[Congressional Record Volume 142, Number 38 (Tuesday, March 19, 1996)]
[Senate]
[Pages S2261-S2263]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  BALANCED BUDGET DOWNPAYMENT ACT, II

  The ACTING PRESIDENT pro tempore. Under the previous order, the Chair 
lays before the Senate H.R. 3019, which the clerk will report.
  The assistant legislative clerk read as follows:

       A bill (H.R. 3019) making appropriations for fiscal year 
     1996 to make a further downpayment toward a balanced budget, 
     and for other purposes.

  The Senate resumed the consideration of the bill.
       Pending:
       Hatfield modified amendment No. 3466, in the nature of a 
     substitute.
       Lautenberg amendment No. 3482 (to amendment No. 3466), to 
     provide funding for programs necessary to maintain essential 
     environmental protection.
       Boxer-Murray amendment No. 3508 (to amendment No. 3466), to 
     permit the District of Columbia to use local funds for 
     certain activities.
       Gorton amendment No. 3496 (to amendment No. 3466), to 
     designate the ``Jonathan

[[Page S2262]]

     M. Wainwright Memorial VA Medical Center'', located in Walla 
     Walla, Washington.
       Simon amendment No. 3511 (to amendment No. 3466), to 
     provide funding to carry out title VI of the National 
     Literary Act of 1991, title VI of the Library Services and 
     Construction Act, and section 109 of the Domestic Volunteer 
     Service Act of 1973.
       Coats amendment No. 3513 (to amendment No. 3466), to amend 
     the Public Health Service Act to prohibit governmental 
     discrimination in the training and licensing of health 
     professionals on the basis of the refusal to undergo or 
     provide training in the performance of induced abortions.
       Bond (for Pressler) amendment No. 3514 (to amendment No. 
     3466), to provide funding for a Radar Satellite project at 
     NASA.
       Bond amendment No. 3515 (to amendment No. 3466), to clarify 
     rent setting requirements of law regarding housing assisted 
     under section 236 of the National Housing Act to limit rents 
     charged moderate income families to that charged for 
     comparable, non-assisted housing, and clarify permissible 
     uses of rental income is such projects, in excess of 
     operating costs and debt service.
       Bond amendment No. 3516 (to amendment No. 3466), to 
     increase in amount available under the HUD Drug Elimination 
     Grant Program for drug elimination activities in and around 
     federally-assisted low-income housing developments by $30 
     million, to be derived from carry-over HOPE program balances.
       Bond amendment No. 3517 (to amendment No. 3466), to 
     establish a special fund dedicated to enable the Department 
     of Housing and Urban Development to meet crucial milestones 
     in restructuring its administrative organization and more 
     effectively address housing and community development needs 
     of States and local units of government and to clarify and 
     reaffirm provisions of current law with respect to the 
     disbursement of HOME and CDBG funds allocated to the State of 
     New York.
       Santorum amendment No. 3484 (to amendment No. 3466), 
     expressing the Sense of the Senate regarding the budget 
     treatment of federal disaster assistance.
       Santorum amendment No. 3485 (to amendment No. 3466), 
     expressing the Sense of the Senate regarding the budget 
     treatment of Federal disaster assistance.
       Santorum amendment No. 3486 (to amendment No. 3466), to 
     require that disaster relief provided under this Act be 
     funded through amounts previously made available to the 
     Federal Emergency Management Agency, to be reimbursed through 
     regular annual appropriations Acts.
       Santorum amendment No. 3487 (to amendment No. 3466), to 
     reduce all title I discretionary spending by the appropriate 
     percentage (.367%) to offset Federal disaster assistance.
       Santorum amendment No. 3488 (to amendment No. 3466), to 
     reduce all title I ``Salary and Expense'' and 
     ``Administrative Expense'' accounts by the appropriate 
     percentage (3.5%) to offset Federal disaster assistance.
       Gramm amendment No. 3519 (to amendment No. 3466), to make 
     the availability of obligations and expenditures contingent 
     upon the enactment of a subsequent act incorporating an 
     agreement between the President and Congress relative to 
     Federal expenditures.
       Wellstone amendment No. 3520 (to amendment No. 3466), to 
     urge the President to release already-appropriated fiscal 
     year 1996 emergency funding for home heating and other energy 
     assistance, and to express the sense of the Senate on 
     advance-appropriated funding for fiscal year 1997.
       Bond (for McCain) amendment No. 3521 (to amendment No. 
     3466), to require that disaster funds made available to 
     certain agencies be allocated in accordance with the 
     established prioritization processes of the agencies.
       Bond (for McCain) amendment No. 3522 (to amendment No. 
     3466), to require the Secretary of Veterans Affairs to 
     develop a plan for the allocation of health care resources of 
     the Department of Veterans Affairs.
       Warner amendment No. 3523 (to amendment No. 3466), to 
     prohibit the District of Columbia from enforcing any rule or 
     ordinance that would terminate taxicab service reciprocity 
     agreements with the States of Virginia and Maryland.
       Murkowski-Stevens amendment No. 3524 (to amendment No. 
     3466), to reconcile seafood inspection requirements for 
     agricultural commodity programs with those in use for general 
     public consumers.
       Murkowski amendment No. 3525 (to amendment No. 3466), to 
     provide for the approval of an exchange of lands within 
     Admiralty Island National Monument.
       Warner (for Thurmond) amendment No. 3526 (to amendment No. 
     3466), to delay the exercise of authority to enter into 
     multiyear procurement contracts for C-17 aircraft.
       Burns amendment No. 3528 (to amendment No. 3466), to allow 
     the refurbishment and continued operation of a small 
     hydroelectric facility in central Montana by adjusting the 
     amount of charges to be paid to the United States under the 
     Federal Power Act.
       Coats (for Dole-Lieberman) amendment No. 3531 (to amendment 
     No. 3466), to provide for low-income scholarships in the 
     District of Columbia.
       Bond-Mikulski amendment No. 3533 (to amendment No. 3482), 
     to increase appropriations for EPA water infrastructure 
     financing, Superfund toxic waste site cleanups, operating 
     programs, and to increase funding for the Corporation for 
     National and Community Service (AmeriCorps).
       Hatfield (for Burns) amendment No. 3551 (to amendment No. 
     3466), to divide the ninth judicial circuit of the United 
     States into two circuits.
       Burns amendment No. 3552 (to amendment No. 3551), to 
     establish a Commission on restructuring the circuits of the 
     United States Courts of Appeals.


