[Congressional Record Volume 142, Number 69 (Thursday, May 16, 1996)]
[Senate]
[Pages S5168-S5176]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  CONCURRENT RESOLUTION ON THE BUDGET

  The Senate continued with the consideration of the concurrent 
resolution.
  Mr. EXON. Mr. President, we have had a good debate. I believe that 
both the Senator from Michigan and the Senator from West Virginia are 
prepared to yield back the remainder of the time, and that would allow 
us to continue to go back to the Republican side for the next 
amendment. I believe that amendment will be offered by the Senator from 
Michigan.
  As I understand it, it is on the same subject that we have discussed 
quite thoroughly. Maybe we can cut back on the use of some of this 
time. I would simply like to emphasize that while it may generally not 
be understood in the Senate, it is not a disgrace to not use the whole 
hour on each side on all of these amendments. It is perfectly 
acceptable and it is certainly respectable to yield back time so that 
we can move ahead on amendments.
  Depending on what happens, as you know, we temporarily set aside, in 
agreement with the chairman of the committee, so that we could move 
ahead. We are not going to have any votes before 8 o'clock. I would 
simply suggest that if the two managers of the

[[Page S5169]]

measure before us are ready to yield back this time and set the 
amendment offered by the Senator from West Virginia up for a vote when 
agreed to by the managers of the bill, then we could move to the 
amendment of the Senator from Michigan and start debating that.
  Mr. ABRAHAM addressed the Chair.
  The PRESIDING OFFICER. Does the Senator yield back time?
  Mr. ABRAHAM. Mr. President, the majority is prepared to yield the 
remainder of its time on the amendment of the Senator from West 
Virginia.
  Mr. ROCKEFELLER. Mr. President, I want to say one sentence and then 
yield the remainder of my time.
  The Senate GOP resolution and the Clinton budget both achieve the 
same short-term solvency. Dr. June O'Neill has certified that the 
Hospital trust fund will be solvent until the year 2005 under the 
President's plan.
  I yield back the balance of my time.
  Mr. EXON. Mr. President, now that all time has been yielded, I ask 
unanimous consent to lay aside temporarily the Rockefeller amendment 
and proceed with the next amendment that I understand under the 
agreement would be the one to be offered by the Senator from Michigan.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered.


                           Amendment No. 3980

  Mr. ABRAHAM. Mr. President, at this time I would like to offer an 
amendment for myself and Senator Domenici.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Michigan (Mr. Abraham), for himself and 
     Mr. Domenici, proposes an amendment numbered 3980.

  Mr. ABRAHAM. Mr. President, I ask unanimous consent that reading of 
the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment is as follows:

       At the Appropriate Place in the Bill insert the following:

     SEC.    SENSE OF THE CONGRESS REGARDING CHANGES IN THE 
                   MEDICARE PROGRAM.

       (a) Findings.--Congress finds that, in achieving the 
     spending levels specified in this resolution--
       (1) the public Trustees of medicare have concluded that 
     ``the medicare program is clearly unsustainable in its 
     present form'';
       (2) the President has said his goal is to keep the medicare 
     hospital insurance trust fund solvent for more than a decade, 
     but his budget transfers $55 billion of home health spending 
     from medicare part A to medicare part B;
       (3) the transfer of home health spending threatens the 
     delivery of home health services to 3.5 million Medicare 
     beneficiaries;
       (4) such a transfer increases the burden on general 
     revenues, including income taxes paid by working Americans, 
     by $55 billion;
       (5) such a transfer artificially inflates the solvency of 
     the medicare hospital insurance trust fund, misleading the 
     Congress, medicare beneficiaries, and working taxpayers;
       (6) the Director of the Congressional Budget Office has 
     certified that, without such a transfer, the President's 
     budget extends the solvency of the hospital insurance trust 
     fund for only one additional year; and
       (7) without misleading transfers, the President's budget 
     therefore fails to achieve his own stated goal for the 
     medicare hospital insurance trust fund.
       (b) Sense of the Congress.--It is the sense of the Congress 
     that, in achieving the spending levels specified in this 
     resolution, the Congress assumes that the Congress would--
       (1) keep the medicare hospital insurance trust fund solvent 
     for more than a decade, as recommended by the President; and
       (2) accept the President's proposed level of medicare part 
     B savings of $44.1 billion over the period 1997 through 2002; 
     but would
       (3) reject the President's proposal to transfer home health 
     spending from one part of medicare to another, which 
     threatens the delivery of home health care services to 3.5 
     million Medicare beneficiaries, artificially inflates the 
     solvency of the medicare hospital insurance trust fund, and 
     increases the burden on general revenues, including income 
     taxes paid by working Americans, by $55 billion.

  Mr. ABRAHAM. Mr. President, the amendment that I have sent to the 
desk is a sense-of-the-Senate amendment regarding changes in the 
Medicare Program. It is certainly in keeping with the sentiments which 
have been expressed by both the Senator from Michigan as well as the 
current Presiding Officer when he was here on the floor a few minutes 
ago.
  Just to go through the salient points of the amendment, the 
amendment, in achieving the spending levels specified in this 
resolution, says that the public trustees of Medicare have concluded 
that the Medicare Program is currently unsustainable in its present 
form;
  Two, the President said that it is his goal to keep the Medicare 
hospital trust fund solvent for more than a decade, but his budget 
transfers $55 billion of home health care spending from part A to part 
B Medicare;
  Three, that the transfer of home health spending threatens the 
delivery of home health care services to some 3.5 million Medicare 
beneficiaries;
  Four, that such a transfer increases the burden on general revenues 
and income taxes paid by working Americans by $55 billion;
  Five, that such a transfer artificially inflates the solvency of the 
Medicare hospital insurance trust fund, misleading the Congress, 
Medicare beneficiaries, and working taxpayers;
  Six, that the Director of the Congressional Budget Office has 
certified that without such a transfer, the President's budget extends 
the solvency of the hospital insurance trust fund for only 1 additional 
year;
  And, seven, that without transfers, the President's budget, 
therefore, fails to achieve his own stated goal for the Medicare 
hospital insurance trust fund.
  Therefore, it is our amendment's sense of the Congress that in 
achieving the spending levels specified in this resolution, the 
Congress assumes that the Congress would keep the Medicare hospital 
trust fund solvent for more than a decade as recommended by the 
President and accept the President's proposed level of Medicare part B 
savings of $44.1 billion over the period 1997 through 2002 but would 
reject the President's proposal to transfer home health spending from 
one part of Medicare to the another, a transfer which would threaten 
the delivery of home health care services to 3.5 million Medicare 
beneficiaries.
  Mr. President, this sense-of-the-Senate amendment incorporates much 
of what I have been talking about here tonight and much of what we 
discussed during our deliberations in the Budget Committee. It is our 
goal on the majority side to try to achieve the two objectives that 
have been set forth by the President, at least his stated objectives: 
One, to make sure with the part A transfer of funds that Medicare 
remains solvent for a decade; and, two, achieve savings of 
approximately $44 billion in the part B portion of Medicare.
  We just do not think that is the way to do this or that it is an 
appropriate way to accomplish this objective by transferring vital 
services that have been covered by the trust fund into the part B 
portion of Medicare, the area that is not covered by the trust fund. We 
believe it is essential that the Congress be on record clearly as 
stating that.
  So, for those reasons, we offer this sense-of-the-Congress amendment 
here tonight. We hope that our colleagues will support it. We feel, as 
I have been talking for the last hour, and others, the Presiding 
Officer as well, that we are headed, with respect to the part A trust 
fund, in a direction of insolvency far sooner than anticipated, that, 
in fact, with the trust fund now operating at a deficit for the first 
time in history, we are waiting for the new projections, but the day of 
reckoning is much closer at hand.
  We do not think it is appropriate to stand by while the trust fund 
moves quickly toward insolvency. We recognize the need to act now, and 
act decisively. It is not inappropriate to act decisively by 
restraining the growth in the ways we are recommending. We are doing 
what is necessary to protect the fund from going bankrupt and making 
sure that protection extends for a decade.

