Children's Health Insurance Program

Floor Speech

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Mr. BROWN. Mr. President, time is running out for us to extend the
Children's Health Insurance Program, a program that began almost 20
years ago in this body and the other body and that right now is taking
care of 10 million children--the children of parents who in most cases
have full-time jobs that don't offer insurance and full-time jobs that
don't pay enough so these families can buy insurance for their
children.

We know that CHIP works. It works for parents, and it works for
children. We know that if we don't act now, States will start rolling
back the CHIP programs. Legislatures are adjourning almost as we speak.
We need to provide States with certainty so they can budget for CHIP
now and 4 years into the future.

Unfortunately, the deal currently being floated in the House would
not fund CHIP for a full 4 years. Instead, if reports are true, it
would permanently repeal the sustainable growth rate--the so-called
doctors fix--while failing to provide much needed certainty to
children's health care. I want to take care of doctors. I want to make
sure this is done right because it affects doctors. It affects doctors'
ability to deliver care. It affects those patients whom doctors serve.
But how do we leave here taking care of the doctors permanently and
shortchanging children, only giving them 2 years of health insurance?
It is past time we fix SGR.

In 2001, when I was a member of the House, Congressman Bilirakis as
the Republican chair of the Health Subcommittee of the Energy and
Commerce Committee and I as the Democratic ranking member wrote the
first SGR fix, so I have been fixing the SGR for a long time. But we
shouldn't be focused in this body and that body on paying doctors at
the cost of shortchanging our children. Our priority must be passing a
full 4-year, clean extension of the current CHIP program, on which
130,000 children in my State depend--again, sons and daughters of
working Oklahoma families and working Ohio families who are working in
jobs where they simply don't get insurance and don't get paid enough
that they can buy insurance. These 10 million children in our Nation
depend on this.

A 4-year extension of CHIP will provide Congress, the administration,
and our States with the necessary time to collect relevant data and
information to fully analyze and prepare for the future of kids
covered. Doing only 2 years is not just shortchanging these children
and creating anxiety in their families, it is also truncating our
ability, compromising our ability to really understand how to fully
integrate CHIP into a health care system overall in the future. We
should be providing certainty and stability for these families, not the
cliche of kicking the can down the road in favor of a short-term fix. A
4-year extension provides that certainty and will make a difference
into the next decade on how, in fact, we take care of low-income
children.

In Ohio alone, CHIP provides insurance to 130,000 children.
Enrollment is expected to grow over the next couple of years. I have
traveled across Ohio in the last few weeks and have met with parents
and children, doctors and nurses, to discuss CHIP. I have been to
Cincinnati Children's Hospital and Toledo Children's Hospital,
Columbus's Nationwide Children's Hospital and Cleveland's Rainbow
Children's Hospital. This morning, I was in Mahoning Valley in
Boardman, a suburb of Youngstown, at the Akron Children's Hospital.
More than 6,000 children in Mahoning Valley rely on CHIP for care.

I met with Ericka Flaherty, a Youngstown parent whose children could
lose comprehensive coverage if we don't extend CHIP now. Her son Chase
was born prematurely, born at 27 weeks. He was immediately diagnosed
with a number of chronic conditions, including a heart defect, chronic
lung disease, and asthma. Chase spent more than 4 months in neonatal
care, and, thanks to outstanding doctors at Akron Children's Hospital,
he is alive and growing today. But he needs many routine medical
visits--visits his family simply can't afford. His parents work, but
they simply can't afford to treat his conditions, including visits to
lung specialists, neurologists, an eye specialist, and the regular
hospital checkup every 2 months. Without CHIP, Ericka would face
significant financial hurdles in getting Chase the care he needs.

I also met with Jessica Miller of Lisbon, a community just south of
Mahoning County, during this roundtable. Her youngest son, Payton, was
diagnosed with a serious respiratory condition. He had to be life-
flighted to Akron Children's Hospital to receive care when he couldn't
breathe. He has been diagnosed with type 1 juvenile diabetes. His
grandmother joined us. Jessica told me that she is so thankful for
CHIP, that she gets Payton all the care he needs to treat these
conditions--care she and her husband Justin would have a hard time
affording otherwise. Justin is working as a paramedic. He was called
out and couldn't be at our meeting today. Justin is full time in
nursing school. They are making something of their lives. I don't want
them to be anxious about the health care of their children.

Throughout Ohio, I hear the same thing: Providing health insurance to
children like Chase and Payton isn't just the right thing to do, it is
the smart thing to do. It means children do better in school. They feel
better when they are in school. They miss fewer days in school because
they get preventive care because their health care needs are taken care
of.

