[Congressional Record Volume 141, Number 81 (Tuesday, May 16, 1995)]
[House]
[Pages H4968-H4974]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1040
  REQUIRING MEDICARE TRUST FUND TRUSTEES TO REPORT CERTAIN FINANCIAL 
                            RECOMMENDATIONS

  Mr. THOMAS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1590) to require the Trustees of the Medicare trust funds to 
report recommendations on resolving projected financial imbalance in 
Medicare trust funds.
  The Clerk read as follows:

                               H.R. 1590

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. TRUSTEES' CONCLUSIONS REGARDING FINANCIAL STATUS 
                   OF MEDICARE TRUST FUNDS.

       (a) HI Trust Fund.--The 1995 annual report of the Board of 
     Trustees of the Federal Hospital Insurance Trust Fund, 
     submitted on 
     [[Page H4969]] April 3, 1995, contains the following 
     conclusions respecting the financial status of such Trust 
     Fund:
       (1) Under the Trustees' intermediate assumptions, the 
     present financing schedule for the hospital insurance program 
     is sufficient to ensure the payment of benefits only over the 
     next 7 years.
       (2) Under present law, hospital insurance program costs are 
     expected to far exceed revenues over the 75-year long-range 
     period under any reasonable set of assumptions.
       (3) As a result, the hospital insurance program is severely 
     out of financial balance and the Trustees believe that the 
     Congress must take timely action to establish long-term 
     financial stability for the program.
       (b) SMI Trust Fund.--The 1995 annual report of the Board of 
     Trustees of the Federal Supplementary Medical Insurance Trust 
     Fund, submitted on April 3, 1995, contains the following 
     conclusions respecting the financial status of such Trust 
     Fund:
       (1) Although the supplementary medical insurance program is 
     currently actuarially sound, the Trustees note with great 
     concern the past and projected rapid growth in the cost of 
     the program.
       (2) In spite of the evidence of somewhat slower growth 
     rates in the recent past, overall, the past growth rates have 
     been rapid, and the future growth rates are projected to 
     increase above those of the recent past.
       (3) Growth rates have been so rapid that outlays of the 
     program have increased 53 percent in aggregate and 40 percent 
     per enrollee in the last 5 years.
       (4) For the same time period, the program grew 19 percent 
     faster than the economy despite recent efforts to control the 
     costs of the program.

     SEC. 2. RECOMMENDATIONS ON RESOLVING PROJECTED FINANCIAL 
                   IMBALANCE IN MEDICARE TRUST FUNDS.

       (a) Report.--Not later than June 30, 1995, the Board of 
     Trustees of the Federal Hospital Insurance Trust Fund and the 
     Board of Trustees of the Federal Supplementary Medical 
     Insurance Trust Fund shall submit to the Congress 
     recommendations for specific program legislation designed 
     solely--
       (1) to control medicare hospital insurance program costs 
     and to address the projected financial imbalance in the 
     Federal Hospital Insurance Trust Fund in both the short-range 
     and long-range; and
       (2) to more effectively control medicare supplementary 
     medical insurance costs.
       (b) Use of Intermediate Assumptions.--The Boards of 
     Trustees shall use the intermediate assumptions described in 
     the 1995 annual reports of such Boards in making 
     recommendations under subsection (a).