  Similarly, we accept the President's proposal to try to reduce the 
part B expenses in the growth of Medicare by $44 billion under this 
budget. We think that is the most appropriate way to address the 
Medicare problems at this time. We would strongly urge our colleagues 
to reject the previous amendment at the proper time, when we come to 
vote, and to instead support our sense-of-the-Congress resolution which 
embodies much of what is in our budget as presented to the Senate here 
this evening.
  I yield the floor.
  Mr. ROCKEFELLER addressed the Chair.
  The PRESIDING OFFICER. The Senator from West Virginia.

[[Page S5170]]

  Mr. ROCKEFELLER. Mr. President, in responding, first of all, I say to 
my friend from Michigan, this is a resolution of the Congress as 
opposed to hard law. This is, I think, something by which the Senator 
is trying to express his views.
  Just a few moments ago I went through the policy aspects of why this 
had all happened. As the Senator from Michigan indicated, before 1980 
it was divided between part A and part B, and then I described the 
conditions at that time. I described what the Congress did after that 
to improve Medicare's home health care benefit--remove the 100-day 
limit and the 3-day hospitalization requirement, and, as a result, 
financing of all home health care services were shipped into part A. 
Then I said, even though part A was never intended to pay for long-term 
home health care benefits, and then I went on to say that the 
President's proposal restores the financing of the home health care 
benefit back to the Congress' original intent.
  So much for the policy. I think, frankly, that it is all right to 
talk about the politics of this issue.
  Mr. President, we did not hear anything about this issue last year. I 
guess that is because back then the Republicans were proposing it. In 
fact, every single House Republican who voted for last year's 
Republican budget voted in favor of a very similar transfer of funding 
for home health care. I am talking about the politics because I am 
trying to question the underlying meaning of this resolution.
  So the Republicans now say that the home health care financing shift 
is a shell game. But they have played the game themselves. I have been 
talking about the House. The Senate Republicans also voted in favor of 
shifting money between part B and part A to improve the solvency of the 
hospital trust fund.
  In fact, during markup in the Finance Committee, Senator Nickles 
offered an amendment which the Republicans adopted that deposited part 
B money into part A trust funds to improve the solvency of the part A 
trust fund. The only policy behind Senator Nickles' proposal was to 
provide political cover, if I may say so, in that they were trying to 
hide that they were using Medicare money to pay for tax cuts for the 
wealthy, but the public, as I indicated, saw through that aspect of it.
  Mr. President, last year, the Republicans said that they wanted the 
President to submit a budget that was certified by the CBO as being in 
balance after 7 years. The President has done that. In addition, Dr. 
June O'Neill, as I said a moment ago, has certified that the 
President's plan extends solvency of the trust fund to the year 2005. 
So there is no difference. It achieves the same level of solvency but 
without the drastic hospital cuts that the Republicans are proposing.
  I believe the President's policy has merit. So did the Republicans 
last year. I urge my colleagues to vote against this resolution.
  I thank the Chair and yield the floor.
  The PRESIDING OFFICER (Mr. Grams). Who yields time?
  Mr. EXON addressed the Chair.
  The PRESIDING OFFICER. The Senator from Nebraska.
  Mr. EXON. Mr. President, I yield myself such time as may be 
necessary. I wish to make a few comments about the situation here at 
hand.
  I want to take people to Nebraska, which is a very typical State in 
the Midwest part of our great country. It is very typical from the 
standpoint of being a substantial rural State with lots of rural, small 
communities and is also typical of the Great Plains States and some of 
the other States of the Union.
  Mr. President, I rise in support of the amendment of my colleague 
from West Virginia. I am a cosponsor of that amendment. The Medicare 
reductions in this budget are too large and are not required to balance 
the budget and extend the life of the Medicare hospital insurance trust 
fund through at least the year 2005. I am particularly concerned about 
the deep and disproportionate cuts that will be borne by hospitals, 
particularly rural hospitals. The Senate Budget Committee said its $170 
billion in reductions and spending growth would include a $123 billion 
reduction in Medicare part A. This will threaten the quality and the 
financial viability of hospitals, particularly the rural and inner-city 
hospitals. Previous Republican budgets slowed the rate of growth in 
hospital payments, but under this year's plan the Congress may need to 
adopt policies that would actually reduce payments, not simply reduce 
the rate of increase in these payments. Under any definition, that 
represents a true cut in spending. So we will not have to get into all 
that argument that we continually get into about what is a cut.
  What I am talking about is it appears to me from some of the other 
information that I will furnish the Senate during these remarks that 
what we are threatened with is a real cut. That means less dollars, 
less dollars and cents than last year, and by any definition that is a 
cut.
  I recently received a letter from Harlan Heald that I will read. 
Harlan Heald is an acquaintance of many, many years way back to the 
time when I was Governor of Nebraska, and if there is a Mr. Rural 
Hospital in Nebraska, it is Mr. Heald. Mr. Heald is President of the 
Nebraska Association of Hospital and Health Systems. They are not a 
political organization. They are an organization that devotes time, 
talent and effort to represent the people who provide hospital services 
in rural Nebraska primarily.
  According to Mr. Heald's analysis, a reduction of $50 billion would 
have a devastating impact on Nebraska hospitals. Mr. Heald writes, and 
I quote:

       Sixty-five rural hospitals would lose $69.1 million over 7 
     years and 12 large rural hospitals would lose $100 million. 
     Thirty out of Nebraska's 65 small rural hospitals would lose 
     money in providing care.