CHIP has been around 18, almost 20 years. It has always been
bipartisan. If we follow these children later in life, we see they have
higher rates of going to college and higher earnings than non-CHIP kids
who don't have insurance. By all kinds of very quantifiable
measurements, CHIP is not just good for those families, it is not just
the right thing to do to continue to fund CHIP over 4 years, it is also
the smart thing to do for our country.

Together with more than 40 of my colleagues, I introduced the
Protecting & Retaining Our Children's Health Insurance Program--PRO-
CHIP--Act, which is a clean 4-year extension of funding for CHIP. PRO-
CHIP would protect the Pediatric Quality Measures Program and provide
funding to sustain this program through 2019.

It would also extend the Performance Incentive Program, which
provides bonus payments to States that help increase Medicaid
enrollment among children, because if we provide insurance for low-
income children, they are going to do better, and society is going to
do better. They are less likely to end up in the emergency room for
something much more serious. For instance, for a child without
insurance who has an earache, the mother and father think that it is
going to cost a lot of money to go to the doctor and that maybe it will
just get better, they wait a week. Into the second week, the pain is
worse. The child can't sleep. The child cries. They eventually go to
the emergency room, which costs a lot more money than going to the
doctor's office, with the possibility that the child has had hearing
loss. That is just one example of why we want to provide insurance and
get them into the doctor early rather than waiting until later.

PRO-CHIP has been endorsed by every children's hospital in Ohio, the
Association of Children's Hospitals, virtually every children's
hospital, I believe, in the country, and other national groups--the
March of Dimes, the American Academy of Pediatrics, the Children's
Hospital Association, and Families USA, all of which want a clean CHIP.
All of them want a 4-year extension for all the reasons we talked
about.

More than 1,500 organizations from across the country--including more
than 75 groups from Ohio and a number from Oklahoma, the Presiding
Officer's State--have written to Congress asking us to ``take action as
soon as possible to provide a four-year funding extension for CHIP.''
Groups, including the Urban Institute, the Medicaid and CHIP Payment
and Access Commission, and the Bipartisan Policy Center, have all noted
the importance of the current CHIP program.

The Urban Institute estimated that an additional 1.1 million children
will become uninsured if separate CHIP coverage were eliminated. Again,
these are sons and daughters of parents who have jobs--jobs that don't
provide insurance and jobs that don't pay enough that they can afford
insurance. This would be a 40-percent increase, if this were to happen,
in the number of uninsured children in the United States relative to
the number projected under the ACA with the continuation of CHIP.

The Bipartisan Policy Center has called for extending CHIP for more
than just the 2 years, but note what they say when calling for a CHIP
extension: ``Two years does not provide sufficient time for state and
federal elected officials and agencies to address major programmatic
changes sought by policymakers on both sides of the aisle and at both
levels of government.''

Support for CHIP has always been bipartisan. Senator Hatch,
Republican from Utah; Senator Kennedy, Democrat from Massachusetts; a
number of us on the Energy and Commerce Committee in the House of
Representatives back in 1997, Republicans and Democrats alike; and
Chairman Bilirakis and I and others helped to write this legislation
which has been successful at bringing the uninsured rate for children
down by more than 50 percent. I am encouraged that Members of both
parties have shown a willingness to come together. Senate Democrats
will have a hard time supporting any plan that doesn't extend CHIP for
a full 4 years.

I want to support the sustainable growth rate. I helped write the
original one. I have supported it for 20 years. We shouldn't be doing
it like this on a temporary 1- or 2-year basis. This is finally going
to get done right, but we don't do that and then leave out the children
by only providing 2 years.

Parents like Ericka and Jessica face enough uncertainty with their
children's health. Most of us in this body are parents, and a number of
us are grandparents. Most of us, because we dress like this and we are
Senators and have good insurance provided by taxpayers--we may have
anxiety about our children and our grandchildren's health, but we don't
have anxiety about their insurance and their ability to go to hospitals
and doctors and specialists to get care. Certainly, we are anxious
about our children and all the things that could happen, but our
anxiety doesn't reach into the whole sphere of worrying about how to
provide insurance for children.

Ericka and Jessica can't be anything but anxious when they hear that
CHIP could end, and they understand that it should be 4 years. CHIP
gives parents like them peace of mind that they will be able to get
their children the care they need without bankrupting those families.
We need to make sure these parents continue to have that peace of mind
with a 4-year extension. The PRO-CHIP legislation we have introduced in
the Senate with almost four dozen cosponsors makes sure those kids
don't lose critical coverage by saying no to any deal that doesn't fund
CHIP for the full 4 years.

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