[Congressional Record Volume 140, Number 112 (Friday, August 12, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 12, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                          HEALTH SECURITY ACT

  Mr. MITCHELL. Mr. President, I ask unanimous consent that the Senate 
now resume consideration of S. 2351, the health care reform bill.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The clerk will state the bill by title.
  The legislative clerk read as follows:

       A bill (S. 2351) to achieve universal health insurance 
     coverage, and for other purposes.

  The Senate resumed consideration of the bill.


                           Amendment No. 2560

            (Purpose: To provide for a substitute amendment)

  Mr. MITCHELL. Mr. President, I send an amendment to the desk and ask 
for its immediate consideration.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Maine [Mr. Mitchell] proposes an amendment 
     numbered 2560.

  Mr. MITCHELL. Mr. President, I ask unanimous consent that reading of 
the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The text of the amendment is printed in today's Record under 
``Amendments Submitted.'')
  Mr. MITCHELL. I ask unanimous consent that there be printed in the 
Record a statement of changes from the prior proposal.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

             Changes From August 9 Mitchell Health Proposal

       Subtitle B of Title II. This provision makes the labor 
     protections under the Home and Community Based Care program 
     conform with labor protections affecting all dislocated 
     workers resulting from enactment of this legislation. From 
     the August 9 document, conforming changes have been made on 
     page 367, line 14; on page 588, lines 14 through page 590, 
     line 13; on page 591, line 13; on page 591; on page 679, 
     strike line 14 and all that follows through line 19 on page 
     684; on page 691, after line 10, insert new subsection.
       Part 3 of Subtitle E of Title III.  This part--Payments to 
     Hospitals Serving Vulnerable Populations--has been deleted, 
     as it was replaced by Part 3 of Subtitle B of Title IV in the 
     previous document.
       Title VII. Section 7132. The self-employment income 
     provision in the original bill (from the Finance Committee 
     bill) modifies the self-employment tax base of S corporation 
     shareholders and limited partners who own at least a 2 
     percent interest and provide significant services to service 
     related businesses. In this amendment, the provision is 
     modified to provide that all two-percent owners who provide 
     significant services to S corporations and limited 
     partnerships will include as net earnings from self-
     employment the lesser of their net share of the income from 
     the trade or business or 30 percent of their Social Security 
     wage base ($18,200).
       Subtitle A of Title VIII. The authorization of funds for 
     the Indian Health Service (included in the original bill) was 
     inadvertently omitted from the August 9 document. The 
     original language has been restored. The provision relating 
     to the direct spending allotment for IHS, which was in Title 
     VIII of the August 9 document, has been returned to Subtitle 
     H of Title III, as it was in the original bill.
       Title XI. Throughout Title XI, the word ``sequester'' has 
     been replaced by the word ``reductions.''

  Mr. DOLE. Mr. President, I ask for the yeas and nays on amendment No. 
2560.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  Mr. MITCHELL. Mr. President, I have discussed with the distinguished 
Republican leader earlier today, and just a short time ago, the process 
for determining the schedule for dealing with this bill over the next 2 
days, and beyond. I indicated to him that we had several amendments 
ready for consideration and will be prepared to proceed with an 
amendment to be offered by Senator Dodd first.
  I invited the distinguished Republican leader to have an alternate 
procedure, where Republican amendments could be considered as well. He 
indicated that they do not have any at this time. Therefore, we will 
proceed with Senator Dodd's amendment, and following that, we will be 
prepared to proceed with other amendments, which I have identified to 
Senator Dole.
  Therefore, if agreeable, Senator Dodd is now prepared to offer his 
amendment.
  Several Senators addressed the Chair.
  The PRESIDING OFFICER. The minority leader is recognized.
  Mr. DOLE. Mr. President, the majority leader is correct. We did have 
a discussion earlier today and one a few moments ago. Following the 
earlier discussion, we had a meeting in my office with some of the 
Republican colleagues, particularly Senator Packwood, who will be 
directing the effort on this side of the aisle. At this time, we do not 
have any amendments.
  As I indicated to the majority leader earlier today, we have a number 
of Members who wish to make statements, who have not made those 
statements. As the majority leader said, and I have said many times, 
obviously, if Members are here with something to say and they are not 
repeating it every half-hour or every hour, the same Senators, I hope 
they will have that opportunity. Of course, once the amendment is 
offered, I assume they can speak to the amendment or the bill 
generally. But we are prepared to proceed on that basis.
  Several Senators addressed the Chair.
  The PRESIDING OFFICER. The majority leader is recognized.
  Mr. MITCHELL. I thank my colleague for his comments. As I indicated, 
I advised Senator Dole earlier today of the amendments we were 
considering and sent a copy of the amendment to his office this 
afternoon so that they would have prior notice of the amendment before 
being offered. We would be prepared to proceed on that. What I hope is 
that Senator Dole and I can have a discussion sometime in the near 
future to determine how our colleagues want to proceed with respect to 
that amendment itself. We will have further amendments, as well.
  Following those discussions, I expect to make a decision, following 
consultation with Senator Dole and the managers of the bill, with 
respect to the schedule for this evening and for tomorrow.
  Several Senators addressed the Chair.
  The PRESIDING OFFICER. The Senator from Connecticut, Mr. Dodd, is 
recognized.


                           Amendment No. 2561

   (Purpose: To promote early and effective health care services for 
                      pregnant women and children)

  Mr. DODD. Mr. President, I send an amendment to the desk and ask for 
its immediate consideration.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Connecticut [Mr. Dodd], for himself, Mr. 
     Kennedy, Mr. Riegle, Mrs. Murray, Mr. Simon, Mrs. Boxer, Mr. 
     Wofford, and Mr. Levin, proposes an amendment numbered 2561.

  Mr. DODD. Mr. President, I ask unanimous consent that reading of the 
amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:
       At the end of section 1201, insert the following new 
     subsection:
       (d) Application of Interim Standards.--
       (1) In general.--During the interim standards application 
     period, a health plan sponsor may only issue or renew a 
     health plan in a State if such plan covers clinical 
     preventive services according to a periodicity schedule 
     established under paragraph (3), including prenatal care, 
     well baby care, and immunizations, for pregnant women and 
     children without imposing cost-sharing requirements on such 
     services.
       (2) Interim standards application period.--The interim 
     standards application period is on or after July 1, 1995, and 
     before January 1, 1997.
       (3) Periodicity schedule.--
       (A) In general.--Not later than July 1, 1995, the Secretary 
     shall establish a schedule of periodicity that reflects the 
     general, appropriate frequency with which clinical preventive 
     services should be provided routinely to children. In 
     establishing the schedule under the preceding sentence the 
     Secretary shall consult with the American Academy of 
     Pediatrics regarding children's preventive care.
       (B) Effectiveness.--The schedule established by the 
     Secretary under subparagraph (A) shall be effective until the 
     Board develops a periodicity schedule under section 
     1213(a)(2).
       (4) Application of rules.--Paragraphs (4), (5), and (6) of 
     section 1111(e) shall apply to this