  Mr. President, I will ask unanimous consent that the full text of Mr. 
Heald's letter be placed in the Record at the conclusion of my remarks, 
after I read that letter, because there are so many interesting factual 
and true statements in it, not from a political standpoint but from 
what the Republican effort and the Republican bill will do to rural 
Nebraska. If it is going to do something to rural Nebraska, it is going 
to do it to rural North Dakota and rural South Dakota and rural Kansas, 
and rural Oklahoma, and every rural State in the United States of 
America.
  These are the consequences of the $50 billion reduction over 7 years. 
What would be the impact then of a $123 billion reduction over 6 years 
that we are now faced with? A loss of this magnitude in a State where 
Medicare patients account for 60 to 70 percent of hospital admissions 
clearly threatens the health care system on which all of us depend. 
Several hospitals in my State are teetering on the brink of insolvency 
while we are here talking about the bankruptcy of Medicare.
  This latest Republican proposal will very likely drive them over the 
edge.
  Mr. President, I wish to read from the letter that I have just 
referenced. This letter is dated May 14, 1996, addressed to me.

       Dear Senator Exon: I have reviewed a summary of the current 
     fiscal year 1997 House and Senate Budget Committee proposal 
     with respect to the Medicare Program. On behalf of the 94 
     acute care hospitals in Nebraska, I wish to call your 
     attention to a very serious potential problem.
       While it appears that the overall Medicare budget 
     reductions of $158 billion are roughly the same as those in 
     the last Republican proposal in January, the budget 
     committees have significantly altered the allocation of 
     reductions within the program, reducing part A spending by 
     $123 billion versus the $77.5 billion proposed in January.
       We have been told on numerous occasions that the reductions 
     are not cuts--

  This is not in the letter. I just want to add here, how many times 
have we heard that here? Back to the letter.

     but are reductions in the rate of spending over a 6-year 
     period. The current budget resolution includes lower budget 
     reductions in part B of Medicare, while the reductions in 
     part A have been significantly increased since the January 
     proposal. The larger Medicare Part A reductions in the 
     current proposal means hospitals will experience actual 
     reductions in payments--not merely a reduction in the rate 
     of payment increase.

  We are talking about real cuts here. I am away from the letter. We 
are talking about real cuts here, when every time we talk about cuts, 
people stand up and say, Oh, only in Washington, DC, is an increase a 
cut. I have always said we must legislate to real needs, what the costs 
are going to be.
  Another editorial comment before I go on with reading this letter 
from an expert on the subject in Nebraska, and that, Mr. President, is 
simply this: I

[[Page S5171]]

am convinced that the reductions in the amount for real needs that the 
Republicans have been espousing are below the projected costs and rises 
in health care over the next 6 years.
  Putting that another way, what I am saying is that the Republicans 
have been saying, ``Oh, well, this is not a cut, this is just a slowing 
down of the growth.'' Time and time again that has been used on the 
floor of the U.S. Senate. Mr. Heald brings us back to reality by saying 
what I indicated when I first started talking on this subject, that 
these cuts are not simply a reduction in the growth. They are cuts, 
dollars and cents, below what hospitals have received before. Back to 
the letter:

       Although I have not received enough detail to permit me to 
     make an analysis of the impact of the proposed reduction in 
     Medicaid Part A spending, I do have information from an 
     earlier proposal last fall that looked at Part A reductions 
     of about $50 billion out of the total reductions over a 
     seven-year period. Although it is a ``crude'' approximation, 
     the impact on Nebraska hospitals looks like this:
       Sixty-five small rural hospitals would lose an aggregate of 
     $69.1 million during the seven-year period of 1996 to 2002. 
     Twelve large rural hospitals would lose a total of $100.4 
     million, and 11 metropolitan (Lincoln and Omaha) hospitals 
     would lose $337.4 million, during the seven-year period. 
     Note--In 1994, 30 hospitals out of Nebraska's 65 small rural 
     hospitals lost money providing care.

  Let me repeat that:

       In 1994, 30 hospitals out of Nebraska's 65 small rural 
     hospitals lost money providing care.
       Again, this is based on a Part A reduction of about $50 
     billion over a 7-year period. I hate to think what these 
     numbers might resemble under the current proposal with 
     Medicare Part A targeted for a $123 billion hit.
       Reimbursement reductions of this magnitude in a state with 
     a disproportionate share of the elderly population, a state 
     in which Medicare patients account for 60 to 70 percent of 
     hospital admissions, clearly threatens the health care system 
     upon which all of us depend.
       Medicare needs to be fixed. There is an opportunity for 
     Congress to change Medicare, but the change must be driven by 
     sound health care policy, not budgetary or political 
     imperatives. The proposed Medicare reductions would crush 
     Nebraska hospitals.
       As always, Nebraska hospitals look to your leadership.

  Mr. President, I also would like to read a letter from the following 
groups: The American Association of Eye and Ear Hospitals, the American 
Hospital Association, the American Osteopathic Healthcare Association, 
the Association of American Medical Colleges, Catholic Health 
Association, Federation of American Health Systems, InterHealth, 
National Association of Children's Hospitals, National Association of 
Public Hospitals and Health Systems, and Premier. This letter is dated 
May 10, and it is addressed by those organizations I just read, to the 
Honorable William Roth, chairman, Committee on Finance.

       Dear Chairman Roth: The undersigned organizations 
     representing hospitals and health care systems have reviewed 
     the Fiscal Year 1997 House and Senate Budget Committee 
     proposal, particularly with respect to Medicare and Medicaid 
     programs.
       While it appears that the overall Medicare budget 
     reductions of $167 billion are roughly the same as those in 
     the Republican offer in January, the Budget Committees have 
     significantly changed the allocation of reductions within the 
     program.

