Children'S Health Insurance Program Reauthorization Act Of 2009
The author Lois McMaster Bujold wrote: Children might or might not be a blessing, but to create them and then fail them was surely damnation. Before 1997, we largely failed the children of the working poor. The Children's Health Insurance…
The author Lois McMaster Bujold wrote:
Children might or might not be a blessing, but to create
them and then fail them was surely damnation.
Before 1997, we largely failed the children of the working poor. The Children's Health Insurance Program changed that. For millions of working families, the Children's Health Insurance Program has truly been a blessing.
Before 1997, kids of the working poor had nowhere to go to get health insurance--nowhere. Their parents' employers did not offer health insurance benefits, and the individual market offered only low-quality insurance options at unaffordable prices. Without health insurance, kids could not see the doctor for a checkup, they could not get a prescription for an earache, and they could not get treatment for common chronic conditions such as asthma. Unhealthy kids cannot run and play, they cannot do well in school, and they cannot grow into healthy and productive adults.
In 1997, Congress took action to address this problem. We established the Children's Health Insurance Program. Today, we finally move forward to keep the program going. The Children's Health Insurance Program has bipartisan roots, and it has achieved what we created it to do; namely, it covers low-income, uninsured kids.
Congress enacted the Children's Health Insurance Program as a bipartisan compromise. Members of Congress wanted to address the rising number of children without health insurance, and Senator Rockefeller, Senator Hatch, Senator Kennedy, and the late Senator John Chafee led the way. I am proud to have helped write and pass the Children's Health Insurance Program 12 years ago. It has been a tremendous success.
The Finance Committee reached a compromise that allowed States to set up children's health insurance programs that would meet their unique needs. States can choose whether they want to participate in the program. Within 2 years of CHIP's creation, every State decided to participate. It was a no-brainer. Every State wanted to address the health care needs of our most vulnerable children.
In its first decade, CHIP cut the number of uninsured children by more than one-third. Today, because of CHIP, nearly 7 million children get the doctors visits and medicines they need. Those healthier childhoods will enable those 7 million kids to become healthy, productive adults.
Health insurance is important. It is more than important; it is critical. Children with health coverage are more likely to get the health care they need, when they need it. Because of CHIP, 7 million kids have regular checkups, see doctors when they get sick, and get the prescription medications they need.
The task before us is to reauthorize this important program. Many will recall that we started this process back in the year 2007.
Congress worked hard, very hard to pass a bipartisan reauthorization package. I can tell my colleagues, Senators Hatch, Rockefeller and myself and Senator Grassley worked hours on end. I cannot tell you the number of hours we met and how hard it was, but we worked together and got that compromise. We got it passed on the floor, passed the House. But President Bush vetoed it twice. Times have changed. President Obama is looking forward to signing the Children's Health Insurance Program bill, and Congress is prepared to act.
Americans overwhelmingly support covering kids. The bill before us today will keep coverage for all children currently in the program, and we will start to reach more than 4 million additional uninsured, low- income kids. In
drafting this legislation, we relied heavily on the two vetoed bills. We keep CHIP focused on kids. That is the focus. Childless adults whom CHIP covers today will transition out of the program. This is focused on kids. This bill will not allow new waivers for CHIP coverage of childless adults. Low-income parents whom CHIP covers today will ultimately transition out of CHIP to Medicaid, with its lower match rate. This bill precludes new waivers for coverage of parents in CHIP. We cover low-income kids first. We agree that low-income kids are our first priority, but we do not limit State flexibility in designing CHIP programs. States choosing to cover kids above 300 percent of poverty will receive the lower Medicaid match for those kids. If they want to do so, they can, but they will get the lower match rate. We also included bonuses for States that meet enrollment targets for kids in Medicaid. Nearly three-quarters of uninsured kids are eligible for either Medicaid or CHIP but have not enrolled. We encourage States to improve their outreach practices to streamline enrollment procedures to keep them enrolled. We maintain State flexibility. We have given States the option to cover legal immigrant children and pregnant women during their first 5 years in the United States. States can decide whether they want to cover those children. Currently, Federal law prevents States from covering legal immigrants on Medicaid or CHIP until they have been in the country for 5 years. But some States have found this provision to be too restrictive. Those States have chosen to use their own money to meet the needs of their residents.
In 2008, for example, 18 States chose to cover legal immigrant children, and 23 States chose to cover legal immigrant pregnant women, rather than deny them the health care they need for 5 years. The Federal Government should not penalize States for trying to help needy populations who are here legally. This bill would allow States the option to cover legal immigrant children and pregnant women in Medicaid or CHIP and receive the appropriate Federal match.
More broadly, we have also created a State option that allows States to designate CHIP funds to offer premium assistance. Premium assistance can help families to afford private coverage offered by employers or other sources. We improve the quality of children's health insurance. Discussions about health insurance often get bogged down in talk about cost and coverage but we ignore quality. Discussions about quality often ignore the unique needs of children. Our CHIP bill launches a substantially new initiative to improve children's health quality. This initiative will invest $45 million a year for 5 years to develop national core measures for children's health quality, improve data collection in CHIP and Medicaid, and promote the use of electronic records. These efforts will help to improve the quality of care available in CHIP and Medicaid.
We pay for what we do. Like the vetoed bills, this legislation will increase the Federal tax on a pack of cigarettes by 61 cents. We also make proportional increases for other tobacco products. Increasing the cigarette tax will discourage smoking, particularly among teens, and that will be good for kids as well.
The bill we are considering today is a good bill. In putting together the Finance Committee's bill, we worked to cover as many low-income, uninsured kids as possible. We respected our budgetary limits, and we made compromises in good faith with our Republican colleagues. In committee, we made further compromises which I hope have strengthened this bill even more. I prefer to be standing here today with all my colleagues beside me, especially my good friends, Senators Grassley and Hatch. But we could not agree on everything. I hope the remaining disagreements do not prevent Senators from doing the right thing. Let us not fail the children of the working poor. Let us get these kids to doctors visits and medications they need, and let us continue the blessing that is the Children's Health Insurance Program.
I yield the floor and suggest the absence of a quorum.