[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]

 
                      UNANIMOUS-CONSENT AGREEMENT

  Mr. MITCHELL. Mr. President, I ask unanimous consent that Senator 
Lott have up to 15 minutes more time; that following that, the Senate 
proceed to debate only on the pending amendment and the bill itself, 
with the time to be equally divided in alternating 30-minute segments, 
with the 30 minutes immediately following Senator Lott's remarks to be 
on the Democratic side, and thereafter, so long as Senators wish to 
speak for the evening; that when the Senate reconvenes tomorrow at 9:30 
a.m., there be a period for morning business not to extend beyond 10 
a.m.; that the Senate then continue to debate the matter from 10 a.m. 
until 5 p.m. tomorrow, under the same procedure--that is, 30-minute 
alternating segments, with the first 30 minutes tomorrow, beginning at 
10 a.m., under the control of our Republican colleagues, and that the 
designation of time, if need be, be under the control of the Senators 
Moynihan and Packwood.
  Mr. COATS. Reserving the right to object.
  Mr. PACKWOOD. Reserving the right to object, did you say confine 
debate tomorrow to the amendments?
  Mr. MITCHELL. No; debate on the amendment or the bill.
  Mr. PACKWOOD. That is the first question I ask. I want to make sure. 
I have, at the moment, 27 Senators who want to make opening statements, 
and some of them are 3, 4 hours long. I do not think they want to be 
interrupted in half hour segments.
  Mr. MITCHELL. Some of the opening statements are 3 or 4 hours long?
  Mr. PACKWOOD. Yes.
  Mr. MITCHELL. Of course there was vigorous protest today when 
Democrats spoke for about an hour. It was suggested that there was some 
kind of scheme or design to prevent Republicans from speaking, and now 
you are suggesting that Republicans want to speak 3 or 4 hours at a 
time.
  Mr. PACKWOOD. I am perfectly willing to go on an equal basis. I want 
the leader to know some of these statements are quite long. I have no 
objection to 4-hour opening statements on the Democrat side either. 
Most of them are in the neighborhood, I would judge, of an hour to an 
hour and a half. But some are 3 or 4 hours.
  Mr. MITCHELL. Well, then, in order to accommodate our Republican 
colleagues, why do I not suggest that we stay in session tomorrow from 
10 a.m. until midnight, and that the time be allocated in 1 hour 
segments?
  Mr. PACKWOOD. From 8 a.m. until midnight?
  Mr. MITCHELL. Ten a.m.
  Mr. PACKWOOD. Well, as the leader knows, either side can tie up the 
other side. Earlier on the product liability bill we were unable to 
come to a vote because the majority of Democrats did not want to do it. 
And the leader is aware that last session we could never vote on 
capital gains because we could not get enough votes to get to cloture.
  All I am suggesting is this. I am looking at the majority leader's 
statement of 2 days ago. It says, ``There will be ample opportunity to 
debate this bill.'' Of course, he was referring to the previous bill, 
but I assume it applies to this one. ``I have said many times no one 
will be rushed. We will stay here as long as it takes us, as many days, 
weeks, or months, if necessary, for every Senator to be able to 
consider the bill amply.''
  Mr. MITCHELL. If the Senator would like to stay in session beyond 
midnight, I am agreeable to that.
  Mr. PACKWOOD. You know there is no purpose in doing that. If we are 
going to stay here until midnight every night, you and I know nothing 
will be accomplished. You can have procedural votes, if that is what 
you insist upon.
  I thought you really meant that our side could make opening 
statements of some consequence and serious nature. We have been 
preparing for this. We have divided up into teams, and we have serious 
things to say on the different issues. The opening statements will 
relate to different sections of the bill. In a sense, the majority 
leader is saying there is something wrong with that.
  Mr. MITCHELL. I am certainly not suggesting that. I think the Senator 
is entitled to have the time he wants to speak, but I am trying to 
accommodate that. I do not appear to be reaching him in an 
accommodation.
  Mr. PACKWOOD. I suggest this for tomorrow. Divide the time equally, 
but not put it into statements.
  Mr. MITCHELL. The problem with that, of course, is that when one 
Senator gets the floor and speaks 3, 4, 5, 6 hours, other Senators are 
totally inconvenienced, I think. I think it is better if we have a 
reasonable schedule in which Senators can plan their appearances and, 
therefore, Senators will not be inconvenienced by the actions of any 
one Senator.
  Mr. PACKWOOD. I will talk to those who want to make opening speeches. 
For those who can confine themselves to an hour, I suggest they speak 
tomorrow.
  Why do we not divide the time in hour segments instead of half hour, 
rotating back and forth, and quit at 4 or 5 o'clock, whatever you said, 
in the afternoon.
  Mr. MITCHELL. I just proposed that a moment ago.
  Mr. PACKWOOD. OK. I did not hear. What is the proposal now?
  Mr. MITCHELL. My initial proposal was half-hour segments. In response 
to the Senator's earlier objection, I proposed 1-hour segments, which I 
take it the Senator now proposes.
  Mr. PACKWOOD. Yes.
  Mr. COATS. Mr. President, reserving the right to object, I want to 
make sure I understand this, because many of us have been waiting very, 
very patiently.
  I am very high on the list. Since I serve on the Labor Committee and 
have dealt with the labor bill that Senator Kennedy proposed, I feel 
like I have some knowledge of the bill.
  I was told that we were assured we were going to take up the health 
bill at 2:15 p.m. Tuesday, without interruption. Once on the bill, we 
would be on the bill. Senators would have the opportunity to speak on 
the bill.
  Yet, there has been a very limited amount of time allocated to that 
purpose.
