|
Washington, D.C. --- U.S. Rep. Frank Pallone, Jr. (D-NJ), Chairman of the House Energy and Commerce Health Subcommittee, gave the following speech today at the National Governors Association meeting in Washington, D.C.
"Thank you for inviting me here today. I am the Chairman of the Subcommittee on Health of the Energy and Commerce Committee, which has jurisdiction over both Medicaid and the State Children's Health Insurance Program (SCHIP), as well as a host of other issues. But needless to say, it is Medicaid and SCHIP that holds the most importance for you as Governors.
"As everyone here knows, the SCHIP program is about to expire and will need to be reauthorized this year. Accordingly, I would like spend most of my time today talking about SCHIP and the issues we face as Congress works to reauthorize this important program.
"I would also like to discuss how you as governors, and the NGA collectively, can assist us in our work. I want to hear about the problems you face with your state programs, as well as your proposed solutions.
"Let me begin by saying, like many of you, before I am an elected official, I am first and foremost a father. With three young children at home, I realize how important it is for kids to have access to quality health care. My wife and I are fortunate that we have the means to provide health insurance coverage to our three children through the Federal Employees Health Benefits Plan.
"But as we all know, not every family is quite as lucky. Far too many American families are struggling day to day to afford the cost of health insurance. As health care costs continue to rise, employer sponsored insurance is eroding. Employers are shifting more costs to workers, or they are dropping coverage altogether. Nor has the individual market been a viable source of insurance coverage for most Americans. The result has been a steady increase in the number of uninsured Americans since 2001.
"Today, there are nearly forty-seven million Americans who don’t have health insurance. Millions more are underinsured. What is even more appalling is that approximately nine million of those who are uninsured are children. That is a national disgrace. In a country as wealthy and compassionate as ours, no child should be left behind without health insurance, let alone nine million.
"This disturbing statistic would undoubtedly be worse if it were not for the State Children’s Health Insurance Program. Since it was established by Congress ten years ago, SCHIP has helped reduce the number of uninsured children in our nation. Thanks to SCHIP, the percentage of low-income children in the United States without health insurance has fallen by one-fourth since it was created in 1997. More than six million low-income children, most of whom would otherwise be uninsured, are enrolled in SCHIP.
"While the program has largely been a success, it is now being threatened. Last year, for the first time since 1998, the number of uninsured children in the country actually increased. We must stop this alarming trend. Part of our effort must include strengthening SCHIP so it can continue to serve those in need.
"The most immediate and glaring problem is the lack of funding for this program. Simply stated, more money is needed in order to ensure the viability of SCHIP and to cover more kids.
"As you all know, at the program's inception, there was more than enough money to go around. But now, as state programs have matured, and more kids have been enrolled, the funding level that Congress authorized 10 years ago is no longer adequate.
"Various health care experts have estimated that we need additional funding over the next five years simply to help maintain the program for those who are already enrolled. And if we are going to find the approximately 6 million children who are eligible for SCHIP or Medicaid, but who are not enrolled, we would need at least $50 billion over the next five years.
"Some people may say that this figure is unreasonable or unrealistic and will be difficult to fund given the budget constraints, but I say how can we afford not to spend this money on this country’s most vital asset, our children. It’s simply a sound investment in our nation’s future.
"By contrast, in his recent FY08 budget, the President proposed a meager $4.8 billion for SCHIP over the next five years. He also proposes reducing payments to States who cover kids above 200 percent of the federal poverty line, as well as low-income parents who are enrolled in state programs.
"To make matters worse, the President has proposed to cut Medicaid funding, which currently serves more than four times the amount of children served by SCHIP. Under the President's plan, $25 billion would be cut from Medicaid over the next five years and $61 billion over the next ten years. Most of this would be accomplished by shifting costs from the federal government to the states.
"In order to compensate for this loss of funds, we anticipate that states are going to be forced to cut back on their Medicaid programs by reducing eligibility, benefits, or payments to providers ... all of which will have a disastrous effect on your ability to provide insurance coverage to low-income families.
"Make no mistake, the president's budget shortchanges America's children and will do nothing to solve the problems you as Governors currently face in trying to cover those children who are uninsured in your states. In fact, it will make matters worse. I have little doubt, that if enacted, the President’s proposal would result in fewer children with health insurance coverage than there are today. Common sense alone tells us that reduced funding and limited eligibility is going to result in fewer enrolled children.
"So let me be clear: I have absolutely no intention of moving the president's proposal through my Subcommittee.
"I have a different approach. As we work on reauthorization, I think that we should be guided by a few principles:
1. Move beyond filling the shortfalls. Our goal is to cover more kids. We can't achieve that goal with the current allotments or the current piece meal approach to fill projected shortfalls. Accordingly, we need to add enough funding to fill the shortfalls, as well as, provide states with an allotment that can account for both medical inflation and population growth.
Additionally, in order for us to make real progress at covering the remaining uninsured children in our country, we must provide states with the resources necessary to implement aggressive outreach strategies and provide benefits for those additional children who they successfully enroll.
2. We should not cut Medicaid to pay for SCHIP. Because of new pay/go requirements implemented by the new Democratic Congress, we must find a way to pay for the SCHIP reauthorization. This will be a difficult task, but one thing we must not do is cut one program that serves low-income children to help pay for another.
3. We should preserve state flexibility. It was Congress' intent to give states the flexibility they need to implement a program that best meets their needs. My home state of New Jersey has often come under attack for the policies we have implemented to make our program work. It is true, we cover kids up to 350% of the poverty level. We also have some low-income working parents enrolled.
But these policies are necessary to make the program work in our state. The cost of living is significantly higher in New Jersey than in other parts of the country, and so we must extend our eligibility above other states. Furthermore, we have found that when we cut parents out of our program (which we did in 2001) eligible children dropped out as a result.
Clearly, if we are to be successful at covering our uninsured children, we need to have this kind of flexibility, as do other states.
"We cannot achieve these goals without your help though. This is a federal-state partnership, and so you as governors are a crucial part of this debate. We need to hear from you about the needs in your state. We have heard from some governors so far. Certainly Governor Corzine (NJ) and Governor Perdue (GA) have been quite vocal in talking about their respective state's needs. However, we need to here from the NGA collectively, especially on the funding issue. We must hear from you loud and clear.
"As you have that internal debate, I hope that you all would agree that we have a unique opportunity before us. Year after year, we have all said that we want to cover the uninsured. Finally, we have the chance to really do something about this problem. Now is not a time for timidity. Now is a time for bold visions and a renewed commitment to our children.
"It is no longer good enough to simply say that we can’t do this because it costs too much money. We as a nation must make choices about how we allocate our resources. I would submit that there are fewer needs more important than those of our children and we should be willing to spend the money necessary to ensure every American child has access to meaningful health care.
"I hope we can work together on this goal. Many of you are working in your respective states to develop universal health care proposals. Massachusetts and California are often cited, and my home state of New Jersey is one of them as well. Needless to say, all of these proposals are going to rely in some part on Medicaid and SCHIP funds. If we fail to strengthen SCHIP, it will be all the more difficult for you to reach your goal.
"In closing, I'll mention that I remember when we established SCHIP ten years ago. We were able to come together in bipartisan spirit and work together on behalf of our nation's children. Ten years later, let us work together again to strengthen this vital program. I am committed to that effort and I hope that my colleagues on both sides of the aisle will join with me.
"Thank you again for inviting me to speak here today. I am looking forward to working with you throughout this process and am now prepared to take questions." |
