John Shadegg

Mr. SHADEGG

Mr. SHADEGG. There are some people on the program at that high a level.

Mr. SHADEGG. Eighty thousand dollars-plus.

Mr. SHADEGG. I think the gentleman has made some strong points, and I would like to draw them out. One of the ones that gets missed so often is we talk about this being a program for poor children. I noticed that the gentleman in his remarks made the point that it really isn't a program for poor children. We have a program for poor children, and that is called Medicaid. That is already in existence. That is one of the points that you made.

Mr. SHADEGG. Mr. Speaker, reclaiming my time for a moment, I think it is kind of sad to take a children's bill, a bill that says this is a health care bill for poor, uninsured children, and exploit it. I would be happy to have a debate about how more Americans can get help getting health insurance. As I said, I have had a refundable tax credit to do that. But to try to pass a bill based on its title, and like this reporter says, how can Republicans possibly vote against a bill called the State Children's Health Insurance Program? You can't possibly vote against that. Well, fortunately, democracy allows us to get into an open debate and say wait a minute. If it really were a bill focused on poor or even near-poor children who are uninsured, we might have a program we could support. But it turns out it is not for the poor or the near-poor, it is not for the uninsured, because more than half already have insurance, and then you discover it's not even for children; it is for adults.

Mr. SHADEGG. So Medicaid covers poor children, and this program was designed to cover the near-poor or the working poor.

Mr. SHADEGG. And now it has been expanded to?

Mr. SHADEGG. They don't want to talk about it; they just want to peel a few Members off. I see that we have been joined by one of your colleagues from Georgia, a medical doctor, Dr. Gingrey. I have been railing against this bill, as you heard me a few moments ago. I have been saying that I find it stunning that the pay-for in this bill contemplates an additional 22 million people who are nonsmokers today needing to take up the smoking habit so they can pay the 61-cent per pack tax in order to have enough money to pay for the bill. So I did this graphic. I created all these cartons. There are 22 cigarette cartons sitting in front of me, representing 22 million, a million for each carton, new Americans who don't smoke now who would have to take up the habit to pay for the bill. I think that is a little deceitful. I certainly can't believe that the proponents of this bill would walk down here and say they think it is a great idea to have 22 nonsmokers in America start the habit. But as a medical doctor, I would sure be interested in your opinion on that issue, or any other comments you have on some of the details on this bill that are important for the American people to know.

Mr. SHADEGG. Wait, wait, wait. I want you to repeat that point because I think it is important.

Mr. SHADEGG. If the gentleman would yield back briefly, and I would like him to continue making that point, I have a hunch there are voters out there, people out there across America, people listening to this saying, no, it can't really be true. It couldn't really be true that the SCHIP covers people who are already insured. It couldn't really be true that the SCHIP program that is supposed to be for poor Americans covers kids in families that make $80,000 a year. It couldn't really be true that the Children's Health Care Program in many States covers more adults than children. Those things couldn't be true, but in fact they are. This chart illustrates the point you were just referring to, and I thought it might be a good graphic for your remarks. This is the number of new smokers needed to provide tobacco tax revenues for the SCHIP bill. As the bill has been written and been voted here on the floor two times now, and as the President vetoed it, this chart shows that this many new Americans, this many new nonsmokers, going up to 22.4 million nonsmokers, to fund the bill by this revenue stream at least, will have to start smoking. I just find so many aspects of this bill just stunning and unbelievable. But there is one; 22.4 million new smokers will need to take up the habit and pay the tax in order to have the revenues that the Democrats project will be needed for this new SCHIP bill.

Mr. SHADEGG. I just want to emphasize some of the points that the gentleman made. I love the name the CHUMP Act. Again, I think it would be hard for Americans to believe that this program is as it is. For example, these cartons represent, each one of them, 22 cartons of cigarettes, 22 million new Americans that will need to start smoking to pay for the SCHIP bill. I guess you can call that a CHUMP Act, because I don't think 22 million Americans who don't smoke now are going to start. If the gentleman will stay, I want him to explain that chart one more time. It shows the kid climbing up and then it shows the kid parachuting down. You call it the CHUMP Act. We call it here the cliff. Maybe you can explain one more time for the voters back home what this cliff means in terms of the funding of the program, because I think it is important for people to understand that it appears the funding is there, but then in year 5, whoops, it disappears.