  The letter goes on and essentially makes the same exact points made 
by the letter that I read, by Harlan Heald.
  So the professionals know what is going on. We know what is going on 
here. I must continue to make the point that Nebraska is not unique in 
this. But if you have a hospital, because of the aging population in 
rural areas of America in toto, where 60 to 70 percent, and some places 
higher, have their beds dedicated to people who are eligible and 
receive Medicare, and for many of them that is the only health care 
system available to them, and you compare that with a hospital, for 
example in Lincoln or Omaha or other more metropolitan areas that have 
their patients coming in only about 20 to 25 percent seniors, you 
quickly understand that what we are doing here is socking it right 
between the eyes of the rural hospitals in the United States of 
America.
  Mr. President, I ask unanimous consent both of the letters I have 
referenced be printed in the Record.
  There being no objection, the letters were ordered to be printed in 
the Record, as follows:

                                           Nebraska Association of


                                 Hospitals and Health Systems,

                                                     May 14, 1996.
     Hon. J. James Exon,
     U.S. Senate,
     Washington, DC.
       Dear Senator Exon: I have reviewed a summary of the current 
     Fiscal Year 1997 (FY '97) House and Senate Budget Committee 
     proposal with respect to the Medicare program. On behalf of 
     the 94 acute care hospitals in Nebraska, I wish to call your 
     attention to a serious potential problem.
       While it appears that the overall Medicare budget 
     reductions of $158 billion are roughly the same as those in 
     the last Republican proposal in January, the Budget 
     Committees have significantly altered the allocation of 
     reductions within the program, reducing Medicare Part A 
     spending by $123 billion vs. $77.5 billion proposed in 
     January.
       We have been told on numerous occasions that the reductions 
     are not cuts, but are reductions in the rate of spending over 
     the six-year period. The current budget resolution includes 
     lower budget reductions in Part B of Medicare, while the 
     reductions in Part A have been significantly increased since 
     the January proposal. The larger Medicare Part A reductions 
     in the current proposal mean hospitals will experience actual 
     reductions in payments--not merely a reduction in the rate of 
     payment increase.
       Although I have not received enough detail to permit me to 
     make an analysis of the impact of the proposed reduction in 
     Medicare Part A spending, I do have information from an 
     earlier proposal last fall that looked at Part A reductions 
     of about $50 billion out of total reductions over a seven-
     year period. Although it is a ``crude'' approximation, the 
     impact on Nebraska hospitals looked like this:
       ``Sixty-five small rural hospitals would lose an aggregate 
     of $69.1 million during the seven-year period of 1996 to 
     2002. Twelve large rural hospitals would lose a total of 
     $100.4 million, and 11 metropolitan (Lincoln and Omaha) 
     hospitals would lose $337.4 million during the seven-year 
     period. Note--In 1994, 30 hospitals out of Nebraska's 65 
     small rural hospitals lost money providing care.''
       Again, this is based upon a Part A reduction of about $50 
     billion over a seven-year period. I hate to think what these 
     numbers might resemble under the current proposal with 
     Medicare Part A targeted for a $123 billion hit.
       Reimbursement reductions of this magnitude in a state with 
     a disproportionate share of the elderly population, a state 
     in which Medicare patients account for 60 to 70 percent of 
     hospital admissions, clearly threatens the health care system 
     upon which all of us depend.
       Medicare needs to be fixed. There is an opportunity for 
     Congress to change Medicare, but the change must be driven by 
     sound health care policy, not budgetary or political 
     imperatives. The proposed Medicare reductions would crush 
     Nebraska hospitals.
       As always, Nebraska's hospitals look to your leadership.
           Sincerely,
                                                  Harlan M. Heald,
     President.
                                                                    ____

                                                     May 10, 1996.
     Hon. William Roth, Jr.,
     Chairman, Committee on Finance,
     Washington, DC.
       Dear Chairman Roth: The undersigned organizations 
     representing hospitals and health systems have reviewed the 
     Fiscal Year 1997 (FY 97) House and Senate Budget Committee 
     proposal, particularly with respect to the Medicare and 
     Medicaid programs.
       While it appears that the overall Medicare budget 
     reductions of $167 billion are roughly the same as those in 
     the last Republican offer in January, the Budget Committees 
     have significantly changed the allocation of reductions 
     within the program. While it is difficult to assess the 
     overall impact of the budget resolution in the absence of 
     greater detail, now larger Medicare Part A reductions mean 
     hospitals are likely to experience actual reductions in 
     payment rates under the committees' proposal.
       The budget resolution now includes lower budget reductions 
     in Part B of Medicare, while the reductions in Part A have 
     increased by approximately $25 billion since the January 
     offer. While the FY 97 budget resolution offers a milder 
     overall approach to deficit reduction compared to last year's 
     resolution, its impact on hospitals appears worse. To achieve 
     reductions of this magnitude, Congress may need to adopt 
     policies resulting in payment rates per beneficiary that 
     would be frozen or actually reduced.
        We also have serious concerns about the Budget Committees' 
     Medicaid reductions. We would like to take this opportunity 
     to reiterate our support for maintaining the entitlement 
     nature of the Medicaid program to ensure that those who have 
     coverage today will continue to have coverage tomorrow. 
     Furthermore, we support maintaining current law provider 
     assessment restrictions and Boren amendment payment 
     safeguards. While the overall reductions are somewhat lower 
     than the January offer, if combined with corresponding state 
     reductions through lower state matching requirements or new 
     provider assessments, these reductions could be quite 
     significant for providers.
       Hospitals and health systems support the need to adopt a 
     reasonable deficit reduction package, and believe that 
     changes in Medicare are needed to keep the Part A trust fund 
     solvent. Many of us have supported various proposals that 
     achieve a balanced budget with reductions in Medicare and 
     Medicaid.

[[Page S5172]]