  Mr. DODD. Mr. President, I offer this amendment that deals, I say to 
my colleagues, primarily with the issue of children, an issue on which 
I hope there is unanimity of thought here. We are talking about some 12 
million young Americans who are without any health insurance today. 
They make up some 36 percent of the uninsured population of this 
country, even though they represent a little more than 25 percent of 
the entire population of the United States.
  There is a disproportionate representation of children among the 
uninsured in this country. While there will be, I am confident, 
significant debate, Mr. President, about various aspects of the bill 
being proposed by the majority leader, on the issue of mandates, and on 
the question of cost containment, and whether or not benefit packages 
ought to be larger or smaller; and I presume we will go through that 
process over the next several days, and possibly weeks.
  But I would hope, Mr. President, that on the issue of one 
constituency, we will all try to come together to do what we can to 
increase the possibility of the most helpless in our society from being 
covered--that is, America's children.
  As I said, there are some 12 million of them, Mr. President. Today, 
they are not getting the kind of proper protection they should have. I 
point out as well, Mr. President, that a significant number of this 12 
million are the children of working families. These are not children 
whose parents are living on public assistance, or depending upon 
someone else for their survival for maintenance on a daily basis. 
Rather, these are children whose parents go out every single day and 
try and hold down jobs and provide for their families through hard work 
and labor.
  These children, through no fault of their own, and through no fault 
of their parents, find themselves exposed not only to the dangers of 
the diseases that can afflict a child at the earliest stages of life, 
but also to those diseases and problems that go unattended and can cost 
significant dollars in later years. I will demonstrate very shortly, 
Mr. President, exactly how that happens.
  So, while there is a small cost involved in prevention and prenatal 
care and in providing for the well child, we now know statistically, 
that children that get the kind of immunizations early on, women who 
are pregnant who get care during pregnancy, not only save that child 
and save that family from the tremendous pain and suffering that can 
accompany an illness, but for those who are not affected by that 
particular argument, if they are only concerned about the costs, if you 
can catch a problem early, or stop one from happening, then there are 
literally thousands and thousands of dollars to be saved for the 
American taxpayers, and to others who end up picking up the costs in 
many cases because the children and families do not have adequate 
coverage.
  So this amendment, which I will explain, is very simple. It is one 
that can be endorsed and supported across the board. I am particularly 
pleased that this is the very first amendment to be considered by this 
body on the issue of health care.
  We are not talking about some arcane issue, some formula that no one 
could possibly understand. We are not talking about some narrow 
constituency.
  We are talking about a group of people in this country that I believe 
all Americans, regardless of party, regardless of ideology, regardless 
of political persuasion, want to do our best to see that they are 
covered and helped.
  For that reason, Mr. President, I offer this amendment as the very 
first amendment to be considered in the national health care reform 
debate.
  Mr. President, the issue of children is one that we have debated and 
discussed. In fact, it is with some degree of irony that the last bill 
that was considered prior to returning to the health care bill was a 
child nutrition bill. I listened to many of the arguments and debating 
points raised here. Again there was virtual support and unanimity about 
WIC Programs and seeing to it that our children are well served.
  I see the presence of my good friend, the minority leader, on the 
floor. Very few people, I would say, fought as hard for food programs, 
for food stamps, than the Senator from Kansas throughout his career.
  Again, I point this out because the issues involving young people, by 
and large, enjoy broad-based support. When we talk about health care, 
we talk about the uninsured; we talk about trying to reach all 
Americans. While it may be difficult to get everybody, because of the 
problems associated with cost and a variety of other questions, I would 
hope that we could at least reach these children. While adults and 
others may be hard to deal with, children ought to be one population 
that we can serve.
  We all lose, obviously, when the worker or the person of tomorrow is 
crippled for life by untreated illness. That occurs today. We all lose 
when a completely preventable disease--let me emphasize that it is a 
completely preventable disease--like measles ripple through the child 
population. We all lose when parents cannot change jobs for fear of 
losing coverage for their children.
  The failings of our current health system are magnified when we look 
at how it treats our youngest citizens. Children are overrepresented 
among the uninsured. I made that point a moment ago. They represent 
some 36 percent of the uninsured population. Of that 37 million or 40 
million people that are uninsured in America today, 36 percent are 
children.
  Children are overrepresented among the uninsured, and our lack of 
emphasis on preventative care hurts children more than any other age 
groups. Americans under the age of 21 comprise a little over 25 percent 
of the total population of our Nation, but 36 percent of the uninsured 
are children.
  There are 12 million Americans under 21 without health coverage. 
There are 9.5 million children under the age of 18 without health 
insurance. And I point out on a parochial basis 44,000 of this 
population of uninsured live in my home State of Connecticut.
  Mr. President, the United States ranks 21st out of 23 industrialized 
nations in the world in terms of infant mortality. I get chilled when I 
just state that statistic. Let me repeat it. Out of 23 industrialized 
nations in the world, the United States ranks 21st in infant mortality. 
We beat only Portugal and Greece. They are 22nd and 23rd. Our infant 
mortality in the United States of America in 1994 is 30 percent higher 
than Germany, 35 percent higher than our neighbor to the north, Canada, 
and twice as high as our chief economic competitor in the world, Japan.
  This, Mr. President, is a middle-class issue, in my view. In fact, 
nearly 58 percent of uninsured children are dependents of parents with 
full-time, full-year jobs. These are children from hardworking families 
who want nothing more than to provide the basics for their kids; food 
to eat, a roof over their heads, and a visit to the doctor when they 
get sick or need a checkup.
  This problem, Mr. President, is embodied in the case of young Chelsea 
Tourigny of Norwich, CT, the town of my family in Connecticut. 
Chelsea's mother wrote about her problem.
  Chelsea suffers from a rare blood disorder that causes frequent 
bruising and occasionally uncontrolled bleeding. Chelsea's father died 
in 1989. But his health insurance was through Electric Boat Division. 
My colleagues are more than familiar with that company because of the 
debates we have had about submarines in this body from time to time. I 
know they have heard me talk about Electric Boat with some frequency. 
This is not an obscure corporation in Connecticut. Electric Boat, the 
father's employer, continued for 3 years after his death the health 
care coverage for Chelsea's treatment, a pretty generous program that 
the Electric Boat Division of General Dynamics provides its employees.
  But then, Mr. President, as happens, the policy expired. Companies 
cannot continue to maintain benefits in perpetuity. The fact that they 
did it for 3 years after the employee's death, I think was rather good.
  Chelsea's mother was able to purchase health insurance for herself, 
for her son, but no health insurance company--no company --would take 
young Chelsea. She had a preexisting condition and was on her own.
  This is a family that works, a family that contributed to the 
economic well-being of the country. In fact, I add in this particular 
case contributed to the security of the country since her father worked 
for a major defense contractor. They did everything right, played by 
the rules. A child incurred an illness through no fault of the parents. 
They had done nothing wrong. They worked hard, contributed to their 
community and their society. Yet, when her father died and they lost 
their company provided benefits 3 years later, the mother went out and 
tried to find some coverage for her family.
  They will take her. They will take the son. But Chelsea falls through 
the cracks.
  Mr. President, the point I made earlier that is illustrated by this 
case is that the overwhelming majority of the uninsured children in 
this country have parents who work full-time, full-year jobs.
  As to welfare children, if you are a welfare child in America, you do 
not get counted in this number because under Medicaid you get covered. 
