Transcripts For CSPAN3 Hearing Focuses On Childrens Health I

Program with the late senator ted kennedy. Before i begin, lets call the meeting to order. Before we begin to take just a moment to say that our thoughts and prayers go out to those who have been impacted over the past few days by hurricane irma. Of course, we continue to keep those suffering from the effects of Hurricane Harvey in our thoughts and prayers as well. These have truly been horrific events, and i hope and pray for the safety of everyone involved. I join with my colleagues in the commitment to doing all we can to assist our citizens who are in need at this extremely difficult time. We will see what we can do to help alleviate some of the pain. Now, the hearing were having today will come to order. 20 years ago senator ted kennedy and i came together to create the Childrens Health Insurance Program, or chip, in order to provide Health Corner for Vulnerable Children and family who were too poor to afford private coverage but still didnt qualify for medicaid. 20 years ago we were at something of a crossroads. The year before c. H. I. P. Was signed into law a rep Congress Passed and a democratic president signed a welfare reform bill which ended the entitlement to cash welfare. Welfare reform sought to replace a culture of dependency with an emphasis on work. The emphasis was to move families off assistance and towards selfsufficiency. C. H. I. P. Was intended to help families. So we needed to be forward thinking taking into account the realities that time with an eye towards future sustainability. Senator kennedy and i worked in good faith for months to craft c. H. I. P. While neither of us got everything we wanted, the result was a dedicated funding stream for the program to help low income families get good, reliable Health Insurance. From the outset, it was a program that was bipartisan and continues to enjoy bipartisan support throughout the country, and i might add in congress. While it isnt perfect and while in my view some of the changes to the program have been regrettable, i believe that overall people consider it to be a success. Current lay provides federal c. H. I. P. Funding through the end of fiscal year 2017. According to the Congressional Research service, if congress doesnt act to provide additional federal funding a number of children who would likely be eligible for c. H. I. P. Will go uninsured once federal funding is exhausted. Additionally, an action by congress with regard to c. H. I. P. Would cause another layer of unpredictability and anxiety for states that have to administer the program. Of course, this anxiety will pale in comparison to what families who rely on chip will be faced if congress dont act. As we contemplate the future of the chip program there are thresholds we need to consider. The basic question is does the Committee Want to reauthorize or mealy extend chip. Reauthorization would entail more extensive debate and consideration of potential policy changes for the underlying program. As many of you know, in 2015 congressman fred upton, who was then chairman of the house energy and commerce committee, and i put forward a number of substantive policy recommendations for reforming c. H. I. P. While some policy changes are in order for the program, but we need to give full consideration to c. H. I. P reform prior to the expiration of federal funding at the end of this fiscal year. With these concerns in mind someone suggested instead of reauthorizing the entire program we act to extend c. H. I. P funding. Of course, that option comes with its own set of questions. For example, we will need to determine the appropriate length for the extension and whether to continue with the 23 increase in federal matching for c. H. I. P provided under the Affordable Care act and extended in 2015. I know some of our members have strong feelings about both of these questions. These are not particularly complicated issues but they will require some deliberation among members of the committee. Long story short, we have some difficult questions ahead of us. Whether we opt to reopen c. H. I. P to reforms or simply provide another extension, the committee will need to address significant time and effort to find answers to these questions. Today we will continue our discussion of these matters as we hear from witnesses who will testify to the importance of c. H. I. P and the need for it to continue. I hope members will listen carefully to these witnesses concerned with their states and let me know how they would prefer to proceed with regard to c. H. I. P. I look forward to working on a bipartisan basis with my good Ranking Member senator wyden and all of the members of the Senate Finance committee to move forward on a bipartisanship bill. With that, let me now turn to my good friend senator warner for his opening remarks. Thank you very much, mr. Chairman. I want as we start this extraordinarily important effort, mr. Chairman, to note your history with senator kennedy. The fact is it was that bipartisan partnership that got this program off the ground. It significantly reduced the number of uninsured kids in america. Were very appreciative that you set this in motion, and i and i know all of the members on our side very much look forward to working with you to make sure that we get this reauthorized and done quickly. Thank you, senator. Colleagues, you know, the fact is it would be easy for those who are casual observers of political news to get lost right now in whats going on in washington d. C. Theres an awful lot of washington lingo thats justin comprehensible to people. Theres