Senator Amy Klobuchar

Working for the People of Minnesota

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Events, Speeches &
Floor Statements

Klobuchar Speaks on Floor about Children's Health Care

July 31, 2007 | Watch

Mr. President, I am here today to talk about health care. Today, 45 million Americans are living without access to affordable health care. In a nation of such tremendous wealth and opportunity, with such a strong belief in science and research and medical advancement--we certainly have that in our State, the State of Minnesota--one wonders how so many of our fellow citizens can be burdened with the daily worry of what to do should a health disaster strike themselves or a loved one.

Health insurance premiums have skyrocketed into orbits unreachable by an increasing number of middle-class families. We have seen this in our State, where we actually have a fairly high level of people covered. But health care premiums for the middle class are so many times out of reach. We have seen nearly a 100-percent increase in the last few years in our State.

The foundations of employer-based health insurance are buckling under enormous cost pressures. The result is that ever more Americans are squeezed by health care costs and face awful decisions about delaying or forgoing needed medical treatment and care.

I, in fact, woke up this morning trying to decide when my daughter would get her braces because of the health insurance policy we got that makes you wait 2 years to get that kind of care. Well, we are lucky to be able to even have that insurance because so many kids in this country do not have it.

In fact, nearly 9 million of the uninsured in America are children. Kids without access to health care are at an enormous disadvantage as they grow up and start to make their life in this world. Children without health coverage are less likely to get basic preventive care, less likely to see a doctor regularly and less likely to perform well in school. Children without health coverage are also more likely to show up at the hospital sicker and more likely to develop costly chronic diseases.

Currently covering 6 million children, the Children's Health Insurance Program succeeded in improving their lives by giving them access to the health care services they need.

It is a successful program that deserves to reach even more children. This is important because, first of all, it is the decent thing to do for America's children who, through no fault of their own, are growing up in families that cannot otherwise get affordable health insurance. But this is also important because it is something that is good for all of us.

That is because insuring our children is a smart investment. It is a smart investment to make sure America's children get preventive medical care. It is a smart investment to help America's children grow up as healthy as they can be. It is a smart investment to have America's children in school focused on learning rather than distracted by a sickness or an injury that has gone untreated. It is a smart investment to have America's children get medical care through a sensible system of health insurance rather than having them end up in a hospital emergency room as their health care provider of last resort, increasing the bill for the rest of us.

I have seen the direct impact at the local level. For 8 years, I was the county attorney. As county attorney, my office represented the largest safety net hospital in Minnesota. That is the Hennepin County Medical Center in Minneapolis. It is one of the Nation's premier public teaching and research hospitals. It has a nationally recognized level 1 trauma center with the largest emergency room in our State.

The hospital serves patients regardless of their ability to pay. As a result, in 2006, the Hennepin County Medical Center's level of uncompensated care added up to $38 million--almost double what it was in the year 2000. That is because the emergency room was these people's doctor. People say: Well, they do not have insurance. They cannot get a doctor. Well, they have a doctor. It is the emergency room. The taxpayers are paying for it, and it is the most expensive place to get health care. It is the clinic of last resort for the uninsured, whether it is for minor illnesses or for more serious conditions that went untreated or could have been prevented.

Both in the short run and over the long term, expanding health insurance coverage offers a better deal for our Nation's health and for our continued prosperity. The people of my State have recognized this for a long time. Back in 1992, the leaders in my State voted to establish MinnesotaCare to provide children and their families with a new opportunity to secure health coverage.

The initiative was created with bipartisan support in our State legislature, and it was signed into law by Republican Governor Arne Carlson.

Within a decade--and thanks to the Children's Health Insurance Program--MinnesotaCare had grown to cover more than 150,000 Minnesotans and helped to make my State No. 1 in the Nation for the percentage of residents with health coverage.

But we are now losing the high ground we worked so hard to gain, as a growing number of Minnesotans, especially children, go without health coverage. Uncompensated health care costs for Minnesota's urban and rural hospitals have jumped substantially in recent years. Much of this increase in uncompensated care is due to a decline in health care coverage in our State.

For example, between 2001 and 2004, the proportion of Minnesotans who had health coverage through their employers declined from more than 68 percent to less than 63 percent. During the same period, the proportion of Minnesota children covered through their parents' employer also declined from roughly 77 percent to 69 percent.