So children of welfare parents do not have this worry. This is an issue 
that affects the children of working, middle-class Americans. That is 
why it is important that we consider it and do everything we can for 
them.
  The Tourignys, as I point out, are not poor. They are middle-class 
citizens, who do not qualify for public assistance, and, I suspect, 
would not ask for it. As Barbara Tourigny said, ``You've got to lose 
everything in order to get health coverage. I am not destitute enough 
yet,'' she said. But she will be if she cannot buy health care for her 
daughter, or has to sell the home, or incur significant financial 
obligations for her.
  Unfortunately, Mr. President, Chelsea is not alone. More and more 
children are joining them. The number of children in this country 
covered by employment-related insurance is dropping. It fell from 64.1 
percent in 1987 to 59.6 percent in 1992. Let me repeat that; in 1987, 
64.1 percent of the population was covered. Now it is dropping to 59.6 
percent. All the trend lines are working in the wrong direction. If 
these trends continue nearly half of all American children will not be 
covered by job-related insurance by the year 2000.
  The majority leader's plan, with its promise of greatly expanded 
coverage for all Americans, will bring health care to millions of 
children who now go without it. And I think everybody, everybody in 
this Chamber ought to get behind that idea. Whatever other differences 
we may have, that issue and that constituency ought to unite all of us.
  In addition, the Mitchell health care proposal recognizes how 
important preventative care is. This amendment that I have offered 
seeks to build on what he has done in this area.
  I finally believe, Mr. President, that this is a moral issue, it is 
an economic issue, and it is inexcusable for us to allow millions of 
our children to go without the medical care that they need. But this is 
also, as I said a moment ago, an economic issue.
  According to the Institute of Medicine, every dollar that we spend on 
immunizing children will save $10 in long-term health care costs. To 
look at this issue through an economic prism, one need only look at the 
managed care companies operating today. All health maintenance 
organizations--some of the most prominent ones, I might point out, are 
operated or based in my home State of Connecticut. These HMO's all 
readily cover preventive services like immunizations and well-child 
checkups. Most HMO's have outreach programs to educate patients and 
encourage them to take advantage of immunizations and other preventive 
services.
  A Rand study found that children in HMO's receive preventive care at 
least 40 percent more often than children in traditional insurance 
plans. They also have a 50 percent higher rate of overall medical 
visits.
  HMO's, Mr. President, do these things because they know it makes 
business sense to do so. HMO's know that providing preventive services 
and encouraging patients to use them are investments that in the long 
run will reduce illness and, very important to them, reduce and cut 
costs.
  In crafting his bill, Mr. President, the majority leader recognized 
the compelling moral and economic reasons for providing preventive 
services for children. Under his plan all health insurance policies 
will cover children's preventive services, like shots and checkups, in 
1997.
  This amendment that I offer this afternoon, Mr. President, would move 
that date up to July 1995. A year and a half may not sound like much I 
suppose in legislative time--less than one Congress, one might point 
out--or in economic terms, I suppose. But it can represent an entire 
lifetime for a young infant and the family.
  Those first 18 months of life are critical. Health problems that go 
undetected then can cause problems for decades, if not a lifetime.
  Mr. President, I say that we should make sure that insurance policies 
cover these critical services sooner, far sooner, rather than later. I 
see no reason to wait until 1997 to detect and prevent diseases in our 
children. I see no reason to wait until 1997 to begin reaping the 
savings preventive care can deliver.
  This amendment would also direct the Secretary of Health and Human 
Services to establish an interim schedule of childhood preventive 
services. That schedule would be enforced until the National Health 
Benefits Board, created by this legislation, developed its own 
permanent schedule.
  That is needed, Mr. President, because the date by which the board 
must define the benefits package does not kick in until July of 1995. 
So you have to have HHS come up with some rules ahead of time in order 
to make this work.
  Again, I suppose some might say, what is a year and a half? But, 
again, Mr. President, if you are a young family out there, particularly 
working families that want to see their children receive the kind of 
benefits and help they need, this becomes important.
  Mr. President, I want to particularly point out, because sometimes we 
say a dollar here, a dollar there, but I think it may be worthwhile for 
my colleagues to just get some sense of what happens just in the area 
of low-birthweight babies, which is a common problem, unfortunately, in 
this country.
  Over 90 infants born to mothers who did not see a health care 
provider during pregnancy--this is the March of Dimes study of 1994, so 
I presume it was the year before or 1992--these babies, we are told, 
are three times more likely to be born low-birthweight than those 
mothers who receive timely prenatal care.
  Close to 40,000 infants die each year--and again I repeat the 
statistic, Mr. President, that we rank 21st in the world among 
industrialized nations in infant mortality.
  The costs for doing this preventive care, what does it mean? The 
average cost of care for low-birthweight infants ranges from $14,000 to 
$50,000, with costs increasing as the birthweight decreases. The source 
for this information is the Annie C. Casey Foundation Kids Count Data 
Book. In 1994, the costs for treating just those low-birthweight 
children born to adolescent mothers was approximately $1.2 billion in 
1989.
  That is a number that ought to get somebody's attention around here. 
Just in the low-birthweight category, $1.2 billion--$1.2 billion--in 
health care costs because of low-birthweight children.
  That is a problem that could get solved if we would reach these 
children of these working families earlier and provide the kind of 
prenatal services and the kind of care they can get. We are not going 
to save every nickel of this, but just think if we could cut into these 
numbers and help these children get a start in life with a good average 
birthweight, instead of going to have to go through the trauma these 
families do. We must remember the staggering costs associated with just 
one problem, just the problem of low-birthweight children.
  The cost we have from the National Adolescent Health Information 
Center is $1.23 billion. It costs $20,000, on average, to provide 
initial hospital care for a low-birthweight infant and $400,000 in 
lifetime medical costs. That is from the Department of Health and Human 
Services Public Health Service, 1990. I might point out that in 1990 we 
were under the Bush administration, so these are their numbers.
  We are talking here, as I say, about an amendment that merely moves 
the date when health insurance plans will include preventive care for 
children up 18 months.
  Most of us here, I think, understand and accept the notion that some 
major parts of the health care bill will have to be phased in over 
time. But, again, as I said at the outset, I hope with this one 
constituency of children, that we might do a little better by speeding 
up the process, saving lives and supporting families that are feeling 
tremendous pressure. I think it is so important to make that point.
  And let me just go to this chart.
  Mrs. BOXER. Will the Senator yield for a question before he presents 
his chart?
  Mr. DODD. I am glad to yield.
  Mrs. BOXER. I want to say to the Senator, to me, as a mom, as someone 
who is very anxious to get into this health care debate, I am very 
pleased that this is the first amendment. I want to thank the Senator 
for that.
  I wondered, does the Senator have a list of the countries that do 
better than we do in terms of infant mortality? Would the Senator be 
willing to read that out loud? Because I think it is important that our 
colleagues on the Republican side and the Democratic side listen to the 
countries that do better than the United States of America when it 
comes to infant mortality.
  And while the Senator's staff may be trying to get that, I wanted to 
point out to the Senator, when I was in the House, I was chair of the 
health task force of the Budget Committee. And in San Diego we learned 
of a child who got the measles because the child did not get a vaccine, 
which, at that time, would have cost $14, and it wound up costing the 
city and county of San Diego $800,000.
  So I think what the Senator from Connecticut is pointing out is that 
here we have morality meeting economic sense. I hope that all of our 
colleagues on both side of the aisle will make that connection. This is 
the right thing to do and it is the smart thing to do.
  I hope the Senator will find the list and let us hear those countries 