Mr. SHADEGG. I thank the gentleman for participating in this debate. I am thrilled we have a democracy here where, while our colleagues may come to the floor and put up pictures of children and say those mean Republicans don't want to cover children, at least we can bring out some of the facts. We can bring out the fact that there is a funding cliff and that you would have to have 22 million nonsmokers take up the habit to pay for the bill. Unfortunately, we have not been able to offer amendments to correct those deficiencies in the bill. But we do support health care for poor and near-poor children. I support it for uninsured children. I have introduced every year for the last 10 years a bill that would give a refundable tax credit to every poor American to go out and buy their own health insurance. The reason I like the idea of giving them the money to buy their own care is because they will buy a plan that meets their needs, not some bureaucrat's needs. They will buy a plan based on choice, not based on government rationing of their care. They will buy a plan that their family likes and a plan that they will have control of. And if they don't get the service they want, they can fire that plan and buy another. It would be portable, and they can take it with them. Instead, we are talking about expanding a government-run program with, quite frankly, a lot of smoke and mirrors that, sadly, people will vote for just because of the name of the bill. Or maybe just because of the name of the bill and because the advocates of the bill can put up a picture of a child and say, Don't you want insurance for that child? Well, I do want insurance for that child. I just don't want insurance for adults under a program that is supposed to be for children. I don't want insurance for already insured kids causing them to drop their insurance. We are joined by Mr. Hensarling from Texas, and I know he has details and thoughts about this program and about how important it is that Americans understand the details of this, so it is not just are you for children or against children. It is a deeper discussion than that. I yield to the gentleman.

Mr. SHADEGG. I think that is an important note. We care about the structure of the bill. My main concern is patient choice. I believe creating government programs and forcing people into those programs is not the preferable way to care for people or to help them. I personally think we would be doing better to give people choice, give them in my case a refundable tax credit and let them buy a health care plan that suits their needs, not to be forced into a government-controlled, government-run bureaucratic, rationed-care program, but give them choice. I was talking with one of the doctors in our conference earlier today, and he pointed out that the reimbursement rates under SCHIP, because it is a government program, are dramatically lower than under many private programs. So kids who do drop their private health insurance and go on a government-run SCHIP program will actually get worst care. I know that the gentleman is an expert on budget and finance, and I think that chart demonstrates, and I don't know whether you want to call it hypocrisy or whether you want to call it trickery or whatever you want to call it, it is playing fast and loose with the budget facts on this bill. Maybe the gentleman would like to direct his remarks to that in light of the fact that the cigarette tax, and I have tried to make a big point out of this tonight, that the cigarette tax in the bill isn't enough to fund the bill. It is kind of a scam. It is kind of a scheme. The cigarette tax in the bill would only fund the bill if 22 million new nonsmokers took up the habit and started smoking. So for a graphic, we got 22 cartons of cigarettes, each carton representing another million Americans who would have to start smoking. I thought it would be helpful if the gentleman addressed those issues as well.

Mr. SHADEGG. We have this chart which makes the point that the gentleman just brought up. The burden of tobacco taxes falls largely on poor Americans. As a matter of fact, 28 percent of the people who smoke are considered poor. They make less than 100 percent of the poverty level. And 26 percent of the people who smoke are near-poor. They are in that 100 to 200 percent. And for the not-poor, that is only 18 percent of Americans. So this tobacco tax that is supposed to pay for the bill, but it is not enough money to pay for the bill unless millions of Americans, 22 million, take up smoking, post the burden of this legislation on the people who can least afford to pay it.