  I said I am high on the list. My turn is finally coming up tomorrow, 
on Saturday. But I have been waiting patiently all week while we have 
disposed of all kinds of other business.
  We have been willing on our side to do that. We accommodated that, 
including today. It is impossible for any of us to make any kinds of 
plans for family, including dinner.
  I came today thinking my turn was finally here, only to learn that 5 
hours will be allocated to a bill we were not even talking about 
earlier in the week.
  So I waited patiently for that 5 hours to expire, and then came down 
ready to make my statement, and an amendment was dropped on even before 
the new bill was presented to the desk.
  I was here when the bill came in. The amendment was already offered 
before the bill was here.
  So now, having waited and been patient, when we are now asked to 
limit what we were going to say to some arbitrary time limit and do it 
on a Saturday, it is difficult for this Senator to just do it, to keep 
changing and agree to changing the rules, or what I think are the 
rules. Maybe they were not rules. In fact, I am willing to let my 
statement be limited. I have no intention of filibustering. I have no 
intention of speaking 4 hours. I have not timed my statement. I do not 
know if it is 39 minutes or 53 minutes or 64 minutes.
  But I would like to give my statement, and I am going to do so in a 
reasonable amount of time. Then I am going to sit down and let whoever 
else wants to talk deliver their statement.
  Mr. MITCHELL. Mr. President, if I might respond, first I am sure it 
was inadvertent, but the Senator is incorrect. The amendment was not 
offered before the bill was introduced.
  Second, as the Senator well knows, unanimous consent is required in 
the Senate before any procedure is ultimately approved. And I do not 
know what he was told or what reports he had, but in the absence of 
unanimous consent, then the schedule is, of course, always subject to 
change.
  It is quite common that I make proposals, as I have just indicated I 
have earlier this evening, as to the schedule for Monday. But until 
consent is granted by our Republican colleagues, there is no agreement 
to that effect.
  If the Senator acts on the basis of a proposal, surely all of us are 
sufficiently familiar with the Senate to be aware that unless and until 
agreement is obtained and approved by consent, it is subject to change.
  I regret any inconvenience to the Senator, but I urge him in the 
future to base his decisions on agreements as opposed to proposals 
which I may make.
  Mr. COATS. Mr. President, further reserving the right to object, I 
certainly understand how the unanimous consent procedure works, and I 
am attempting to abide by that.
  It has been a floating crap game this week in terms of what we are 
doing and when we are doing it. It literally changed several times an 
hour. It is extraordinarily difficult for any Senator to understand 
what the next procedure is going to be. But I understand that is how 
the Senate works.
  I do believe that operating on a Saturday with the Members having 
changed travel plans, it is important to keep some semblance of order. 
I will not object to an hour time limit imposed for tomorrow on 
individual speakers, and going back and forth.
  However, I just hope that if it turns out that this Senator needs--or 
a Senator from the other side needs--another 3 minutes or 7 minutes to 
finish a statement they have been working on for a long time, there 
will be some consideration in granting that. I have no doubt the 
Senator will grant that.
  Mr. MITCHELL. I say to the Senator that we are in tomorrow. I do not 
know if the Senator was here earlier.
  I indicated it had been my intention and hope that we be in session 
and voting tomorrow, but the distinguished Republican leader has 
advised me that the Republicans would use their ability under the rules 
of unlimited debate to prevent a vote from occurring tomorrow. That is 
the reason there is not going to be a vote tomorrow.
  Second, as I stated earlier and I repeat, the only recourse I have to 
guarantee a vote would be to call for a vote on a procedural matter. I 
have concluded that I will not do so tomorrow because I do not believe 
it would serve any useful purpose.
  So if the Senator is inconvenienced because we are not going to be 
doing something that we thought we were, that is the reason for it.
  Mr. COATS. Mr. President, further reserving the right to object, I 
ask the floor manager, how many Republican Senators have had the 
opportunity to give opening statements.
  Mr. PACKWOOD. So far?
  Mr. COATS. So far.
  Mr. PACKWOOD. Eight.
  Mr. COATS. Eight of forty-four Republican Senators.
  Mr. LOTT. I think I am the ninth one.
  Mr. PACKWOOD. We have 28 signed up who want to give opening 
statements. The remainder want to, but 28 have not given them yet.
  Mr. COATS. Mr. President, it seems to this Senator, on the most 
important bill I have certainly faced since I have been in the Congress 
since 1981, and what many consider one of the most important pieces--if 
not the most important piece--of legislation that Congress has ever 
considered, there ought to be some willingness to allow individual 
Members to express their opinions on this without the implication that 
Senators on this side are somehow not cooperating with the majority 
leader or the majority party simply because they are not ready to vote 
on a Saturday after we have had 6 hours and eight Senators allowed to 
speak.
  The implication is that somehow the Republicans are being unfair, 
that we are trying to delay consideration of this legislation, when 36 
of us have not even had an opportunity to say the first word.
  So again, I say I will not object to the unanimous consent request. 
But this Senator certainly does not want to be left in the position 
where the impression is given that I am asking for something 
extraordinary and out of the ordinary, when 36 of our colleagues have 
not even had a chance to say the first word on probably one of the 
most--if not the most--important bill this Senate has taken up in a 
long, long time.
  The PRESIDING OFFICER. Is there objection to the unanimous consent 
request?
  The Senator from Oregon.
  Mr. PACKWOOD. I object.
  I was going to change the unanimous consent for tomorrow to 6 hours 
equally divided, and if one of my speakers happens to go for 15 or 20 
or 25 minutes, to take it out of the 3 hours rather than trying to 
confine that person.
  The Senator from Indiana may need 47 minutes or 53 minutes, or 
something like that. We end up with the same amount of time. At least, 
we will have a little more flexibility in allocating it.
