[Congressional Record Volume 141, Number 167 (Thursday, October 26, 1995)]
[Extensions of Remarks]
[Page E2038]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




[[Page E2038]]


               COALITION BUDGET RECONCILIATION SUBSTITUTE

                                 ______


                            HON. BILL ORTON

                                of utah

                    in the house of representatives

                       Wednesday, October 25, 1995

  Mr. ORTON. Mr. Speaker, I am submitting for the Record an amendment 
in the nature of a substitute to H.R. 2491, The Seven Year Balanced 
Budget Reconciliation Act. This amendment reflects the changes to 
amendment No. 7 which I submitted on Friday. The changes that we have 
made to our alternative are technical changes that we have made as the 
Congressional Budget Office has reviewed our language. As a minority 
within the minority party, we have been at the back of the line in 
having our substitute scored by CBO. CBO provided us with preliminary 
estimates on Monday and has continued to supply us with additional 
scoring throughout the week. We did not receive final scoring of some 
of the items until a few hours ago. This delay in having our substitute 
scored has prevented us from submitting our amendment earlier, because 
we are committed to ensuring that our substitute will balance the 
budget by 2002.
  Most of the changes in this amendment are minor changes in the 
drafting of individual provisions that were necessary to clarify out 
intent for CBO. Other minor changes in the amendment were necessary to 
achieve the savings that we anticipated in certain areas. The changes 
in the amendment I am submitting today are as follows:


                                medicare

  Based on CBO scoring and interpretation of our Medicare proposal, we 
had to make several changes in order to achieve the objectives we had 
set out in our plan:
  The capitated payments to Medicare Choice plans was reduced to 6 
percent in 1996 through 1998 and to 5.5 percent in 1999 and thereafter. 
Payments in areas with reimbursements between 85 percent and 100 
percent of the national average would be set at 160 percent of the 
national average. Payments in areas with reimbursements above 120 
percent of the national average would be set at 35 percent of the 
national average;
  The freeze on clinical labs and durable medical equipment was 
extended from 4 years to 7 years;
  The medical economic index floor on payments to physicians was 
reduced to 91 percent in order to achieve the level of saving from 
physicians we had anticipated; and
  We corrected drafting errors to clarify that PPS hospitals were 
included in the 1-year update freeze and that the 10-percent reduction 
in capital payments is extended for 7 years. In addition, we corrected 
effective dates for several provisions.


                                medicaid

  Because CBO scored the per capita limits on Medicaid significantly 
differently than it had scored similar proposals earlier this year, we 
had to reduce the per-capita growth rate on Medicaid to CPI minus 0.5 
percent in 1996 through 1998 and CPI minus 0.3 percent in 1999 and 
thereafter; and
  In order to have the savings from targeting the Disproportionate 
Share Payments to hospitals with low-income utilization of more than 25 
percent scored by CBO we had to write in National DSH limits of $6.5 
billion in 1997 and 1998, $5.5 billion in 1999 and 2000 and $5 billion 
thereafter. These lower national limits are consistent with the savings 
that will result from targeting DSH payments.


                             welfare reform

  After reviewing the work provisions and other welfare reform 
provisions that were in the Deal welfare reform substitute, CBO 
concluded that the welfare reform provisions would achieve greater 
savings than it had estimated when the Deal substitute was considered 
in March. As a result, we have made changes to the welfare reform 
provisions to remain consistent:
  Section 9806, ``Narrowing of SSI Eligibility on the Basis of Mental 
Impairments'' was dropped; and
  The participation rates in the Work First program were increased by 4 
percent a year in each year from 1997 through 2001. The new 
participation rates are 20 percent in 1997, 24 percent in 1998, 28 
percent in 1999, 32 percent in 2000 and 36 percent in 2001.


                     discretionary spending limits

  The discretionary spending limits were adjusted slightly in each 
year. The new outlay caps are as follows: $536.6 billion in 1996, 
$530.2 billion in 1997, $526.1 billion in 1998, $524.2 billion in 1999, 
$523.3 billion in 2000, $529.5 billion in 2001, and $529.5 billion in 
2002.


                            deficit targets

  After receiving final estimates from CBO, we adjusted the deficit 
targets to reflect the deficit reduction glide path that we anticipate 
will result from this bill. The deficit targets are as follows: $179.2 
billion in 1996, $160.4 billion in 1997, $132.5 billion in 1998, $111 
billion in 1999, $85.3 billion in 2000, and $41 billion in 2001.
  Mr. Speaker, I encourage my colleagues to review this amendment 
carefully and join me in voting for ``The Common Sense Balanced Budget 
Reconciliation Act'' tomorrow.

                          ____________________