Mr. SHADEGG. I think we're about to run out of time. I want to thank the gentleman very much for participating in this debate. I think there are millions of Americans who don't quite understand and who perhaps learned a little more tonight about why the President would veto this bill and why many of us would vote to sustain that bill, about our concern that it is called a program for the near-poor or the working-poor uninsured children, and it turns out it's not for the near-poor or working-poor uninsured children. As we've demonstrated in this discussion tonight, it covers people who make up to $60,000 and in some cases $80,000 and more a year. It's not for the uninsured because the original study shows 61 percent of those who became eligible already had private insurance, and under the new bill, one out of every two who become eligible will have already had private insurance, and they'll drop that insurance. And when they do, the cost of the private insurance for everybody else, everyone else who has a child in that private insurance, will go up. It turns out so it's not for the poor or the near-poor or the working poor. It's not for the uninsured, because we discover it makes millions, 2 million by the latest estimate, children who are already privately insured eligible to go on this program. Then you think, well, the children's health care bill has to be for children and you discover, shock of all shock, the children's health care program isn't for children; it's for adults. I thank the gentleman. I think the 22 million new smokers is a stunning fact. I'm sorry we haven't been able to offer amendments on the floor. I'm glad this debate gives us a chance to explain to the American people what's going on, and that there's more to this bill than just the title, and it's important to pay attention to these details.

Mr. SHADEGG

Mr. SHADEGG. Madam Speaker, I thank the gentleman for yielding. It really is a sad day here in the United States Congress. This is an effort in pure politics. If this was an honest effort at compromise, how come nobody ever sat down with the President? How come nobody ever sat down with our leaders? The gentleman just said that they tried to address the issues. Everybody here on the floor knows they didn't address the issues. Adults remain covered under this legislation, though Republicans said adults shouldn't be covered in the child health care program. And crowd-out, the issue of people losing their private health insurance, causing the private health insurance to go up in cost, was not addressed. The CBO, a nonpartisan body, says 2 million people will lose their private coverage by crowd-out under this legislation. The sad thing is, this is pure politics, and it was demonstrated the day that the override attempt failed. Because, on that day, the Republicans had an opportunity to celebrate, having sustained the President's position. But we weren't proud of that moment or of that day because we'd like to deal with the Nation's problems. You know who applauded on that day? Democrats applauded when the override failed. Why? For political gain, not because they care about insurance or kids or kids' health, but because they want political gain. That's sad; this is a sad day for this Congress.

Mr. SHADEGG

Mr. SHADEGG. Madam Speaker, I listened to one of my colleagues just a moment ago say that this bill should be easy to reauthorize and should be done on a bipartisan basis, and, indeed, it should. But it is not because it has fallen victim to politics. It is victim to overreaching and political exploitation. This is a program that is supposed to be about uninsured poor children. But the President vetoed it because the majority insisted on expanding it to already insured middle-class children and adults. We can reform this program and keep it where it is supposed to be, and then we can move on to real health care reform. In his State of the Union address this year, the President proposed an idea to help every uninsured American, a proposal to end the outrageous discrimination by which those who have employer-based insurance get it with pretax dollars but the rest, who don't, have to pay more. We can do better for all Americans. We can help all the uninsured. And when this veto is sustained today, as it should be, let's reauthorize this program, but then let's reform health care for all the uninsured.

