HELP subcommittee focused on uninsured

Nearly 47 million Americans do not have health insurance. It is estimated that of the 47 million, 9.4 million children are uninsured while 7 million of them are eligible for the State Children’s Health Insurance Program (SCHIP) but are not enrolled. Furthermore, approximately 37 percent of the 6.6 million children currently enrolled in SCHIP have parents who work in businesses with fewer than 100 employees with no access to affordable coverage for themselves due to the high cost of health insurance in the private small-group and individual markets.

Last year, I held two hearings in the subcommittee I chair in the House known as the Health, Employment, Labor and Pensions, or HELP, Subcommittee to address the ever growing problem of the uninsured. The first hearing considered whether Congress should allow small employers access to buy into a public healthcare program, such as SCHIP. During the second hearing, we heard from several insurance commissioners whose states have enacted, or want to enact, laws to cover their uninsured but are unable to, due to a federal law known as the Employee Retirement Security Act (ERISA).

I worked with Chairman John Dingell (D-Mich.) of the House Energy and Commerce Committee last year to include a provision in the Children’s Health and Medicare Protection Act (CHAMP) that would establish a demonstration program for up to 10 states to offer employers and their employees the option to buy into a state’s children’s health insurance program. Unfortunately, the proposal was not included in the final conference report of the CHAMP Act due to claims that provision would lead to government-controlled socialized healthcare. This claim is simply not true since at least 48 states currently run their SCHIP programs through a private insurance provider.

Specifically, the provision would allow a state to participate in the demonstration program if it does not impose a waiting list, cap enrollment or impose any other enrollment limitation on low-income children at or below 200 percent of the Federal Poverty Level (FPL). As for the employer qualifications, 50 percent of his or her workforce must consist of full-time employees with family incomes at or below 200 percent of the poverty line.

Furthermore, eligible employees must have at least one eligible SCHIP child in their family.

If an employer agrees to participate, the program requires the employer to make a contribution no less than 50 percent of the premium toward the family coverage. The employee is required to make a contribution no greater than 5 percent of his or her entire income of the premium toward family coverage. The SCHIP funds used to cover the eligible children are the only allowable SCHIP funds that may be applied toward the family coverage. At the state’s discretion, any remaining cost of the family coverage may be covered by the employer or the state. Specifically, the state may use its own funds or apply an access fee to the employer for utilizing the purchasing pooling power of their children’s healthcare program.

For the past several months, I have been speaking with employers, unions and insurance companies to devise a proposal that would allow states to move forward with their proposals to provide coverage to the uninsured, while protecting those employers that offer adequate coverage to their employees. In the coming months, I plan to introduce this legislation and offer it as a real solution to reduce the number of the uninsured in America today.

There is a child in America right now who needs to go to the pediatrician, but his or her parents are unable to afford healthcare coverage even though they have jobs. The key question is whether we should provide healthcare coverage for that child and family. I say without question we should.

Andrews is a member of the House Education and Labor Committee.