  Mr. MOYNIHAN. Fine.
  Mr. MITCHELL. Mr. President, I have no objection to that.
  I want to note, if I can make a comment, we had a situation earlier 
where Democrats spoke for 1 hour, and not only an implication but a 
direct accusation was made that this was some scheme to prevent 
Republicans from speaking. So my proposal was directly responding to 
that concern to accommodate what were Republican protests. I just want 
to make that clear.
  Now, those who have protested to the prior situation are objecting to 
what I have proposed to accommodate their concerns. But the managers 
are fully capable of allocating the time and I am perfectly prepared to 
renew my request with just the time equally divided under the control 
of the managers.
  Mr. DODD. Mr. President, reserving the right to object, I just point 
out, and I will not object to this, but it is not inconceivable we are 
playing the numbers game again very briefly where one colleague of ours 
on the other side could end up taking the 2 hours or 3 hours, and we 
will be hearing the argument on Monday that only 10 Senators have had 
an opportunity to make opening statements.
  So I just point out that I hope we do not hear that argument on 
Monday.
  Mr. MITCHELL. I expect the Senator will.
  Mr. DODD. I hope we do not hear the argument that we were unable to 
get the statements out because someone used all the time.
  I do not object to this. I wanted to make that point.
  Mr. MITCHELL. That is what already happened during part of this week.
  Mr. President, let me restate the request so there can be no 
misunderstanding. There has been so much back and forth here.
  Mr. President, I ask unanimous consent that, as to this evening, upon 
the completion of Senator Lott's remarks, there be debate to continue 
for so long as Senators wish to debate, with the time allocated in 
alternating 30-minute segments this evening, and the first segment 
following Senator Lott be for Democratic Senators to be followed by 
Republican Senators, and so on for, as long as Senators wish to stay 
and speak; that tomorrow, the Senate reconvene at 9:30; that there be a 
period for morning business until 10 a.m.; that the time between 10 and 
5 be for debate only; and that it be equally divided and under the 
control of the managers.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered.
  Mr. MITCHELL. I thank my colleagues.
  Mr. LOTT. Mr. President, I am delighted to be able to begin to return 
now to the general debate and discussion of the amendment of the 
Senator from Connecticut.
  I think one of the points that the Senator from Indiana tried to make 
was that this bill, which is the latest Clinton-Mitchell bill, version 
No. 3, was laid down at 5 o'clock, an amendment was offered immediately 
today, and then, and only then, did we get this bill delivered to us.
  Now it is being said, we should vote tonight. I do not know what the 
cost estimates are. I think that is a legitimate question.
  Mr. DODD. I have the cost estimates. I gave them earlier. The CBO 
estimates $100 million the first year, $300 million the second year, 
$100 million the third year, and no cost in the years thereafter. That 
is the CBO's estimate.
  Mr. LOTT. Those are very legitimate questions, and there are others 
on this amendment and on other amendments.
  Clearly, to infer that we are, you know, delaying things because we 
are not ready to vote on amendments to a bill we did not see until 5 
o'clock this afternoon, is not appropriate.
  We have, I think, every right--in fact a responsibility--to take a 
look at this legislation and to take a look at amendments before we are 
forced to start voting.
  All right, maybe we had eight Senators speak on our side for 6 hours. 
That is less than 1 hour each. But there are a lot of Senators that do 
want to speak on this issue. In fact, I have had my own constituents 
already saying, ``Now, where are you? I thought you would be speaking 
up on this issue.'' I have been waiting my turn.
  If you look at other major pieces of legislation, I think you will 
find they were debated not for a few hours, and in broken fashion, or a 
week or 2. They went on for days, weeks, and I believe even perhaps 
months in one or two instances.
  So for us to be able to have some time to speak on this issue before 
we start addressing amendments, I think is fundamentally fair--and I 
know the chairman of the Finance Committee would support that effort.
  Like tonight, there are so many questions I have, there are so many 
areas I would like to speak on, but I would really be trying to relate 
this to the alternative bill that I have and, in fact, to the middle-
class.
  I am going to speak for about an hour. And for an old House guy, it 
is not easy. I used to speak in 5-minute bursts. I know the Senator 
from Connecticut used to do that. But, after a while in the Senate, it 
certainly takes a little longer. Certainly this legislation deserves a 
little time.
  We want to cooperate, but we are not going to be rushed into it.
  Under the Clinton-Mitchell bill that we saw earlier this week, if 95 
percent of the population is not covered by the year 2,000 and, if 
Congress does not act, businesses with more than 25 employees will have 
to pick up 50 percent of their employees's insurance.
  The Clinton-Mitchell bill also has a lot of other taxes than what has 
been mentioned in my earlier remarks here today.
  We could fix the problems with health care without raising any taxes, 
but yet in this bill--the latest version, I presume, also--we do have a 
45-cent-per-pack tax increase on cigarettes. We have a 1.75 percent tax 
on all insurance premiums, not the high-priced ones, not for just some, 
but for all insurance premiums, as I understand it; plus a 25 percent 
excise tax on the so-called high-priced insurance plans.
  Businesses also would lose health plan deductions if the plans--
listen to this--businesses would lose their health plan deductions if 
the plans they offer do not conform to the standard, expensive 
Government benefits plan.
  Do it our way or you cannot do it. You will lose your deduction.
  This is an indirect mandate, but a very serious one. If businesses 
provide insurance for their employees, the only policies that will not 
be heavily taxed will be the Government-tailored plans, and they will 
be very costly. The employers must pass this along in the form of lower 
wages, less jobs, and/or higher prices for the consumers.