     However, we are gravely concerned about the level of 
     reductions proposed by the Budget Committees in these 
     programs.
       We strongly urge you to reconsider both the overall level 
     of Medicare and Medicaid reductions included in the budget 
     resolution and, in your capacity as chairman of the 
     authorizing committee, adjust the allocation between Parts A 
     and B proposed by the Budget Committees.
         American Association of Eye and Ear Hospitals, American 
           Hospital Association, American Osteopathic Healthcare 
           Association, Association of American Medical Colleges, 
           Catholic Health Association, Federation of American 
           Health Systems, InterHealth, National Association of 
           Children's Hospitals, National Association of Public 
           Hospitals and Health Systems, Premier.
  Mr. EXON. Mr. President, I understand at this time we are trying to 
reach a unanimous consent agreement to have a vote at 8:30. Is that the 
Senator's understanding?
  Mr. ABRAHAM. Yes.
  Mr. EXON. Go ahead.
  Mr. ABRAHAM. Mr. President, I ask unanimous consent that a vote occur 
on or in relation to the Rockefeller amendment, to be followed by a 
vote on or in relation to the Abraham amendment, beginning at 8:30 p.m. 
this evening, with the first vote being the standard 15-minute vote, 
the following vote being limited to 10 minutes in length.
  Mrs. BOXER. Reserving the right to object, I do not want to object 
because the Senator knows I have been waiting for quite a while. I 
would like to ask if we could have debate on the Boxer Medicaid 
amendment immediately following the vote, so we can get that done. 
There are Senators who wish to speak to it. I will be glad to agree to 
a reasonable time agreement.
  But it is very important to this Senator because this is the time I 
can debate. I want to make sure I can get it done tonight.
  Mr. EXON. Let me respond to the Senator from my perspective, and I 
cannot speak for the majority. We are now considering the Abraham 
amendment. We will vote on that. If this unanimous consent request is 
agreed to--and if I agree to it, I must say--immediately following 
that, we would be up for consideration of an amendment from the 
Democratic side. I have indicated to my friend from California that she 
would be first up with her amendment.
  So I will simply say, after the vote, you would, as far as I am 
concerned, be recognized to offer your amendment. If it is possible--
obviously it is not between now and the scheduled vote at 8:30--I would 
certainly recommend to Chairman Domenici that we proceed with the order 
which would allow you to follow the vote.
  Mrs. BOXER. I am sure that then there would be a Democratic 
amendment; is that part of the agreement, immediately following the 
vote on the Abraham amendment?
  Mr. ABRAHAM. We have not agreed to that at this point. Let me just 
state for the benefit of all our colleagues, it is also my 
understanding there is an interest on both sides to proceed at some 
point to a vote on the President's budget tonight. I think, as I 
understand, the Senator from California would like to have debate on 
her amendment tonight, not necessarily a final vote tonight.
  So I think we can work out something else: A vote on the President's 
budget can take place in a way that would allow those Members who have 
other obligations to fulfill them this evening and still accommodate 
your desire to have the debate, for the next amendment to be yours. But 
I do not think we have worked those two parts out. I think on your side 
there is an interest in making both of those things happen. I guess we 
just have not proceeded to the point of having that agreement worked 
out. This is as far as we were able to, basically, negotiate.

  Mrs. BOXER. If my friend will yield, I am reassured by the 
conversation of the two managers. I feel comfortable that sometime this 
evening--and I am willing to stay here as late as necessary--I will 
have an opportunity to do that. With that verbal assurance, I withdraw 
my objection.
  Mr. EXON. I say to my friend from California, there has been one or 
two attempts previously to include what would follow in a unanimous 
consent agreement. We have shied away from that and not made that kind 
of commitment at all. I suspect we will not be able to at this time.
  I simply say that I think there is every likelihood that we may, if 
we can break the logjam, get a vote on the President's budget that this 
Senator has been trying to accomplish since 11 o'clock this morning. 
That may happen before the debate on your amendment, but I think there 
is every likelihood that you will have an opportunity to offer your 
amendment and engage in a debate, whether that is at 10 o'clock or 1 
a.m. tomorrow morning, sometime in that general timeframe.
  Mrs. BOXER. I am gratefully reassured. I thank the Senator.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered. The Senator from Michigan.
  Mr. ABRAHAM. Thank you, Mr. President. I would like to get an 
indication of how much time has been used on each side.
  The PRESIDING OFFICER. The Senator from Nebraska has used about 39\1/
2\ minutes. That is how much time is remaining in the debate.
  Mr. ABRAHAM. Approximately 20 minutes.
  The PRESIDING OFFICER. He has used approximately 20 minutes, and the 
Senator from Michigan has used approximately 10 minutes.
  Mr. ABRAHAM. I am wondering in light of that--we have Senator Frist 
who has been hoping to have a chance to speak to this. There are only 
about 5 minutes left. Can we agree to let him finish the debate to the 
point that the vote has been agreed to? With that, I yield to the 
Senator from Tennessee until the vote is at hand.
  The PRESIDING OFFICER. The Senator from Tennessee is recognized for 
approximately 6 minutes.
  Mr. FRIST. Thank you, Mr. President.
  Mr. President, I rise in support of the sense-of-the-Congress 
amendment of the distinguished Senator from Michigan. Just to bring it 
back, because we have been traveling a great deal over the last hour, 
that particular amendment says that the Congress assumes that Congress 
would keep the Medicare hospital insurance trust fund solvent for more 
than a decade, as recommended by the President; No. 2, accepts the 
President's proposed level of Medicare part B savings; and No. 3 and 
most important, what I would like to speak to is reject the President's 
proposal to transfer home health spending from one part of Medicare to 
another which threatens the delivery of home health care services to 
3.5 million Medicare beneficiaries.
  Mr. President, it was exactly 13, almost 14, months ago that we all 
received the status of the Social Security and Medicare Programs which 
was compiled and written by six trustees, three of whom were from 
President Clinton's Cabinet. In that, they use very simple words. And, 
again, this is 14 months ago. We are waiting for the April edition--it 
is a month, a month and a half late now--of this so-called Medicare 
trustees' report.
  The very first page says:

       The Federal Hospital Insurance Trust Fund, which pays 
     inpatient hospital expenses--

  Which I should add is part A--

     will be able to pay benefits for only about 7 years and is 
     severely out of financial balance in the long range.

  Mr. President, it continues to say that:

       The trustees believe prompt, effective and decisive action 
     is necessary.

  Last year, we took that action. We passed in this body a proposal 
that would save and preserve Medicare. It was sent to the President of 
the United States and it was vetoed.
  The Medicare trustees' report basically said this. This is 1995 and 
the year 2000. This is bankruptcy on this line. This is the Medicare 
part A trust fund. Last year, the report said we would be going 
bankrupt in 7 years, the blue line.
  What we have found happen over the last 14 months is that things are 
much worse than we had even anticipated at the time. Without doing 
anything over the last year and a half, in large part because of scare 
tactics put on television to scare our senior citizens away from change 
which will preserve this program, we now find that Medicare is going to 
be going bankrupt almost a year and a half earlier unless we act. It is 
1996. We have about 5 years before Medicare goes bankrupt.

  That is part A. Medicare part A is hospitals, part B physicians. Part 
A is

[[Page S5173]]

going bankrupt much quicker than we ever anticipated. The President's 
answer to that is,

       Let's take the fastest growing part, the home health care 
     out of part A and transfer it elsewhere and then we can say 
     part A is solvent long term and we'll feel good about that.

