Children's Health Insurance Program Reauthorization Act of 2007

Floor Speech

CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT OF 2007 -- (Senate - November 01, 2007)

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Mr. CARDIN. Mr. President, quite frankly, I don't understand the objections of the President of the United States to the Children's Health Insurance Program we are considering here today. I hope we all understand the importance of this program and how important it is for children in America to have health insurance. We know, and we have a lot of studies which show, that children who have health insurance are far more likely to be immunized against diseases, far more likely to have the benefits of preventive health care, are far more likely to get the type of health care intervention that will lead to healthier lives. Quite frankly, that will save us money because they are going to be healthier and need less health care during their lifetime. We also know that children who have health insurance are far more likely to have better attendance records at school. The list goes on and on and on. So it makes sense for children to have health insurance.

The legislation we are considering is aimed at working families--working families that cannot afford the cost of health insurance. These are families playing according to the rules. They are doing everything right, but they can't afford the cost of insuring the family with health insurance.

A family from Baltimore came and testified before the Presiding Officer's committee for the reauthorization of the CHIP program. The mother explained that having children's health insurance--having the Maryland program--that mother no longer has to wake up in the morning and decide whether the child is sick enough to see a doctor. She doesn't have to worry that if her child is playing on a playground and gets hurt, how they will be able to afford that bill.

Our children are the innocent casualties of the failure of our country to have universal health coverage--universal health insurance. They are the innocent casualties. The bill we have before us tries to do something about it.

This is a bill that is not a Democratic bill or a Republican bill; it is a bill that has been compromised in the best sense of the legislative process: Democrats and Republicans working together to produce a bill that could be supported not just for 1 year but supported now for a decade. It is a bill that builds upon private insurance. That was important to get the consensus among Democrats and Republicans. It is a bill that is administered by our States; it is not administered in Washington. This is a program that our States administer. I am proud of the State of Maryland MCHIP program, the Maryland Children's Health Insurance Program. It is designed in Maryland to meet the needs of our children, and the Federal Government is a partner in helping to pay for the program. This is a bill that has been worked in the best sense of the legislative process, by Democrats and Republicans.

It is an affordable program. I have heard the President of the United States talk about the affordability. This program is affordable. First, as I mentioned earlier, it saves health care dollars. Children who have access to preventive health care are going to save us money over the long term in health care expenditures. Secondly, this bill is paid for. I know that is not always the case with legislation we pass, but this bill will not add a penny to the deficit. In fact, I would argue that this bill will actually help us in balancing the Federal budget. It is fully paid for by an increase in the cigarette tax, but economists tell us that as a result of the increase in the cigarette tax, there are going to be millions of people who will either stop smoking or will never start smoking--particularly young people who won't start smoking now because of the extra cost in buying a pack of cigarettes. The Presiding Officer and I know how much that will save in our health care system for someone who doesn't smoke. That is not figured into the cost estimates here, the savings we will have to our health care system because of the number of children who will never start smoking.

In Maryland, this bill will mean that Maryland will not only be able to continue the 100,000 children who are currently enrolled in the program--because if we don't pass this bill, we can't continue our current commitment--but will add 40,000 more children to the Maryland Children's Health Care Program.

That is good. We need to do that. Let me remind you that, in Maryland, we have 800,000 people without health insurance. That is not just children, that is the whole community that has no health insurance. Obviously, we want to reduce that number. This bill makes a small step in dealing with the gap we have in America where people have no health insurance, but it is an important step because it deals with children. We can certainly do that.

I wish to talk about one part of the program that, quite frankly, hasn't gotten a lot of attention, and it is a very important part, which is the reason we need a reauthorization bill. In a reauthorization bill, we can expand the program to deal with the needs in our communities. This bill covers required dental services, so all the children in the Children's Health Insurance Program will receive dental insurance coverage.

C. Everett Koop, a former Surgeon General of the United States, says, ``There is no health without oral health.'' Again, he is a former Surgeon General. The American Academy of Pediatric Dentistry said dental decay is the most chronic childhood disease among children in the United States--five times more likely than asthma. Regarding the vulnerability of our children, of those children between the ages of 6 to 8, 50 percent have tooth decay. If you are poor and live in poverty, you are two times more likely to have a problem with your teeth. If you happen to be a minority--if you are an African American, 39 percent of them have untreated tooth decay. If you live in a rural part of your State--Mr. President, I know your State and my State have rural communities--only 11 percent of our population ever visit a dentist. We have a problem with dental care in this country. Twenty-five million Americans live today in areas that have inadequate dental care services. So we can do better, and this bill moves us in the right direction. There is a direct relationship between general health and oral health. We know that. One example: Plaque has been directly related to problems with heart disease. We know there is a relationship there, and there is a lot to be learned.

