[Congressional Record Volume 142, Number 36 (Friday, March 15, 1996)]
[Senate]
[Pages S2145-S2147]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     NATIONAL GOVERNORS' ASSOCIATION WELFARE AND MEDICAID PROPOSALS

  Mr. ROTH. Mr. President, 3 months ago President Clinton vetoed the 
Balanced Budget Act of 1995. The failure to balance the Federal budget 
continues to hang like a dark cloud over American families and 
businesses. The heavy yoke of Federal budget deficits still threaten to 
choke off economic growth and future prosperity. Moreover, by vetoing 
this legislation, the President also preserved a welfare system which 
traps millions of children into a cycle of dependency.
  A few weeks after the balanced budget veto, President Clinton stopped 
welfare reform again by vetoing H.R. 4, the Personal Responsibility and 
Work Opportunity Act of 1995. However, the President also pledged that, 
``I am nevertheless determined to keep working with the Congress to 
enact real, bipartisan welfare reform.''
  Mr. President, 1 month ago the men and women who serve as the chief 
executives of our 50 States presented the President, the Congress, and 
the American people with bold new proposals to restructure Medicaid and 
reform the welfare system. Gathering from across the country, the 
Governors set aside their own differences and found the common ground 
and bipartisan consensus which have been missing in Washington. The 
Governors have presented us with a fresh opportunity to bridge the 
differences which divide the Congress and the President.
  The Committee on Finance has recently completed a series of hearings 
on the National Governors' Association proposals. On February 22, six 
Governors, four Democrats and two Republicans, urged the Congress to 
quickly pass both welfare and Medicaid reforms. We heard from Governors 
Carper, Chiles, Engler, Miller of Nevada,

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Romer, and Thompson--who along with Gov. Mike Leavitt of Utah--created 
the welfare and Medicaid proposals at a time when few believed such a 
task would be possible.
  It would have been easy for these Governors to allow politics and 
individual interests to divide them. Instead, they put their 
reputations on the line when it would have been safe to simply leave 
the task for someone else. This was an effort that was built on a 
genuine search for common ground and bipartisanship.
  Indeed, the proposals were adopted unanimously with the support of 
the most conservative and most liberal Governors and everybody in 
between.
  The Finance Committee heard additional testimony from the Secretary 
of Health and Human Services and two panels of experts on the 
Governors' proposals. Let me briefly summarize and highlight some of 
the most important provisions of the NGA proposal.
  In welfare reform, the Governors agreed to build upon H.R. 4 which 
President Clinton vetoed, but they have responded favorably to many of 
the President's requests. The President called for additional child 
care funds. The Governors ask for $4 billion more in child care funds. 
The President insists he supports time limits on welfare benefits and 
the Governors agree.
  The President called for protecting States in the event of an 
economic downturn, so the Governors propose another $1 billion for the 
contingency fund.
  The President objected to certain Federal mandates and the Governors 
agree. The President and the Governors also agree on the concept of 
performance bonuses to reward States for moving families from welfare 
to work.
  In ``Restructuring Medicaid,'' the Governors responded to many of the 
President's concerns outlined in his veto of the Balanced Budget Act. 
Perhaps most important, States would guarantee Medicaid coverage to 
nearly every current Medicaid recipient. The current mandatory services 
would all be guaranteed. The Governors increased funding for persons 
with disabilities. The Governors agreed to continue current nursing 
home laws and regulations.
  These are all significant compromises for the Governors to make. 
These changes demonstrate that the Governors are firmly committed to 
this bipartisan effort.
  In a speech to the National Conference of State Legislatures last 
July, President Clinton expressed doubts about whether block grants for 
Medicaid and food stamps would keep pace with changing economic 
conditions. Once again, the Governors responded to the President's 
concerns. Governor Romer has described the NGA Medicaid proposal as a 
``true combination of a per capita cap and a block grant.'' Under the 
Governors' proposal, each State would receive a base allocation of 
funds. In addition, there would be a supplemental insurance umbrella to 
provide funding for unanticipated growth in the program.
  In light of all of these changes, one might objectively expect an 
enthusiastic endorsement of the NGA proposals from the administration. 
The proposals moved significantly to the President's positions. They 
were constructed with the help of Democratic Governors, some who served 
with President Clinton in the National Governors' Association when he 
was a Governor.
  To be candid, the administration's response to the Governors' 
proposal has been profoundly disappointing. Even with all of the 
modifications offered in the Governors' proposals, Secretary Shalala 
testified the administration opposes the NGA proposal in its present 
form. It is apparent that while the administration talks about 
comprehensive reform, it, in fact, prefers the status quo.
  At this year's State of the Union Address, President Clinton told the 
Congress and the American people that, ``the era of big government is 
over.'' I guess the folks at HHS did not get the message.
  In describing the current welfare system, the Governors and the 
administration would seem to be talking about two different worlds. The 
current welfare system is a masterpiece of mediocrity at best. But time 
and again, the administration talks about protecting children as if the 
current system were good for children. In contrast, the Governors have 
told Congress that the current welfare policies ``punish parents who 
work too much, they punish mothers and fathers that want to stay 
together, they punish working families who save money, and they reward 
teenagers who have babies out of wedlock.'' This is not a legacy to 
leave for our children.
  The family is the cell of society and Washington has proven it does 
not know how to build strong families, only bureaucracies. And now the 
bureaucracy threatens to stop bipartisan welfare reform.
  The Governors are looking forward while the Federal bureaucracy 
clings to the past. While the administration talks about a commitment 
to the present system, Governor Thompson talks about being trapped in a 
failed system. The bureaucracy would have us believe that States are 
poised to callously reduce health care coverage for the poor. In 
contrast, Governor Thompson believes he would be able to expand health 
coverage to an additional 30,000 children who are not covered today if 
reforms are made. He would add hospital coverage for 32,000 indigent 
adults.
  While the Governors tell us that immediate action is necessary, the 
administration wants to appoint a commission to study the current 
Medicaid formula.
  While Democratic and Republican Governors alike sharply criticize the 
current waiver process and the heavy hand of the Health Care Financing 
Administration, Secretary Shalala defends keeping the power in the 
hands of the Federal bureaucracy. The very idea that the Federal 
Government must protect children and the elderly from the Governors and 
State legislatures is not only wrong. It is insulting.
  President Clinton had it exactly right when he told the National 
Conference of State Legislatures last July that ``we couldn't have done 
all this without a strong commitment to changing the way the government 
does the people's business here in Washington, because the old federal 
ways and the old federal bureaucracy were not going to permit the kind 
of changes we have to make to get to the 21st century.''
  How prophetic and how ironic. The old Federal ways and the old 
Federal bureaucracy are alive and well and are now standing in the way 
of authentic welfare reform. How predictable but disappointing.
  Well, Mr. President, the Chief Executive cannot escape the blame for 
this result.
  President Clinton went on to say that, ``reinventing government means 
reinventing the way the Federal Government does business with you as 
well. We have worked very hard to forge a genuine partnership between 
the States and the National Government.''