Mr. SHADEGG

Mr. SHADEGG. Madam Speaker, I'd like to take this opportunity to recognize an outstanding leader in the field of long-term care and aging services. Margaret M. (Peggy) Mullan is the outgoing chair of the American Association of Homes and Services for the Aging (AAHSA), and I congratulate her on what has been accomplished during her 2-year term. AAHSA members help millions of individuals and their families every day through mission-driven, not-for-profit organizations dedicated to providing the services that people need, when they need them, in the place they call home. Its 5,700 member organizations, many of which have served their communities for generations, offer the continuum of aging services: adult day services, home health, community services, senior housing, assisted living residences, continuing care retirement communities and nursing homes. AAHSA's commitment is to create the future of aging services through quality people can trust. During the 2 years that Peggy Mullan led AAHSA, she worked tirelessly to transform aging services, and her leadership has moved the field forward in a number of ways. Under her stewardship, AAHSA has created the Long-Term Care Solutions Project, an innovative plan to revise the financing of aging services. In addition, she placed major emphasis on diversity as part of her leadership agenda, achieving substantive, enduring, and diverse leadership development among our members. She presided over the inauguration of the Advancing Excellence in Nursing Homes campaign, a coalition of long-term care providers, caregivers, medical and quality improvement experts, government agencies, consumers and other stakeholders dedicated to reinvigorating efforts to improve the quality of care and quality of life for those living or recuperating in America's nursing homes. She positioned AAHSA as a leader in achieving the goals of the National Commission for Quality Long-term Care, a non-partisan, independent body charged with improving long-term care in America. The commission is working to develop solutions to the challenges of better financing for long-term care, ensuring consumer choice, attracting and retaining qualified caregivers, and making useful information on long-term care options available to consumers. Peggy Mullan is a true leader in the field of aging services. In addition to chairing AAHSA, she is the executive director of the not- for-profit Beatitudes Campus in Phoenix, where over 600 elders live in apartments, assisted living, and a skilled nursing center. Hundreds of other elders from the surrounding community receive rehabilitation and education at Beatitudes. At Beatitudes, she has been instrumental in developing a seamlessly integrated system of services to meet the changing needs of residents as they age, a model for the way aging services should be provided to America's elders. Prior to her work at Beatitudes, Peggy had a leadership role with Volunteers of America. She has chaired the Arizona Association of Homes for the Aging, and has served on Arizona governor's committees and task forces on the nursing shortage, long- term care, Alzheimer's residential care, and assisted living. She also has been a delegate to the White House Conference on Aging. Although Peggy Mullan is stepping down as AAHSA's chair, her service to our country's elder population will continue. I urge my colleagues to join me in congratulating her on her leadership and I look forward to continuing to work with her to create a healthy, ethical, and affordable system of long-term care and aging services for America's elders.

Mr. SHADEGG

Mr. SHADEGG. I thank the gentleman for yielding. Mr. Speaker, I rise in strong support of health care for America's poor and near-poor children. I also rise in equally strong opposition to this bill. For more than a decade, I have introduced into the United States Congress every single year a bill that would give every single child covered by this bill health insurance. Indeed, it would provide to every family covered by this bill a source of money, tax funds, to them and their family, to buy the health insurance they need for them and their children. But make no mistake about it. This bill is a fraud. The American people are smart. They know it is a fraud. This bill is Congress playing fast and loose with the facts. If we are going to have a debate about covering every single American, let's have that debate. But let's not hide it in a debate about children's health care. The American people are generous to a fault. They want to cover poor children. They want to cover children who are uninsured. The SCHIP program we have was supposed to do just that. But this program is a fraud. It doesn't cover just poor and near-poor. It covers middle-class families. Some will say, ``Oh, it is capped at 300 percent of the Federal poverty level.'' But under the law and the language in the bill, States can define income any way they want. Therefore, there is no cap on income. It doesn't just cover uninsured children. It covers more children who are insured already than those who are uninsured. CBO says that if we pass this bill, 2 million children currently covered by insurance, getting better coverage than they will get under this bill, will lose that coverage and go on SCHIP. Be proud of reducing the quality of the care they get. In fact, this bill isn't even limited to children. Indeed, this bill will cover adults. In Wisconsin today, 75 percent of the SCHIP money is used to cover adults. In Minnesota, it is 61 percent. In Arizona, we do the same. Mr. Speaker, if we want to have a debate about universal care, I am for that debate. I have got that bill. But don't have a bill that is a fraud. We must be honest in this debate. This bill will hurt children's health care in America.