  Employers, because of the Clinton-Mitchell ``antidiscrimination'' 
clauses, must provide insurance to all employees, if even one single 
employee is covered. These mandates are bad, once again, for middle-
income people.
  How will business react to these mandates? A Hewit study of large 
employers found that 34 percent of them would reduce or terminate part-
time job positions if insurance coverage was mandated for these 
workers.
  Keep in mind now that the Clinton-Gephardt version has that mandate 
at 80 percent, and much earlier than even the Clinton-Mitchell plan.
  The Clinton-Mitchell bill's exemption for companies with less than 26 
employees would stunt business growth--hiring of that 26th worker would 
mean wages for that worker, and health coverage for the entire firm. 
There would be little incentive, certainly, for businesses to expand.
  Now we all represent our respective States. So I keep saying, what is 
it going to mean in my own State?
  There will be some benefits, there is no question, in this plan. But 
in my State, a Government-run health care system would, once again, 
destroy thousands of jobs that we really cannot afford to lose.
  Mr. President, there is a report by the Family Research Council, 
entitled, ``Families With Children in Mississippi Bear the Brunt of Job 
Losses to Employer-Mandated Health Care proposals.''
  Mr. President, this report shows that families with dependent 
children in Mississippi will bear a disproportionate share of the job 
losses under any employer mandate. Under a Clinton-like bill with 
subsidies, 3,400 of the estimated 6,200 jobs lost in Mississippi would 
be shouldered by families with dependent children--55 percent of the 
job losses will come from families with children, even though working 
parents are only 47 percent of the State's labor force.
  Without subsidies--paid for by the middle class--job loss for 
families with dependent children would climb to 61 percent of all job 
losses--working parents would absorb 17,500 of the 28,900 jobs lost. 
Surely, Government-run health care will make thousands of families in 
the middle-income area in Mississippi worse off than they are today. 
They could very likely lose jobs, as these statistics show.

  This bill, this 1,443-page bill, as I understand it, has 17 new 
taxes; community rating mandates in the bill, that will make younger 
workers heavily subsidize the insurance costs of older workers and 
retirees; some 50 new bureaucracies; and, as I mentioned earlier, a 
projected cost of over $1 trillion over 8 years. To me that is 
disaster. This is the second largest entitlement program in human 
history, as I have been told, bringing over 100 million people into the 
Government-mandated health care system.
  That is the key factor. We are going to bring all these people into 
the Government-run system.
  It is untrue that Government-run health care will help the middle-
class. It will hurt it. Under the Government-run plan, premiums could 
cost families up to $6,946 a year, according to the Hewit study I 
referred to. The people back home need to remember this statistic. That 
is almost $2,000 more per year than the 1992 average cost of $5,028 a 
year.
  You folks that are working, blue-collar workers, you are going to pay 
$2,000 more than you were paying in 1992 under this plan.
  The health scare bills have frightened middle-class Americans. The 
American people see the debate turning in a dangerous direction, 
towards a new, costly, bureaucracy that will not solve our problems. In 
fact, it make their problems worse.
  That is why almost two out of three people think that Congress should 
take their time and do this, this legislation, next year. Common sense 
and prudence have been replaced by desperation, by those who want 
bureaucrats to take over one-seventh of the Nation's economy. I think 
we need to calm down and take a serious look at what we are doing. We 
can fix the problems with the system, and the plan that Senator Dole 
and Senator Packwood have offered will solve those problems of high 
cost, portability of insurance, availability of affordable insurance, 
and the inclusion of those Americans with preexisting conditions 
through the free market. They give people the medical savings accounts 
which would certainly help middle-income Americans by allowing families 
flexibility in choosing their health insurance. And the Dole-Packwood 
bill does have assistance for low-income people. I believe about $100 
billion--
  Mr. PACKWOOD. It is $108 billion, I think.
  Mr. LOTT. There is $108 billion for that purpose. We can let 
Americans continue to choose their own doctors. We can have real 
malpractice reform. We can plug the holes in the system without new 
taxes, without new bureaucracies, and without price controls.
  We fix all this without decimating the middle class. Americans do not 
want this Government-run, Government-controlled system. The market 
works. We have seen time and time again that Government-run programs do 
not work. The costs almost invariably spiral out of control. Under this 
Clinton-Mitchell plan or any other Government-first, people-last plan, 
middle-income families will pay more for less health care.
  So, with that, Mr. President, I yield my time at this point. I surely 
will have, perhaps, some more questions for the Senator from 
Connecticut later on, and I will have at least one amendment I will be 
prepared to offer before we finish this legislation, directed at trying 
to be helpful to middle-income Americans.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New York is recognized.
  Mr. MOYNIHAN. Mr. President, may I congratulate the Senator from 
Mississippi for forceful and factual argument which will not find much 
support on our side of the aisle but will be, nonetheless, admired.
  May I make one point to him? The Republican mayor of New York City, 
my good friend and our respected mayor, Rudolf Giuliani, wrote a letter 
to the House leadership in which he was joined by two eminent labor 
leaders, Stanley Hill and Dennis Rivera. And Mayor Giuliani made this 
point, a rather important point from our perspective. He said:

       America is debating universal health care. New York has 
     given universal health care for most of this century.

  I might point out, you know, we grew to be the preeminent Nation in 
the world under arrangements that are different from other parts. 
Hawaii has universal employer mandate. But we have had universal health 
care. I can speak as the child who has the normal range of mishaps and 
number of visits to hospitals and doctors. There were no bills. You 
could pay, but if you did not pay there was no consequence. It was 
understood that health care would always be available in New York City. 
So we are not exactly embarking on an enterprise heretofore unknown in 
North America. There are those who think New York City sometimes may 
not be part of North America but I insist to the contrary, island 
though it may be in large measure.