I am going to try to put a face on this issue because we talk about what it means to have 25 million people who don't have access to dental services. I will tell you about one child, Deamonte Driver. He lived in Prince George's County in my State, which is about 6 miles from here. He was a 12-year-old who had problems with his teeth. His mom tried to get him to see a dentist and could not find one who would treat him. He sort of fell through the cracks.

Finally, he was suffering from horrible headaches, so his mother did what many parents do with children who don't have health insurance--took the child to the emergency room. One of the reasons we want to see the CHIP bill passed is to get children less expensive preventive health care so they don't have to use emergency rooms as primary care facilities. He went to the emergency room, and he was admitted. It seemed as if he didn't just have tooth decay, he had an abscessed tooth that went untreated. No dentist would see him. He had no insurance. They performed an operation and tried to alleviate his pain and save his life. They performed a second operation and spent a quarter of a million dollars, which we paid for because it was uncompensated care. That boy died because, in 2007, we have no program in this country to provide that child an $80 tooth extraction and for children to be able to see dentists.

Mr. President, one of the really good things about this bill before us--our reauthorization bill--is we have a chance to do something about that. We have a chance to do something about the Deamonte Drivers of our communities, to make sure our innocent children get the type of attention they so much deserve.

What does this bill do for dental care? It has a guaranteed dental benefit, coverage of dental services necessary to prevent diseases, promote oral health, restore oral structure to health and function, and treat emergency conditions. That is what is covered in this legislation which we will vote on in a few hours. How do you meet that? It is interesting. The States are giving benchmarks. You can do it if you have a benefit like ours, our Federal plan, in which dental benefits are included. The State can meet the requirements by providing the benefits Federal employees get. They can take the dental benefits in their State employees' plan and use that as a model or they can take the most popular commercial plan in their State for enrollment for Medicaid enrollees and use that as their benchmark.

So when you are using commercial insurance as the benchmark for what children should be able to have insurance to deal with their dental needs, to me, that is the way we should be going. It is in this bill.

This is even more important. The bill provides for dental education for parents of newborns. When babies are born, they don't have teeth, so why is that important? One out of every five children between the ages of 2 and 4 has tooth decay in their baby teeth. This bill provides for education so that parents know about the risks of oral health and know how to deal with oral health as their babies grow up. It also makes it easier to locate a participating provider.

Let me go back to Deamonte Driver again, from Prince George's County. His parents sought the help of a social worker, Laurie Norris, who tried to find a dentist who would treat Deamonte Driver. That social worker made over 20 phone calls to try to find a dentist who would treat Deamonte Driver--without success. Think about the time that went into that. Think about how many parents must be so discouraged in trying to get help for their children.

Well, this legislation before us today, which we will vote on in a couple of hours, does something about that. It requires that the Web page on the Children's Health Insurance Program list the coverage available by State for dental benefits under the CHIP program, plus the list of providers who will provide that care. So if this bill becomes law, with one phone call or one click of the mouse, a parent will be able to know exactly what the benefits are and exactly which dentist that parent can contact in order to get his or her child the type of care they need.

I have heard my colleagues talk a lot about this Children's Health Insurance Program, how important it is to the health of the people in our communities. I know how important it is in Maryland. I am proud of our program at the State level, which has the cooperation and help of the Federal Government as a partner. It is a bipartisan bill, developed by Democrats and Republicans, and the bill makes sense from the point of view of proper allocation of money in our health care system and will save us money--all of those things.

At the end of the day, it does speak about priorities. What is important? Where are our priorities? What do we want to be known for? Whom did we stand up for?

This bill spends $35 billion over a 5-year period, and it is fully paid for. We can all make our own comparisons, but I think about the cost in Iraq, which, over a 3-month period, is costing more than this bill, and it is not paid for, but we seem to always have the money for that. And we come up with excuses to oppose this legislation.

I thank the leaders who were responsible for bringing this legislation forward. I urge my colleagues to support it. I hope we can get the type of support we need to pass this, notwithstanding the objections of the President. I always hold out hope that President Bush will sign a bill--a bill that will allow the people of Maryland and throughout this country to have adequate care so that we don't have to again see a story such as Deamonte Driver's--a child who died because we could not find a way to get him basic dental care.

I urge my colleagues to support this legislation.

With that, I yield the floor.

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