  The SPEAKER pro tempore (Mr. Barrett of Nebraska). Pursuant to the 
rule, the gentleman from California [Mr. Thomas] will be recognized for 
20 minutes, and the gentleman from Florida [Mr. Gibbons] will be 
recognized for 20 minutes.
  The Chair recognizes the gentleman from California [Mr. Thomas].
  Mr. THOMAS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, before us today is H.R. 1590, a bill which would have 
the Board of Trustees for the Federal Hospital Insurance and 
Supplementary Medical Insurance trust funds submit specific 
recommendations on how to resolve the financial crisis facing Medicare 
in a reasonable timeframe.
  Mr. Speaker, I reserve the balance of my time.
  Mr. GIBBONS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I was hoping the gentleman from Texas [Mr. Archer] would 
be here on this one because I was going to sympathize with him. This 
bill is not even worth the time of Congress to take up. This is a waste 
of time and a waste of money and a waste of effort. If you want a 
report like they are asking for in this, you can write the folks a 
letter down there and for 32 cents you can mail it to them or if it is 
official business, I guess it is, you can mail it under the frank and 
get the same response.
  I thought this might be for real until I went home this weekend and 
one of my neighbors showed me the slick letter from the Republican 
National Committee in which they lay all this plot out that must have 
gone to the printer long before it ever became public up here, unless 
they send that slick magazine by the fax system. This is all laid out 
in the Republican national publication that is sent to all the wealthy 
folks in my congressional district seeking more contributions, in which 
they try to scare them to death by saying the Medicare system is going 
broke.
  I was here and voted for Medicare and it had a life expectancy of a 
year then in the trust fund and it has never had a long life expectancy 
in the trust fund and a part of that is the trustees' way of telling 
Congress, ``Well, don't be generous with the Medicare benefits because 
the system's always going broke.''
  Well, now it is only going to take 7 more years for it to go broke. 
That is a great improvement over past estimates which have been as low 
as 2 years and 3 years and one time it got up to 5 years. It has gotten 
a little further out sometimes or other during the economic cycles.
  Yes, the Medicare system needs changes, incremental changes, but it 
is not going broke and I think that message ought to go out of here, 
and to be sending this bill through Congress to reinforce what the 
Republican National Committee is putting out is a travesty upon the 
Congress, it is a travesty upon the system, and it is a travesty to get 
the same information for a 32-cent letter to the trustees.
  When you ask the trustees what is to go wrong with this program, you 
are asking the wrong people. You should be asking the people who have 
something to do with controlling the cost of expenditures in this 
program. They are the ones that are the experts in this area. The 
trustees are to just receive the money, put it in the bank and account 
for it and issue this annual report. They do not participate in the 
running of the program.
  I am sorry that we are wasting this time here. I hope my Democratic 
colleagues will realize that this is a political ploy, not a real piece 
of legislation, will give it the kind of treatment it ought to have 
and, that is, vote ``no'' on it and let's let this thing go.
  I am sorry we are costing the American public as much money as we are 
debating this senseless subject of asking for this trustees' report, 
but that is the way business is conducted around here now.
  Mr. Speaker, I reserve the balance of my time.
  Mr. ARCHER. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, this bill, we believe, is very important in moving us 
along in the process of saving Medicare so that the moneys will be 
there to pay the bills.
  As we learned in our Committee on Ways and Means hearing on the 
status of the Medicare trust funds 2 weeks ago, the trust fund for part 
A is out of balance and heading to bankruptcy. Part B spending is 
increasing at an unsustainable rate, 12 percent per year.
  We heard testimony expressing a sense of urgency about the condition 
of Medicare, an urgency which was also clearly reflected in the April 3 
reports of the trustees for both parts A and part B of Medicare.
  This Congress must recognize the crisis which the Medicare trustees 
have identified and we must act to preserve Medicare. However, first it 
is important to seek the most knowledgeable advice in considering a 
resolution for the problems facing the program. Congress should have 
the guidance of the administration and its Medicare trustees who have 
the responsibility for overseeing the entire program.
  Those trustees are unquestionably in the best position considering 
their understanding of the Medicare program and the analytical 
resources at their disposal to provide guidance to the Congress as we 
begin this process to preserve the program.
  When one reviews their combined education and training and experience 
in Government service and in the private sector, it is clear that they 
are uniquely qualified to rapidly provide us with recommendations and 
assistance.
  Prior to his appointment as Secretary of the Treasury, the managing 
trustee, Secretary Robert Rubin, was responsible for overseeing the 
administration's domestic and international economic policymaking 
process. Last fall the President appointed him to co-chair the 
President's health care reform initiative.
  Secretary Shalala is currently responsible for the Medicare program 
and has at her disposal literally thousands of Government employees 
responsible for the health entitlement programs and health policy 
generally. She was, as chancellor of the University of Wisconsin, 
responsible for the oversight of a 488-bed teaching and research 
hospital and she had a major role in shaping the President's health 
care reform policy.
  Commissioner Chater also has considerable experience in health care 
and health care policy. She holds undergraduate and graduate degrees in 
nursing and she was appointed by the Governor of Texas, Ann Richards, 
in 1991, to chair the State's health policy task force.
  [[Page H4970]] Secretary Reich is an economist and former professor 
of economics. He along with the other trustees had a key role in 
development of the President's health care reform initiative which 
contained significant reductions in the growth of the Medicare program.
  H.R. 1590 would have these trustees build on their important work on 
the Medicare actuarial reports to provide us with suggested solutions 
to the financial crisis that they have identified. I am confident that 
as they deliberated over the financial concerns of Medicare, they felt 
duty bound to begin to develop a strategy to avoid the collapse that 
their report predicts.
  I believe the American people expect their political leaders to face 
up to the major issues of the day in a bipartisan manner and with the 
executive and legislative branches working together. This legislation 
provides for such an approach to solving Medicare's financial problems 
because the 4 trustees I have described serve at the highest levels of 
the current administration. Their guidance will lay a useful base for 
the Congress to join with the President to craft a solution that 
assures Medicare coverage for this generation and the next.
  I urge my colleagues to approve this bill so that we can get on with 
the important work at hand on a bipartisan, collegial basis.
  Mr. Speaker, I reserve the balance of my time.
  Mr. GIBBONS. Mr. Speaker, I yield 3 minutes to the gentleman from 
Missouri [Mr. Gephardt], the Democratic leader.
  (Mr. GEPHARDT asked and was given permission to revise and extend his 
remarks.)
  Mr. GEPHARDT. Mr. Speaker, I rise today to urge my colleagues to 
defeat this bill, to say no to this cynical strategy to force the 
Medicare trustees to figure out how to pay for tax cuts for the 
privileged few. Make no mistake about it, that is what the Republicans 
are trying to do with this bill. They produce a budget that reduces 
taxes for the wealthiest Americans, giving the richest 1 million 
Americans a $20,000 tax giveaway each year.
  To fill that gaping budget hole, they want to carve almost exactly 
the same amount out of Medicare, taking money away from struggling 
seniors and their families to line the pockets of those who already 
have it made.
  Americans have known for years that Republicans are no friends of 
Medicare. After all, many Republicans voted against the very creation 
of the program. Year after year when concerns have been raised about 
the solvency of the Medicare trust fund, about our ability to preserve 
Medicare benefits, not just for today's seniors but for future 
generations, Democrats have acted and Republicans have barely lifted a 
finger to help.
  So why can they not just be honest about it? Why can Republicans not 
just say we want to cut Medicare and we want to give the money to the 
wealthiest Americans? If that is what they believe, they should have 
the courage to stand up and be proud of those beliefs.
