Health Care
Quality, Affordable Health Insurance for All
Our health care system is in trouble: costs are rising at an unsustainable rate, too many Americans are uninsured, and quality of care isn’t up to par. High costs are making it increasingly difficult for Montana’s families and businesses to afford comprehensive health insurance, which means that Montana’s rate of uninsured is growing rapidly. Although the United States spends twice as much on health care as any other country, we clearly don’t have twice as much health care.
Charting a Course for Health Care Reform
So how do we fix our health care system? I see five broad principles of reform. As Chairman of the Finance Committee, with jurisdiction over the major public health insurance programs, I have begun a series of hearings to explore each principle in greater depth. By having an open and honest dialogue, I am confident that we can build momentum, find consensus, and bring about reform.
Universal Coverage: The first principle is universal coverage, every Montanan and American has a right to affordable health coverage. Universal coverage is essential if we are to make meaningful progress on the other four principles. We cannot address the health care system, if we leave a growing portion of the country behind. The solution, however, must build on the current system and must involve a public and private sector mix.
Sharing the Burden: The second principle is sharing the burden. Neither the employer-based system nor the individual market can fulfill the demand for affordable, portable, quality coverage. One way to ensure affordable coverage is to create “pooling” arrangements, which allow individuals and businesses alike to take advantage of their collective purchasing power and save in administrative costs.
Controlling Costs: The third principle is controlling costs. Health care costs are rising at four times the rate of inflation. America cannot sustain its current rate of growth in health care spending. Any serious proposal must slow the rate of growth of health care costs. Our economy and nation’s competitiveness depend upon it.
Prevention: The fourth principle is prevention. American health care tends to address what happens when you are sick. By making prevention the foundation of our health care system, we can spare patients needless suffering. We can avoid the high costs of treating an illness that has been allowed to progress.
Shared Responsibility: The fifth principle is shared responsibility. We want universal coverage. But the question is: Who will bear the burden of a new system? In my view, everybody must shoulder the burden together. Health coverage is a shared responsibility and all should contribute. That means individuals, employers and the government.
I believe we can reduce the number of the uninsured by building on existing programs, and we must protect and strengthen these programs as we work towards broader reform.
Children’s Health Insurance Program (CHIP)
Making sure Montana’s children have access to quality health care is one of my top priorities. The CHIP program currently provides health care insurance to over 16,000 low-income kids in Montana alone. The program covers over 6 million children nationwide and has lowered the number of uninsured children in the past ten years. This is a very important program.
I'm proud of the role I played in crafting the federal CHIP legislation when it was passed by Congress and signed into law in 1997.
I have continued to play a role in supporting the program, both nationally and in Montana. Once CHIP became law; I worked with the Montana Legislature and former State Auditor Mark O'Keefe to find funding for Montana's share of CHIP.
When Montana submitted its CHIP application, I worked with Donna Shalala, then-secretary of the U.S. Department of Health and Human Services, to expedite the federal agency's review of the plan.
In 1998, I worked to increase Montana's share of CHIP funding by nearly $2 million, by pushing a change in the way the U.S. Census Bureau counts uninsured Indian children. That amounted to an increase in CHIP funding for Montana of about 20 percent.
In 2000, I helped broker a compromise between states that had spent all their CHIP funding and those that had not, allowing Montana to keep about $2.7 million in CHIP funds. Provisions of the CHIP law would have forced 40 states, including Montana, to surrender a total of $1.9 billion in CHIP funding.
In 2004, I tried to broker a compromise to extend the availability of $1.1 billion in federal CHIP funds.
In 2006, I co-authored a compromise that redistributed funds to protect a number of states against experiencing gaps in federal CHIP funding through May of 2007.
Reauthorization of CHIP
After a successful ten year history, the CHIP program came up for reauthorization last year. I led an effort in the Senate to craft a reauthorization package that would build on the previous success of the CHIP program and provide the additional funds I know Montana and other states need. Some states need additional funds just to maintain current enrollment. Other states could expand their CHIP coverage with increased CHIP funding. Health care for kids is getting more expensive, just like it is for adults, so the additional money is important. We got agreement in the Senate and passed a bill providing $35 billion over the next five years for CHIP. Then, we worked with the House and passed a compromise bill with the same level of funding. The President vetoed that bill. Congress decided to work on a new compromise and sent a second reauthorization bill to the president, which was also vetoed.
In light of the President’s vetoes, Congress extended the current program until March 31, 2009 at the end of 2007. Also at that time, Congress authorized sufficient funding for all states to continue current enrollment through that date. I believe we cannot afford to lose ground in our fight to get kids health care coverage, so as Chairman of the Finance Committee, I will continue to work with my colleagues to develop a reauthorization plan that fully funds CHIP going forward and work to cover more eligible kids.
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