  That is more gimmickry. That is more smoke and mirrors. It is really 
deceptive to the American people. We need to make part A truly solvent. 
To make it truly solvent, we need to address the real problem. This is 
the amount of deficit spending. We began deficit spending last year. 
The trustee report said it would be next year. It actually began last 
year.
  A report from the monthly Treasury statement, the highlight of fiscal 
year 1996 through March 31, tells that for the first 6 months of this 
year, we are running a $4 billion deficit. We are on our way to 
bankruptcy.
  Mr. President, the problem that we have today in this transfer of 
home health care is this: If we transfer this $55 billion of assets out 
of the part A trust fund and put it elsewhere, yes, we can say part A 
is solvent for 10 years, but the overall Medicare Program is not, and 
unless the overall Medicare Program is solvent, we cannot deliver care 
to those 37 million Americans out there. More smoke and mirrors. Let us 
say we do not transfer that $55 billion of home health care out, then 
what happens to the solvency of the trust fund? You can see that it is 
going to go bankrupt between the year 2000 and the year 2001. 
Therefore, we must act and we must act decisively.
  How do we respond? In the balanced budget resolution proposal which 
is before us, we can see that we have solvency out to the year 2006. 
This is 1996, 2006, this line is solvency. Current law, if we do 
nothing, we are bankrupt in the year 2001.
  Under the President's proposal, we extend that 1 year--only 1 year. 
That will scare seniors once they know that. We need to look at that 
balanced budget proposal, look what we do by opening it up, allowing 
some competition, slowing the growth from 10 percent down to 6 percent, 
and that is not a cut. We are slowing the growth from 10 to 6.1 
percent. We are going to increase spending from $4,800 in 1995 to 
$7,000 a year in the year 2002. That is not a cut.
  Mr. President, by supporting this sense-of-the-Senate amendment, we 
do reject the President's proposal to transfer home health spending. 
Why? Because it is more gimmickry, it does not assure long-term 
solvency of the Medicare trust funds. I urge all my colleagues to vote 
to support this amendment.

  Mr. ABRAHAM addressed the Chair.
  The PRESIDING OFFICER. The Senator from Michigan.
  Mr. ABRAHAM. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. ABRAHAM. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 3979

  Mr. ABRAHAM. Mr. President, in accordance with the earlier unanimous 
consent agreement, at this time I move to table the Rockefeller 
amendment, and ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There appears to 
be a sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. The question now occurs on the motion to lay 
on the table the Rockefeller amendment. The yeas and nays have been 
ordered. The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. LOTT. I announce that the Senator from Kansas [Mrs. Kassebaum] is 
necessarily absent.
  Mr. FORD I announce that the Senator from Arkansas [Mr. Pryor] is 
necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 55, nays 43, as follows:

                      [Rollcall Vote No. 117 Leg.]

                                YEAS--55

     Abraham
     Ashcroft
     Bennett
     Bond
     Brown
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Cohen
     Coverdell
     Craig
     D'Amato
     DeWine
     Dole
     Domenici
     Faircloth
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Hatfield
     Heflin
     Helms
     Hutchison
     Inhofe
     Jeffords
     Kempthorne
     Kerrey
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Nunn
     Pressler
     Roth
     Santorum
     Shelby
     Simpson
     Smith
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner

                                NAYS--43

     Akaka
     Baucus
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Byrd
     Conrad
     Daschle
     Dodd
     Dorgan
     Exon
     Feingold
     Feinstein
     Ford
     Glenn
     Graham
     Harkin
     Hollings
     Inouye
     Johnston
     Kennedy
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Pell
     Reid
     Robb
     Rockefeller
     Sarbanes
     Simon
     Wellstone
     Wyden

                             NOT VOTING--2

     Kassebaum
     Pryor
       
  The motion to lay on the table the amendment (No. 3979) was agreed 
to.
  Mr. ABRAHAM. Mr. President, I move to reconsider the vote by which 
the amendment was agreed to.
  Mr. DOMENICI. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. SPECTER. Mr. President, in the vote to table the Rockefeller 
amendment, I supported the budget resolution, which is moderate and 
maintains the solvency of Medicare.
  Contrary to the argument that there are Medicare cuts, the fact is 
that Medicare expenditures increase by an average of 6.1 percent 
annually with the following total expenditures each year: 1996, $196 
billion; 1997, $209 billion; 1998, $224 billion; 1999, $236 billion; 
2000, $249 billion; 2001, $263 billion; 2002, $279 billion.
  On the 1996 budget resolution, I voted to increase Medicare 
expenditures when the rate of increase was reduced by $268 billion and 
there was a tax cut of $245 billion. In this budget resolution, the tax 
cut is limited to $122 billion to cover a child tax credit.
  I ask unanimous consent that the table on the ``Chairman's Mark 
Budget Aggregates'' be printed in the Record together with the 
``Medicare Fact Sheet.''
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                                            CHAIRMAN'S MARK BUDGET AGGREGATES                                                           
                                                                  [Dollars in billions]                                                                 
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                 6-year 
                                                                     1996       1997       1998       1999       2000       2001       2002      total  
--------------------------------------------------------------------------------------------------------------------------------------------------------
Discretionary:                                                                                                                                          
    Defense.....................................................        265        265        263        266        269        268        268       1599
    Nondefense..................................................        271        271        264        260        256        250        249       1551
                                                                 ---------------------------------------------------------------------------------------
        Subtotal discretionary..................................        536        536        527        526        526        518        516       3150
                                                                 =======================================================================================
Mandatory:                                                                                                                                              
    Social Security.............................................        348        365        383        402        422        444        467       2484
    Medicare....................................................        196        209        224        236        249        263        279       1459
    Medicaid....................................................         96        105        111        117        126        133        139        731
    Welfare programs............................................         85         89         89        102        100         98        106        583
    EITC (outlays)..............................................         16         18         18         19         20         20         21        116
    Other mandatory.............................................         57         62         82         71         83         84         82        464
Net interest....................................................        240        242        244        243        240        238        236       1444
                                                                 =======================================================================================
      Total outlays.............................................       1575       1626       1678       1717       1764       1798       1846      10430

[[Page S5174]]

                                                                                                                                                        
Revenues........................................................       1431       1471       1532       1600       1675       1755       1846       9879
Resulting deficit/surplus.......................................       -147       -155       -146       -117        -89        -43          0  .........
--------------------------------------------------------------------------------------------------------------------------------------------------------
Note: Details may not add to totals due to rounding. All totals shown on a unified budget basis.                                                        
Prepared by SBC Majority Staff, 08-May-96                                                                                                               


                                                                    ____


                          Medicare Fact Sheet


                    The committee-passed resolution

       Total medicare spending, 1997-2002: $1.459 trillion.
       This is $60 billion more government spending than was in 
     the BBA, and $103 billion more than in last year's budget 
     resolution.
       Total savings, relative to new CBO baseline: $158 billion.
       Part A: Meets the President's test of keeping the part A 
     trust fund solvent for a decade without gimmicks, which 
     requires $123 billion of savings (CBO).
       Part B: Assumes part B savings equal to the President's 
     part B savings ($44 billion).
       Graduate Medical Education: Assumes $10 billion of 
     spending.
       Total spending growth from 1996 to 2002: 43 percent.
       Average growth rate from 1996 to 2002: 6.1%, or more than 
     two times inflation difference between Committee-passed and 
     the President's plan: 58 per beneficiary per day per capita 
     spending--1995: $4,800, 1996: $5,300, 2002: $7,000.
       Keeps the Hospital Insurance Trust fund solvent through 
     2006, without gimmicks, meeting the President's stated goal.
       Makes no assumption about the part B premium, but is 
     consistent with a plan that matches the President's premium 
     proposal.


