[Congressional Record Volume 141, Number 154 (Friday, September 29, 1995)]
[House]
[Pages H9722-H9727]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             TOP 10 GOP OUTRAGES REGARDING MEDICARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of May 
12, 1995, the gentleman from West Virginia [Mr. Wise] is recognized for 
60 minutes as the designee of the minority leader.
  Mr. WISE. Mr. Speaker, before I begin my next text, I yield to the 
gentlewoman from New York [Ms. Slaughter].


           forgery of national alliance for justice document

  Ms. SLAUGHTER. Mr. Speaker, I thank the gentleman from West Virginia 
[Mr. Wise] for that, because I want to tell everyone what Washington's 
dirty little secret is, since they have been talking about it all 
afternoon.
  The committee staff of this group over here forged a document 
yesterday. They took a letterhead from an organization that they had 
asked to come in to testify, took it, as though it was from this 
organization, copied down the board of directors and listed their 
members and put next to some of them millions of dollars that they 
claimed they got in Federal grants.
  Mr. Speaker, when we heard from the the National Alliance for 
Justice, the woman who heads it up, she told these people over here 
that she does not get a dime's worth of Federal money. She said that 
she not only resented the fact that they forged that document with 
false testimony, but she also said, I will not tell you what these 
people get in Federal money. I do not know. But there is one person 
here, she said, this afternoon, that has given me permission to tell 
you how much Federal money she gets. It is the Arts Alliance. Zero. 
Zip.
  Mr. Speaker, do the people care on this committee? Not a bit. I sat 
as a member at the Waco hearings.
  Mr. McINTOSH. Mr. Speaker, would the gentlewoman yield?
  Mr. WISE. Mr. Speaker, I control the time, and the gentleman will 
have time later.
  The SPEAKER pro tempore. The gentleman from West Virginia controls 
the time.
  Mr. McINTOSH. Mr. Speaker, the gentlewoman has made a very serious--
--
  Mr. WISE. Regular order, Mr. Speaker.
  The SPEAKER pro tempore (Mr. Everett). The gentleman from West 
Virginia controls the time and has yielded to the gentlewoman from New 
York.
  The gentlewoman from New York may proceed.
  Ms. SLAUGHTER. Mr. Speaker, on the Waco hearings we found that the 
committee had turned over lots of its responsibilities to the NRA, and 
now we find this same committee staff is forging documents to be given 
out to the press purporting to be a true statement. Mr. Speaker, in the 
name of all the men and women who served us before in this House, who 
stood on this floor and with truth and with eloquence did the best they 
could for the American people, I am more than outraged at the dirty 
little secret that this subcommittee would stoop to crime in order to 
make their point.
  I am sure they are going to have an hour more of it this afternoon, 
but if people want to know the truth of the testimony, they should let 
us send them the record of that hearing.
  Mr. WISE. Mr. Speaker, I am going to address an issue because, as 
this Congress heads off for recess, I think it is time to talk about 
the Republican excesses.
  What has been going on here for the last few weeks, Mr. Speaker, it 
suddenly occurred to me, I hear a lot about Medicare when I am home, 
and I hear a lot about Medicaid, and they are very, very important 
topics. But I think it is also important to look at some of the other 
things taking place that affect middle-income and low-income men and 
women in this country and to talk about exactly what is taking place.
  It occurred to me it is a lot like watching a freight train go by. 
The train builds up speed, and when it starts rolling, a person cannot 
pay attention to what is in each car, they just know there is an 
enormity. There is a big train going by. I want to talk about what is 
in each car. So I have compiled a list here, and with apologies to 
David Letterman, we have titled it the top 10 GOP outrages, because I 
think the people in the country, Mr. Speaker, ought to know exactly 
what has taken place.
  This is not a complete list. This is only a quick culling of the 
various committees to see what we consider to be the top 10 outrages. 
Top 10 outrage No. 1, this is the most incredible one, in some ways, to 
me, because it is the idea that came about in the Senate finance 
committee called child support surcharges.
  People are not going to believe this one. This is if an individual 
has to get the State to get child support for them and to track their 
deadbeat spouse down someplace to get that child support, they will now 
pay a 10 percent surcharge under this one. They will pay a 10 percent 
commission. Child support surcharges. I like it. It turns every human 
resource worker into a bounty hunter. Put a star on them, send them 
out, 10 percent right off the top. They are already down, let us put 
them down a little more.
  No. 9 sort of follows up on this. This does get into the Medicaid 
area. No. 9 is liens on Medicaid families. This one may boggle people's 
minds a little bit. Medicaid families, by definition, for the most 
part, are already low income. In many cases they may be middle-income 
families that have their mother or father or grandparent in a nursing 
home. This takes all the Federal protections that are built in against 
putting them into poverty.
  What it would do, Mr. Speaker, is to permit Medicaid to put liens on 
the elderly and their families in this way. There would be no more 
guarantee under the Medicaid block grant of coverage for nursing home 
care after an individual or family has spent its savings. Right now if 
a family spends their assets down to a certain level, they do not get 
kicked out of the nursing home. This would remove that protection. It 
eliminates current protections that stop the States from imposing liens 
on personal residences. That is homes and farms.
  States would be required to require adult children of nursing home 
residents to contribute toward the cost of their parents' care, 
regardless of the financial obligations. Regardless of the financial 
circumstance or family obligations of the adult children. The States 
could be allowed to do this.
  There would, finally, be no more guarantee, it is gone, that spouses 
of nursing home residents would be able to retain enough monthly income 
to remain in the community. Presently, there is some protections for 
families from Medicaid. Those protections under the Medicaid 
legislation would be removed. That is No. 9.