  A vigorous proponent of health care, an able and informed Senator who 
has been patiently awaiting without making any points of order as to 
gain any special attention, the distinguished Senator from Washington--
I am happy to yield her. Would half a hour be sufficient?
  Mrs. MURRAY. Mr. President, 15 minutes will be sufficient.
  Mr. MOYNIHAN. I yield as much time as she wants within the half-hour.
  Mrs. MURRAY. Mr. President, I thank the distinguished Chair.
  We have heard many statements over the last several days, meant to be 
scary and frightening, but I submit to this body who is really 
frightened and in a frightening position today is our Nation's 
children. Because if we continue in today's trend without passing 
health care reform, they will not grow up with affordable, quality 
health care and have the quality of life that I hope to pass on to my 
children and my grandchildren.
  I am pleased tonight to join Senators Kennedy and Dodd in offering 
the amendment that is before us for our Nation's children.
  I ask unanimous consent that Senators Daschle, Boxer, and Mitchell be 
added to this amendment.
  The PRESIDING OFFICER (Mr. Bryan). Without objection, it is so 
ordered.
  Mrs. MURRAY. The American people have heard discussions on this floor 
about employer mandates, premium caps, and triggers. We have heard a 
lot about purchasing co-ops, alliances, and malpractice limits. Why? 
Because these are the issues that affect big interests, those who 
control our Nation's health care system today.
  But my parents taught me a lesson a long time ago, that the little 
guy is just as important as the big guy. And that is what this 
amendment is all about. It takes us back to why this debate started in 
the first place. It reminds us that our society is not well served by 
the current system.
  Parents across this country worry about our children's health. 
Parents who have no health insurance worry about what they will do when 
their child gets sick. Those who are insured worry about whether they 
are covered against everything that could and often does happen to our 
children.
  I know what it is like to sit in a doctor's office with a sick child. 
I know the frustration, trying to ease a child's tears and the silent 
helplessness of soothing pain. And I know the anxiety.
  Too many times I have rushed to the doctor's office waiting to hear 
the physician ask, ``What's wrong with this little one?'' But all too 
often I was questioned by the receptionist: ``Do you have health 
insurance? Well, we will have to call the company to see if this is 
covered.''
  Unfortunately, nearly 10 million children in this Nation never even 
hear that question. Unless we change the system, 10 million children 
will remain on the outside, without adequate health care.
  And what happens to these children as they grow older? The social 
cost is enormous. These children at risk grow into adolescents and 
young adulthood, toughened by hardship. And they come to believe that 
no adult really cares for them. Is it any wonder that we see higher 
dropout rates and more brutal juvenile violent crime? Of the medical 
costs that are preventable--that are preventable--teen health problems 
now surpass $27 billion a year. Can this country afford this?
  The Mitchell bill puts our Nation's children on the right path 
towards a healthy future. The purpose of this amendment is to give them 
a jump start. We heard before that this amendment has to do with 
subsidies. It has nothing to do with subsidies. It simply requires 
private insurance companies to provide coverage for preventive services 
for pregnant women and children for any plan issued after July 1, 1995. 
Our children grow up fast. This amendment gets them on the right road 
from the start.
  Raising kids has become more complicated and scarier. This amendment 
takes one worry away from America's families. Our country cannot afford 
to neglect our future generation. As John Kennedy once said, ``The 
needs of our children should not be made to wait.'' I hope this body 
keeps that statement in mind as we continue to debate this bill. ``The 
needs of our children should not be made to wait.''
  I yield the floor.
  Mr. MOYNIHAN. May I thank once again the distinguished Senator from 
Washington, who cares so very much about this subject and knows so very 
much about it, for a remarkably concise and moving statement.
  The majority leader?
  The PRESIDING OFFICER. The majority leader is recognized.
  Mr. MITCHELL. Mr. President, I would like to make just two points 
briefly. First, the distinguished Senator from Mississippi and several 
of our colleagues have referred to the Government-run system, in an 
obvious effort to create the impression that the legislation I have 
proposed and which is being considered would create a Government-run 
system. Those were the exact words used.
  Let me make clear that my amendment will have just the opposite 
effect. One of the largest Government-run systems now is the Medicaid 
system, which provides health insurance for persons with incomes below 
the poverty level. Under my legislation, most of that program will be 
abolished and the assistance now going to them under a Government 
program would be channeled to them to encourage them to purchase 
private health insurance.
  So, in effect, a very large Government program would be abolished and 
those persons would enter the private health insurance system where 
most Americans are.
  I recognize that our colleagues are obviously engaged in a tactic of, 
if you repeat something often enough, people will come to accept it, 
even if it is not correct. That is what has occurred with respect to 
this Government-run system. Much the same thing occurred a year ago, 
Mr. President, when we were debating the President's economic plan. 
Many of our colleagues today making these charges about the pending 
bill repeatedly talked about how the President's economic plan would 
raise taxes on small business and raise the tax rates of large numbers 
of Americans, and they were successful in persuading Americans of that, 
even though it was not true.
  Polls showed last year that a large number of Americans believed that 
their income tax rates were going up when, in fact, only about 1.2 
percent of Americans, those at the very top of the income scale, did 
have their income tax raised. A large number of other Americans, much 
larger numbers, had their taxes gradually reduced or they received some 
significant benefit.
  So I accept the fact that campaigns of misinformation do work, but I 
think it is important that those of us involved in the debate make 
clear what the circumstances are.