  Instead, they want to hide behind the Medicare trustees, to ask a 
group of overseers to make their deep and dangerous Medicare cuts. But 
we are talking about Medicare trustees, not tax cut trustees. To ask 
them to fund the Republican giveaways for the wealthy is to degrade 
their very purpose, to make them pawns to an extremist agenda. It is 
wrong and we should not stand for it.
  Republicans claim to be concerned about the solvency of the trust 
fund. They say that they want to save Medicare. But if that were true, 
why would they have refused to help Democrats improve Medicare year 
after year until they needed a way to pay for tax breaks for the 
privileged few?
  And why would they propose tax breaks that are far deeper than any 
that would be needed to ensure the solvency of the trust fund, 
following the time-honored Republican maxim, give tax breaks first, 
then ask questions later.
  Mr. Speaker, I don't need a commission or a political fig leaf to 
tell me what these cuts would do to America's working families. In my 
State of Missouri, seniors would see their benefits slashed by $873 a 
year by the year 2002. A story on the front page of today's New York 
Times says there is simply no way to make these cuts, the largest 
Medicare cuts in history, without, and I quote, real pain.
  The Times even quotes a Republican health policy expert as saying, 
and I quote, some of the providers will probably not survive the 
pressure. In other words, hospitals will close or cut services, not 
just for seniors but for everybody.
  Last week's Washington post quotes confidential Republican memos that 
show very clearly that under their plan Medicare deductibles will go 
up, premiums will increase, charges the Republicans continue to deny.
  We need to talk openly and honestly about improving Medicare and 
making the trust fund solvent but not as a way to pay for tax breaks 
for the privileged few. Medicare is a trust fund. It is not a slush 
fund. It is about health care, not stealth agendas. This bill is 
nothing more than a political ploy and frankly while I do not agree 
with very much of the Republican agenda, I never expected them to try 
to hide from their own agenda.
  Reject this bill. Throw away the fig leaf, and then let's have a real 
debate about Medicare based on policy, not on tax breaks for the 
privileged few.
  Mr. ARCHER. Mr. Speaker, I yield 3\1/2\ minutes to the gentleman from 
California [Mr. Thomas], the respected chairman of the Subcommittee on 
Health of the Committee on Ways and Means.
  (Mr. THOMAS asked and was given permission to revise and extend his 
remarks.)
  Mr. THOMAS. Mr. Speaker, I want to thank the minority leader for a 
wonderful speech as he leaves the floor because it is not a speech for 
this particular bill at this particular time. It is an excellent 
political speech for some time in the future, perhaps. Today we have on 
the floor H.R. 1590. What it does is ask the trustees to tell us what 
their suggestions are as to how to save the trust fund. Last week, the 
full Committee on Ways and Means met and the trustees presented their 
report. In the conclusion, the trustees said that experience to date 
suggests that the prospective payment system has worked but extension 
of this payment system to other providers could provide another 5 to 10 
years before the fund is depleted.
  We are asking them to give us the specifics on their recommendation, 
on their conclusion of their report.
  In addition, the report goes on to say, to facilitate this effort, 
the trustees further recommend legislation. They go on to suggest 
legislation in their report.
  The minority leader was feeling very good about talking about tax 
cuts and Medicare. That is simply oil and water on the floor this 
morning. The bill says to report back, submit to the Congress 
recommendations for specific program legislation designed solely--
solely--one, to control Medicare hospital insurance program costs and 
to address the projected financial imbalance in the Federal hospital 
insurance trust fund in both the short and long range, and to more 
effectively control Medicare supplementary medical insurance costs--
period.
  That is what H.R. 1590 asks for. On the committee hearing, we asked 
the Secretary to provide some suggestions. She said she would be 
providing none. Had the administration been willing to cooperate and 
address the shortfall of funds in an openhanded, working together 
method, we would not be here on the floor asking this House to pass 
H.R. 1590. We must require the trustees to provide us with what they 
hinted at as one of the sources for changes.
  As the minority leader attempted to raise the specter of partisanship 
in trying to solve the health care funding program for our seniors, I 
just would suggest that perhaps he and a few other Democrats look at 
health affairs, winter 1994, and an article by Guy King.
  Who was Guy King? Guy King was the chief actuary of the Health Care 
Financing Administration from 1978 until July 1994, and played a 
significant role in developing the cost estimates for the Clinton 
administration's health care reform proposal.
  One of the chief architects of the President's health care reform 
proposal said, ``Even President Clinton's proposed health care reform 
legislation, with its ambitious and highly controversial cuts in the 
Medicare Program, would have had only a minor effect on the deepening 
financial crisis of 
[[Page H4971]] Medicare part A, hypothetically extending the life of 
the program by only a couple of years at most.''
  The program has been in trouble for several years, the President's 
proposal would have bought only a couple of years, with all due respect 
to my friend from Florida, the trustees say this program is in trouble. 
Regardless of the arguments of making it a partisan argument, the 
seniors expect and deserve solutions to make sure that Medicare is 
sound.
  Who else but the trustees of the program should be asked, what are 
your ideas to make the program sound?
  Pass H.R. 1590.
  Mr. GIBBONS. Mr. Speaker, I yield 3 minutes to the gentleman from 
Washington [Mr. McDermott].
  Mr. McDERMOTT. Mr. Speaker, this bill is nothing more than a sham and 
a public relations gesture to mask the fact that Republicans are 
proposing $283 billion in Medicare cuts to pay for tax cuts to the 
well-off.
  If Republicans care so much about Medicare, why did they not wait for 
policy recommendations before proposing Medicare cuts? This is a 
classic case of slash first and ask questions later.
  The fact that cuts are proposed before getting advice is the smoking 
gun that proves that the Republican's real intent is to cut Medicare 
regardless of any objective recommendation.
  We know why they have to cut Medicare. Medicare is the only place 
where Republicans can find enough money to pay for their Contract on 
America.
  If Republicans care so much about Medicare, why did they take $87 
billion in earmarked funds out of the Medicare trust fund to pay for 
tax cuts to wealthy seniors?
  What makes this bill so obviously a sham is that the Medicare 
trustees who are being required by this bill to provide policy advice 
on the Medicare trust fund have absolutely no authority or basis for 
making policy recommendations. They are not Medicare experts or health 
policy experts. They are accounting fiduciaries.
  But the Republicans did not go to the policy arms of Congress for 
recommendations. They went to the entity least able to provide 
recommendations and not designed to engage in policy functions.
  They were afraid that the policy experts would tell them that they 
cannot slash Medicare without terrible consequences for Medicare 
beneficiaries, their families, and the health care delivery system.
  They were afraid the policy experts would tell them that they have to 
expand coverage for everyone if Medicare is to be really safe.
  They were afraid the people who know what they are talking about 
would tell them that Medicare savings need to be kept in the health 
care delivery system to improve coverage for seniors and their 
families.
  Mr. Speaker, Republicans just discovered the trust fund problem while 
Democrats have worked successfully for decades to incrementally improve 
and extend the trust fund viability each year, often against the 
backdrop of Republican opposition.
  The Nation that we suddenly need a 30-year solution by June 30 from 
an entity totally unsuited to the assignment does not even pass the 
straight face test.
  We will address the trust fund problem as we always have. But we will 
address it outside the context of tax cuts and budget politics. We will 
address Medicare and the trust fund in the context of health policy, 
not arbitrary budget targets.
  We will address the trust fund in the context of health reform that 
keeps our entire health care system stable, not according to campaign 
manifestos that Republicans never dreamed they would actually have to 
use to govern.
  But we will never be able to give the American people confidence in 
the government, if Republicans continue to substitute ridiculous 
gimmicks like this bill for substantive approaches to health security 
for senior citizens and every American.
                              {time}  1100

