The best reason I can think of to support the "Child Health Insurance and Lower Deficit" (CHILD) Act is Stacey Smith (not

her real name).

When Stacey was 8 years old, she broke her arm and needed orthopedic surgery to repair the fracture. Her mother did not have a job that offered health benefits, and she was not making enough money to be able to pay for the special surgery. Today, Stacey's arm is crooked.Unfortunately, there are 10 million children, including 7 million Stacey Smiths, in our country who are not eligible for Medicaid. In Utah, an estimated 55,586 children under the age of 18 were without health coverage in 1996. Almost 90 percent of these children live in working families, and two-thirds live with both parents. The problem is that these working families are poor and don't make enough to pay for health insurance.

Those of us who opposed, and fortunately killed, the Clinton health-care reform plan, a one-size-fits-all, big government entitlement proposal, now face the choice of either denying the existence of cracks in the health-care system, cracks through which children like Stacey Smith often fall, or of developing a proposal that meets our criteria for good public policy.

I am not one who can turn a blind eye to Stacey Smith or the 7 million uninsured children she represents, so I took up this challenge and introduced the CHILD Act.

The bill is a simple block grant to the states. A state, which may choose whether or not to participate, may define eligibility so as to target the neediest families in the state.

States may design their own programs in any number of ways, such as a voucher program, direct purchase, contracts with one or more private insurers, or other delivery systems. States may also impose sliding fee scales or other cost-sharing requirements on beneficiaries.

Moreover, because these grants are appropriated funds, the provisions in the Hyde Amendment prohibiting federal funding of abortions or abortion services apply.

The bill creates no new federal agencies or offices. Because the IRS already collects the tobacco tax and HHS already distributes block grants, there would be no new federal agencies created by this bill.

The bill is not an entitlement. Not only does the bill not create a new entitlement, but it also does not expand an existing one. An entitlement is a program for which everyone who qualifies is entitled to the benefit. But, there is a specific provision in the CHILD bill

Sec. 2824 stating clearly that nothing in this bill guarantees a benefit to any person. Moreover, Medicaid was deliberately rejected as the delivery system for the CHILD program largely because it was an open-ended entitlement program and it simply does not make sense to enlarge a program that itself needs to be streamlined.

Another potential pitfall, that of exploding the number of uninsured children, was avoided by including a provision prohibiting employers from "dumping" children currently covered under an employer-sponsored plan into the public program.

The bill is also fully financed by means of a 43-cent-per-pack increase in the tobacco tax. While I generally oppose tax increases of any kind, the serious adverse effects of smoking on health and on health costs, including on public programs like Medicare and Medicaid, outweigh my reticence to increase this particular excise tax. If, at the same time, we can discourage more people, especially youth, from smoking, then I consider that an important fringe benefit of the bill.

A full one-third of the revenue will go for deficit reduction I insisted on this provision for the simple reason that our children, for whom we are today seeking better health care, will tomorrow be overwhelmed by decades of accumulated deficits if we do not act to get our budget balanced.

Finally, Utahns know from working cooperatively in community organizations that there is a time and a place for compromise. Congress is no different. To achieve anything worthwhile in our efforts to provide access to health care for children, we must have collaboration tempered by realism and bipartisanship consistent with basic principles. I intend to work cooperatively with all of my Senate colleagues, both Republicans and Democrats, in the fine-tuning of this bill as it moves through the legislative process.

I am proud to represent Utahns who, as a compassionate and thoughtful citizenry, have always tried to find reasonable, cost-effective ways to assist those who, despite their best efforts to be independent, need a hand to provide basic health care for their kids. We value children in Utah, and the bill I have introduced is one that I believe a vast majority of Utahns can support.