  Finally, if I could make one comment on one aspect of the discussion 
this evening. We have had a lot of colorful talk by some of our 
colleagues about the fact that there have been some changes in the 
bills that have been presented, and to a person unfamiliar with Senate 
procedure and the practices of the Senate, it might sound unusual or 
uncommon or strange that a bill is changed in the process. But, of 
course, as every Senator knows and as everyone who follows the 
legislative process knows, it is a common event that bills are changed 
in the process and a draft bill is introduced, labeled as such, 
technical corrections are found, typographical errors occur, 
substantive changes are made to accommodate concerns expressed by one 
or another Senator.
  And so I hope that most people have enough of an awareness of the 
legislative process to understand that it is a common event that change 
occurs as bills move through the process.
  Indeed, just yesterday, Senator Dole described one such circumstance 
with respect to his bill, the bill that he and Senator Packwood 
introduced earlier this week. Senator Dole told us that when he 
announced his plan to introduce a bill in June and after that plan was 
studied, the Governors Association issued a letter criticizing it and 
he then, as he put it, worked with the Governors over the next few 
weeks to change his plan to accommodate their concerns. And, therefore, 
the bill introduced by Senators Dole and Packwood this week was, by 
their own account, different from the plan they announced in June 
because they made a legitimate and appropriate effort to accommodate 
the concerns of Governors.
  Indeed, I am going through the same process now with Governors. They 
have sent a memorandum to me expressing concerns about some parts of 
our bill, and we are meeting with them in an effort to accommodate 
those concerns.
  I fully expect, Mr. President, that when Senators Dole and Packwood 
introduce their bill as an amendment to be considered, it may well have 
some changes from the version that was introduced earlier this week. 
Should we then engage in flamboyant rhetoric about the fact that they 
may make a couple changes in their bill and suggest that is something 
unusual and we then get up and hold up the two bills in our hands and 
wave them around like a pair of fans and suggest that there is 
something unusual or different or inappropriate with that? The answer 
is, of course, no. This is a regular part of the process.
  The legislation I introduced today as a substitute amendment has a 
few minor changes from the version introduced on August 9, and I expect 
now within the legislative process there are going to be many other 
changes proposed by Senators and adopted by the Senate.
  So I hope that no Americans are diverted or distracted by all of the 
fuss and feathers about changes made in the bill. It is a common event. 
It occurs regularly. I am certain it will occur with respect to other 
bills that are proposed here. We accept it as a part of the process. We 
are now reviewing the bill that was introduced by our colleagues in an 
attempt to determine in what respect it differs from the plan announced 
in June, and I hope that the debate now can focus on the real issues.
  Mr. DODD. Will the majority leader yield?
  Mr. MITCHELL. Yes; certainly.
  Mr. DODD. I am pleased the majority leader has made this point, 
because I think some of you have seen some of our colleagues wave these 
volumes around. If I understand what you said, in effect, the 
substitute introduced this afternoon at approximately 5 o'clock is 
virtually the same bill we have been talking about for the past several 
days with literally technical and minor corrections; is that not 
correct?
  Mr. MITCHELL. A couple of the changes are substantive, but there are 
very few in there.
  Mr. DODD. But this notion of holding one bill in your left hand and 
another bill in your right hand and implying or suggesting that we are 
dealing with entirely two distinct products is engaging in a bit of 
hyperbole or exaggeration.
  Mr. MITCHELL. Well, it gets you on TV.
  Mr. DODD. I just lastly ask the majority leader, I think I understood 
the unanimous consent request in the sense that now the pending 
business is the amendment I offered at roughly 5:30 this afternoon.
  Mr. MITCHELL. That is correct.
  Mr. DODD. We have no agreement on when this amendment can be 
considered and voted upon; is that correct? Or do I have a time when I 
can anticipate we might get a vote on that amendment?
  Mr. MITCHELL. I have proposed to the distinguished Republican leader 
that we vote on that amendment at 5 p.m. on Monday, but he has not yet 
been able to get that cleared or has not responded on that. So as of 
now, there is no time, but my hope is we can go to that amendment--
  Mr. DODD. So it being Friday night now at 8 o'clock, and Saturday and 
Sunday and virtually all day Monday would be time devoted to the 
general discussion of either this amendment or the bill at large.
  Mr. MITCHELL. That is correct, although there will be no session on 
Sunday.
  Mr. DODD. I thank the majority leader.
  Mr. MITCHELL. I yield the floor.
  Mr. MOYNIHAN. Mr. President, I happily yield such time as he may 
wish--and I believe he indicated 10 minutes, but it does not matter--to 
the Senator who has so singularly helped bring us to this historic 
moment, the Senator from Pennsylvania, my friend, Harris Wofford.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. WOFFORD. I thank the Senator.
  I wish to thank the Senator from Connecticut for bringing this 
amendment to us as the first amendment of this bill. And I want to 
thank the majority leader just now for cutting through some of the fog 
of confusion that has been laid down over the country and helping to 
start make it clear that this is not more government-run medicine but 
it is building on our private health insurance, pointing out that in 
the Medicaid program it is helping to move people into the kind of 
choices that other people have in the private health insurance system.
  This is an amendment that deals with extending the private health 
insurance system to make it real and effective for children and 
pregnant women in this country.
  Winston Churchill used to say that buying milk for babies was the 
best investment a nation could make in the future.
  The second best investment we can make is in well-baby care and 
childhood immunization and adequate prenatal care. That is why we need 
this amendment, to give kids a good, fighting chance.
  There are members of this Senate who, for reasons I do not 
understand, seem almost proud of how far they can stretch out the 
deadline for universal coverage. With all due respect to them, I 
disagree strongly.
  Wherever we possibly can, and especially wherever it costs us 
nothing, we must move ahead sooner rather than later. That should be 
our guiding principle in evaluating this and every other amendment to 
the health care bill. For health care delayed is health care denied.