  Now, Mr. Speaker, continuing in the same vein let us go to No. 8. No. 
8 is no more Federal nursing home standards. That one, I know, is hard 
to believe, that anyone, in their right mind, would say that after all 
the years that it took to finally get some nursing home standards, some 
minimal standards so that people are no longer lying in their feces, so 
that they are guaranteed adequate care, so that they cannot be strapped 
down without adequate due process, so that a whole lot of other things 
cannot happen to the loved ones we put in nursing homes, I know it is 
hard to believe, but, yes, it is true there would be no more Federal 
nursing home standards. It would strictly be up to the States.
  I happen to think States are quite capable of the job, but the 
reality is, in many cases, it took the Federal Government to make sure 
there were adequate nursing home standards. So that is No. 8, no more 
nursing home standards.
  To continue this juggernaut, No. 7, if an individual cannot get in 
the nursing home to get warm, they should not go home, because there is 
no more energy assistance. The LIHEAP program, the Low Income Heating 
and Energy Assistance has been stricken by the Republican leadership. 
It has eliminated all funding for LIHEAP, the Low Income Heating Energy 
Assistance Program that provides heating assistance for low-income 
senior citizens.
  Mr. Speaker, in my State of West Virginia alone last year, LIHEAP 
served 190,000 people in the coldest 

[[Page H 9723]]
parts of the winter, and it was $12.2 million of energy assistance.
  We can see a pattern developing here. We are going to charge people 
for getting them their child support, we are going to put increased 
liens on Medicaid families, we are going to remove the Federal nursing 
home standards and so that when they get home there is no energy 
assistance to assist them there either.
  I want to turn for a second now, Mr. Speaker, to those men and women 
who are working and who have been trying to put away enough for their 
retirement. I call this one ``There may not be any light at the end of 
the tunnel after all.'' We have worked for 40 years for our pension; 
right? Well, problem. Because No. 6 is the pension grab.
  Here is what happened, just happened last week in the Committee on 
Ways and Means under the Republican leadership, they have now permitted 
employees to raid the employee pension plans.
  Here is how it works. Presently, companies that want to go into 
pension assets, the ones that have been built up for the benefit of the 
retirees, if they want to go in without penalty they can only do so to 
use the funds for the health insurance for retirees. But to use the 
money for other reasons they have to pay a penalty tax of 50 percent 
withdrawal.
  What that does, Mr. Speaker, is it tells them to keep their fingers 
off the pension fund. I think we remember the 1980's and the trouble a 
lot of people got into, both pensioners and companies. This is designed 
to stop that and it has been pretty effective.
  Now, the Republican leadership would permit firms with pension plans 
that hold at least 125 percent of the assets needed to meet anticipated 
pension liabilities to withdraw the funds for any purpose, any purpose, 
without the worker's permission. We may say what is the problem? One 
hundred twenty-five percent of assets needed, surely that is enough to 
cover any future liabilities. Mr. Speaker, it is enough to cover it 
today when the stock market is high, but what about those pension plans 
that are heavily involved in stock purchases? What happens when those 
stock values drop? Does anyone think the stock market is not going to 
dip?
  What happens is, after they have gone in and taken the money out and 
the stock market drops, then that pension fund is undervalued. The 
great all American pension grab.
  We are not content just to stop with seniors or potential retirees or 
working people, let us move to No. 5. This one is kind of old but it 
has such resonance that I thought it should be brought up there because 
this one will create the ultimate food fight and it is cuts in child 
nutrition.
  As I say, Mr. Speaker, what this will do is to put the school lunch, 
the school breakfast, the summer lunch program into block grants with 
lower funding levels, and also the women, infant and children program 
will go into a separate block grant and send it to the States. And, 
yes, I have heard the arguments ad infinitem, ad nauseam. It is like 
eating the third helping of broccoli to hear this again, about how it 
is not a cut, it is an increase because we are giving it a 4.5-percent 
increase.
  Mr. Speaker, what they are not saying is that is not enough to keep 
up with the demand. They are also not telling us that while it is a 
4.5-percent increase in their calculations for school lunches, they 
took from something else that is all in the block grant. It is like it 
is all on one tray now, and now we have to decide how many beans we 
want and how many carrots and so on.
  Mr. Speaker, West Virginia alone received $50 million in cash 
assistance and $5 million in commodity assistance last year, served 
180,000 school lunches, and 77,000 school breakfasts. 57 percent of 
school lunches in my State go to those who qualify for a free or 
reduced lunch. And just so we understand, Mr. Speaker, West Virginia is 
not simply relying on the Federal Government, we put an equal amount of 
money in ourselves. But making this into a block grant and cutting 
school nutrition and child nutrition is going to be a real body blow to 
our children. As the button once said, pick on somebody your own size.
  Let us jump back for a second to senior citizens. This one kind of 
fascinates me. There have been a lot of hearings around here. Mr. 
Speaker, we all know we can walk up and down these halls everyday and 
there is no shortage of hearings. My goodness, we had 28 days of 
hearings on Whitewater alone. The only person who has not been called 
as a witness is Socks, but he may be coming up shortly.
  On this one, what is the program that probably is the most important, 
the largest part of our budget in health care, most important to 37 
million Americans and senior citizens? Medicare. This program has just 
celebrated its 30th anniversary. Its 30th birthday. If we are going to 
change it, one would think we would have, I presume, a lot of 
exhaustive fact-finding hearings. But this leads to number four on our 
list of Republican outrages. One day of hearings on Medicare.
  That is true, the program that is scheduled to be cut $270 billion, 
the program that 37 million senior citizens depend upon, the program 
that is vital to many of the health care providers in this country, the 
program that helps fund the medical education and research that we all 
take for granted in this country, that program, 30 years of experience, 
gets one day of hearings. And, incidentally, some of the witnesses not 
permitted to testify were the trustees of the Medicare program.