                           Amendment No. 3513

  The ACTING PRESIDENT pro tempore. Under the time agreement on these 
amendments, there is 1 hour now allocated to the Senator from Indiana 
[Mr. Coats]. The amendment is now before the Senate.
  Mr. COATS. Mr. President, thank you.
  Last week, as we were looking at potential amendments for this 
legislation, the issue of the potential discrimination that might exist 
regarding payments from the Federal Government to medical hospitals and 
to individual residents in training, loans, and other Federal 
assistance that is available for these individuals and these 
institutions, was threatened by potential loss of accreditation to 
these institutions as a result of the Accrediting Council on Graduate 
Medical Education's change in their requirements for accreditation to 
mandate the training in abortion techniques.
  Previously, this had been done on a voluntary basis. Many hospitals, 
for a number of reasons, whether they are religious reasons, moral 
reasons or just purely decisions on the basis of the board of directors 
or governors of these institutions, determined that they would not have 
a mandatory program of abortion training. Voluntary programs existed. 
Those who sought that training had access and could receive that 
training, but it was not mandated.
  The change in regulations on the part of the Accrediting Council on 
Graduate Medical Education threatened to withdraw accreditation from 
many of these institutions unless they opted out under a so-called 
conscience or moral clause. It was my feeling and the feeling of many 
that this opt-out clause was not sufficient to address the concerns of 
a number of institutions, particularly nonreligious-based institutions. 
So I offered an amendment last week which was designed to clarify this.
  That amendment essentially said that any State or local government 
that receives financial assistance should not subject any health care 
entity to discrimination on the basis that the entity refused to 
undergo training in the performance of induced abortions or to require 
or provide such training to perform such abortions or provide referrals 
for the training for such abortions.
  We, in discussion with a number of other Senators, came across a 
possible misinterpretation of the exceptions to the section that 
basically said that nothing in this amendment that I am offering should 
in any way restrict or impede the accrediting council from making that 
accreditation. The concern was, if I state it correctly, that we would 
lose a valuable means of examining the various programs that existed in 
hospitals and resident training programs for determination of whether 
or not the Government should participate. It is legitimate that we have 
an accrediting process on which we can rely. What I was trying to do 
with my amendment was simply address the question of training for 
induced abortions.

  We had exceptions to that which basically stated that nothing in this 
act should prohibit the accrediting agency or a Federal, State, or 
local government from establishing standards of medical competency 
applicable to those individuals who voluntarily elected to perform 
abortions or prevent any health care entity from voluntarily electing 
to be trained or arrange for training in the performance of or 
referrals for induced abortions.
  We have had numerous discussions with the Senator from Maine relative 
to this language. Some negotiations over the weekend have resolved 
this. It preserves the entire impact of the Coats amendment and yet 
addresses and clarifies the concerns of the Senator from Maine. So I am 
pleased to announce this morning that we have reached agreement on this 
amendment. The amendment will be cosponsored by the Senator from Maine. 
We resolved the language differences. It also addresses an issue of 
second-degree, which would have prolonged the debate

[[Page S2263]]

on this important broader bill, and so I am happy to report to my 
colleagues that we will be able to free up some time on that basis for 
discussion of the amendment that is offered by the Senator from 
California, Senator Boxer.

