far below New Mexico's current or past eligibility levels. The children in those States are certainly no more worthy of health insurance coverage than the children of New Mexico.
As the health policy statement by the National Governors' Association reads, ``The Governors believe that it is critical that innovative states not be penalized for having expanded coverage to children before the enactment of S-CHIP, which provides enhanced funding to meet these goals. To this end, the Governors support providing additional funding flexibility to states that had already significantly expanded coverage to the majority of uninsured children in their states.''
Consequently, the bill I am introducing today corrects this inequity. The bill reflects a carefully-crated response to the unintended consequences of CHIP and brings much needed assistance to children currently uninsured in my State and other similarly situated States, including Washington and Vermont.
Rather than simply changing the effective date included in the BBA that helped a smaller subset of States, this initiative includes strong maintenance of effort language as well as incentives for our State to conduct outreach and enrollment efforts and program simplification to find and enroll uninsured kids because we feel strongly that they must receive the health coverage for which they are eligible.
The bill does not take money from other States' CHIP allotments. It simply allows our States to spend our States' specific CHIP allotments from the Federal Government on our uninsured children--just as other states across the country are doing.
I ask unanimous consent that the text of the bill be printed in the Record.