                              {time}  1645

  Is not it interesting, every Republican I know has been waving the 
Medicare trustees' report saying this is why we have to make these cuts 
because of the Medicare trustees' report and then they never invited 
the people who wrote the report that they are talking about. 
Interesting. Anyway, that earned outrage No. 4.
  But turning quickly in the same vein to outrage No. 3, No. 3 is $270 
billion in Medicare cuts. Why is that an outrage? If that is what is 
necessary to save the program, by golly do it. That is what senior 
citizens are saying. They want to see the program made solvent. The 
outrage is that what everyone estimates to save the program is not $270 
billion over 7 years; it is somewhere between $90 billion and $120 
billion on 7 years. That leaves a gap of $150 to $170 billion too much 
that they are taking out of Medicare.
  And where does that go? Well, it goes, of course, to the tax cut. We 
will talk about that in a minute; that is $245 billion. But it has 
other implications as well. The 40 percent of the money that will come 
out of Medicare will not go to save Medicare because it cannot. 
Medicare is in two parts, Part A, the trust fund, and Part B, 
outpatient care. The trust fund is what is considered in trouble. The 
trust fund is the only part that you can put money in to ``save.'' That 
is estimated to be $90 billion, and yet 40 percent of the money comes 
out of Part B and therefore does not even go toward the trust fund. It 
will result in higher premiums for our senior citizens. It is going to 
result in a lot of troubles for our hospitals.
  In West Virginia, Calhoun General closed just this week. I cannot say 
it is because of this, but this will make it inevitable that other 
hospitals close. What happens when a hospital closes in that area? When 
you are injured in Calhoun County, you have a 90-minute drive to the 
closest emergency room. That is what it means.
  That is No. 3, $270 billion in Medicare cuts, and would not it be 
nice if we could let the Medicare trustees tell the Committee on Ways 
and Means what they think of the committee's proposals?
  No. 2, 100 percent of senior citizens are going to take a whack, a 
real hit because of No. 3. Hold that figure in mind. It is not too hard 
to remember. 100 percent. Every senior citizen. Now, outrage No. 2 is 
tax breaks for the wealthy, because as those senior citizens are being 
cut about three times what is necessary to make Medicare solvent where 
is the difference going? The difference is going to the $245 billion 
tax cut basically to the upper income.
  Now, I have heard the talk about how there is a $500 child care tax 
credit and that will go to middle income and low-income people. The 
problem is it will not, Mr. Speaker. This tax cut, 51 percent of the 
benefits go to people making over $100,000 a year, they get around 
$2,400 back. Now, for the person 

[[Page H 9724]]
making $20,000 a year or less, they get something like $90 back.
  What does that translate into? For about two-thirds of the people in 
my State, it is 20 cents a day, is what they get back in a tax cut; $7 
a day is what the person over $100,000 a year gets back. The person 
getting 20 cents back loses their student loan ability and their 
Medicaid, they lose their earned income tax credit assistance, and they 
will pay more for Medicare. Their senior citizen mother or father or 
grandparent, they may be paying a lot more for them out of pocket, so 
they are going to lose a whole lot because of this.