  Mr. ARCHER. Mr. Speaker, I yield 1 minute to the gentleman from 
Pennsylvania [Mr. English], a respected member of the Committee on Ways 
and Means.
  Mr. ENGLISH of Pennsylvania. Mr. Speaker, I rise in support of H.R. 
1590, a bill to require the Medicare trustees to submit to Congress 
real legislative recommendations that will keep Medicare from going 
broke.
  Mr. Speaker, prior to taking office, in my previous career, I served 
as a public trustee of a major municipal pension system, and in that 
pension system I felt I had the fiduciary responsibility to preserve 
that system by recommending certain courses of action.
  Unfortunately, the Medicare trustees currently have no legal 
obligation, notwithstanding their moral obligation, to use their 
expertise to guide Congress in preserving Medicare.
  The trustees have told us notwithstanding what you have heard on the 
floor today unambiguously that the Medicare part A fund will go 
bankrupt by 2002.
  Now we need the trustees to give us real options on how we can 
continue to grow Medicare at a rate where we can preserve it for future 
generations, and also protect the benefits of senior citizens.
  The Clinton trustees, Donna Shalala, Robert Reich, Robert Rubin, 
Shirley Chater, have so far refused to offer Congress any real options. 
This bill would make them do it. Let us vote for it.
  Mr. GIBBONS. Mr. Speaker, I yield 2 minutes to the gentleman from 
Oregon [Mr. Wyden].
  (Mr. WYDEN asked and was given permission to revise and extend his 
remarks.)
  Mr. WYDEN. Mr. Speaker, every Member of this body knows that Medicare 
needs reform. But Medicare reform is a heat-seeking missile, and the 
purpose of this bill is to have Republicans avoid taking any heat. It 
is a last-minute idea to get someone else to make massive cuts in 
Medicare that are going to hurt seniors.
  It cannot be done in 30 days in a reasonable fashion. It stops the 
trustees from looking at health care reform as it should be, in a 
systematic way. It is a mistake. It is going to be bad for the Nation's 
older people.
  I urge my colleagues to vote against it.
  Mr. ARCHER. Mr. Speaker, I yield 1 minute to the gentleman from 
Texas, Mr. Sam Johnson, another respected member of the Committee on 
Ways and Means.
  Mr. SAM JOHNSON of Texas. Mr. Speaker, I rise today in support of 
this bill to require the Medicare Board of Trustees to make 
recommendations on resolving the financial crisis in Medicare. They 
reported on April 3 that the Medicare trust fund is going to be 
bankrupt at the latest by the year 2002. If nothing is done, this trust 
fund is going to go bankrupt and there will be no Medicare.
  Clearly, this is not something that we can choose to address. It is 
something we must address.
  Medicare is not simply a budget issue and should not be used merely 
to score political points. Our Nation's seniors deserve better than 
that.
  Everyone, the Congress, the President, and his Cabinet must fulfill 
the duties of their offices by acknowledging the problem and offering 
solutions. So far the White House and Democrat congressional leadership 
have chosen to ignore the crisis in Medicare, and that is why this bill 
is necessary.
  I hope the administration is listening. By refusing to address 
Medicare, they jeopardize the entire system. Americans say help us save 
Medicare. Vote ``yes'' on this bill.
  Mr. GIBBONS. Mr. Speaker, I yield 2 minutes to the gentleman from 
California [Mr. Waxman], a real expert in medical care.
  Mr. WAXMAN. Mr. Speaker, I thank the gentleman very much for yielding 
time to me.
  Mr. Speaker, this debate has nothing to do with the saving of the 
Medicare part A trust fund. The Republicans are looking for huge cuts 
in Medicare, $283 billion over 7 years, far beyond any amount that is 
going to be needed reasonably to extend the solvency of the part A 
trust fund.
  What is really going on here is that the Republicans' pollsters have 
told them if they are going to come out and cut Medicare to this extent 
the American people will not stand for it, so instead they have 
developed this ruse about the Medicare trust fund. It is very much like 
what went on in Vietnam. We burn down a village in order to save 
people. They want to burn 
[[Page H4972]] down Medicare in order to save the part A trust fund.
  I must say this is hypocritical. This trustee group that looks at the 
part A side is not the proper organization to give us the proposals for 
the massive cuts the Republicans are urging upon us. And we are being 
told that they can do it in 30 days, which is impossible.
  And third, they are being told to come up with proposals for these 
kinds of reductions in Medicare far beyond what is needed to save the 
trust fund. But they cannot look at the whole health care system. They 
cannot look at the impact of these massive cuts, not just on the 
elderly, but on average working Americans who are going to lose their 
health insurance as well.
  Mr. Speaker, I urge defeat of this proposal. I urge defeat of the 
budget that calls for these Medicare cuts, and I urge defeat of all of 
those who are going to go to the polls next year saying they saved 
Medicare by cutting it and gutting it.
  Mr. THOMAS. Mr. Speaker, I yield 1 minute to the gentleman from 
Nebraska [Mr. Christensen], a valued member of the Committee on Ways 
and Means.
  Mr. CHRISTENSEN. Mr. Speaker, Medicare is going broke, there is no 
doubt about that. The trustees of the Medicare trust fund, including 
four Clinton appointees, announced beginning next year that Medicare 
will spend more than it takes in. By 2002 it will be completely 
bankrupt. If this happens, no one in America will have Medicare, no 
one.