that do better than we do on infant mortality.
  Mr. DODD. I thank my colleague from California. We will try to get 
that list for you.
  I have made note that we are 21st among industrialized nations. 
Portugal and Greece are the two that come after us at 22 and 23. 
Actually, Canada does much better than we do.
  Here is the list. Here is the United States right here at 22d. That 
is where we rank in infant mortality.
  Japan ranks No. 1 with the lowest infant mortality rates.
  Ireland--I am proud to say Ireland comes in No. 2.
  I say to the distinguished Senators from New York and Massachusetts, 
you will be pleased to know that Ireland is No. 2 in infant mortality.
  Finland, Singapore, Hong Kong, Sweden, The Netherlands, Norway, 
Denmark, Canada, Germany, Switzerland, Australia, United Kingdom, 
France, Austria, South Korea, Greece, Spain, Italy, New Zealand all do 
better than the United States in infant mortality.
  We rightfully take so much pride in this country in things that we do 
well. We lead the world in so many areas. I think everybody would like 
to see the United States do far better in the area of infant mortality 
than we do today so we could take pride in this area, too.
  Mr. DOLE. Will the Senator yield?
  Mr. DODD. I am glad to yield.
  Mr. DOLE. I think the Senator makes a good point.
  But I would also point out that a lot of these countries do not have 
the drug culture we have, they do not have AIDS babies, crack babies, 
babies having babies. There are a lot of reasons. If you look down some 
of those countries, they have not been infested like we have with some 
of these problems. That makes a difference. It does not lessen the 
problem.
  But I think we have some basic problems we need to face up to that 
may or may not deal with this particular amendment that gets back to 
families and values and things of that sort.
  Mr. DODD. I thank my colleague from Kansas.
  It is correct that we do have a diverse population, and that is worth 
noting.
  The bottom line, I suppose, at the end of the day is, we are still 
ranked 22d in this area.
  We are not exclusive or alone in some of these areas. There are a 
number of countries in Europe and elsewhere that suffer from many of 
the same problems.
  But, nonetheless, I think, as we are looking at the health care bill, 
the fact that children are about 36 percent of the uninsured in the 
United States America is a staggeringly high statistic. And, it is 
something we can and should do something about.
  I might further point out regarding a couple of the problems my 
colleague and friend from Kansas mentioned, the drug problem and the 
like, we unfortunately did not get a rule passed last night in the 
other body on the crime bill. A lot of that crime bill--a good part of 
it--some of it was to deal with prevention and deal with issues that 
might be of some assistance in the problem areas we needed to face. At 
any rate, those are the countries, I say to my colleague from 
California, that do a better job than we do.
  Let me point out with this chart, if I may, the statistic I pointed 
out earlier, because I think this needs to be emphasized. I think there 
is a great misunderstanding about who we are talking about in this 
population of uninsured. This amendment focuses on children, and I 
think it is important not only to point out the majority of these 
children are within working families, but also where trend lines are 
going. The basic point of this chart is that 64 percent of the children 
uninsured were within working families. And the number now, of those 
who are covered, is dropping to 60 percent. Families with one or more 
full-time workers have roughly the same numbers: 64 percent down to 60 
percent. So we are seeing the problem getting worse. I think it is 
critically important to point out the direction we are going in this 
area.
  The last chart I will put up, if we have it here, is the one that 
points out the poorest Americans. Again, there may be some truth to 
what my colleague from Kansas has said that it is because of a myriad 
of problems we face in this country. But I think something of a source 
of shame is, of all the industrialized nations, the United States has 
the unique distinction of having, as the poorest sector of its 
population, its children. In most countries, it is the older 
population. They are on fixed incomes, struggling to make ends meet. 
The United States is the only country that has kids as the poorest part 
of the population.
  I think we all know and appreciate how important it is going to be 
for this next generation of children to be the best educated, best 
prepared generation that this country has ever produced. We are not 
going to reach those goals if they start out in life at the earliest 
days, even before birth, not getting the kind of treatment and care and 
nurturing that is necessary for them to succeed.
  We know now, as a result of the Carnegie Foundation study, General 
Accounting Office reports, Head Start reviews, and so forth, the 
children that get adequate nutrition, the children who start out right 
and get the help and support in the earliest days of their lives, are 
less likely to have the learning problems. A child that is well fed, 
that is healthy, learns at a far better rate and retains knowledge at a 
much higher rate than children who are not.
  That is not some theory I am espousing here. That is just a fact. So 
when we talk about ``these kids,'' these kids become parents pretty 
soon. They raise children. If this trend continues, then these numbers 
begin to explode. So the importance of focusing on 12 million--again, I 
cite we are talking about 37 million to 40 million uninsured in the 
country; 12 million of that number are children. Hence, the reason I 
think it so important that this amendment that is focused on children 
be a critical part of the majority leader's proposal to deal with 
national health care reform. If we do not focus on these kids and get 
them started early, then, as I pointed out earlier, we pay an awful 
price financially as well.
  So I am very hopeful this amendment will be adopted. I am pleased to 
have as my cosponsor my colleague from Michigan, Senator Riegle, who 
has done terrific work, I point out, on the Finance Committee during 
the consideration of the health reform package in that committee, and 
my colleague from Massachusetts, as well as my colleague from Illinois, 
Senator Simon, and others who are cosponsoring this amendment.
  I hope we can have a good debate and discussion and bipartisan 
support as we begin the process of fashioning a health care reform 
package.
  I will just end on this note, Mr. President, and yield the floor to 
others to comment on this. We have now started the debate and the 
process of dealing with this bill. My hope is we will find some common 
ground for children.
  It is quite clear the American public would like us to come up with a 
sound, intelligent, well thought out health care reform package. The 
majority leader has put forward a bill that I think deserves support. 
He is the first to admit it is not perfect. People have other ideas. 
But let us get to it. Let us drop the labels. Let us not sit back, as 
we too often do, and engage in the partisan politics that have caused 
this institution to grind to a halt.
  We have a chance now, in these next few weeks here, to do something 
that seven Presidents and six decades of effort in previous Congresses 
have failed to accomplish. This is the first time we have had a health 
care bill on the floor of this body. We have an opportunity to make a 
difference, and my hope is we will do that.
  Mr. RIEGLE. Will the Senator yield for a moment?
  Mr. DODD. I yield to my colleague from Michigan.
  Mr. RIEGLE. Mr. President, I appreciate my colleague yielding. I 
thank him for his leadership on this amendment and also, over the 
years, on issues related to children.
  I want to say to the Senator, these children we are talking about are 
in working families across America. They have no health insurance now. 
You know, they are not Republican children or Democratic children. They 
are America's children. They need this coverage; they need this 
preventive care so they have a chance to grow up and be well, healthy, 
and strong so they will be able to move into the work force at some 
time and form families of their own. They are our Nation's future. What 
happens to our children and our country is really the story of the 
future.
  I appreciate the point, as well, that Senator Dole made a minute ago 
about some of the special problems that we have in our country with 
drugs and teenage unwed mothers, and things of that kind. But by the 
same token, if you look at these other nations, they have some of those 
problems, too; but these nations that are doing better than we are with 
their children are far poorer nations. In other words, they have less 
to work with and are still managing, somehow, to see to it that their 
children have a full chance in life.
  All of us here, one way or another, have experienced situations--
either personally or within our families--where a medical situation can 
strike, and it can come without any warning. Certainly I think if we 
could ward something off, if we can prevent a child from having to go 
through a terrible trauma of some kind of health crisis that might take 