  So, tax cuts, I thought we were about balancing the budget. If you 
are balancing the budget, which is tough enough to do in 7 years 
without a tax cut, you really want to add $245 billion. Incidentally, 
if you are making $350,000 a year, you hit the lotto because you get 
$20,000 a year back. The folks at the other end get 20 cents a day 
back. That is No. 2, tax cuts for the wealthy.
  No. 1, I know, Mr. Speaker, this is just a crescendo of excitement. 
Drum rolls. Really, Bob, that is the No. 1 outrage. It is enough, Bob, 
you really ought to stop. Stop me, Mr. Speaker, before I peel again.
  Here we go. No. 1 is after a lot of consultation, remember I just 
told you about the tax cut for the wealthy? Now I know you are not 
going to believe this, Mr. Speaker, but it is true. A middle income tax 
increase. That is right. Middle income tax increase. While the 
Republican leadership is putting through a bill that will cut taxes for 
the wealthiest, it is increasing taxes for low and middle income 
persons.
  Bob, you must be all wet. They would not do that, would they? Look at 
what happens. Presently there is something in the law right now called 
the earned income tax credit. A working family in this country that 
earns under, I believe, $28,000 a year is eligible for a tax credit. 
And it not only goes to their income taxes; it means they can get money 
back from their Social Security tax, their FICA tax and sales tax. It 
is money directly in their hands.
  What it means it is good for business and it is good for the 
employee, because it is like subsidizing the low-income worker. And 
when Congress voted to increase that earned income tax credit just 2 
years ago that I proudly voted for, and I might add not one Republican 
voted for, when Congress voted to increase that, it voted to make the 
person making minimum wage, about $4.25, in effect it made their wage 
about $6. Not one penny came out of the employer, but it was done 
through the Tax Code.
  So now it is being proposed in the Committee on Ways and Means to 
take back some of that tax credit. What that is is a middle income tax 
increase. These people will be paying more in taxes after all this 
passes than they did before.
  Let me tell my colleagues in West Virginia, that means that 98,800 
middle income families will face a tax increase, about 90 percent of 
the families in this program. Remember, the Republican tax plan for a 
child care credit, it does not pay you the money if you did not pay 
that much in taxes, so you do not get as much benefit from it if you 
are in the lower income brackets. But this program, the one they are 
cutting into, that does pay you. So the Republican plan means very 
little for low income and middle income people. This plan puts money in 
your pockets, and that is the one they are cutting. So, the $500 per 
child tax credit does not help many of our middle income families. In 
fact, one in three American children will receive no aid from their 
credit. They do get aid from this. And so after everything is done, 
there is a middle income tax increase coming, thank to the Republican 
leadership.
  So let me just quickly run over this list again because I know 
everybody has got pencils and they are jotting it down. I think Mr. 
Speaker, that it would be worthwhile for every Member to be talking 
about this when they are home. The excesses are during the recess, and 
I hope that every constituent across the country will ask with these 10 
things, the 10 top outrages that Congress has been working on in the 
last few weeks.
  First of all, No. 10, child support surcharge. That is right, 
charging single parent families 10 percent to go get the child support 
that they are not able to get themselves.
  No. 9, relaxing and doing away with the regulations that stop people 
from having liens put on them on Medicaid families.
  No. 8, removing Federal nursing home standards.
  No. 7, no more energy assistance for low income senior citizens.
  No. 6, going after the pensions and permitting corporations to take 
money out of pension funds without adequate protection and with no 
penalty.
  No. 5, cutting child nutrition programs making it harder for kids to 
be able to get that one hot meal a day.
  No. 4, only 1 day of Medicare hearings when they were able to have 28 
days of hearings on Whitewater, 10 on Waco, and however many have been 
going on on Ruby Ridge.
  No. 3, $270 billion in Medicare cuts when $90 billion will do the 
job.
  No. 2, tax breaks for the wealthy.
  And of course, No. 1 at the same time they are giving tax breaks for 
the wealthy No. 1 is actually asking middle income and low-income 
people to pay a tax increase.
  Mr. Speaker, those are my selections for the top 10 GOP outrages of 
the last 2 weeks, and my hope is that we will all be hearing about 
these a lot during our October recess.
  Mr. Speaker, at this point, I yield the balance of my time to the 
gentleman from New Jersey [Mr. Pallone].
  The SPEAKER pro tempore (Mr. Everett). The gentleman from New Jersey 
is recognized for up to 36 minutes.
  Mr. PALLONE. Mr. Chairman, I would also like to point out that one of 
the items that the gentleman from West Virginia mentioned as one of his 
top Republican outrages was the fact that there was only 1 day of 
hearings on Medicare last week in the House of Representatives before 
the Committee on Ways and Means.
  However, I would like to point out that in my committee, the 
Committee on Commerce which also has jurisdiction over Medicare, as 
well as jurisdiction over Medicaid, which is the Federal Health Care 
Program for poor people, we have not had any hearings on either one of 
the issues.
  In fact, last Friday, we reported out a Medicaid reform bill that 
cuts Medicaid by $180 billion and essentially eliminates the 
entitlement status of Medicaid, so that poor people have no guarantee 
of health insurance anymore. We did not have a single day of hearings 
on the Medicaid changes.
  In addition, I understand now that the Republican leadership has 
finally introduced a Medicare reform bill in order to implement the 
$270 billion in cuts to Medicare, and my committee, the Committee on 
Commerce, will be meeting on Monday, this coming Monday, to mark up the 
Medicare bill without even 1 hour or 1 minute of hearings on the 
Medicare bill.
  So here we have a situation where probably the most important change 
that will take place in this House and in this Congress, the effects 
and the changes on Medicare and Medicaid which affect millions and 
millions of Americans, and we will not have had a single day of 
hearings on either one of these bills before the time when they came to 
the committee to be marked up.
  It is indeed an outrage. It is an outrage that is out of proportion, 
when we think about the level of cuts; $270 billion in cuts in Medicare 
and $180 billion in cuts in Medicaid. Cuts that these two health 
insurance programs, primarily for seniors, cannot take without major 
changes that are going to be negative and affect the quality of 
Americans' health care, and particularly seniors' health care, in a 
very, very negative way.
  Fortunately, the Democrats, realizing the fact that there were not 
going to be any hearings on either one of these programs, decided, 
starting last week, to have their own hearings, alternative hearings on 
the Medicare Program on the lawn of the Capitol. We finished 4 days, 
today, of those hearings, and I want to tell my colleagues that they 
were very productive hearings.
  Mr. Speaker, I wanted to give some information about what some of my 
constituents said who attended the hearings, both health care 
providers, representatives of hospitals in my district in New Jersey, 
as well as senior citizens and senior citizen advocates from my home 
State of New Jersey.
  Before I get to that, I wanted to point out the fact that 
increasingly 