the continuing resolution, the debt ceiling, csr payment, cost sharing, nbaa that is the defense fact and i think all of us could go on and on with others. Today were talking about the Childrens Health Insurance Program, c. H. I. P. It is the only health bill with a time stamp on it. The program is going to expire in a few weeks, and i think our message needs to be on this committee that we see our jobs as putting kids first. That means we are going to have to swing into action quickly here because this program is a lifeline for 9 million, almost 9 million vulnerable kids. It is a source of profound relief for parents across the country, and i want to talk for a moment about the kind of person who really sees this as the lifeline ive described. I might be talking about a single mom who works multiple jobs, pays the bills and handles all of what life throws at her all by herself. The last thing that single mom needs is a government letter stamped notice of termination, explaining that her sick kids are on their own because c. H. I. P funding has run out. That single mom is already juggling an awful lot, and i think it is fair to say she doesnt read page 817 of the morning newspaper every day because she has too much going on to be able to do that and try to decode all of this washington lingo to determine if the congress is going to act. That single mom sits in her kitchen, and if all shes got is that scary termination letter were going to see a lot of single moms and families in a huge mess very quickly. Thats the prospect families across the country face in a matter of weeks and it is what they dont deserve. Kids who desperately need care might not get it. States are going to be required to start planning for the worst. That means enrollment freezes, belt tightening and emergency steps to try to preserve care for kids currently in the program. But a vulnerable child not yet enrolled in c. H. I. P might have to, in effect, wait until the Congress Gets its act together. That leaves families with a mountain of stret, anxiety and heart ache. At worst, it is a life and death proposition for a great many of some of the most Vulnerable Children in our country. Of some of the most Vulnerable Children in our country. So today the finance committee is going to discuss the leading Health Care Issue congress has to address. Has to address this fall. The congress created chip with one goal in mind. That was to make sure that no american child falls through the cracks of our Health Care System. In the coming weeks weve got an opportunity as chairman hatch just noted to put together a strong bipartisan agreement that upholds chip promise to family and gives those kids security for years to come. Im beginning this discussion in an optimistic kind of way because ive discussed this as i know many of you have with chairman hatch and know the history. In the decades since they led the congress to create chip, the percentage of kids in america living without Health Coverage has fallen from nearly 14 to less than 5 . So chairman hatch and senator kennedy gave us concrete proof again that you can have senators who can have fierce disagreements on a variety of issues finding Common Ground when it comes to big challenges. And i submit and ive heard senator casey and others talk about this, it doesnt get any bigger than standing up for Vulnerable Children. S so its important for the congress to act soon. Theres no kicking this can down the road with a short term bill and it cant wait until december. The states run their programs differently. Some are going to run out of founding earlier than others. In that time no family should face the panic of being unable to get the care their sick child needs. As i wrap up one other point is to note how chip and medicaid work hand in hand. For American Kids and families, particularly those families working hard every day to climb into the middle class, chip adds a level of security to the health care of that single mom and others beyond above and beyond medicaid. But chip can only work if medicaid works. So weve got hard work to do, colleagues, now to uphold the senates promise to kids and families. Were going to hear from a Witness Panel that i think will be fair to say knows chip from a to z. And an independent expert who knows the Program Inside and out. So i see that as an opportunity for all senators, both sides of the aisle, to learn about and discuss the Critical Program and set the stage for the work to come. Im confident that in short Order Congress can pass a strong and bipartisan extension of chip that will last for many years. This is exactly what the important work the finance committee is all about. Chairman hatch is going to have to be doing some juggling here, so im going to call an audible and id like to welcome each of our three witnesses to our hearing today. Each of your perspectives is important with respect to chip. First were going to hear from mrs. Leanna george who will be introduced by our friend senator burr. Thank you, senator wyden. Caleb, wave at everybody. Were glad to have you. Leannas daughter is eligible for medicaid because of her disability. Caleb, her son, is insured by the chip program. She serves as the beneficiary. Shes also a chairperson of a North Carolina council on Educational Services for Exceptional Children is is the secretary of the consumer Family Advocacy committee, a local Management Entity that connects Johnston County citizens and Substance Abuse services. She is not only a mom. She is an advocate in every sense of the word at every level. Leanna, we are honored to have you here today. Welcome. Thank