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| July 30th, 2007 |
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Media Contact(s): Peter Carr (202) 224-9854,
Jared Whitley (202) 224-5251 |
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FLOOR STATEMENT: PASS S. 1893, THE CHILDREN’S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT OF 2007
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Washington - Today Sen. Orrin G. Hatch (R-Utah) delivered the following speech on the Senate floor.
Mr. President, this week the Senate will focus on how to reauthorize and finance the CHIP program. Therefore, I would like to take some time on the Senate floor today to set the ground for that process by examining the history of the CHIP program and the successes it has had over the last decade.
The Balanced Budget Act of 1997 – BBA 97 – created CHIP as Title XXI (21) of the Social Security Act. Today, all 50 states, the District of Columbia and five territories have CHIP programs. As is allowed by the law, 17 states use Medicaid expansions, 18 states use separate state programs and 21 states use a combination approach of both their Medicaid program and the state program.
The CHIP program is financed through both the federal and state governments and is overseen by the states. States receive an enhanced federal match for the CHIP program – this federal match is significantly higher than the federal match that states receive through the Medicaid program. The Medicaid federal medical assistance percentage, known as F-MAP, ranges between 50% and 76% in FY 2006; the CHIP F-MAP ranges from 65% to 83.2%.
Through BBA 97, approximately $40 billion in federal funding was appropriated for the CHIP program. Overall, states have spent $10.1 billion dollars since it was first implemented through September 30, 2005.
Today, approximately 6.2 million children have their health insurance coverage through the CHIP program. As one of the original authors of the CHIP program with Senator Kennedy, Senator Rockefeller, and the late Senator Chafee, I am very proud of the program’s successes and I want these successes to continue.
When we drafted this legislation in 1997, our goal was to cover the several million children who had no insurance coverage. Their families were too poor to qualify for Medicaid; however, their families did not have enough money to purchase private health insurance. We have gone a long way in meeting that goal, but we are clearly not there yet. Coverage of these uninsured children is still my top priority.
I have always believes that we shouldn’t even consider expanding this program to other populations until we have covered all children who do not have health care coverage. Unfortunately, that has not been the case and a program that was created for low-income children has covered childless adults, parents of CHIP-eligible children and pregnant women. How has this happened? Both the Clinton and Bush administrations granted waivers to states to cover adults, something that I strongly oppose. Today, 11 states cover parents through state waivers and six states cover childless adults in CHIP through state CHIP waivers.
When Senator Rockefeller, Senator Kennedy, Senator Chafee and I worked on the original legislation in 1997, our goal was to cover the several million children who had no health insurance, but I believe that the bill before the Senate today makes great progress in this area.
I believe the bill the Senate is considering this week captures the true essence of the 1997 law and builds on that foundation to insure even more children.
That, indeed, should be our purpose.
The bill drafted by Finance Committee Chairman Baucus, Finance Ranking Republican Member Grassley, Finance Health Subcommittee Chairman Rockefeller and myself is the very essence of compromise.
To be fair, it does not make any of us Republicans comfortable to face a veto threat from our President. It does not make me comfortable to face a veto threat issued by my colleague and good friend from Utah, Secretary Leavitt. It does not make me comfortable to advocate for such a large sum in new spending.
At the same time, I know none of you on the other side of the aisle are comfortable with the fact that we did not authorize spending up to the $50 billion limit in the budget resolution. Many of my Democrat colleagues made sacrifices in endorsing this bill and in sacrificing program expansions they so dearly advocated.
Senator Kennedy and I often like to joke with each other that if neither side is totally comfortable with one of our compromises, we must have done a good job. And in that spirit, I say to my colleagues, we must have done a good job.
This bill will makes it all about the kids. That was our goal, and we achieved it. Our bill will provide health coverage to 2.7 million of the 6 million currently uninsured, low-income children who are 200% of the federal poverty level and below.
I want to circle back to the cost of this bill.
I remember so well my conversations with my colleagues in 1997 about the cost of this bill and the precedent it could represent. We must recognize that we have already covered the kids who are easy to find. Six million of them to be exact.
We can all be proud of that.
But one of the lessons we have learned along the way is that it will cost proportionately more to cover the remaining children. They are harder to find and thus harder to cover. This is what CBO told us.
So you can’t do the simple math and say “It cost $40 billion to cover 6 million kids, so it should cost $40 billion to cover the remaining 6 million kids.” It doesn’t work that way. CBO told us that we need to give states more money to cover these new uninsured children and that is what we have done.
We have made a number of other important decisions in this bill.
We have restored the program back to its intent – to cover children, not adults. This was a hard decision for Senators from states with adult waivers, and I commend them for their commitment to the children.
The legislation before the Committee removes childless adults from the CHIP program by the end of FY09 and afterwards, gives the states the option of covering these individuals through Medicaid.
It also prohibits the approval of any new state waivers for parents to be covered through CHIP.
Only parents living in states with approved parent waivers will be eligible for health coverage through the CHIP program.
The next tough issue was the coverage of pregnant women. While I was not opposed to this in theory, in practice we all know that the cost of one delivery could fund insurance for three or four children. That is why I oppose this coverage in 1997.
I have been convinced that states should have the option of covering pregnant women through the CHIP program. This was a difficult decision for me and, again, a true compromise.
Third, we included money for outreach and enrollment. This is key for enrollment, but as we found out, it is very expensive. So we made the decision to place a limit on the amount of money dedicated to these efforts.
Fourth, our legislation includes premium assistance through CHIP for coverage through private plans. And if it is determined that family coverage would be more cost efficient, the entire family would be covered through this health plan. This is something that was very important to me and Senator Grassley. Utah has started such a program with the hopes of providing affordable coverage to an entire family.
Fifth, our legislation includes a cap of 300% of the federal poverty level for eligibility in CHIP. If a state provides CHIP coverage above that level, it will not receive the enhanced match. States with higher eligibility levels when this legislation becomes law would be grandfathered-in.
Finally, I am pleased that this bill changes the name SCHIP back to CHIP, the way it was before the House added the superfluous S.
Mr. President, this is a good bill. It accomplishes what we have set out to do – to take care of the children.
Yes, I wish it did not cost what it does, but I am persuaded this is necessary spending when I think of the six million American children who are leading healthier lives because of our vision and commitment.
We should not let the opportunity pass us buy to build on that solid foundation and do even more good for the children, our future.
I will add one more point that I want my Republican colleagues to take to heart. This is a bipartisan compromise bill. It is not like the legislation being considered by the House of Representatives that will cost up to an additional $50 billion to reauthorize the CHIP program over the next five years. In my opinion, the Senate version of this legislation is the better deal for the American people and it is my hope that my colleagues who disagree will me will take one more look at this legislation.
I urge my colleagues to support this legislation.
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