their life or impair them for life--why would we not want to do that? 
Is that not one of the reasons we formed ourselves as a Nation, to look 
after our own well-being as a people, and especially our children?
  Whatever else we do not do on health care--I hope we can do it all, 
or do as much as we can--the kids of the country who are uninsured and 
are underinsured cannot fend for themselves. They need our help. We owe 
that to them. We want them to love this country and understand the 
country matters. We want them to be devoted to the country. But I think 
we have to show a certain measure of love and devotion to them. It is a 
reciprocal arrangement. If we are going to expect people to feel as if 
they are part of America and the country matters, we have to show they 
matter to the country. They are important to us. We want to help them.
  We hear a lot of citations around here, religious citations of one 
kind or another. But from the teachings that I got from the earliest 
age in the church I was taken to by my parents, I think I remember as 
vividly as anything the notion in the Bible of the teachings that Jesus 
said: Let the little children come unto me.
  Mr. MOYNIHAN. ``Suffer.''
  Mr. RIEGLE. ``Suffer the little children to come unto me.''
  Regardless of one's religious practice, I think because of the 
universal humanity and decency that is so manifest and powerful, that 
is one thing we can do in this country--care for our children.
  I thank the Senator for yielding.
  Mr. PACKWOOD. Mr. President, parliamentary inquiry. Do I understand 
when we yield, we are supposed to be yielding for questions, not 
yielding the floor for purposes of statements?
  Mr. MOYNIHAN. Will the Senator from Connecticut yield for a question?
  The PRESIDING OFFICER. The Chair will enforce the rules of debate.
  Mr. MOYNIHAN. Is the Senator aware--
  The PRESIDING OFFICER. The Senator from Connecticut still has the 
floor.
  Mr. DODD. I was yielding, for a question, to the distinguished 
Senator from New York.
  The PRESIDING OFFICER. The Senator from New York.
  Mr. MOYNIHAN. Is the Senator aware, as I am sure he is, that in the 
underlying measure here, the bill reported by the Committee on Finance, 
there is a provision that the subsidies for health insurance will be 
available to all children under 21, and all pregnant women--an 
extraordinarily universal proposition--and that this measure was 
offered to the committee bill by the distinguished Senator from 
Michigan, who forbears to identify himself with the measure? But it 
should be acknowledged that it is his--and, indeed, ours.
  The Senator brings forward now essentially those provisions, for 
which I am, for one, very grateful; and the Senator is aware of its 
``paternity"?
  Mr. DODD. Mr. President, I mentioned a moment ago--in fact the 
Senator from Michigan had authored a very significant provision within 
the Finance Committee bill's package that relates to this issue very 
specifically--the Senator from New York is absolutely correct--and 
enjoyed, I gather, pretty broad-based support.
  Again, I make the point, I think these issues are ones that ought to 
bind us together. I thought, Mr. President, because there has been so 
much animosity as part of the debate that we might begin considering 
this bill on an issue that ought to bind us together a bit. I have 
listened over the last several days to one set of accusations being 
fired back and forth here. Here is a group of people we all care about 
in this country and something we can do something about.
  So while there are those who want to just make a good political issue 
out of this question, I think people sent us here to try and get 
something done, and clearly health care is an area they want us to work 
on.
  Rather than get into this business of back and forth, here is an area 
we can work together on. If we cannot work together on this, then I do 
not hold out much hope of working on anything. If 12 million kids in 
this country, many of whom are children of working families, if we 
cannot do a better job for them in all of this, then I do not know what 
we can do well.
  Looking down the States--and I mentioned the number generally--the 
State of Texas, 23 percent of the children uninsured in that State; 22 
percent in New Mexico; Arkansas, 19 percent; California, 17 percent; 
Louisiana, 19 percent.
  I am going to ask unanimous consent to print this list in the Record, 
because my colleagues may be interested in how their States come out in 
this area.
  Mr. President, we all need to do work in this area, to do a better 
job to see to it these kids are getting the kind of coverage they ought 
to have. I am sure everybody has gotten letters, gotten calls from 
families within our States citing one example after another, whether 
because of a preexisting condition or whatever.
  I have a telephone number in my office that is very similar to the 
Capitol number. I am not going to give out my office number because I 
can imagine what would occur if I did, but that number, CA4-3121, is 
very similar. So I answered the phone and just this afternoon have 
taken a bunch of calls.
  The last call I received, I will say to my colleague from New York, 
is a constituent of yours. She works at Bloomingdale's in New York City 
and called to express her deep concern. She has two daughters, one 24, 
one 29. One is married, both have jobs, neither have health insurance 
today, and she is worried about them. She has health coverage at 
Bloomingdale's where she is working, but she is concerned with the 
Macy's acquisition, and so forth, and that she may lose it. But she is 
worried about her two adult daughters.
  Mr. MOYNIHAN. Will the Senator yield for a question?
  Mr. DODD. I will be glad to.
  Mr. MOYNIHAN. Is he aware--I am sure he is--that he is describing 
working families?
  Mr. DODD. Absolutely.
  Mr. MOYNIHAN. The indigent, dependent families of the country have 
Government health insurance in the form of Medicaid. It is those who 
are working who do not, and it is an irrational arrangement and this 
would respond to it.
  Mr. DODD. My colleague is absolutely correct. I make this point----
  The PRESIDING OFFICER. If the Senator will withhold for a moment. The 
Chair reminds Senators they may ask the Senator from Connecticut 
questions.
  Mr. DODD. Mr. President, I am responding to the question of the 
Senator from New York, and I appreciate him raising the question. I 
think it needs to be emphasized, and that is, 82 percent of the 
uninsured population in this country are working people, out every day, 
holding down jobs, trying to keep their families together.
  As I said a moment ago, it is a great irony in a sense. If you are 
incarcerated and watching this debate somewhere in America and you get 
sick, you get health care. Imagine that. Or if you are on welfare in 
the United States somewhere, you get health care. If you are a part of 
the Federal employment force or one of us here, you have health care. 
The people who are out working are not watching this program because 
they have a job, they cannot watch this program, they are out there 
without health care coverage. We have to do more for working families 
in this country. Working people----
  Mr. GREGG. Will the Senator yield for a question?
  Mr. DODD. Let me complete the thought. I will be glad to yield. These 
are working people. We take care of the incarcerated, the welfare 
recipients and take care of Federal employees. And yet if you are out 
working, avoiding those situations, we do not do a very good job. 
Eighty-two percent of the uninsured in this country are working, and 12 
million of that population are kids and a significant percentage of 
them are children of working families.
  We ought to be able to do better in a great country like this and a 
strong Nation. We lag behind. And the Senator from Michigan pointed out 
correctly. We have great wealth. The nations that are ahead of us, with 
the exception of Japan, I suppose, have far less resources than we do. 
If they can do a better job in infant mortality, I would like to think 
my country can. I think being a patriot in this country means a lot of 
things, not the least of which is that we take care of working people 
and their children on something as basic as health. That is not a 
privilege, that is a right: Basic health care. That ought to be 
something that joins all of us together.
  Mr. GREGG. Will the Senator yield for a question?
  Mr. DODD. I will be glad to yield.
  The PRESIDING OFFICER. The Senator from New Hampshire is recognized 
for the purpose of a question.
  Mr. GREGG. The Senator made an eloquent statement.
  Mr. DODD. I have to take a question.
  Mr. GREGG. This will be a question, I assure you. I duly noted the 
Chair's admonitions. Actually, I wanted to ask a question earlier and 
you were into your speech, so I could not get in there. But the Senator 
from New York raised the issue of the underlying bill, which is the 
Finance bill. And now we have the Mitchell bill, which has just, as I 
understand, been delivered to the desk, which is the third 
configuration of that bill.
  What I am trying to figure out is how they work relative to the 
people that you are concerned about, especially children and pregnant 
women. I read the CBO language on how this works relative to children 
and women. I note that they say:

       The system of subsidies for families which would also 
     change significantly raises concerns about affordability and 
     equity. The special subsidies for low-income children and 
     pregnant women would be dropped, making health insurance more 
     expensive for low-income families without an employer 
     contribution, even though they would now be required to 
     purchase coverage.

  What they are talking about here is a State that has been a mandated 
State under the plan. That, of course, is under the Mitchell plan as it 
was originally presented in the bill 3 days ago and has been amended. 
Maybe the plan has been amended again under this proposal. I was 
wondering if you could explain to me, because I am trying to understand 
this, how, if you are in a mandated State versus an unmandated State 
under the Mitchell plan, this subsidy works in relationship to what the 
CBO is saying here, which is that it does not work? The CBO is 
essentially saying, to quote again:

       The special subsidies for low-income children--

  Who I think are the people you are targeting--

     and pregnant women would be dropped.

  I am just trying to get a sense of how the Mitchell bill works.
  Mr. DODD. You are asking how the Mitchell bill works. We can have a 
good debate over the next several days. I should have pointed out 
earlier what the Senator from Michigan, Senator Riegle, has done in the 
Finance Committee bill in the area of principally subsidies. We are 
dealing with benefits, rather than subsidies. They complement each 
other.
  So for purposes of clarity, that is a slight distinction here. What 
we are doing is saying--and I pointed this out earlier--that the 
guidelines in this area will have to be developed by the Health and 
Human Services administration because the effective date of this 
amendment would actually occur prior to the time that the board is 
established that would set the benefits within this category. So that 
board would then make the suggestions in this area.
  As for the issue of a mandated State, or a State that is not--staff 
provided me a response to your question. The subsidies of pregnant 
women and children are used in the voluntary situation until the year 
2000 to get us to 95 percent. It would continue beyond that.
  So I guess the question of if you did not meet that 95 percent 
number, then by the year 2000--that would continue beyond that 
particular period of time as well in a State that was under the 
mandate.
  Mr. GREGG. Will the Senator yield for a further question? I 
understand the point you are making is to basically energize the 
activity of the bill relative to the manner in which payment is applied 
at an earlier date. It is all tied into the issue of subsidy.
  Under this bill, as I understand it from the CBO report and from the 
small amount I have been able to read of the prior bills, there are 
approximately 100 million to 120 million people who receive 
subsidies, with those subsidies being fairly significantly targeted on 
the group that you are concerned about, children. But the mandated 
language in this bill that creates a mandated State versus an 
unmandated State has created a situation where CBO says that because of 
the disruption, complication, and inequities that would result, CBO 
does not believe it would be feasible to implement the mandated system 
in some States but not in others and the system would have to include 
either all States or no States.

