September 28, 2007

HR 976, THE CHILDREN'S HEALTH INSURANCE BILL

            Mr. CARDIN.   Today is truly an important day for America's children.     On Tuesday, the House passed the Children's Health Insurance Bill, and very soon, the Senate will vote.   We will provide $35 billion over the next five years to expand     health insurance coverage for the children of America's working families.  

 

            We know that there is a crisis in health care in this country.    

More than 46 million Americans don't have any health insurance coverage, nine million of them are children, and most of them are in working families.    That is a disgrace.     

 

            Now there are many proposals out there to increase the number of Americans with health insurance coverage.   As Congress begins to consider these proposals, there is something we can do today to decrease the number of uninsured children by nearly 4 million.  

 

            Earlier this year, in February, I introduced to the Senate Finance Committee   a Baltimore family that has benefited from CHIP. Craig and Kim Lee Bedford are working parents who own a small business and simply cannot afford health insurance for their five children through the commercial market.    Through the Maryland MCHP program,   the Bedford Family's five children   receive affordable, quality health care.  

 

            We have the evidence that enrollment in the CHIP program improves the health of the children who are enrolled, their families, and the communities in which they live.

 

            When previously uninsured children are enrolled in CHIP, they are far more likely to receive regular primary medical   and dental care, and they are less likely to use the emergency room for visits that could be handled in a doctor's office.

 

            They are more likely to get necessary immunizations and other preventive care, and to get the prescription drugs they need.

 

            But there are still millions of children who have not enrolled in the programs offered by their states.  

 

            Our states are making progress--simplifying their enrollment procedures, expanding outreach efforts, and using joint applications for Medicaid and CHIP so that families can enroll together.    

 

            But this reauthorization bill, with $35 billion in added funding, is needed to help them make real progress.

            I want to talk for a moment about Maryland's program.  

            It has one of the highest income eligibility thresholds in the nation, and this is important because of the high cost of living in our state.    

            It is at 300% not because our governor wants to move people from private insurance to public insurance plans.   It is at 300% because working families at this income level do not have access to affordable health insurance policies.   Those families need CHIP.

            Children under the age of 19 may be eligible for MCHIP if their family income is at or below 200 percent of the Federal Poverty level, or up to $34,000 for a family of three.

            We also have an MCHIP Premium program, which extends coverage to children at moderate income levels-between 200 and 300 percent of poverty, or up to $51,500 for a family of three.  

 

            The premiums, which are paid per family, regardless of the number of eligible children, are between $44 and $55 a month.  

Our program has been a true success.   Enrollment has grown from about 38,000 enrollees in 1999 to more than 101,000 today.  

            In my state of Maryland, the need has always exceeded the available funds.    The federal match through the CHIP formula established in 1997 is not enough to meet all of the costs of the MCHIP program.

            Some states do not use their entire allotment, while other states, like Maryland, have expenditures that exceed their allotments.   Congress has addressed this problem by redistributing the excess to the shortfall states.

            The 109 th Congress passed provisions to address the FY2007 funding shortfalls.            That bill didn't include any new money, but it allowed the redistribution of $271 million already in the program, and that was important for thousands of Maryland families.

            Without that legislation, Maryland would have been forced to either freeze enrollment or reduce eligibility for CHIP.  

            Now, we must move forward for future years.   That is what

we are doing on the floor of the Senate today.   This conference report increases the

allotment for Maryland for next year from its current projected level of $72.4 million

for Fiscal Year 2008 to $178.8 million.   It also allows us to continue to cover children

in families with incomes up to 300% of poverty.    Maryland would also have access to a

contingency fund if a shortfall arises and additional funds based on enrollment gains.  

With this new money, Maryland can cover as many as 42,800 children who are now

uninsured over the next five years.

           

 

            There is another vitally important part of this conference report that I want to talk about.     Title V ensures that dental care is a guaranteed benefit under CHIP.   According to the American Academy of Pediatric Dentistry, dental decay is the most common chronic childhood disease among children in the United States.  

 

            It affects one in five children aged 2 to 4; half of those aged 6-8, and nearly three-fifths of fifteen year olds.

 

* tooth decay is five times more common than asthma among school age children.  

 

* children living in poverty suffer twice as much tooth decay as middle and upper income children

 

* 39 percent of black children have untreated tooth decay in their permanent teeth;

 

*   11 percent of the nation's rural population have never visited a dentist,

 

*   an estimated 25 million people live in areas that lack adequate dental care services.

 

            I want to say a few words about a young man named Deamonte Driver.   He was only 12 years old when he died last February from an untreated tooth abscess.     It started with an infected tooth. Deamonte began to complain about a headache on January 11.   By the time he was evaluated at Children's Hospital's   emergency room, the infection had spread to his brain, and after several surgeries and a lengthy hospital stay, he passed away.

            For want of a tooth extraction that would have cost about $80, he was subjected to extensive brain surgery that eventually cost more than a quarter of a million dollars.   That is more than three thousand times as much as the cost of the extraction.     After Deamonte's death, the public took note of the link between dental care and overall health that medical researchers have known for years.    His death showed us that, as C. Everett Koop once said, "there is no health without oral health."

            Deamonte's brother, DaShawn, is still in need of extensive dental care, and, like him, there are millions of other American children who rely on public health care systems for their dental needs.

 

            No child should ever go without dental care,    I have said before that I hoped Deamonte Driver's death would serve as a wake-up call for   the 110 th Congress.   Mr. President, I believe that it has.

 

 

            Earlier this year, I brought Deamonte's picture down to the floor.    I have it with me again today.             It's here because we must never forget that behind all the data about enrollment and behind every CBO estimate, there are real children in need of care.      

 

            When I spoke about Deamonte right after his death, I urged my colleagues to ensure that the CHIP reauthorization bill we send to the President   includes guaranteed dental coverage.

 

            This bill would make guaranteed dental coverage under CHIP the law of the land, and I want to take this time to personally  thank the members of the conference committee for ensuring that a dental guarantee is in this bill.  

 

            One other tragic piece of Deamonte's story is that, once his dental problems came to light, his social worker had to call 20 dental offices before finding one who would accept him as a patient.   The conference report includes a provision that will make it much easier for parents and social workers to locate participating providers.  

 

            It requires the Secretary of Health and Human Services to include on its website www.insurekidsnow.gov and the HHS toll-free line (1-877-KIDS-NOW) information about the dental coverage provided by each state's CHIP and Medicaid programs, as well as an up-to-date list of providers who are accepting CHIP and Medicaid patients.   

 

            Parents will be able--with one phone call or a few mouse clicks--to find out what their child is covered for and where they can receive care.     There is more work to do, as I have learned from working with my dedicated colleagues here on this issue, particularly Senators Bingaman and Snowe.  

 

            We still have to improve reimbursement for dental providers, and get grants to the states to allow them to offer dental wraparound coverage for those who may have health coverage, but no dental insurance.   But these provisions are a very good start.

 

             Mr. President, I  am deeply disappointed by the President's statements about CHIP.     When he says that this is government-run insurance, he is  mistaken.         This program is administered by our states, with help from the federal government, to ensure that working families who cannot afford private health insurance, can enroll their children in private health insurance plans.   

 

            I would hope that after today's vote in the Senate, he will reconsider his position on this bipartisan,  responsible, and paid-for bill.       CHIP covers urban and rural children, who live in every state, whether Democratic or   Republican.    

 

            Congress has come together after months of work to reauthorize a program   that's been a proven success and has served   the needs of America's working families.    I urge the President to join us in this truly bipartisan effort and sign this bill into law.