                          The president's plan

       Total medicare spending, 1997-2002: $1.526 trillion.
       Total savings, as scored by CBO: $116.1 billion.
       Total savings claimed by the President: $124 billion.
       Average growth rate from 1996 to 2002: 7.2%.
       Total growth from 1996 to 2002: 52%.
       HI Trust Fund goes bankrupt in 2002, buying only one 
     additional year of solvency.
       Transfer $55 billion of home health spending from part A to 
     part B, artificially inflating the life of the HI trust fund. 
     Even with this gimmick, the HI trust fund goes bankrupt in 
     2005, and the President fails to meet his stated goal of 
     solvency for a decade.


                              Basic Facts

       Number of beneficiaries, 1996: 37.5 million.
       1995 total medicare spending: $180 billion.
       1996 medicare spending: $199 billion increase in spending, 
     net of premiums, from 1995 to 1996: +$19.2 billion (+12%).
       This increase in spending from 1995 to 1996 is more than is 
     spent in 1996 on: elementary, secondary, and vocational 
     education ($15.5 billion); all justice / crime / law 
     enforcement spending ($17.5 billion); all spending for 
     science, space, and technology ($16.5 billion); and 
     comparable to all spending for natural resources and the 
     environment ($21.5 billion).
  Mr. DOMENICI. Mr. President, I understand the next vote is going to 
be on the Abraham-Domenici amendment. Have the yeas and nays been 
ordered on that?
  The PRESIDING OFFICER. No.
  Mr. DOMENICI. I ask for the yeas and nays on that amendment.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  Mr. DOMENICI. Mr. President, I ask unanimous consent that the third 
vote in this voting sequence be on or in relation to the Exon amendment 
No. 3965, the so-called President's amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DOMENICI. So that will follow the Abraham-Domenici. I think that 
will be the last vote tonight.
  Has this been ordered for 10 minutes?
  The PRESIDING OFFICER. It has been ordered for 10 minutes.
  Mr. DOMENICI. I ask unanimous consent that there be 10 minutes on the 
Exon amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DOMENICI. I ask for the yeas and nays on the Exon amendment.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  Mr. DOMENICI. Mr. President, I think I should announce that while we 
are going to try to stay on after this vote to see what we can do to 
negotiate and get some consent----
  Mr. MURKOWSKI. We cannot hear you.
  Mr. DOMENICI. Perhaps if some of you would not talk so much you could 
hear me.
  The PRESIDING OFFICER. There will be order in the Chamber, please.
  Mr. DOMENICI. I am not running for anything around here. That is why 
you do not pay attention.
  Could we have order, Mr. President?
  The PRESIDING OFFICER. Could we have order in the Chamber, please?
  Mr. DOMENICI. Mr. President, we are going to convene tomorrow morning 
at 9:30. We cannot tell you yet whether there are going to be votes. We 
think there will be. Certainly tomorrow we are going to work a long 
time trying to get amendments up. If Senators have amendments and can 
be here tomorrow, they ought to be here. We are going to use a lot of 
time on this budget resolution tomorrow. If we can get an orderly 
sequencing of amendments, we might not have to stay here and vote. If 
we can just get started in the morning to let us see where we are, but 
for now you ought to be here because we may have votes early in the 
morning.
  Is that a fair statement, Mr. Minority Leader?
  Ms. MIKULSKI. Are there additional votes tonight?
  Mr. DOMENICI. There are no additional votes tonight--I have already 
announced that--after the two remaining ones.
  Mr. EXON. Mr. President, could I add one thing that I think should be 
driven home? If we are going to expedite this process, we are going to 
have to have people who are on the list to come and offer their 
amendments on Friday, or on Monday and not leave here tonight and 
assume that they are home free until sometime on Tuesday because, if we 
all do that, then Tuesday is going to be a much worse day than it is 
destined to be in any event. So I hope people listened to what Senator 
Domenici said and be here tomorrow to offer amendments, and not just 
assume, and then everybody flock in here as they usually do at 2:30 on 
Tuesday afternoon and say, ``Why can't I have 2 hours on my 
amendment?'' It will not be.
  Mr. DOMENICI. Mr. President, fellow Senators, I want to repeat what I 
said. I have been asked by the majority leader to indicate to all of 
you that we are trying to finish this budget resolution Tuesday night. 
If that means at 12 o'clock on Wednesday morning at 1 or 2, that is 
included in the definition of Tuesday. It may be Wednesday, or Tuesday 
morning at 4 a.m. But we are going to try. If you can start offering 
amendments tomorrow, we may have an agreement that on Monday there will 
not be any votes. If we get a sequencing of amendments where you offer 
10 or 15 amendments and offer them on Monday, then we may, indeed, be 
able to give some of you the opportunity to not have to be here on 
Friday and Monday. But we need cooperation before we do that.
  Mr. EXON. Mr. President, may I add one other thing? I ask the 
Democrats before they leave here tonight and the Republicans before 
they leave here tonight to come to our desks and tell us when you will 
be here tomorrow, or want to be here tomorrow, or Monday with regard to 
offering your amendments. If you will do that, and we will be working 
back and forth as best we can on amendments as we have been, then we 
might be able to reach some kind of a agreement that, yes. You want to 
be here at 10, maybe not 10, or 10:30, we might be able to get an 
orderly process going because otherwise Tuesday is going to be 
unbelievably bad.

  So please drop by if you can be here on Friday like you are supposed 
to be, and tell us when you will be here, and we will be glad to 
accommodate you as best we can on timing.
  Mr. DOMENICI. Mr. President, I yield the floor.


