(As Prepared for Delivery)
Many of the best ideas in public policy are the simplest. The Children’s Health InsuranceProgram is based on one simple and powerful idea – that all children deserve a healthy start inlife, and that no parents should have to worry about whether they can afford to take theirchild to the doctor when the child is sick. CHIP can make the difference between a childstarting life burdened with disease – or a child who is healthy and ready to learn and grow.The enactment of Medicaid in 1965 brought decent health care to families living in poverty,including children. But it became clearer and clearer as the years and the decades passed,that more and more children were unable to obtain health care because they lived in familieswhose incomes were too high tot qualify for Medicaid but too low to afford health insurance.Finally, in Massachusetts, in the 1990’s we agreed that health care coverage for children is anecessity and that action needed to be taken. John McDonough, Executive Director of HealthCare for All in Massachusetts, deserves much of the credit for what came next. His pioneeringwork while he was in the Massachusetts Legislature on children’s health care led to thepassage in 1993 of the state’s Children’s Medical Security Plan, which guaranteed qualityhealth care to children in families ineligible for Medicaid and unable to afford health insurance.
A year later, Massachusetts expanded eligibility for Medicaid, and financed the expansionthrough a tobacco tax – the same approach we used successfully a few years later for CHIPand the same approach that is proposed in the bill before us now.Rhode Island and other states took similar action, and helped create a nationwide demand foraction by Congress to address the unmet needs of vast numbers of children for good healthcare.
In 1997, Congress acted on that call, and the result was CHIP. Senator Hatch and I workedtogether then—as we have this year—to focus on guaranteeing health care to children whoneed it. Now, in every state in America and in Puerto Rico, CHIP covers the services that givechildren a healthier start in life – well child care, vaccinations, doctor visits, emergencyservices, and many others.
In its first year 1997, CHIP enrolled nearly a million children, and enrollment has grown eversince. An average of 4 million are now covered each month, and 6 million are enrolled eachyear.
As a result, in the past decade, the percentage of uninsured children has dropped from almost23 percent in 1997 to 14 percent today. That reduction is significant, but it’s obviously farfrom enough.
CHIP improves the overall quality of life for children fortunate enough to have its coverage, byallowing them to get the care they need when they need it. They’re more likely to have a realdoctor and a real place to obtain care, and, their parents don’t delay seeking care when theirchild needs it. Children on CHIP also have significantly more access to preventive care.Studies also show that CHIP helps to improve children’s school performance. When childrenare receiving the health care they need, they do better academically, emotionally, physicallyand socially. CHIP helps create children who will be better prepared to contribute to America.
And CHIP all but eliminates the distressing racial and ethnic health disparities for the minoritychildren who disproportionately depend on it for their coverage.CHIP’s success is even more impressive and important when we realize that more and moreadults are losing their own insurance coverage, because employers reduce it or drop itentirely.
That’s why organizations representing children, or the health care professionals who servethem, agree that preserving and strengthening CHIP is essential to children’s health. TheAmerican Academy of Pediatrics, First Focus, the American Medical Association, the NationalAssociation of Children’s Hospitals and countless other organizations dedicated to children allstrongly support CHIP.
A statement by the American Academy of Pediatrics puts it this way--“Enrollment in SCHIP isassociated with improved access, continuity, and quality of care, and a reduction inracial/ethnic disparities. As pediatricians, we see what happens when children don’t receivenecessary health care services such as immunizations and well-child visits. Their overall healthsuffers and expensive emergency room visits increase.”
Today, we are here to dedicate ourselves to carrying on the job begun by Congress ten yearsago, and to make sure that the lifeline of CHIP is strengthened and extended to many morechildren.
Millions of children now eligible for CHIP or Medicaid are not enrolled in these programs. Of thenine million uninsured children, over two-thirds—more than 6 million – are already eligible forMedicaid or CHIP. These programs are there to help them, but these children are not receivingthat help either because their parents don’t know about the programs, or because of needlessbarriers to enrollment.
Think about that number—9 million children in the wealthiest and most powerful nation onearth. 9 million children whose only family doctor is the hospital emergency room. 9 millionchildren at risk of blighted lives and early death because of illnesses that could easily betreated if they have a regular source of medical care.
9 million uninsured children in America isn't just wrong—it's outrageous, and we need tochange it as soon as possible.
We know where the Bush Administration stands. The President’s proposal for CHIP doesn’tprovide what’s needed to cover children who are eligible but unenrolled. In fact, thePresident’s proposal is $8 billion less than what’s needed simply to keep children now enrolledin CHIP from losing their current coverage—$8 billion short. To make matters worse, thePresident has threatened to veto the Senate bill, which does the job that needs to be done ifwe’re serious about guaranteeing decent health care to children of working families acrossAmerica.
We can't rely on the Administration to do what is needed. We in Congress have to step up tothe plate and renew our commitment to CHIP.
That’s why I’m supporting the CHIP bill before us. It is a genuine bipartisan compromise, andI commend Senator Baucus, Senator Grassley, Senator Rockefeller and Senator Hatch for theirdedication to making sure that more of America’s children have a start at a healthy life.This bill provides coverage to 4 million children who would otherwise be uninsured.
It adjusts the financing structure of CHIP so that states that are covering their children aren’tforced to scramble for additional funds from year to year, and, so that Congress doesn’t haveto pass a new band-aid every year to stop the persistent bleeding under the current program.Importantly, this bill will not allow states to keep their CHIP funds if they aren’t doingsomething to actually cover children.Equally important, this bill allows each state to cover children at income levels that makesense for their state.
The bill also supports quality improvement and better outreach and enrollment efforts for theprogram. It’s a scandal that 6 million children today who are eligible for the program are notenrolled in it.
In sum, this bill moves us forward together, Republicans and Democrats alike, to guaranteethe children of America the health care they need and deserve.
Our priority should be not merely to hold on to the gains of the past, but to see that allchildren have an access to decent coverage. Families with greater means should pay a fairshare of the coverage. But every parent in America should have the opportunity to meet thehealth care needs of their children.
Quality health for children isn't just an interesting option or a nice idea. It's not justsomething we wish we could do. It's an obligation. It's something we have to do. And it’ssomething we can do today. I look forward to working with my colleagues to make sure thisvery important legislation is enacted.
Laura Capps/ Melissa Wagoner (202) 224-2633