[Congressional Record Volume 142, Number 44 (Wednesday, March 27, 1996)]
[Senate]
[Pages S2916-S2917]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          WELFARE AND MEDICAID

  Mr. KYL. Mr. President, I want to comment briefly this morning on 
welfare and Medicaid, because the majority leader has indicated that 
these are going to be two of his priorities after the recess. We are 
going to bring these bills to the floor in an effort to get them passed 
yet again and to get them signed by the President.
  It seems we are in a campaign mode now. Everyone is focused on the 
Presidential election. It does not seem like it was just 4 years ago 
that President--candidate then--Bill Clinton was going around the 
country saying we need to end welfare as we know it. People might ask 
what has happened in the last 4 years? The President seemed to be 
committing himself to ending welfare as we know it. Yet, during the 
first 2 years of his administration, when the Democrat Party controlled 
the House and Senate, nothing was done. When Republicans finally came 
in and it was part of the Contract With America, however, something did 
get done. We passed bills for welfare reform, and they not only 
reformed the essence of the welfare program to put more focus on people 
working, on providing incentives to families, and to reducing the costs 
of welfare, but also returned much of the decisionmaking to the States 
under the theory that the States and local governments would have more 
connection with the specific people on welfare and would know better 
how to run the programs for the benefit of the people in their 
individual States.
  We, therefore, passed a Balanced Budget Act that included significant 
welfare reform and sent that bill to the President on November 17. He 
vetoed the bill on December 6 and said that he wanted a different 
welfare bill. So we sent him another welfare bill. This time the Senate 
voted on a separate welfare bill, and the vote was 87 to 12. That is 
about as bipartisan as you can ever get in the U.S. Senate. Yet the 
President rejected that as well. In fact, in his State of the Union 
speech he said, ``I will sign a bipartisan welfare bill if you will 
send it to me.'' We have already done that by a vote of 87 to 12. 
Democrats and Republicans alike understood the need for real welfare 
reform, and we sent that to him. But it still was not good enough.
  So, the Nation's Governors got together, Democrats and Republicans, 
and unanimously agreed on welfare reform and on Medicaid reform, which 
I will speak to in just a moment. Initially, it seemed like we had an 
opportunity, not only to get the legislation passed through the House 
and Senate--that would be fairly easy--but to get the President to sign 
it, which is required in order for it to become law. But now, once 
again, it appears the President will not take yes for an answer, or he 
got cold feet or something, because now Secretary Shalala, for example, 
is saying she does not really like the idea of a block grant.

  As everybody knows, the block grant is fundamental, it is essential, 
it is the central point here of our Medicaid and welfare reform. In 
other words, instead of having Washington decide what to do, we send 
the money directly back to the States for them to make the decision how 
best to operate the program in their State with a few general national 
guidelines, the rest of the decisions being made at the State level. 
So, once again, we proposed a specific idea, this time with all of the 
Nation's Governors in support. The administration is still saying no. 
It makes you wonder whether this President is really committed to 
welfare and Medicaid reform. Will we, in this Presidential campaign, 
once again be debating an issue that was debated 4 years ago, about 
which we all thought we were in agreement?
  Let me quickly turn to Medicaid because the majority leader also 
indicated that he thinks, and I agree, that we need to have these two 
issues both sent to the President for reform because they both involve 
the same general element of return of control to the State. Medicaid is 
growing at roughly 10 percent annually. This is the program of health 
care for our indigent citizens. Obviously, without reform, that program 
is going to be in trouble. As a matter of fact, the Federal Government 
will spend over $1 trillion between 1995 and the year 2002 on Medicaid. 
Without reform, the States will spend $688 billion of their own money 
on Medicaid between 1996 and the year 2002. This represents 8 percent 
of the States' non-Federal revenue and an increase of 225 percent 
between 1990 and the year 2002. Obviously, this system must be 
reformed.
  The legislation that we put together recognizes that there is a need 
for Federal support, there is a need for Federal standards, but the 
States can run these programs. My own State of Arizona was the first to 
get a waiver and, from the very beginning, it ran a program it calls 
ACCESS, which provides medical services to the poor and has done so at 
a cost that the State of Arizona could afford.
  The bottom line of the reform that we have put together on Medicaid--
and here, again, the Governors have been in agreement on this--is that 
the program will continue to grow, but just not as fast as it has in 
the past, because the States would be given more latitude to run the 
programs on their own.
  Total Federal and State spending of Medicaid under these programs we 
have designed would, over the next 7 years, be at least $1.36 trillion. 
The Federal portion of this amount would exceed $780 billion. Federal 
spending for Medicaid would increase at an average annual rate of 5 
percent, between 1996 and the year 2002. It would grow from just over 
$157 billion in 1995 to at least $220 billion in the year 2002, which 
represents an increase in spending of more than 40 percent, Mr. 
President. That is not a cut, lest anybody suggest that it is.
  The key, as I said, is to allow the States greater flexibility to 
restructure the benefits of Medicaid to suit their own State's 
beneficiaries. Again, the National Governors Association has reached an 
agreement on Medicaid as well as on welfare.
  The point of our comments this morning is to try to stress the fact 
that the Congress has been willing, the

[[Page S2917]]

Nation's Governors and legislatures have been willing, but there is 
only one person who stands in the way of Medicaid and welfare reform. 
His name is Bill Clinton. He is the President of the United States. He 
said he was for reforming these two programs when he ran for President 
4 years ago. But it has been 4 years and nothing has happened and 
nothing did happen until Republicans gained control of the House and 
Senate.
  It should be very clear to our colleagues and the American people, 
this Republican Senate and the Republican House, the Nation's 
Governors, and many of our Democratic friends in the House and Senate 
are in agreement on what needs to be done. Will the President of the 
United States get that message before this next Presidential campaign? 
If he does not, my suggestion is that the American people will send 
that message loud and clear, because we should not have to wait until 
1997 to reform welfare and Medicaid.

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