  What did the Clinton appointees say? On page 13 they said under 
present law there is no authority to pay hospital insurance benefits if 
the assets of the HI trust fund are depleted.
  On page 3 they said under all of the sets of assumptions, the trust 
fund is projected to become exhausted even before the major demographic 
shift begins. That is before the baby boomers hit.
  What did President Clinton say? That is even harder to find, because 
he did not say anything. He did not say anything in the State of the 
Union Address, he did not even mention it in his budget. I think he has 
taken a walk on this issue.
  I believe that the Republican leadership is dedicated to reforming, 
preserving, and improving Medicare. I believe the board of trustees 
should do the very same thing.
  H.R. 1590 will simply require the board of trustees to give us their 
input on how to solve the Medicare crisis. It is as simple as that.
  Mr. GIBBONS. Mr. Speaker, I yield 1 minute to the gentleman from 
Michigan [Mr. Levin], another real expert in medical care.
  (Mr. LEVIN asked and was given permission to revise and extend his 
remarks.)
  Mr. LEVIN. Mr. Speaker, I think there is a problem that we face with 
Medicare, but here is what this bill says: We Republicans will be 
general; you Democrats be specific. The Republicans are saying we will 
supply the sugar deficit reduction, you provide the medicine.
  That is bad politics and bad policy. I say to the Republicans, say 
what you mean. All you talk about is generalities, setting up a 
commission.
  Are higher part B premiums likely under your proposal, a deductible 
increase, a coinsurance for home health, a coinsurance for skilled 
nursing, et cetera?
  This document that you have brought here is nothing but a 
smokescreen. It is an effort to try to avoid the responsibility that 
you have to be specific.
  I urge that we vote against this because you are trying to default in 
your obligations and shift it to somebody else, and that will not work.
  Mr. THOMAS. Mr. Speaker, I yield 3 minutes to the gentleman from 
Florida [Mr. Bilirakis], chairman of the Subcommittee on Health and 
Environment of the Committee on Commerce.
  (Mr. BILIRAKIS asked and was given permission to revise and extend 
his remarks.)
  Mr. BILIRAKIS. Mr. Speaker, I rise in support of this legislation. As 
a Member of Congress who represents one of the largest concentrations 
of older Americans in the United States, I am quite troubled by the 
1995 Annual Report of the Board of Trustees of the Federal Hospital 
Insurance and Supplementary Medical Insurance Trust Funds. In their 
1995 report, as has already been reported here many times. The trustees 
urged Congress to examine the Medicare Program because both trust funds 
are facing serious financial problems in both the short-term and the 
long-term.
  The trustees expressed deep concern about the growth of the program's 
costs, especially given the past and projected costs of the program. 
The trustees also urged Congress to control the costs of the Medicare 
Program through legislation as part of ``broad-based health care 
reform'' because they indicated that ``prompt, effective, and decisive 
action is necessary,'' using their words.
  Mr. Speaker, the Medicare hospital insurance trust fund is 
financially out of balance, but spending growth by the supplementary 
medical insurance [SMI] part B trust fund also is a concern because the 
rate of growth is unsustainable. The cost growth directly affects 
Medicare beneficiary part B premiums as well as general revenues from 
which the largest share of SMI costs are financed.
  Mr. Speaker, I think we all have to maybe look in the mirror and ask 
ourselves a question. Are we all truly concerned about saving Medicare 
or will we continue to use it as political demagogery as is done by 
some election after election. Maybe the fear is that if we solve the 
Medicare problem, it will not any longer be available for demagogery.
  Considering the serious nature of this matter, the Congress in a 
bipartisan way, and I have not heard much bipartisanship here this 
morning, in a bipartisan way, and the White House must work together. 
We must protect current and future Medicare beneficiaries from the 
looming financial crisis.
  The trustees have evaluated very carefully the Medicare program in 
great detail. They now must follow through. We have to basically 
mandate that they follow through with their recommendations to the 
Congress for legislative reform, and that is what this legislation is 
all about. It is a step in the right direction and will enable us to 
find solutions to the Medicare crisis.
  For this important reason, I urge my colleagues to support this bill.
  Mr. GIBBONS. Mr. Speaker, I yield 2\1/2\ minutes to the gentleman 
from Michigan [Mr. Bonior], the distinguished assistant Democratic 
leader.
  Mr. BONIOR. Mr. Speaker, I thank my colleagues for yielding me this 
time.
  Mr. Speaker, Republicans do not seem to understand, Medicare is a 
trust fund, a trust fund, not a slush fund, a trust between the people 
and their Government.
  In their budget Republicans propose cutting Medicare by $288 billion 
in order to pay for tax breaks for the wealthiest few in our society, 
but they refuse to say exactly where these cuts will come from. 
Instead, they are trying to get someone else to do their dirty work.
  First they tried to pass it off on the President, and that did not 
work. Then they tried to pass it off on House Democrats, and that did 
not work. So now they are trying to pass it off on the Medicare 
trustees' board.
  There is not a single senior citizen representative who sits on this 
board, not one, and we all know what is going on here, Mr. Speaker.