  I guess what I am getting to--
  Mr. DODD. If I could respond to the Senator----
  Mr. GREGG. How is your system going to improve the situation if CBO 
is saying that the underlying bill is going to undermine the situation?
  Mr. DODD. Let me respond to my friend and neighbor from New England 
in this way. This amendment does basically one thing, and that is 
accelerate the benefits to pregnant women and infant children by a 
space of a year and a half. That is what it is designed to do, to speed 
up the delivery of those particular benefits for children.
  The issue of the mandates is a very legitimate question. I presume we 
are going to spend some time discussing that issue. But it does not 
pertain to my amendment.
  Mr. GREGG. If the Senator will yield further, it does because the CBO 
language--that is the group they are talking about--they are saying 
special subsidies for low-income pregnant women would be dropped and 
essentially would not work.
  So I guess my concern is that even though you may accelerate these 
benefits, that the underlying bill undermines these benefits, and 
because of its complexity in the manner in which it has required 
different States--as I understand it, the complexity occurs when 
different States do not reach 95 percent.
  I guess all I am trying to get is an explanation, and what the 
Senator is saying is, well, this is not the proper time to explain it 
because it does not apply to this language. I guess my concern is that 
this is an integrated effort here. We are dealing with a system that is 
a matrix of a lot of different--a very heavily woven matrix, and when 
you pull on one end, as you are here, I presume you affect the other 
end of the bill. And one of the other ends of the bill is in language 
which they say does not work.
  I am just trying to get an explanation of how it works.
  Mr. DODD. Mr. President, I think I heard a question at the end of 
that; the intonation of the voice rose to a question.
  I just say once again that the issue of whether States trigger in, in 
the year 2000, based on the 95 percent coverage rule has nothing to do 
with my amendment. My amendment places a condition on private insurance 
plans. What I am talking about is the acceleration of the benefit so 
that children would be able to receive that benefit at an earlier date. 
And the question of the state mandate in the year 2000 is irrelevant.
  Mr. LOTT. Will the Senator yield on that point?
  Mr. DODD. I think the Senator from West Virginia wanted to ask me to 
yield to him.
  I will be glad to yield.
  I would point out, I presume he has a question which he would like to 
raise.
  Mr. LOTT. Is he yielding for a question?
  Mr. DODD. He is yielding for a question.
  Mr. ROCKEFELLER. I thank the Senator from Connecticut for his 
courtesy.
  I wish to point out, before I begin what is a defense of this current 
amendment, that the Senator from New York, the chairman of the Finance 
Committee, has been on this whole subject for three decades or more. 
And I keep thinking of the time back in 1965 when he wrote a book which 
was criticized by many, but which was absolutely accurate, and which is 
even more accurate today because it predicted what was true at the 
time, and predicted what would happen, and what would happen has 
happened. And this amendment gets to a number of those matters.
  I think this is a first-class amendment because I think it puts 
children first. I think it is going to make a real difference in 
people's lives.
  The PRESIDING OFFICER (Mr. Feingold). The Senator will remember that 
the Senator holding the floor can yield only for a question.
  Mr. ROCKEFELLER. Then, in that case, I would ask of the Senator from 
Connecticut, I would simply stipulate that I would like to make a 
statement in defense of the amendment.
  Mr. COATS. Does the Senator yield the floor?
  Mr. DODD. I yielded for a question, and if my colleague has a 
question--
  Mr. ROCKEFELLER. I do not have a question. I have a statement.
  Several Senators addressed the Chair.
  Mr. LEAHY. May we have order.
  The PRESIDING OFFICER. The Senator from Connecticut has the floor.
  Mr. DODD. I thank the Chair.
  Mr. COATS. Would my friend yield to me for a true question?
  Mr. DODD. In a minute. Let me see if we cannot move along a little 
bit. I do not intend to hold the floor. I offered the amendment. I 
would hope we would have discussion of the amendment. If people have 
questions about it, so be it. A lot of people want to talk on this 
amendment so, Mr. President, at this point I yield the floor.
  Mr. KENNEDY addressed the Chair.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Mr. COATS. Mr. President, parliamentary inquiry.
  Mr. KENNEDY. I thank the Chair----
  Mr. COATS. Parliamentary inquiry.
  Mr. MOYNIHAN. Mr. President, may we have order.
  Mr. KENNEDY. For the opportunity to speak on this amendment 
generally.
  May we have order, Mr. President. I do not yield to the Senator.
  Mr. COATS. I did not ask the Senator to yield.
  Mr. KENNEDY. I have been recognized.
  Mr. COATS. I am asking for a parliamentary inquiry.
  The PRESIDING OFFICER. The Senate will come to order.
  Mr. KENNEDY. I do not yield to the Senator from Indiana.
  The PRESIDING OFFICER. The Senator from Massachusetts has the floor.
  Mr. COATS. Parliamentary inquiry, Mr. President.
  Mr. KENNEDY. I do not yield to the Senator and ask for the regular 
order.
  Mr. COATS. I did not ask the Senator to yield.
  Mr. KENNEDY. I ask for the regular order.
  Mr. COATS. I am not asking the Senator to yield.
  Mr. KENNEDY. The regular order is the Senator from Massachusetts is 
recognized, and I intend to proceed under the time honored code of this 
institution and not to be interrupted at this time.
  Mr. DODD. Does the Senator have the right to make a parliamentary 
inquiry?
  The PRESIDING OFFICER. The Senator from Indiana----
  Mr. KENNEDY addressed the Chair.
  The PRESIDING OFFICER. If the Senator from Massachusetts will 
withhold for just a moment, I want to remind Senators, the Senator from 
Indiana must have the floor in order to make a parliamentary inquiry, 
and the Senator from Massachusetts has the floor.
  Mr. KENNEDY. Thank you, Mr. President.
  Generally, in the institution, we permit those who are the principal 
sponsors, or the principal cosponsors of the amendment at least a brief 
opportunity to indicate why they are supporting the amendment. The 
Senator from Connecticut has been the primary sponsor of this 
amendment, and the Senator from Michigan, Senator Riegle, who had been 
a primary sponsor of a similar amendment in the Finance Committee. I 
see our friend and colleague from West Virginia, who is chairman of the 
children's commission, who did so much work for the children; Senator 
Murray, and others who wanted to speak on it.
  But I hope, at least as one of those who supports the amendment, I 
will be allotted time to make a very brief comment. I see others here. 
And I know there has been set a time for a vote to happen.
  I will just take one aspect of the reason for the support of this 
amendment, because the Senator from Connecticut has outlined the case 
extremely well.
  I think everyone in this body understands that parents are the first 
responsibility for their children. All of us understand that that is a 
given. All of us understand that the most important opportunities for 
children to develop are in a home in which there is going to be 
nurturing, caring, loving, and affection, and where there is going to 
be the opportunity to receive health care. We understand that great 
African adage that it takes a village to bring up a child. It takes 
loving parents; it takes loving members of a family; it takes those 
members within a community. And we understand that.
  But we also take note of what has happened in our society over the 
period of recent times, and the pressures which children, particularly, 
are under. And the Senator has reviewed that in very great detail.
  I will just mention very briefly what has happened between 1980 and 
1990 in terms of the change in the number of poor infants and toddlers 
by State according to the GAO: In Arizona, the total numbers have 
increased by 90 percent; in the State of California, 49 percent; in 
Colorado, 57 percent; in the State of Florida, 47 percent; in Wyoming, 
69 percent; in Texas, 60 percent--percentage increase in numbers of 
those children that are living in poverty in this country from 1980 to 
1990. This is not something of a few statistics.
  This is a real human tragedy. And the interesting irony is if you 
look through the GAO study, the one State which has had the most 
dramatic reduction is where? Good old Hawaii--the only State that has 
shared benefits, that has a requirement that employers are going to 
provide for their employees and have the kind of preventive programs 
that are included in this Dodd amendment.
  Mr. President, I find that I am somewhat amazed by the 
characterizations of the bill as an employer mandate, particularly with 
regard to this amendment. Whether you are for an employer mandate or 
against, this amendment does not include them. No employer is required 
to offer coverage. No employer is required to contribute to coverage. 
All this amendment says is that insurers must start including 
preventive services for children and pregnant women in any policy they 
sell.
  The Mitchell bill provides for a standard, comprehensive benefit 
package to be offered by all Americans. This is not a radical approach. 
Twenty-one States already mandate coverage of well-child care. Many 
insurance policies are already voluntarily included, the FEHB plan 