  The Senator from Maine is present this morning, and I know she has 
some comments to make in this regard. Let me say this. The Senator from 
Tennessee, Senator Frist, has been instrumental in helping us first 
understand the accrediting process and the importance of the 
accrediting process. As a medical doctor, he has some knowledge and 
personal experience with this issue and these questions that I cannot 
begin to bring to the debate. He and his staff have been immensely 
helpful in helping us to draft this legislation so we can accomplish 
what we intended to accomplish, but also retain the integrity of the 
accrediting process.
  I am very happy to yield to him. I will yield whatever time the 
Senator from Tennessee desires in order to speak to this amendment.
  The ACTING PRESIDENT pro tempore. The chair did not hear the Senator 
seek to modify his amendment.
  Mr. COATS. Mr. President, this is an appropriate time to ask 
unanimous-consent to modify my amendment. I send that modification to 
the desk.
  Mrs. BOXER. I object.
  The ACTING PRESIDENT pro tempore. There are no yeas and nays ordered, 
so the Chair is corrected. Since there is a time agreement, it takes 
unanimous consent.
  Mrs. BOXER. I object at this time.
  The ACTING PRESIDENT pro tempore. Objection is heard.
  Mr. COATS. Mr. President, I will discuss this modification with the 
Senator from California and, hopefully, we can resolve the question 
here. At the present time, I want to yield time to the Senator from 
Tennessee.
  I will withhold the unanimous-consent request at this time so I can 
discuss it with the Senator from California.
  I yield whatever time the Senator from Tennessee needs.
  The ACTING PRESIDENT pro tempore. The Senator from Tennessee.
  Mr. FRIST. Mr. President, I commend the Senator from Indiana for his 
thoughtful approach to this important issue. My colleague has proposed 
an amendment that will protect medical residents, individual 
physicians, and medical training programs from abortion-related 
discrimination in the training and licensing of physicians. However, in 
our efforts to safeguard freedom of conscience, there are limits to 
what Congress should impose on private medical accrediting bodies. I 
believe this amendment stays within the confines of the governmental 
role and addresses the matter of discrimination in a way that is 
acceptable to all parties.

  This amendment states that the Federal Government, and any State that 
receives Federal health financial assistance, may not discriminate 
against any medical resident, physician, or medical training program 
that refuses to perform or undergo training and induced abortions, or 
to provide training or referrals for training in induced abortions.
  Discrimination is defined to include withholding legal status or 
failing to provide financial assistance, a service, or another benefit 
simply because an unwilling health entity is required by certain 
accreditation standards to engage in training in or the performance of 
induced abortions.
  The primary concern that occurs when one addresses any accreditation 
issue is that quality of care will be sacrificed. As a physician, the 
care of patients is my highest priority, and this amendment 
specifically addresses this issue. It makes it clear that health 
entities would still have to go through the accreditation process, and 
that their policy with regard to providing or training in induced 
abortion would not affect their Government-provided financial 
assistance, benefits, services, or legal status.
  The Government would work with the accrediting agency to deem schools 
accredited that--and I quote from the amendment--``would have been 
accredited but for the Agency's reliance upon a standard that requires 
an entity to perform an induced abortion, or require, provide, or refer 
for training in the performance of induced abortions or make 
arrangements for such training.''
  Mr. President, this amendment arose out of a controversy over 
accrediting standards for obstetrical and gynecological programs. The 
Accreditation Council for Graduate Medical Education, the ACGME, is a 
private body that establishes and enforces standards for the medical 
community. As a physician, I deeply respect and appreciate the ACGME, 
and I understand the fundamental need for quality medical standards and 
oversight.
  Moreover, I feel strongly that the Federal Government should not 
dictate to the private sector how to run their programs. We must not 
usurp the private accreditation process. But, at the same time, 
Congress is responsible for the Federal funding that is tied to 
accreditation by the ACGME, and as public servants, we must ensure that 
there is no hint of discrimination associated with the use of public 
funds.

  I am pleased, Mr. President, that we could work together to address 
the legitimate concerns of both sides in crafting this amendment. I 
join with the Senator from Indiana and the Senator from Maine in 
supporting this amendment, which will prevent discrimination with 
respect to abortion, but preserve the integrity of the accreditation 
process.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Thomas). Who yields time?
  Mr. FRIST. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. COATS. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. COATS. Mr. President, I ask unanimous consent that the time that 
is now running during any quorum call be equally divided between both 
sides.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  Mr. COATS. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. CAMPBELL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CAMPBELL. Mr. President, I ask unanimous consent that I be 
allowed to speak as in morning business for a period of 4 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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