[[Page H 9725]]
this opposition to Speaker Gingrich and the Republican leadership's 
Medicare cuts and Medicare changes for both Medicare and Medicaid are 
being opposed in a bipartisan fashion.
  One of the things that has bothered me the last few weeks in 
listening to some of the statements on the floor of this House is that 
increasingly my colleagues on the other side, on the Republican side, 
suggest that somehow this is all very partisan, that the Democrats are 
attacking the Republican leadership for the changes that are being 
proposed in Medicare and Medicaid, and that all of this is coming from 
the Democratic side and that we are just being very partisan about it.
  The reality is that increasingly, over the last weeks, it has not 
been a partisan battle. There has been bipartisan opposition to the 
Medicare and Medicaid proposals that Speaker Gingrich and the 
Republican leadership have come forward with.
  In a sampling of opposition, this Wednesday there were a number of 
Republican Senators who expressed concern about the Medicare proposal 
put forward by the Republican leadership. On Wednesday, there were 
three Republican Senators who voiced doubts about mixing a big tax cut 
with planned surgery on Medicare and Medicaid. They said in essence, 
look, why is it that we are cutting Medicare and Medicaid this amount 
in order to finance a very large tax cut primarily for wealthy people?
  Senator Orrin Hatch of Utah and Senator Alan Simpson of Wyoming and 
Senator Alfonse D'Amato of New York expressed skepticism about cutting 
taxes while Congress is struggling to balance the budget. They 
indicated strongly their concern about how they are going to make these 
cuts in Medicare at the same time that tax cuts were being proposed for 
wealthy Americans.
  In addition to that, I was very pleased to see that in my own home 
State, the gentlewoman from New Jersey [Mrs. Roukema] has expressed 
concern about both the Medicare changes as well as the Medicaid 
changes. The gentlewoman is quoted in an article that is in today's New 
York Times where she says she is concerned about the effects of the 
Medicare proposals.
  Mr. Speaker, the gentlewoman noted recent estimates from the 
Congressional Budget Office showing that most of the $270 billion in 
Medicare savings would be achieved by limiting payments to hospitals, 
nursing homes, and home care agencies.

       These are sobering numbers. They open up a number of 
     concerns about whether the savings will come through a 
     reduction of care or through the new choices that people are 
     given.