you very much, senator burr. Second we are going to hear from dr. Ann schwartz, commonly known in washington as mack pack. Mack wak pack is the aemggency provides policy and Data Analysis and makes recommendations to congress. The secretary of health and Human Services on a vied variety of issues on medicaid and the state chip program. She previously served as the Deputy Editor of Journal Health a hai affairs and special director to the physician payment review commission. A precursor to the medicare payment advisory commission. Dr. Schwartz has also held positions on the staff of the u. S. House of representatives. And holds a position at john hopkins university. Finally we will hear from ms. Linda neblo who is going to be introduced by our good friend senator warner. Thank you. I want to echo what both you and chairman hatch said about the importance of chip. Its a critically Important Program and id like to present to my colleagues my good friend linda noblo who is the chief Deputy Director for the Commonwealth Agency or as we call them virginia d mass. We go back to the days when bob casey addressed me as his excellency the governor. Linda at that point was director of the division of maternal and child Health Services. Our chip program back in the early 2000s was frankly a dra dreadf dreadful disaster. We were sending millions back because we didnt sign up enough children. We came in and with lindas help make it a much easier process to get through the signup process. Turned a multipage application into a single page application process. Linda and i traveled the state at clinics and other gatherings. Because ive heard from a lot of good folks at dmass, we went from the bottom of the peril to where we signed up our eligible children. We were recognized as one of the most effective chip programs in the country. Shes gone on to serve and has come back to dmass. Thank you senator wyden. Thank you, senator warner. Now we have gotten to the best part and thats our witnesses. Why dont we begin with you, ms. George. Well go right down the row. Its a tradition on this committee if you could perhaps highlight your testimony in five minutes. Well make your prepared remarks a part of the record in full. Please proceed, ms. George. Thank you very much. Good morning. My name is leann george and as the senator indicated im from Johnston County North Carolina. Thank you for the opportunity to be here today and meet with you and share my familys experience and how it impacts families like mine throughout our great country. Im married to a wonderful man named jim. He is a marine corp vet. Hes in the third year of an electricians training program. I have two children, ser ren knee who lives in a group home and my son caleb. Both my children are on the autism speck truck. Caleb has adhd as well as a genetic nur logical. While im not here to testify on behalf of mack pack, it wausnt until i was appointed to the commission i realized chips future was so uncertain. I was not aware that chip was in danger and that the children of working class families like mine were in jeopardy of losing their Health Insurance. And while there is need for the waivers i already said that part. Im sorry. As the commission discussed chip Program Began to wonder just how would losing chip impact my family. How would it affect the month le premiums we pay for our insurance . Would caleb with access to the services he needs . How much would it cost us . With our current Health Insurance plan, there would be no increase to our premium because my husbands plan only covers employees or family only coverage. Theres no employee and spousal coverage. However, it has a very high deductible which already prevents my husband and i from accessing medical care that we need. This in short means that the services that caleb needs would be pretty much out of our financial reach to get for him without chip. These Services Include Occupational Therapy which addresses motor challenges that impact his ability to write. And perform basic selfcare tasks like tying his shoes. He receives periodic mris which allows us to be proactive in treatment which results in Better Outcomes for our children. My son takes daily medication which helps him be able to focus in school which impacts his grades, his ability to learn. Over the years the chip program has provided all these services to us for little to no cost. Even in years when weve had cost sharing, chip is still a tremendous value for my family. Without chip coverage, his access to services would be greatly diminished. Chip also provides families with Financial Security and moms like me with peace of mind. In january my husband was laid off of work. That resulted in an insurance lapse for him and me. We worked hard to ensure that he continued his medication that he needed, but i was able to feel confident caleb had the services and support he needed should he become sick. Im so thankful ive never had to call his pediatrician and say im going to have to cancel our pointment, we dont have insurance. Ive never had to watch him lying in his bed sick with a fever and not be able to pursue medical intervention for him. Chip has meant my son has continued to receive the services he needs without interruption despite what challenges my husband and i were facing. If chip was to go away, families like mine would be forced to make tough decisions for our children. Monetary resources are already stretched thin. Families have to ration medical care which can result in something that appears minor right now that progressing into a very serious condition. Other families may procrastinate w