Not surprisingly, the number of Minnesota children lacking health coverage increased significantly. Today, an estimated 82,000 Minnesota children are without health coverage.

At the time when thousands of Minnesotans are losing coverage from their employers, or they are being priced out of the insurance market by ever-higher premiums, MinnesotaCare's funding has also been scaled back. In Congress, we have the opportunity to do something about this--starting with the reauthorization of the Children's Health Insurance Program.

Recently, the Senate Finance Committee approved bipartisan legislation to reauthorize the Children's Health Insurance Program. Although I believe it could be even stronger, this compromise legislation authorizes $35 billion over 5 years to expand the Children's Health Insurance Program and extend quality health insurance to an additional 3.2 million children who currently lack coverage.

This legislation provides much needed funding for States to maintain and expand their programs and ensure that States that have suffered Federal funding shortfalls, including Minnesota, will now experience a stable level of Federal dollars.

As a State-Federal partnership, Children's Health Insurance Program has granted States the ability to tailor their programs to meet the needs of their residents. Some States increased eligibility levels for children. Other States allowed pregnant women to be covered under the program.

With MinnesotaCare, my State was an early leader in covering children from working families who had incomes above the Federal poverty level but still could not afford health insurance. In 2001, Minnesota was granted a waiver to extend the coverage to parents with incomes up to twice the Federal poverty line.

I would like to make one point clear. In no way is Minnesota covering parents at the expense of children. When the Children's Health Insurance Program was established in 1997, Minnesota already had one of the highest levels of covering children. So why did Minnesota include low-income working parents? The reason is simple. Ample research shows that when parents have coverage, children also get coverage, and they are more likely to actually receive medical care.

I have to point out the Bush administration agrees--or at least at one time it did. Here is a quote from Health and Human Services Secretary Tommy Thompson in June of 2001, when his Department approved Minnesota's waiver. He said:  ‘I am thrilled today to extend the promise of health care insurance to parents. We know there is a greater likelihood that kids will stay insured if their parents also have coverage.’

Agreeing with Secretary Thompson was Mark McClellan, the Administrator for the Centers for Medicare and Medicaid Services. Testifying in 2006 before the Finance Committee about the virtues of parent coverage, he said: ‘Extending coverage to parents and caregivers may also increase the likelihood that their children remain enrolled in SCHIP.’

So as recently as last year, top officials in the Bush administration were on record affirming the strong evidence of the role of parental coverage in the health care and well-being of children. Now the President and his allies have backtracked and would prefer to take coverage away from American families, including 34,000 parents in Minnesota alone.

I will tell my colleagues what seems odd to me. Both the President and the Vice President were recently in hospitals, and they were covered. That is good. But why would they want to deny millions of kids in this country the same right? Why would they want to deny 34,000 parents in Minnesota the same right?

As Congressional Budget Office Director Peter Orszag stated during a Finance Committee markup of this bill:

     When you remove parents from health coverage, you end up removing kids too.

     It doesn't make sense. Our goal must be to secure health care access for more--not fewer--Americans.

The White House is living in the past instead of looking to the future. Leaders at the State level, including many Republican Governors, have already moved well beyond the President's constricted position and are committed to trying to expand health coverage to their residents.

Minnesota's Republican Governor, Gov. Tim Pawlenty, currently the chair of the National Governors Association, recently signed a letter to congressional leadership asking them to reauthorize the Children's Health Insurance Program. I have this letter in front of me and I wish to quote from it:

The Nation's governors call on Congress and the administration to reauthorize the State Children's Health Insurance Program prior to September 30, 2007.

They talk about how the authorization is critical for the safety net.

Then they go on to say:  ‘While we have not taken a position on the actual overall funding amount or the sources of revenue used as offsets, we are encouraged by the Senate Finance Committee's efforts to move a bipartisan reauthorization bill that provides increased funding and reflects the general philosophy that State flexibility and options and incentives for States are preferable to mandates.’

Not only did Gov. Tim Pawlenty sign this, I know the Governor of the Presiding Officer's home State of Ohio signed it. I also see that Governor Schwarzenegger of California signed this. There are dozens and dozens of signatures of the Nation's Governors.

I ask unanimous consent to have printed in the Record this letter from the National Governors Association, Gov. Tim Pawlenty, Chair.

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