                              {time}  1700

  I would like to repeat again. In my home State of New Jersey, along 
the Jersey shore which I represent in Congress, I represent a large 
part of the New Jersey shore, we had three Republican State 
legislators. they are Senator Leonard Connors, Assemblyman Jeffrey 
Moran and Assemblyman Christopher Moran, all Republicans from Ocean 
County in New Jersey. They sent a letter to Senator Dole and also to 
Speaker Gingrich this week asking them to back off on the proposed cuts 
in Medicare because of the impacts that they could have on senior 
citizens.
  They pointed out that financing tax breaks for the rich on the backs 
of our elderly is morally bankrupt. The Senator and the two 
assemblymen, again all Republican, also were critical of the increases 
proposed by Speaker Gingrich in his plan in the Medicare part B 
coverage, from $552 annually to $1,116. they said the plan is signing a 
death warrant for millions of senior citizens across the country.
  So for my colleagues on the other side of the aisle who would suggest 
that somehow this is strictly the Democrats that are complaining about 
these cuts in Medicare and what they are going to mean for senior 
citizens, I tell you we have U.S. Senators, U.S. Congressmen, we have 
State legislators from the State of New Jersey, all Republicans who are 
concerned about what is happening here. They have reason to be 
concerned, for a number of reasons.
  Let me give some of the concerns expressed at the alternative 
hearings that were held by the Democratic Caucus on the lawn on the 
East Front of the Capitol this week. I attended each of those hearings. 
We had some representatives from my district in New Jersey who spoke 
out each of the days, Wednesday through today, and expressed their 
concerns.
  One of the speakers who gave testimony who I was most impressed with 
was Dr. Anita Curran, who is associate dean for Environmental and 
Community Medicine at the University of Medicine and Dentistry in New 
Jersey and the Robert Wood Johnson Medical School in New Brunswick, 
which is in my district. Dr. Curran pointed out how every aspect of 
health care in New Jersey as well as in this country as a whole is very 
interconnected and that programs like Medicaid for the poor, Medicare 
for senior citizens, nutrition programs, even some of the welfare 
reform that we have talked about on the House floor, the very cuts that 
impact health care in each of these programs have a cumulative effect.
  She represents the Robert Wood Johnson Medical School, a teaching 
hospital. Many of the significant cuts in Medicare affect teaching 
hospitals, making it more difficult for those hospitals to train 
residents and train doctors who are going to go into the community in 
the future. A lot of those doctors at the Robert Wood Johnson Medical 
School also work at the Eric B. Chandler Health Center, which is a 
community-based health center in New Brunswick that handles a lot of 
Medicaid recipients, poor people who are on Medicaid.
  What Dr. Curran pointed out is that when you cut back on the amount 
of money going to teaching hospitals, like Robert Wood Johnson, you are 
also having an impact on the community health center because there will 
not be the teachers there to work at the community health center and 
help the poor and needy people in New Brunswick and in the area served 
by the Eric B. Chandler Health Center.
  Also, the Medicaid dollars that are being cut for the health center 
through Medicaid are going to have an effect on the teaching hospital 
because now all of a sudden there is less money coming in through 
Medicaid as well. So the cutbacks in Medicare and the cutbacks in 
Medicaid do not just affect seniors, they do not just affect poor 
people, they also affect everyone. Essentially, if the hospital in the 
community does not have the money to operate and either has to close or 
cut back on services either for inpatients or for outpatients, everyone 
suffers, and that is the dramatic impact of these cuts both in Medicare 
and Medicaid.
  We had other people that spoke at the hearings that were held out on 
the lawn. I wanted to mention Margaret Chester, who is executive 
director of the Middlesex County Office on Aging in my district. She 
spoke very eloquently about the programs and how these cutbacks are 
going to affect the senior population that are helped by the Middlesex 
County Office on Aging.
  One of the things I asked about, which was particularly disturbing, 
again points out how the interrelationship between cuts in Medicare and 
Medicaid, are a group of seniors or elderly who are called qualified 
Medicaid beneficiaries. These are seniors who are low income. I think 
they cannot be making more than about $625 a month through Social 
Security or pensions or whatever they get. And right now under current 
law, their Medicare part B premiums the premium that they have to pay 
in order to have their doctor bills covered through Medicare, that 
money is paid by Medicaid. So even though they are on Medicare, the 
program for seniors, and they have to pay this premium to get their 
doctor's bills paid, Medicaid says for that Medicare part B premium.
  Under the Medicaid bill that was passed out of the Committee on 
Commerce, my Committee on Commerce last Friday, there no longer is any 
guarantee that Medicaid will pay that part B premium for those elderly 
and poor Medicare senior recipients. Where are they going to get the 
money? Where are they going to get the money to pay for that part B 
insurance to cover their doctor bills? They are already so poor that 
they barely can make ends meet.
  Their Medicare part B premiums under Speaker Gingrich and the 
Republican leadership proposal are going to double over the next 7 
years. So, if they were paying $40 now, they are going to be paying 
probably $100 within 

[[Page H 9726]]
the next 7 years. Yet they do not have Medicaid paying for any part of 
it anymore. There is no way that they can afford to pay that. The end 
result is that, if some of the States decide not to take on that extra 
burden, they are simply going to be out on the street. They will not 
have any health care.