offered by Blue Cross, which most of us have, includes it as well.
  So this is not a radical program. We know there are a list of various 
studies that have indicated why this is necessary. I would just mention 
one, and then I will yield because I see others who desire the floor.
  That is the excellent study that was developed by Dr. Hamberger, a 
former president of the Insurance Institute of Medicine, one of the 
most distinguished health philosophers, I think, head of the Carnegie 
Commission. His view of what was happening to children was not really 
directed to the numbers of children that were in poverty, teenage 
pregnancies, the numbers of children that were dropouts in terms of 
schools. He did the health analysis, benefiting from the studies that 
have been done on the development of the brain and what happens to 
these children in the earliest of years from 0 to 3 without having 
adequate nutrition, without having adequate nurturing, without having 
adequate caring.
  He did this excellent study, which the Members of this body should be 
concerned with, and the Carnegie Commission talked about the impact 
that it has on children in terms of their life's experience. He talks 
about what it means in terms of costs, and we are going to hear, What 
is the cost of this? What is the cost of that? He does that in terms of 
showing why this is sound. But he talks about what it means in terms of 
the real possibilities of these children in their lives and their 
future and how they are going to socialize with their neighbors and 
with the members of their families.
  No one can read, no one can pay attention to that Carnegie Commission 
report, which really is an indictment of our society for failing to 
understand the real challenge that this Nation faces in caring for its 
children.
  This Dodd amendment addresses in an important way, perhaps not as 
much as any of us would, a strong downpayment, advancing the time of 
coverage over the Mitchell bill, advancing it to demonstrate that we in 
this Congress say that children should no longer be left out and left 
behind.
  It is a compelling amendment. I am so glad at least, I say to my good 
friend and colleague from New York, that finally we are talking about 
health care in this body, that finally we are talking about dealing 
with something that really makes a difference for peoples' families. 
And Members here are on their feet ready to speak and ready to debate 
this issue. I hope that we will be able to get to an early resolution 
of an amendment which reaches to the heart and soul of what this debate 
is all about; that is, whether we are going to care about the needs of 
our children as much as we are going to care for the special interests.
  Mr. DOLE addressed the Chair.
  The PRESIDING OFFICER. The Republican leader is recognized.
  Mr. DOLE. Mr. President, we have a filibuster going on here this 
afternoon. At least it appears that way. We have those who offer 
amendments, and they have dominated the floor. At this point, if we are 
not going to start this debate, we are not going to make any agreements 
anymore. We should have had the bill read. It is 1,400 and some pages.
  But I understood, in visiting with the majority leader, that there 
would be some give and take. We have not had any opportunity. We have 
numbers of Members who want to make statements who are on the floor. It 
has taken since 5 o'clock to have amendments offered and farm it over 
to everybody on that side. It is probably by design. Maybe they have 
been losing the debate. Maybe they think they can bring up a couple of 
amendments and talk about the children, or talk about the disabled. 
Maybe that will somehow change the tide of American public opinion. It 
is not going to happen.
  We want to find out how it is paid for. Nobody opposes helping 
children, or pregnant women, or the disabled. Somebody is going to pay 
higher premiums. We ought to find that out. If we ever get to ask the 
question, we will find out some of these things.
  Even more importantly, we have only had on this side about 6 hours to 
speak on a bill that is going to affect everyone in America. If this is 
how we are going to conduct the business, then we will have to revise 
what we have in mind. If we are going to have a balance in time, OK. 
But if the Democrats are going to decide they will speak a certain 
time, and that we can have whatever is left, then it is not going to 
work.
  So I just suggest to my colleagues that we came on this floor in good 
faith today. We agreed to the majority leader's unanimous consent 
request. We did not have to. We could have had the bill read.
  Then we have this kind of display, which I think is unfair and 
unseemly when we are talking about health care. We want to talk about 
health care on this side of the aisle, too. We have as much right to 
talk about health care. We are going to take every right to talk about 
health care. We want the American people to know what is in this bill.
  Somebody ought to explain the bill before we start offering 
amendments.
  I would suggest the absence of a quorum. We will have a vote at 6:20. 
Then we will determine after that vote how we are going to play this 
game.
  I suggest the absence of a quorum.
  Mr. MITCHELL. Mr. President, would the Senator withhold it for a 
moment to permit me to make a few comments?
  Mr. DOLE. Sure.
  Mr. MITCHELL. Mr. President, the previous days of debate were 
conducted in a manner in which the time was equally divided. Indeed, on 
one occasion the Democratic manager yielded time to a Republican 
colleague to give him additional time to finish his remarks.
  We have now been on this amendment for about an hour, and I can 
assure the Senator and all of our colleagues that there was no design 
or intent or plan to foreclose our Republican colleagues from speaking. 
We recognize that every Senator has the opportunity, the right, to be 
heard, and that clearly will be the case here.
  Second, with respect to the agreement to permit the bill to come up 
by unanimous consent today, as the distinguished Republican leader 
knows, that was agreed to by him and me on Tuesday of this week as part 
of a broader discussion involving the days of debate only, leading up 
to until now.
  I indicated at that time that I would withhold filing a motion to 
invoke cloture on the motion to proceed if we had an assurance that we 
would be able to go to the legislation, and that if we did not receive 
that assurance--for which I am grateful to the distinguished Republican 
leader. We have proceeded as we did agree. We have no intention of 
foreclosing anyone from speaking. And there will be ample opportunity. 
As I said, only about 1 hour has transpired on this amendment.
  I have seen many, many occasions when the introductory statements 
with respect to amendments by the cosponsors have vastly exceeded 1 
hour.
  So I do not think any implication can or should be drawn from the 
fact that just about an hour having elapsed it has all been by the 
sponsors of the legislation. That is, I think, a rather common 
occurrence in the Senate.
  I really want to say that it is our desire and intention that 
everyone have full opportunity, that there is no--the Senator suggested 
or asked whether it was by intention or design. That is not the case. I 
do not think there has been any such action on our part. So everybody 
will have full opportunity, and we want everyone to be heard on any 
aspect of the amendment or the bill.
  It is my hope that we can proceed to a vote on the amendment after 
there has been ample opportunity for consideration and debate on that. 
Of course, Senators are free to debate other issues during the same 
time as well as the amendment.
  But I do want to make that comment in response to the Senator.
  Mr. DOLE. I thank the majority leader. We have tried to sort this 
thing out. But I must say, and maybe I have not been here long enough 
to understand what I am talking about, about what is going on over 
there. Or maybe I have been here too long and I understand what I 
thought was going on. There is not any doubt in my mind about what is 
happening; any doubt in the mind of the people who are participating. 
They did not offer the amendment and sit down. They offered the 
amendment and farmed it out to the floor.
  I assume the inference must be the Democrats love children and we do 
not like children, so we should not be entitled to speak; or that the 
Democrats are concerned about pregnant women and the Republicans are 
not, so we should not be allowed to speak on things like that. So we 
should not be allowed to speak on things like that. That is not the 
case, and we are not going to be denied the opportunity to present our 
case. As I have said to the majority leader, this is an important 
issue. We have a lot of statements to make. Our people are concerned in 
our States. We want to know what all these things are going to cost. 
How much is the bill going to cost. It is going to cost the State of 
Wisconsin about $900 million over the next few years. We would like to 
find out some of these facts before we start offering anything. There 
may not be any problem with the amendment. This moves up the date a 
year and a half, but somebody has to pay for it. Subsidies do not kick 
in and--

  Mr. DODD. Will my colleague yield?
  Mr. DOLE. I would, but it is time to vote and we would not want to 
miss the vote.
  Mr. DODD. I ask unanimous consent to speak for another minute.
  Several Senators objected.
  The PRESIDING OFFICER. Objection is heard.

                          ____________________