Small Business Tax Relief Act of 2007
Floor Speech
SMALL BUSINESS TAX RELIEF ACT OF 2007 -- (Senate - August 02, 2007)
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AMENDMENT NO. 2600
(Purpose: To amend title XXI of the Social Security Act to limit the use of funds for States that receive the enhanced portion of the CHIP matching rate for Medicaid coverage of certain children)
On page 83, strike line 2 and insert the following:
level.
``(C) USE OF FUNDS.--Payments under this paragraph may only be used to provide health care coverage or to expand health care access or infrastructure, including, but not limited to, the provision of school-based health services, dental care, mental health services, Federally-qualified health center services, and educational debt forgiveness for health care practitioners in fields experiencing local shortages.''.
AMENDMENT NO. 2571 TO AMENDMENT NO. 2530
Mr. SANDERS. Madam President, I ask unanimous consent that the pending amendment be set aside to call up Sanders amendment No. 2571, that the amendment be considered as read, and that it be set aside.
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The Senator from Vermont [Mr. Sanders] proposes an amendment 2571 to amendment No. 2530.
The amendment is as follows:
AMENDMENT NO. 2571
(Purpose: To establish an incentive program for State health access innovations)
At the end of title I, insert the following:
SEC. __. INCENTIVE PROGRAM FOR STATE HEALTH ACCESS INNOVATIONS.
Section 2104, as amended by section 108, is amended by adding at the end the following new subsection:
``(l) Incentive Program for State Health Access Innovations.--
``(1) ESTABLISHMENT OF STATE HEALTH ACCESS INNOVATIONS INCENTIVE POOL.--
``(A) IN GENERAL.--There is hereby established in the Treasury of the United States a fund which shall be known as the `CHIP State Health Access Innovations Pool' (in this subsection referred to as the `SHAI Pool''). Amounts in the SHAI Pool are authorized to be appropriated for payments under this subsection and shall remain available until expended.
``(B) TRANSFER OF FUNDS.--Notwithstanding subsection (j)(1)(B)(i), from the amount appropriated for fiscal year 2008 under such subsection, $250,000,000 of such amount is hereby transferred to the SHAI Pool and made available for expenditure from such pool for the period of fiscal years 2008 through 2012.
``(2) AWARD OF GRANTS.--
``(A) IN GENERAL.--The Secretary shall award grants to eligible States from amounts in the SHAI Pool in accordance with this subsection.
``(B) ELIGIBLE STATE.--For purposes of this subsection, an eligible State is a State--
``(i) for which the percentage of low-income children without health insurance (as determined by the Secretary on the basis of the most recent data available) is less than 10 percent; and
``(ii) that submits an application for a grant from the SHAI Pool for the purpose of carrying out programs and activities that are designed to expand access to health providers and health services for low-income children who are eligible for medical assistance under the State plan under title XIX (or a waiver of such plan) or child health assistance under the State child health plan under this title.
``(3) REQUIREMENTS.--
``(A) PRIORITY IN AWARDING OF GRANTS.--In awarding grants under this subsection, the Secretary shall give preference to grant applications that--
``(i) propose innovative approaches to increasing the availability of health care providers and services;
``(ii) create longer-term improvements in health care infrastructure;
``(iii) have potential application in other States;
``(iv) seek to remedy shortages of health care providers; or
``(v) result in the direct provision of health services.
``(B) PROHIBITIONS.--The Secretary shall not--
``(i) award a grant to carry out programs or activities which the Secretary determines would substitute for services or funds provided by a State or the Federal Government; or
``(ii) disapprove any grant application on the basis that programs or activities to be conducted with funds provided under the grant would be provided through or by an entity that otherwise receives Federal or State funding, such as a Federally-qualified health center.
``(C) TERM, AMOUNT, AND NUMBER OF GRANTS PER ELIGIBLE STATES.--
``(i) TERM.--A grant awarded under this subsection may be renewed each year for a period of up to 5 years, but in no case later than fiscal year 2012.
``(ii) AMOUNT.--No grant awarded under this subsection may exceed $2,000,000 for any fiscal year.
``(iii) NO LIMIT ON NUMBER OF GRANTS PER STATE.--Nothing in this subsection shall be construed as limiting the number of grants that an eligible State may be awarded under this subsection.
``(D) ANNUAL AGGREGATE LIMIT.--The aggregate amount of all grants awarded from the SHAI pool shall not exceed--
``(i) $50,000,000 in fiscal year 2008;
``(ii) $100,000,000 in fiscal year 2009;
``(iii) $150,000,000 in fiscal year 2010;
``(iv) $200,000,000 in fiscal year 2011; and
``(v) $250,000,000 in fiscal year 2012.''.
Mr. SANDERS. Madam President, as my colleagues know, this legislation, the SCHIP legislation, includes a $3 billion incentive pool, and the purpose of this pool is to provide States with the funding they need to do outreach efforts in order to attract children into the program. The reality is, however, a number of States today have already enrolled 90 percent of their kids into the SCHIP program, and with the passage of this bill, more States will soon be at that level.
Further, we want to provide strong incentives for States below the 90-percent enrollment to reach that level.
This amendment, in order to incentivize States to reach that level of 90 percent, would allow States to apply for multiple grants of up to $2 million each when they achieve an enrollment rate of greater than 90 percent of children below 200 percent of poverty. These grants would help assure the children we enroll in SCHIP have a place to go to receive medical care and to find the personnel they need to provide that care. These grants would come from a pool of money--the State Health Access Innovations Pool--of $250 million, about 8 percent of the $3 billion incentive pool. This money will be used to find innovative approaches to increasing the availability of health and providers and services and would result in the direct provision of health services.
The reason for this initiative is pretty clear. In Vermont and in many other parts of this country, one can, in fact, have health insurance and yet find it quite difficult to buy or to find providers of that service. So what we are saying is let us make sure that when our kids do have health insurance, there will be doctors, there will be dentists, and there will be other health care providers. This is a good amendment, and I certainly hope it will be supported.
The other amendment I have offered, amendment No. 2600, is a simple amendment to Section 111 of the Children's Health Insurance Program reauthorization. Section 111, as my colleagues know, applies to certain qualifying States that expanded their Medicaid Program to cover kids prior to the enactment of CHIP in 1997. I wish to commend the Finance Committee for working language into the current bill that will no longer penalize these ``early expansion States'' and will allow States to cover children between 133 percent and 300 percent of the Federal poverty level to be covered under the CHIP program.
My amendment simply states that payments to States to cover these children who were previously covered under Medicaid be used solely to fund health care-related activities. Specifically, the language states that payments may only be used to provide coverage or to expand access for health care infrastructure, including but not limited to the provision of school-based health services, dental care, mental health services, federally qualified health centers, and educational debt forgiveness for health care practitioners in fields experiencing local shortages.
This amendment is a simple provision that will specify that States benefiting from an increased match must use these funds for health care and will allow States to address coverage issues as well as the crucial area of expanding access to services, something that particularly affects rural and inner city communities. I urge support for this amendment.
Madam President, I suggest the absence of a quorum.
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