Mr. SHADEGG

Mr. SHADEGG. I thank the gentleman for yielding. I think the gentlelady is correct. I think intellectually we could come to an agreement. Sadly, the language of this bill is fatally flawed. Page 3, line 18, the language she refers to is not workable for reasons that I think both sides understand. It says that no warrant is required when you know that both persons are outside the United States. It is impossible to know that both the person placing the call and the person receiving the call are outside the United States. So section 3 grants no authority whatsoever. You might as well make it blank paper, because it does not give us any authority, even if well-intended. Second, the bill, for the first time in the 200-year history of this Nation, says that when our executive branch wants to gather foreign-to- foreign intelligence, it must first go to the judiciary. That is a violation of the Constitution, and it places the duty for protecting American citizens in the hands of unelected judges. In reality in this Nation, the duty to protect us from enemies foreign and domestic is in the hands of the executive branch. This legislation is fatally flawed, even if well intended.

Mr. SHADEGG

Mr. SHADEGG. I thank the gentleman for yielding, and I really wish this debate was about what my colleagues on the other side want to make it about. I wish this bill was a debate about the uninsured children of the near poor or the working poor. I wish it was a debate like we had 10 years ago about insuring children too well off to get Medicaid but not well enough to buy insurance. But that is not what it is about. It is about cutting Medicare to provide health care services to middle- and upper middle-income children and to provide health care services to adults. And when you hear SCHIP, children, you don't expect that. When you think it is to go to the uninsured, you don't expect that. The median income in America, listen carefully, is $45,000. This bill will extend SCHIP benefits to families earning $60,000 and up to $80,000. That means it does not provide money for health insurance to the poor or the near poor or the working poor. We are all for that. That is why we initiated the program. We just don't think it ought to go to upper middle-income Americans. And let's see what the program has done. Sixty-one percent of the children who are in the SCHIP program today had private health insurance before the program was created. They dropped their private health insurance to take SCHIP. Is that what generous, compassionate Americans want to do for the poor? I don't think so. They dropped their private insurance to take SCHIP. CBO says that the Democrats' billions of dollars larger program will produce one person dropping private insurance for every one person who gets SCHIP insurance. Speaker after speaker on the other side has said this will insure 5 million more children. What they don't tell you is that 5 million children, according to SCHIP, will drop their private insurance. Obviously, what they want is to take people off of private insurance and put them on SCHIP. That's not what the American people understand when they understand that that is supposed to be a bill about the children of the working poor. I urge my colleagues to oppose this bill. It's a fraud.

Mr. SHADEGG

Mr. SHADEGG. I move to strike the last word.

Mr. SHADEGG. I rise in strong support of the McHenry amendment to reduce the budget of the Office of the Secretary by $101,000. The reason I support that amendment is because I do not support cutting the Medicare Advantage program by billions of dollars and hurting seniors. Point of Order

Mr. SHADEGG. Thank you. I would rather cut the Secretary's budget by $101 billion as a way to save money than to cut the Medicare Advantage program because the Medicare Advantage program helps millions of Americans and thousands in my own congressional district. So as the Democrats propose to cut that program in their SCHIP bill, I believe it would be better to cut this program. I rise in support of the McHenry amendment to cut $101,000 from the Secretary's budget because the Medicare Advantage bill will cut 3 million seniors' ability to collect their benefits through Medicare Advantage. That 3 million includes some of the poorest of seniors who are on Medicare Advantage, and I would rather cut $101,000 from the Secretary's budget than cut that money going to Medicare seniors who need it desperately. I support the amendment by the gentleman from North Carolina (Mr. McHenry) to cut $101,000 from the budget of the Secretary of Agriculture because the other cut we are faced with is a $15 billion cut in part A, including a cut in benefits to skilled nursing facilities, as the Democrats propose to do in their SCHIP bill. I would rather cut the Department of Agriculture's budget than---- Point of Order

Mr. SHADEGG. Parliamentary inquiry.

Mr. SHADEGG. I presume I can state my reason for supporting the amendment; is that correct?