                              {time}  1115

  Republicans have what the New York Times calls a secret plan to cut 
Medicare. That means higher deductibles, higher premiums, more copays 
for lab tests, for home health care, for skilled nursing care, and 
importantly, less choice of doctor for every senior citizen in America.
  How are they going to do this? Well, in this resolution they are 
trying to hide behind the unelected board that does not have one senior 
representative sitting on it.
  Let us be honest what is happening here: Their cuts in Medicare are 
not going to fix the Medicare system. If that is what they wanted to 
do, they would just do it. Senior citizens are going to pay $1,000 a 
year to give tax breaks to the wealthiest people and the wealthiest 
corporations in America. That is what their Medicare proposal does 
outlined in their memo. That is not fair. The American people know it 
is not fair.
  [[Page H4973]] Republicans cannot hide behind this meaningless 
resolution. I urge my colleagues to vote ``no'' on this resolution.
  Mr. THOMAS. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from 
Arizona [Mr. Kolbe].
  (Mr. KOLBE asked and was given permission to revise and extend his 
remarks.)
  Mr. KOLBE. Mr. Speaker, I rise in strong support of H.R. 1590, and I 
commend the chairman, the gentleman from Texas [Mr. Archer] and the 
chairman of the subcommittee, the gentleman from California [Mr. 
Thomas] for their foresight in soliciting the views of the Medicare 
trustees on how we should address this problem.
  We have heard from at least a couple of speakers on the other side a 
very cute phrase, ``It is a trust fund, not a slush fund.'' The fact of 
the matter is, Mr. Speaker, the trustees have said their trust fund, 
our trust fund, the seniors' trust fund, is going broke. It is 
bankrupt. They will not legally be able to make any payments out of it 
if we do not do something to fix it.
  In fact, they said very clearly in their report, ``Medicare program 
is clearly unsustainable in its present form.'' And they said, ``We 
strongly recommend the crisis presented by the financial condition of 
the Medicare trust funds be urgently addressed on a comprehensive 
basis.'' They are the fiduciary trustees. They are in a position to 
know something about the problems. They are in a position to make 
recommendations.
  I think it is ironic that the detractors of this legislation argue 
that it is a political gimmick. Nobody argues it is going bankrupt. We 
cannot ignore it. We have to do something. We need to act now.
  The Congress has a historic opportunity to do something about it. The 
trustees are in a position to help us, tell us what to do about it, 
make those recommendations. We should solicit their advice. Does it not 
make sense to hear from the experts, the fiduciary experts responsible 
for this trust fund?
  We should vote ``yes'' on H.R. 1590.
  Mr. THOMAS. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from 
Florida [Mr. Weldon].
  Mr. WELDON of Florida. Mr. Speaker, I thank the chairman for yielding 
me this time.
  Prior to coming here to the U.S. Congress, I was a practicing 
physician in Florida. I, indeed, took care of a lot of Medicare 
patients. Fully half of my clinical practice was in taking care of 
Medicare patients, and I got to see firsthand the tremendous value to 
those people of having this program, particularly those low-income 
seniors who always were very comforted by the knowledge they could have 
access to good quality medical care under this program.
  Unfortunately today, the way things stand, this program stands the 
real possibility of going bankrupt, and we, as Republicans, are 
proposing that we save the Medicare Program. We are not cutting 
anything. What we want to do is control the growth of the program.
  Today in America, the Government spends $4,600 per senior citizen, 
and we are talking about allowing that program to grow to about $6,300 
per senior.
  But our colleagues on the other side of the aisle and the President, 
they propose no program, but just to let this program grow to the 
extent that it would cost $8,600 per senior citizen, and we are seeing 
we need to look at this program in a way to save it, to help our 
seniors to continue to have the quality access to medical care that 
they demand, that they deserve, and the Republicans are ready to act.
  We are asking for some serious input from the trustees of the 
Medicare Program, and I support this bill, and I urge all of my 
colleagues to vote for it.
  Mr. GIBBONS. Mr. Speaker, I yield the remainder of my time to the 
gentleman from California [Mr. Stark] who, I think, knows more about 
this program than any Member of Congress, House or Senate.
  Mr. STARK. Mr. Speaker, I want to thank the distinguished ranking 
member for that eloquent introduction.
  It is obvious that there are some people on the other side of the 
aisle who think they know more about this bill and about the Medicare 
program, but if this bill were not such a cheap, cynical effort to 
manipulate public opinion, I would be tempted to ignore it. It is not 
needed, and it accomplishes nothing, and nothing that cannot be done 
now without legislation.
  It is technically flawed. It asks the wrong people to render opinions 
on issues that are not within their jurisdiction or their area of 
expertise or their mandate. At best, this is suggesting that the dog 
ate the homework. It is a prime example of Washington run amok, wasting 
everybody's time, money and creating unnecessary bureaucratic mishmaw 
when the majority is blindly casting about for someone else to fulfill 
its responsibility. They really have a responsibility to propose a 
budget along with the details that are necessary to meet the fairy tale 
requirements in their budget. No amount of effort to shift the 
responsibility to someone else is going to hide the basic fact that the 
Republican Party is intellectually bankrupt. It is offering us a flimsy 
outline of a radical fairy tale world populated by rich, white suburban 
lawyers and MBA's, a world without aging or poverty, with education by 