  I congratulate the Senator from Connecticut and Senator Kennedy from 
Massachusetts for seeing that this is obviously a first priority and 
the first place to begin in strengthening and improving this bill so 
that it will make sense and dollars and cents for the American people.
  This amendment will save dollars and lives. We know that from 
experience. In Pennsylvania, in 1985, two ministers in Pittsburgh 
approached Blue Cross/Blue Shield of Western Pennsylvania to see what 
could be done to help the thousands of Pittsburgh children whose 
families could not afford even basic health services.
  Out of that encounter came a program called the Caring Program. It is 
funded jointly by Blue Cross/Blue Shield and private contributions. The 
Caring Program provides to thousands of children the same kinds of 
services this amendment would cover. Pennsylvania's Blue Cross/Blue 
Shield knows that covering preventive services for children and 
pregnant women is the right thing to do. And as tough-minded business 
people, they also know it makes sense, dollars and cents.
  Infants who get their immunizations and well-baby care, whose mothers 
get prenatal care are not nearly as likely to get sick. The old saying 
is true, an ounce of prevention is worth a pound of cure. The 
investment in preventive care pays for itself many times over.
  Another Pennsylvania program is built on that same common sense 
approach. We call it CHIP, the Children's Health Insurance Program. 
Governor Casey established this in 1992. CHIP provides free or low-cost 
health care for children living in low-income families. It is 
administered by Blue Cross/Blue Shield and U.S. Healthcare. Thirty-two 
thousand Pennsylvania children are enrolled in CHIP; 32,000 children 
are healthier and better able to learn because Pennsylvania said no 
child's health should depend solely on his family's income.
  Tending to the same basic health needs of children and pregnant women 
works, whether it is in a fee-for-service plan or a managed care plan. 
These programs are part of the reason that Pennsylvania's percentage of 
uninsured children is less than half the national average. Pennsylvania 
is showing that the solutions are out there and they work.
  A Pennsylvania pediatrician, Dr. Elias Schwartz wrote to me this 
week, and I quote:

       Our children are our future. When we care for them and 
     their mothers, we also care for the productive, contributing 
     citizens they will become.

  This amendment alone cannot close the health care gap for America's 
children, but it can make a big difference. What this amendment says is 
simply that insurance companies must include and cannot charge co-pays 
for well-baby care and childhood immunizations and prenatal care.
  I do not know how many Members of this Senate have ever seen a 2-
pound baby, as I have. It is an amazing sight. And I have seen some of 
these babies who survived and thrived and seen the joy of their 
families. I have seen it at a hospital cost of half a million dollars. 
And I have seen and held a million-dollar baby.
  The doctors often point out to me that with the mother's lack of 
health insurance, those costs then are shifted to other people's bills 
and that with just a few hundred dollars of prenatal care, this 
$500,000, this $1 million baby would have been born healthy.
  My colleague, Senator Gramm, said yesterday that ``not even God can 
prevent preexisting conditions.'' That may be so. But this Congress can 
prevent discrimination based on pre-existing conditions. And we can 
prevent many of the illnesses that rob our children of their health, 
their potential, and their lives by passing this amendment.
  Mr. President, I call for action as soon as possible on this 
amendment, to move forward to build a bill which the Finance Committee 
and the Labor Committee jointly have put together, a bill that has been 
known and debated for months, a bill in which this principle and the 
purpose of this amendment has been an essential guiding point from the 
very beginning. By this strengthening amendment, we can make that bill 
better and bring the process, for which so many of us have worked for 
so long, to fruition.
  I thank the Chair.
  Mr. MOYNIHAN. Mr. President, may I ask the Chair how much time 
remains?
  The PRESIDING OFFICER. Four minutes and 40 seconds.
  Mr. MOYNIHAN. We have on this side 4 minutes and 40 seconds. I yield 
to the Senator.
  Mr. ROCKEFELLER. I would say to the distinguished chairman from New 
York my remarks will take more time than that, so perhaps, if on the 
half-hour rule, we would have a quorum call or something, then it would 
go to the Republican side and then I could speak in the next half-hour.
  Mr. MOYNIHAN. I think I will suggest the absence of a quorum.
  The PRESIDING OFFICER. The absence of a quorum having been suggested, 
the clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DURENBERGER. Mr. President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. MOYNIHAN. Mr. President, I ask unanimous consent that the 
Democratic side might have an additional 12 minutes, I believe is 
required.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered.
  Mr. MOYNIHAN. I yield 15 minutes, an accumulated 15 to the 
distinguished Senator from West Virginia.
  Mr. ROCKEFELLER. I thank the distinguished chairman of the Finance 
Committee.
  Mr. President, I am extremely pleased to rise in support of our first 
amendment that would expand vital coverage for preventive services to 
children and pregnant women. I am extremely pleased that our first 
amendment puts children first because, frankly, that is a very large 
part of what health care reform must be about, creating a secure health 
future for our Nation's children.
  This amendment is extremely important. It is an amendment that 
matters. It is an amendment that will make a real difference in 
people's lives.
  Three years ago, the National Commission on Children, which I 
chaired--this is sort of a summary of it. It is very interesting, Mr. 
President, I would note--and I would also point out to my friend from 
New York--this was a commission that had 32 members, including 3 
members of the Bush administration, that had about as many Republicans 
as Democrats. It was all about children and all about health care and 
all about all kinds of other things, and we had a completely unanimous 
vote. After 2 years of work, the vote was unanimous, and we covered the 
waterfront so far as children's issues are concerned.
  One of the things we suggested was moving forward on universal health 
coverage for children, and 2 years before that the Pepper Commission 
made similar recommendations. The distinguished Senator from Minnesota 
certainly remembers that. That was this effort: Universal coverage, in 
fact, starting with children. Pregnant women and children were the 
first order of priority.