  Last, today at our alternative Medicare hearings, we had two senior 
citizen advocates from my district, one is Dave Sheehan, who is the 
director of the Edison Township Senior Center in Edison, NJ, and also 
Dave Keiserman, who is State chairman of the New Jersey Council on 
Senior Citizens. And what they pointed out and what I wanted to 
reiterate today is how unable, how difficult it is going to be, if not 
impossible, for seniors who now receive Medicare to pay these 
additional payments out of pocket that have been proposed in both the 
bill put forward by the Republican leadership in the House and the bill 
put forward by the Republican leadership in the Senate.
  I already mentioned some of the proposals in the House bill with 
regard to Medicare part B that pays for doctors' expenses for seniors, 
doubling of the part B premiums over the next 7 years. How can these 
seniors, most of whom make less than $25,000 a year, something like 75 
percent of the seniors in the country make less than $25,000 per year, 
how are they going to be able to pay double their part B premiums? But 
if you look at the Senate bill, the one that is being considered on the 
other side of the Capitol, they go beyond the increase in the part B 
premiums. They talk about doubling the part B deductible from $100 
today to $210 in 7 years. They talk about also delaying eligibility for 
Medicare from age 65 to age 67. We really do not know how far these 
additional out-of-pocket payments are going to go. We have heard now 
about increased deductibles, increased part B premiums, raising the age 
of eligibility for seniors for Medicare. Where do we go from here?
  Well, the bottom line is that increasingly what we are finding, when 
these Republican leadership proposals go to the Congressional Budget 
Office, is that there are huge gaps in how much money they can actually 
save. There is a real question about whether or not any of these 
proposals on the Senate side or the House side are going to be able to 
save $270 billion to achieve that level of cuts in Medicare. And so 
what I think is going to happen is that we are going to see more and 
more of an effort to try to find more and more of that money to pay for 
those cuts out of increased out-of-pocket costs to the beneficiaries, 
to the senior citizens.
  Do not be surprised to see larger deductibles. Do not be surprised to 
see copayments. Do not be surprised to see eligibility going from 65 to 
67 or maybe even to 70. Do not be surprised to see even larger Medicare 
part B premiums than what has already been discussed.
  I just wanted to spend a little time, Mr. Speaker, if I could, on 
Medicaid, the program for poor people, which I would point out again, 
70 percent of that money in New Jersey for Medicaid goes to pay for 
senior citizens and those who are primarily in nursing homes. The 
figure for the rest of the country is pretty much the same. A majority 
of the money that we now spend on Medicaid, even though it is a program 
for poor people, is for senior citizens, most of which pays for nursing 
home care.
  The bill that our Committee on Commerce reported out on Medicaid last 
Friday was a travesty. We had no hearings, again. Whatever they do on 
Ways and Means, we do not have any hearings in the Committee on 
Commerce. We get the bill and then the next day we have the markup, and 
we do not even have an opportunity to have a hearing at all.
  In the Committee on Commerce, the Medicaid bill that was reported out 
was indeed a travesty. The New York Times, in an editorial on September 
26 called it a cruel revision of Medicaid. Just let me give you a 
sentence for two. They said, ``Congress shows no signs of slowing its 
assault on the social safety net stitched together over six decades. 
The House Commerce Committee tore another hole in the net on Friday by 
eliminating the Federal guarantee of Medicaid insurance.''
  Essentially, what the Republicans did in this Medicaid bill was to 
eliminate the entitlement statute for Medicaid. So in effect, there is 
no guarantee that anyone gets Medicaid coverage anymore. They send the 
money in a block grant to the States, and they leave it up to the 
States to decide what they want to do with the money, with very few 
strings attached.
  I have to tell you, Mr. Speaker, I had a forum last Monday, actually 
it was Tuesday, in my district, after this Medicaid bill had passed out 
of the Committee on Commerce. And I told the senior citizens at a 
senior center in Long Branch, the town that I live in, about some of 
these cuts and what they will mean, and they were really outraged. And 
they had reason to be outraged.
  One of the things that we pointed out to the seniors and really to my 
constituents in general is the fact that all the protections that 
existed under the Medicaid Program in the past, when someone had to be 
placed in a nursing home, all the protections with regard to the 
nursing home, all the protections with regard to the family of the 
person who went to the nursing home, the family, the spouse that had to 
stay back in the home or the kids that were still in the community, all 
those were just eliminated completely by the Republican majority on the 
Committee on Commerce.
  There are no longer any nursing home standards. The money goes to the 
States in a block grant. The nursing homes can do what they want unless 
the States come in and start regulating them. So all the concerns about 
proper sanitation in nursing homes, code enforcement in nursing homes, 
proper care, that there are nurses that are visiting the patients in 
nursing homes, none of that has any Federal protection anymore. Just as 
bad was the fact that the protections for the spouse who has to stay at 
home were eliminated.
  Right now, under current law, if your husband goes to a nursing home 
and you are the woman who stays at home, you get to keep your home, you 
get to keep your car. And you get to keep about $14,000 in a savings 
account that they cannot go against you to pay for that nursing home 
care for your husband who is in the nursing home. That is all out the 
window now. If a State wants to, they can simply go after those assets 
or include those assets in calculating whether or not someone is 
eligible for Medicaid placement in nursing home.
  They also eliminated all the protections under current law for 
children. So there is nothing to prevent a State, if it wants to, to 
say, your dad is now in a nursing home and so we are going to go after 
your house, the children, or we are going to go after your assets to 
pay for his nursing home care. Again, all those protections were simply 
eliminated.
  The other thing that happened, which I found extremely disturbing, is 
that the Federal law right now with regard to Medicaid, links the 
actual reimbursement rate that is paid to nursing homes to a standard 
based on the amount of money that is necessary to pay for adequate 
care. In other words, the States, under current law, have to give the 
nursing homes enough money to pay for adequate care of the person who 
is in the nursing home. That was abolished. We had a vote on it. Again, 
it was voted down by the Republican majority.
  So what we are going to see increasingly is less money going to the 
States, no safeguards for the States, the States paying less and less 
money for nursing home care that is less than adequate, and no way to 
make sure that under Federal law that those nursing homes are adequate 
and provide proper care.
  The last thing that I wanted to mention, going back again to the fact 
that this is not at all a partisan issue, and I hate the fact that it 
keeps being characterized as such, is that in my home State of New 
Jersey, in a lot of the other States around the country, many of the 
Republican elected officials have been very critical of this Republican 
leadership Medicaid proposal because of the formula that is being used 
to decide how much the individual States are going to receive.
  I would point out that it really does not matter what the formula is 
because since there is going to be so much less money going to the 
States to pay for Medicaid, however you figure out the formula, the 
States are not going to have enough money to provide adequate care. But 
I want to commend my 