  Mr. President, at the current rate of spending, the welfare system is 
driving both partners into bankruptcy. Who then will be left to serve 
the needy?
  Over the next 7 years, the Federal, State, and local governments will 
spend more than $2.4 trillion on the current welfare and Medicaid 
programs. That is equal to all State and local government expenditures 
between 1992 and 1994. In 1994, for $2.4 trillion, you could have 
purchased:
  Every farm, including the value of all land and buildings in the 
United States;
  All livestock;
  Every new house sold in the United States;
  All household equipment sold in the United States, including all 
furniture, every television, all dishes, every kitchen appliance, and 
home computer;
  Every piece of clothing and all shoes sold;
  All nonresidential buildings, that is, every office building, 
hospital, and school purchased in 1994.
  All nonresidential information processing equipment including all 
office computers and photocopying equipment.
  These are some of the things you could have bought in 1994 and there 
would still have been enough money to fund the entire Medicaid Program 
in 1994. It is simply outrageous for the administration to scare the 
American people about slowing the rate of growth in these programs.
  We need to talk about what happens if we do nothing. The plain fact 
remains that if we do nothing to the current welfare system, more 
children will

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be on welfare in the coming years. It is time the administration 
stopped hiding behind children.
  the NGA proposals have sparked an important debate not only about the 
future of these programs, but the future of the relationship between 
the States and the Federal Government as well. Despite Secretary 
Shalala's opposition to every fundamental change to the current welfare 
system, we should move forward on the Governors' welfare and Medicaid 
proposals. It is time to dispell the false choices conjured up by the 
bureaucracy and give the States the opportunity to change the future.
  Mr. President, 37 months ago, President Clinton promised the Nation's 
Governors that he would work with them to ``remove the incentive for 
staying in poverty.'' He told the Governors that ``many people stay on 
welfare not because of the checks * * * they do it solely because they 
do not want to put their children at risk of losing health care or 
because they do not have the money to pay for child care * * *.''
  As President Clinton has indicated, Medicaid must be part of the 
solution for returning families to work. Separating Medicaid from the 
rest of the welfare reform package simply will not work. Medicaid 
reform is welfare reform. If the President genuinely wants bipartisan 
welfare reform, his administration cannot pitch the NGA proposal out as 
just so much straw.
  At that NGA meeting 3 years ago, President Clinton also told the 
Governors that the American people ``don't want our process divided by 
partisanship or dominated by special interest, or driven by short-term 
advantage.''
  Mr. President, the Governors have given us the opportunity to meet 
this expectation. it is my hope that the President will join with us 
and embrace this opportunity.
  If the administration rejects this last best chance for 
bipartisanship in the next few weeks and welfare reform fails for a 
third time, the American people should clearly understand that 
Governors they elected were defeated by the Federal bureaucracy and the 
special interests it serves. The American people should then judge the 
administration not by its words but by its deeds.

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