  An overall theme and major strength of the Mitchell bill is its 
special emphasis on children and mothers through special targeted 
subsidies that will begin as quickly as feasible. The Mitchell bill 
gives children a head start on health coverage, and this amendment 
gives children a real jump start. It will give a large number of 
hardworking families an immediate health benefit beginning July 1, 
1995, less than 1 year away.
  Under this amendment, private insurance policies will be required to 
offer preventive services to children, and to mothers without any cost-
sharing requirements. The amendment is long awaited and way overdue, 
according at least to this Senator's timetable. But we are finally 
here, and this is what matters the most. I predict that this amendment 
will be favorably voted on. I pray that it will be favorably voted on, 
and I pray that the vote will be bipartisan.
  I believe and I deeply hope we are going to start putting aside some 
of what we saw earlier this evening--that is, the politics and the 
rhetoric--and focus on what we are hired on by our constituents to do 
here in the Congress; that is, to focus on health care policies as a 
first priority.
  As we begin debating the majority leader's bill and focus on its 
policies, I think we are going to be surprised in fact by the amount of 
agreement that can be reached in many, many areas if there is the will 
for us to do so on both sides. I hope that this is just the first 
example of a potentially emerging consensus.
  Why children and why preventive services? For all the obvious 
reasons, and more. America's record on children is not particularly 
admirable. We have lost some very important ground over the past decade 
and a half. Since 1980, no progress has been made in reducing the 
overall rate in which babies are born too small and too soon. Low-
birthweight babies are 40 times more likely to die in their first month 
of life, and 5 times more likely to die later in their first year.
  In my own State of West Virginia, we have made some progress in 
reducing the number of babies born at a low-birthweight and lowering 
our infant mortality rate. But it is still much too high. Forty-four 
percent of our teen mothers in West Virginia, and 26 percent of all 
mothers in West Virginia, do not receive adequate prenatal care.
  The U.S. infant mortality rate remains stuck well below many other 
industrialized countries, something which our colleagues on both sides 
of the aisle are very, very aware of. The emotional and physical 
tragedy of a baby starting off his or her first few days, sometimes 
months, in a neonatal intensive care unit is bad enough. But it is also 
a tremendous waste of our precious health care dollars. The average 
cost of providing neonatal intensive care for one low-birthweight baby 
could finance the cost of providing prenatal care for 58 women for the 
entire trimester. It is time, Mr. President, that we got much smarter 
about spending our health care dollars, and this amendment is one way 
that will advance that.
  Another example is immunizations. In 1979, the Surgeon General set a 
goal of immunizing 90 percent of 2-year-olds against common childhood 
diseases by the year 1990. Today, we are at 72 percent, a 2-percent 
increase from 1990, and a long way from our goal. I do not think that 
the cost-benefit of adequately immunizing our children even needs 
repeating.
  Ninety percent of private health insurance for children is purchased 
through their parents' job-based health plans. The amendment before us 
will be of significant benefit to many of those children and their 
families, since less than half of conventional indemnity policies even 
cover preventive care services for children.
  Only about 42 percent of children with health insurance have coverage 
for routine immunizations, less than half, and only a third of health 
insurance policies in medium and large firms--the percentage for small 
firms would be much less, of course--even cover well-baby care. This 
amendment will give those children and those infants without 
immunization and without well-baby coverage a direct benefit, and it 
will do it in less than 1 year from today.
  About 5 million women, Mr. President, have private insurance policies 
that do not cover maternity. These women will directly benefit from the 
amendment before us. They will no longer have to worry about seeking 
early prenatal care because of the expense, because it will be there 
for them.
  Under this amendment, cost-sharing requirements for preventive, cost-
effective care would be prohibited. This is extremely important and 
very cost effective. We know from studies that cost-sharing 
requirements can deter people from seeking care, including necessary, 
very necessary, medical care. One study found that even nominal 
copayments for doctor services kept people from seeking early medically 
necessary care.
  So not having copayment responsibilities means that people are going 
to take advantage of health care, and are going to get prenatal care, 
and a lot of children are going to start life off a lot healthier.
  Mr. President, I would also like to take a second to remind my 
colleagues that job-based coverage for children has diminished 
significantly over the past 15 years. And that is a cause for alarm. 
Having a job is no longer an assurance of reliable health insurance 
coverage. In 1980, 40 percent of employers paid for dependent coverage 
in full. In 1990, 10 years later, that number is only one-third of 
employers.
  The majority leader's bill provides us the road map to stop the 
deterioration of job-based coverage, beginning with insurance reforms 
and voluntary purchasing cooperatives to help small companies afford 
coverage for their workers and for their families.
  By 1997, which is really just a few years from now, the Mitchell bill 
will mean that 74 percent of all currently uninsured children in my 
State of West Virginia--that is 48,000 children--will have private 
health insurance coverage. That is enormously important public policy. 
And it is of enormous importance to my people in West Virginia. Not 
Medicaid; I am not talking about Medicaid or some other new Government-
run health program--but a private health insurance policy with decent 
reimbursement rates and wide doctor acceptance.

  Mr. President, in closing, as I said earlier, the majority leader's 
bill will give children a stable, secure health care system. This 
amendment is a good start because it will give millions of our children 
a better start. I urge my colleagues, when the time comes, to adopt 
Senator Dodd's excellent amendment.
  I thank the Chair and the distinguished chairman of the Finance 
Committee.
  I yield the floor.
  Mr. MOYNIHAN. Very well done, sir. It appears that no other Senator 
is seeking recognition on either side.
  Mr. PACKWOOD. Mr. President, I have a few remarks.
  Mr. MOYNIHAN. Forgive me.

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