[[Page H 9727]]
Governor, Governor Christine Whitman, and also the members of my State 
delegation, the Republicans in my State delegation, New Jersey, all of 
whom have protested to Speaker Gingrich and to the Republican 
leadership that the formula for Medicaid is inadequate and certainly 
unfair to the State of New Jersey.

                              {time}  1715

  Now what the Governor of New Jersey pointed out is that in the next 
year, in 1996, there will be a 7.2-percent Medicaid grant increase to 
the States under the formula that Speaker Gingrich has put forward, but 
after that, for the fiscal years from 1997 to 2000, there is only a 2-
percent annual increase in the amount of money the States get to 
provide for Medicaid expenses, and essentially what the Governors said, 
and I quote, is that ``we cannot achieve that level of savings, we 
cannot operate that program with the level of money that we are going 
to be getting from Medicaid.''
  So, if I could just conclude by pointing out again, as much as most 
of the people opposing this Gingrich plan are Democrats, there are a 
lot of Republicans in my State and in other parts of the country at 
every level, whether it is the Senate, whether it is the Governors, 
whether it is the other members of our congressional delegation, or 
State legislators who are pointing out that there is absolutely no way 
that we can continue to provide adequate care under the Medicaid 
Program for our poor people and particularly for our elderly who are 
the  main beneficiaries of the Medicaid Program, and the same concerns 
are now being expressed as well on the Medicare Program, that this 
level of cuts that are being proposed by Speaker Gingrich and the 
Republican leadership are simply inadequate to provide quality care for 
our seniors and for the people who are part of the Medicare and 
Medicaid Programs.

  Mr. Speaker, I am pleased to see that the cracks are starting to 
show, that we are seeing a slowdown in effect in the effort to try to 
move both of these bills through Congress. We have a week now, next 
week, and there will be no votes on the floor of the House of 
Representatives on any bills, and I am hopeful that the momentum will 
continue to build during this next week so that, when we come back 
around Columbus Day, there will be even more and more opposition on a 
bipartisan basis to these terrible changes that are being proposed in 
the Medicare and Medicaid Programs.

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