Formerly Uninsured Congressmen Debate Health Care

As the health care debate ensues across the country, some question whether lawmakers expected to vote on the legislation understand what it means to live without health insurance. Rep. Raul Grijalva, a Democrat from Arizona, and Rep. Henry Cuellar, a Democrat from Texas, are both sons of migrant workers. Each spent a big part of their lives without health care, but that doesn't mean they both have the same opinion about health care legislation. They explain their contrasting views.

Copyright © 2009 NPR. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

JENNIFER LUDDEN, host:

If you are one of the estimated 46 million Americans without health insurance, you might watch congressmen from both parties debate health care and wonder do they really know what it's like to be without medical coverage.

Today, we're going to talk with two congressmen who do. Democratic Representative Raul Grijalva of Arizona and Democratic Representative Henry Cuellar of Texas. Both are sons of migrant workers, each spent a big part of their adult lives without health care. But that doesn't mean they feel the same way about the proposals now being debated. Congressmen, welcome to the program.

Representative HENRY CUELLAR (Democrat, Texas): Thank you very much.

Representative RAUL GRIJALVA (Democrat, Arizona): Thank you.

Rep. CUELLAR: And thank you (unintelligible) here with my good friend Raul.

LUDDEN: Congressman Cuellar, let me start with you. Last time you were on the show, you told us about growing up in a family of eight children and not having health insurance until you became a member of the state legislature in Texas. What did your parents do when you or one of your brothers and sisters got sick?

Rep. CUELLAR: Well, they waited like a lot of people do when they don't have insurance. They waited till somebody got really, really, really sick, and then they took him over to go see a doctor. The preventive care that a lot of us take for granted, we just didn't have it.

You know, my parents did the best that they could under the conditions and, you know, I love them for everything they did for me and my seven other brothers and sisters that I have. But the reality is, you know, at that time, I think my dad was making about $300 a month for eight kids. You know, you don't have much money afterwards after you pay a little rent, when you buy food, pay the electric bill. To turn around and say, you know what, let's see if we have enough money for insurance. Reality is people just don't have that. There's a lot of people in the same situation.

LUDDEN: Congressman Grijalva, I understand you didn't get health insurance until your third child was born. Is that right? How did you cope as a parent?

Rep. GRIJALVA: Well, we were, you know, we would pay as you go. And that was same with my parents and when I was growing up. Luckily, he got a nice - he's got a job where there was union benefits attached to it. And part of the agreement was that he had coverage.

And when I got married and the babies were coming, we didn't have insurance. And we were fortunate in finding a clinic, Catholic Social Services, that allowed Mona and I to get the prenatal care, but it was a (unintelligible) clinic in which we paid what we could afford to pay and the bill was carried over. I think those babies took us about 10 years to pay off. But we were fortunate. Other people just waited till it was time to have the baby and then would go straight to the hospital, to the emergency room.

LUDDEN: Well, I want to ask both of you. Can you tell us briefly, do you think it's the government's responsibility to guarantee medical coverage for everyone? Congressman Cuellar.

Rep. CUELLAR: Well, first of all, I think government has to play a role. If it's a 100 percent, I don't think it's a 100 percent, our responsibility, and I'm talking about the government. I think when you look at the reality right now, government does play a big part. Forty six percent of all the health care that we provide in the United States right now is provided by government: Medicare, Medicaid, CHIPS, VA. Forty two percent is provided by the private insurance, 12 percent comes out of the pocket when you look at those expenses.

So, I think government plays a role in being (unintelligible), but the private sector surely has to play a role and the individual responsibility has to surely be the other factor.

LUDDEN: But if the private sector has been playing a role and we have 46 million uninsured, doesn't there - doesn't that mean something else has to happen?

Rep. CUELLAR: Oh, yeah, no, no, no. I don't disagree with that. I mean this is one of the reasons where we're coming in. Guaranteed by the federal government totally, all dollars, no. Do we need to do something on behalf of the federal government, where we have a partnership - if I can use that with the private sector and the individual responsibility -the answer is, in my opinion, yes.

LUDDEN: Congressman Grijalva, what do you think about what should happen to cover the uninsured?

Rep. GRIJALVA: I think government has a major responsibility - and it's not about intervention and control, it's about extending a benefit to all Americans. This health care reform debate is really sort of narrowing down to what a public option is or is it as part of this plan.

LUDDEN: Well, you've recently said you won't support any bill that does not include a public option.

Rep. GRIJALVA: Absolutely. And the reason I said that is because we're then talking about actually layering more federal money on top of an existing system that has the gaps that you noted about uninsured, about prohibitions for preexisting conditions, about no real opportunity for that huge middle margin of the working folk that are the ones that don't make enough to qualify for the Medicaid, the safety net programs and yet make too much - don't make enough to be able to pay the premium for private insurance.

Rep. GRIJALVA: That's where this public option is targeted. And I think that is a huge amount of people in this country that could benefit from that program.

LUDDEN: But Congressman Grijalva, if it comes down to a compromise, say, a health coop system, something short of a public option. If it's that or nothing, which would guarantee tens of millions continue without insurance, would you change your vote there?

Rep. GRIJALVA: I - I don't think so. And I say that because the coop idea would never get off the ground. And it would never really be the competitive edge and the competitive friction that you need in the marketplace for the private insurances to lower cost, extend coverage, provide affordability. We don't have that competitive friction going on. And the public option would provide that. And I think we're just recycling the same system and then in 10 years we'll have 66 billion people uninsured.

LUDDEN: Congressman Cuellar, you've told us here in a district, where some parts of like 40 percent of the population living below the poverty line. I imagine there's a lot of uninsured. I'm imagining you're hearing from this population. Can you get reelected there if you don't vote for some kind of health care reform that would guarantee coverage?

Rep. CUELLAR: Well, first of all, I do believe in health care reform. We do know that we've got about 46 million people across the nation have no coverage. Texas has one out of four. My district - that don't have insurance - in my district I have one out of three out of a 650,000 people that I represent, 267 have no coverage itself. Now, I feel that, you know, like Raul said a few minutes ago, you know, we do have different options, you know, some of us feel a little strongly on some options but one of the things that I believe in is the end goal.

And my four end goals that I'm looking at is how do we provide coverage to those people that have no coverage? Two, choice is very, very important, whether you go to a private insurance or you go to a public choice or coop, whatever you want to go with. You know, how do you talk about the rising cost? You know, people who have insurance say that in, you know, for example, in the state of Texas, you know, the last eight years insurance premiums have gone up more than a 104 percent. And the last thing is how do we do this where it doesn't keep adding to our national debt. That is, we got to pay for it.

LUDDEN: Well, let me ask you something. You've talked a lot about the importance of lowering costs - we just have a minute left. But is it bringing the 46 million uninsured into the system? Doesn't that have to be part of any overall plan that can lower cost and kind of amortize things for hospitals and insurers?

Rep. CUELLAR: Sure. I mean, I think anytime you bring - you increase the pool, you know, the - that's just one way of helping reduce some of the costs that we have. That's one way. There's other ways. You know, I believe in, you know, I think I can support the public option. We can modify it, make some changes, maybe even put a trigger to it. My end goal is those four points that I mentioned.

LUDDEN: All right. Democratic Texas Representative Henry Cuellar joined us by phone from Laredo, Texas. And Democratic Arizona Representative Raul Grijalva joined us by phone from Tucson, Arizona. Thank you both so much.

Rep. CUELLAR: Thank you very much.

Copyright © 2009 NPR. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to NPR. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR's prior permission. Visit our permissions page for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Support comes from: