Today the Health and Environment Subcommittee is discussing an issue that is of great importance to me: providing health care coverage for the uninsured. Many members of this Subcommittee have also proposed various legislative solutions to address this problem, including Chairman Tom Bliley, Subcommittee Chairman Mike Bilirakis, Rep. Sherrod Brown, and Rep. Frank Pallone. I thank the majority for holding a hearing on this crucial topic.

What motivated Congress to propose the Medicare program three-quarters of a century ago was an appalling lack of health insurance among the elderly. Today Medicare is the most popular and most successful health insurance program in the country, guaranteeing virtually every senior citizen affordable health care coverage. But millions of Americans do not enjoy a similar guarantee. I think they should, so in every Congress since 1954, I have introduced H.R. 16, a bill originally authored by my father, which would provide meaningful health care coverage to all Americans.

Today we discuss less comprehensive proposals, which are modified versions of past ideas. First, HealthMarts are a variation of Health Insurance Purchasing Cooperatives, which currently exist in a number of states, including California, Florida, and Ohio, and were the foundation of President Clinton’s 1994 health care reform plan. Second, Community Health Centers have been fulfilling their mission of providing care to the uninsured for over three decades. Third, a majority of states fund high-risk insurance pools to subsidize coverage for people with health problems who would otherwise have to pay astronomical rates in the individual market.

Any solution to provide health insurance to more Americans must be designed carefully so that the current fabric of health care coverage is not undone. Appropriate safeguards must be in place to ensure that risk-pooling arrangements do not upset the fragile balance in the small group and individual health insurance markets. Community Health Centers are already under a great deal of strain, both from rising numbers of uninsured and payments cuts, and we must not add to their burden. Finally, high-risk pools cannot effectively serve individuals unless they are adequately funded and provide comprehensive, meaningful benefits.

Yesterday, a number of my Democratic colleagues, including ranking Subcommittee member Sherrod Brown, introduced a bill that would allow people ages 55 to 65 who are uninsured to buy-in to the Medicare program. The near-elderly are among the most vulnerable of the uninsured. This bill builds on a successful program that has already helped millions of Americans obtain needed health care, and is worthy of this Subcommittee’s attention.

However, lack of insurance coverage is not the only health care problem Americans are facing. Many Americans who are currently insured find their coverage lacking some of the basic protections that make health insurance meaningful: access to specialty care; access to emergency care; an independent external appeals procedure to resolve disputes; care provided according to good medical practice; reliable accounting principles; and a mechanism to ensure that these protections are enforceable.