osmosis, and beggars on white stallions. Oh, to be a young Republican 
and naive.
  Mr. DEUTSCH. Mr. Chairman, will the gentleman yield?
  Mr. STARK. I yield to the gentleman from Florida.
  Mr. DEUTSCH. Mr. Speaker, I wish to highlight a question to the 
distinguished chairman. Last year the facts regarding the program were 
the same, and in your subcommittee, I was curious about the Republican 
Members of the Republican leadership in terms of their response to the 
attempts with the program last year.
  Mr. STARK. Reclaiming my time, the gentleman raises a very good 
question. Last year we had a health reform bill. We laid out specific 
Medicare savings. It would have reduced Medicare spending by about $168 
billion over 7 years and improved the status of the trust fund, and we 
did not wait for the President's proposals, nor did we rely on alarming 
statements about the status of the trust fund, nor did we try and scare 
the seniors. We worked, and we came up with a balanced, fair, health 
reform plan that provided coverage for all Americans, and every one of 
the Republicans on the subcommittee and the full committee voted 
against those cuts. They turned their back on the medical trust fund 
last year when they had a chance to help seniors and other Americans 
who did not have health care. Where were they then? They took a walk.
  And now they are still taking a walk. They still have not figured out 
what to do, and they are asking us to buy into this cockamammie plan.
  The gentleman rises a great issue. Every Republican on the committee 
voted against bringing these savings. Ironically, the only action taken 
thus far by the other side for the solvency of the trust fund is to 
give seniors, rich seniors, a tax cut, and take it out of the trust 
fund, to take $87 billion over 10 years and give it to the richest 
seniors and cut the money out of the Medicare part A trust fund. That 
is the only thing they have come up with so far.
  Why not do what the chairman of the Committee on the Budget has done 
and let the committee work its will, come out with details, show us 
what they are planning to do, as our minority leader and as our 
distinguished whip showed us in their comments just a moment ago, that 
they plan to cut the poorest of the Medicare beneficiaries, to increase 
their co-pays, to deny them choice of doctors and plans, to give them 
vouchers that will not work?
  I urge you to show the emperor-Speaker has no clothes and vote ``no'' 
on this silly bill.
  Mr. THOMAS. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, the gentleman from California is quite right. Last year 
the attempts to adjust the Medicare program were contained in an ill-
conceived, comprehensive national health care program that had three 
things wrong with it: A majority of the Democrats did not support it, a 
majority of the Republicans did not support it, and a majority of the 
American people did not support it.
  I will also say, in his attempt to reach for rhetoric, I am 
personally embarrassed for the gentleman from California to say the 
members of the board of trustees of the HI trust fund and the 
supplemental Medicare insurance trust 
[[Page H4974]] fund do not have any knowledge about how to fix the 
program. Perhaps the gentleman, in his wisdom, forgot that one of the 
trustees was the Secretary of the Treasury, Mr. Rubin. Perhaps he 
forgot one of the trustees was the Secretary of Health and Human 
Services who oversees the entire Medicare program. She is one of the 
trustees. Perhaps the gentleman, in his rhetorical splendor, forgot 
that Shirley F. Chater, Commissioner of Social Security, is one of the 
trustees. Those are all President Clinton's appointees who are charged 
with running the program, besides statutorily being trustees of the 
trust fund. They have responsibility.
  In their report they suggested in a general way legislative changes. 
Read the conclusion of the trustees' report. They said generally we 
should take programs that are in effect and extend them to other areas. 
What H.R. 1590 asks is to be specific in the recommendations that those 
trustees made, including the Secretary of Health and Human Services.
  In addition, there has been great weight placed on linking fixing 
Medicare with tax cuts and arguing that our attempt to fix Medicare is 
because we want to spend it on taxes. Where were you folks a couple of 
months ago when the House of Representatives voted out tax cuts that 
were fully funded? Was a piece of Medicare funding used for those tax 
cuts? Yes. What was it? The only Medicare cuts suggested by President 
Clinton in his fiscal year 1996 budget. They totaled a munificent $10 
billion, and they were extenders of current limitations. That is all 
the Democrats have offered from the Clinton administration. We accepted 
those and included them in the fully funded tax cuts.
  What is in front of us is the bankruptcy of Medicare. Listen 
carefully: ``Today Medicaid and Medicare are going up at 3 times the 
rate of inflation. We propose to let it go up at 2 times the rate of 
inflation. Today Medicare beneficiaries get $4,700. In 2002, we propose 
$6,300.'' That is going up, that is not going down. Who said, ``Today 
Medicaid and Medicare are going up at 3 times the rate of inflation. We 
propose to let it go up at 2 times the rate of inflation?'' President 
Clinton 2 years ago.
  How interesting when you see an opportunity to make political hay 
with seniors. You refuse to give responsible suggestions for change.
  H.R. 1590 is a responsible suggestion for change, and we urge its 
passage.
  The SPEAKER pro tempore (Mr. Barrett of Nebraska). The question is on 
the motion offered by the gentleman from California [Mr. Thomas] that 
the House suspend the rules and pass the bill, H.R. 1590.
  The question was taken.
  Mr. GIBBONS. Mr. Speaker, I object to the vote on the ground that a 
quorum is not present and make the point of order that a quorum is not 
present.
  The SPEAKER pro tempore. Evidently a quorum is not present.
  The Sergeant at Arms will notify absent Members.
  The vote was taken by electronic device, and there were--yeas 247, 
nays 170, not voting 17, as follows:

                             [Roll No. 330]

                               YEAS--247

     Allard
     Archer
     Armey
     Bachus
     Baesler
     Baker (CA)
     Baker (LA)
     Ballenger
     Barr
     Barrett (NE)
     Bartlett
     Barton
     Bass
     Bateman
     Bereuter
     Bilbray
     Bilirakis
     Bliley
     Blute
     Boehlert
     Boehner
     Bonilla
     Bono
     Brewster
     Brownback
     Bryant (TN)
     Bunn
     Bunning
     Burr
     Burton
     Buyer
     Callahan
     Calvert
     Camp
     Canady
     Castle
     Chabot
     Chambliss
     Chapman
     Chenoweth
     Christensen
     Chrysler
     Clinger
     Coble
     Coburn
     Collins (GA)
     Combest
     Condit
     Cooley
     Cox
     Crane
     Crapo
     Cremeans
     Cubin
     Cunningham
     Davis
     Deal
     DeLay
     Diaz-Balart
     Dickey
     Doolittle
     Dornan
     Dreier
     Duncan
     Dunn
     Ehlers
     Ehrlich
     Emerson
     English
     Ensign
     Everett
     Ewing
     Fawell
     Fields (TX)
     Flanagan
     Foley
     Forbes
     Fowler
     Fox
     Franks (CT)
     Franks (NJ)
     Frelinghuysen
     Frisa
     Funderburk
     Gallegly
     Ganske
     Gekas
     Geren
     Gilchrest
     Gillmor
     Gilman
     Goodlatte
     Goodling
     Gordon
     Goss
     Graham
     Green
     Greenwood
     Gunderson
     Gutknecht
     Hall (TX)
     Hancock
     Hansen
     Hastert
     Hastings (WA)
     Hayes
     Hayworth
     Hefley
     Heineman
     Herger
     Hilleary
     Hoekstra
     Hoke
     Horn
     Hostettler
     Houghton
     Hunter
     Hutchinson
     Hyde
     Inglis
     Johnson (CT)
     Johnson, Sam
     Jones
     Kasich
     Kelly
     Kim
     King
     Kingston
     Klug
     Knollenberg
     Kolbe
     LaHood
     Largent
     Latham
     LaTourette
     Laughlin
     Lazio
     Leach
     Lewis (CA)
     Lewis (KY)
     Lightfoot
     Linder
     Livingston
     LoBiondo
     Longley
     Lucas
     Manzullo
     Martini
     McCollum
     McCrery
     McDade
     McHugh
     McInnis
     McIntosh
     McKeon
     Metcalf
     Meyers
     Mica
     Miller (FL)
     Molinari
     Moorhead
     Morella
     Murtha
     Myers
     Myrick
     Nethercutt
     Neumann
     Ney
     Norwood
     Nussle
     Orton
     Oxley
     Packard
     Parker
     Paxon
     Petri
     Pombo
     Porter
     Portman
     Pryce
     Quillen
     Quinn
     Radanovich
     Ramstad
     Regula
     Riggs
     Roberts
     Rohrabacher
     Ros-Lehtinen
     Roth
     Roukema
     Royce
     Salmon
     Sanford
     Saxton
     Scarborough
     Schaefer
     Schiff
     Seastrand
     Sensenbrenner
     Shadegg
     Shaw
     Shays
     Shuster
     Sisisky
     Skeen
     Smith (MI)
     Smith (NJ)
     Smith (TX)
     Smith (WA)
     Solomon
     Souder
     Spence
     Stearns
     Stenholm
     Stockman
     Stump
     Talent
     Tate
     Tauzin
     Taylor (MS)
     Taylor (NC)
     Thomas
     Thornberry
     Tiahrt
     Torkildsen
     Torricelli
     Traficant
     Upton
     Visclosky
     Vucanovich
     Waldholtz
     Walker
     Walsh
     Wamp
     Watts (OK)
     Weldon (FL)
     Weldon (PA)
     Weller
     White
     Whitfield
     Wicker
     Wolf
     Young (AK)
     Young (FL)
     Zeliff
     Zimmer

                               NAYS--170

     Abercrombie
     Andrews
     Baldacci
     Barrett (WI)
     Becerra
     Beilenson
     Bentsen
     Bevill
     Bishop
     Bonior
     Borski
     Boucher
     Browder
     Brown (CA)
     Brown (FL)
     Brown (OH)
     Bryant (TX)
     Cardin
     Clay
     Clayton
     Clement
     Clyburn
     Coleman
     Collins (MI)
     Conyers
     Costello
     Cramer
     Danner
     de la Garza
     DeFazio
     DeLauro
     Dellums
     Deutsch
     Dicks
     Dingell
     Dixon
     Doggett
     Dooley
     Doyle
     Durbin
     Edwards
     Engel
     Eshoo
     Evans
     Farr
     Fattah
     Fazio
     Fields (LA)
     Filner
     Frank (MA)
     Frost
     Furse
     Gejdenson
     Gephardt
     Gibbons
     Gonzalez
     Gutierrez
     Hall (OH)
     Hamilton
     Harman
     Hastings (FL)
     Hefner
     Hilliard
     Hinchey
     Holden
     Hoyer
     Jackson-Lee
     Jacobs
     Jefferson
     Johnson (SD)
     Johnson, E. B.
     Johnston
     Kanjorski
     Kaptur
     Kennedy (MA)
     Kennedy (RI)
     Kennelly
     Kildee
     Klink
     LaFalce
     Lantos
     Levin
     Lewis (GA)
     Lincoln
     Lofgren
     Lowey
     Luther
     Maloney
     Manton
     Markey
     Martinez
     Mascara
     Matsui
     McCarthy
     McDermott
     McHale
     McKinney
     McNulty
     Meehan
     Meek
     Menendez
     Mfume
     Miller (CA)
     Mineta
     Minge
     Mink
     Moakley
     Mollohan
     Montgomery
     Moran
     Nadler
     Neal
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Pallone
     Pastor
     Payne (NJ)
     Payne (VA)
     Pelosi
     Peterson (MN)
     Pickett
     Pomeroy
     Poshard
     Rahall
     Rangel
     Reed
     Richardson
     Rivers
     Roemer
     Rose
     Roybal-Allard
     Rush
     Sabo
     Sanders
     Sawyer
     Schroeder
     Schumer
     Scott
     Serrano
     Skaggs
     Skelton
     Slaughter
     Spratt
     Stark
     Stokes
     Studds
     Stupak
     Tanner
     Tejeda
     Thompson
     Thornton
     Thurman
     Towns
     Velazquez
     Vento
     Volkmer
     Ward
     Waters
     Watt (NC)
     Waxman
     Williams
     Wilson
     Wise
     Woolsey
     Wyden
     Wynn
     Yates

                             NOT VOTING--17

     Ackerman
     Barcia
     Berman
     Collins (IL)
     Coyne
     Flake
     Foglietta
     Ford
     Hobson
     Istook
     Kleczka
     Lipinski
     Peterson (FL)
     Reynolds
     Rogers
     Torres
     Tucker

                              {time}  1148

  Mr. KANJORSKI changed his vote from ``yea'' to ``nay.''
  So (two-thirds not having voted in favor thereof) the motion was 
rejected.
  The result of the vote was announced as above recorded.
  

                          ____________________