                       Vote on Amendment No. 3980

  The PRESIDING OFFICER. The question now occurs on the amendment 
offered by the Senator from Michigan.

[[Page S5175]]

 On this question, the yeas and nays have been ordered, and the clerk 
will call the roll.
  The bill clerk called the roll.
  Mr. LOTT. I announce that the Senator from Kansas [Mrs. Kassebaum] is 
necessary absent.
  Mr. FORD. I announce that the Senator from Arkansas [Mr. Pryor] is 
necessarily absent.
  The PRESIDENT OFFICER (Mr. Burns). Are there any other Senators in 
the Chamber who desire to vote?
  The result was announced--yeas 53, nays 45, as follows:

                      [Rollcall Vote No. 118 Leg.]

                                YEAS--53

     Abraham
     Ashcroft
     Bennett
     Bond
     Brown
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Cohen
     Coverdell
     Craig
     D'Amato
     DeWine
     Dole
     Domenici
     Faircloth
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Hatfield
     Heflin
     Helms
     Hutchison
     Inhofe
     Jeffords
     Kempthorne
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Pressler
     Roth
     Santorum
     Shelby
     Simpson
     Smith
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner

                                NAYS--45

     Akaka
     Baucus
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Byrd
     Conrad
     Daschle
     Dodd
     Dorgan
     Exon
     Feingold
     Feinstein
     Ford
     Glenn
     Graham
     Harkin
     Hollings
     Inouye
     Johnston
     Kennedy
     Kerrey
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Nunn
     Pell
     Reid
     Robb
     Rockefeller
     Sarbanes
     Simon
     Wellstone
     Wyden

                             NOT VOTING--2

     Kassebaum
     Pryor
       
  The amendment (No. 3980) was agreed to.
  Mr. EXON. Mr. President, I move to reconsider the vote.
  Mr. DOMENICI. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 3965

  Mr. DASCHLE. Mr. President, the President's fiscal year 1997 budget 
builds on the immense economic success of his 1993 budget.
  Since the enactment of that historic deficit reduction package, the 
Federal deficit has been cut in half--from $290 billion to a projected 
$144 billion in 1996, according to the Congressional Budget Office. The 
deficit as a share of the economy is down from 4.7 percent in 1992 to 
2.3 percent today. Last week CBO projected the 1996 deficit may be even 
lower--down to $130 billion.
  These favorable reports serve as testament both to the effectiveness 
of the 1993 deficit reduction package and a strong Clinton economy. 
Actual total deficit reduction achieved by the 1993 budget package is 
now estimated by CBO to be approximately $800 billion over 5 years. All 
this progress has come from a deficit reduction package that was 
enacted without a single Republican vote.
  Although most of my colleagues on the other side of the aisle 
predicted the 1993 package would bring about job loss and recession, 
economic indicators have improved vastly since the Bush recession. 
Unemployment is down from 7.3 percent in January 1993 to 5.4 percent in 
April 1996. Inflation has been remarkably low during these times of 
sustained economic growth, with the consumer price index increasing 
less than 3 percent in each of the last 3 years. Since January 1993, 
8.5 million jobs have been created, and more than 90 percent of those 
were private sector jobs.
  Interest rates--responding to sound fiscal policies--have fallen well 
below the levels of 3 years ago, with the 30-year average rate dropping 
from 7.67 percent in 1992 to about 7 percent today. Business investment 
in equipment is up 11 percent per year in real dollars since the fourth 
quarter of 1992. And corporate profits are up to a 13-percent annual 
rate since fourth quarter of 1992.
  The economy is strong. But the new Clinton budget is sensitive to the 
underlying anxiety and apprehension of America's working families. This 
budget secures the integrity of the Medicare trust fund through 2005, 
and it does so without ravaging Medicare. In contrast, the Republican 
budget cuts $50 billion more.
  The President's budget maintains guaranteed health care for nursing 
home seniors and poor children under Medicaid. In contrast, the 
Republican budget could cut as much as $250 billion in Medicaid.
  The President's budget maintains America's investment in education 
and job training--Head Start, Basic Education Assistance (title 1), and 
Job Training for Dislocated Workers. In contrast, the Republican budget 
cuts $60 billion from these priorities.
  The President's budget does not raise taxes on working Americans. In 
contrast, the Republican budget cuts $20 billion from the earned income 
tax Credit, raising taxes on 6 to 10 million hard-pressed working 
families.
  The President's budget protects the environment. In contrast, the 
Republican budget cuts EPA operating programs by 11 percent in 1997 and 
by 23 percent in 2002.
  The President's budget does not offer tax breaks for the rich at the 
expense of Medicare and education. In contrast, and contrary to the 
representations made by some of my colleagues, the Republican budget 
provides $180 billion in tax breaks for the wealthiest Americans over 
the next 6 years.
  Mr. President, the President's budget would balance the budget by 
2002 using CBO economic assumptions. But, unlike the Republican budget, 
it would balance the budget without abandoning America's priorities. It 
would preserve paycheck security, health security, and retirement 
security for America's working people.
  The spending cuts in the President's budget are significant, yet they 
are made in the right places. The President's budget would achieve more 
than $600 billion in spending cuts by 2002. It would reduce the size of 
the Federal Government work force by 200,000, making it the smallest it 
has been in 30 years.
  Finally, the President's budget would provide targeted tax relief for 
working families and for families trying to send their children to 
college.
  The bottom line, Mr. President, is that the President's budget is a 
budget that reflects the priorities of the American people. In 
contrast, the Republican budget is the same extreme proposal the 
American people rejected last year.
  The PRESIDING OFFICER. The question now occurs on amendment No. 3965, 
as amended, offered by the Senator from Nebraska [Mr. Exon]. The yeas 
and nays have been ordered.
  The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. LOTT. I announce that the Senator from Kansas [Mrs. Kassebaum] is 
necessarily absent.
  Mr. FORD. I announce that the Senator from Arkansas [Mr. Pryor] is 
necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
who desire to vote?
  The result was announced--yeas 45, nays 53, as follows:

                      [Rollcall Vote No. 119 Leg.]

                                YEAS--45

     Akaka
     Baucus
     Biden
     Bingaman
     Boxer
     Bradley
     Breaux
     Bryan
     Bumpers
     Conrad
     Daschle
     Dodd
     Dorgan
     Exon
     Feingold
     Feinstein
     Ford
     Glenn
     Graham
     Harkin
     Heflin
     Hollings
     Inouye
     Johnston
     Kennedy
     Kerrey
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Nunn
     Pell
     Reid
     Robb
     Rockefeller
     Sarbanes
     Simon
     Wellstone
     Wyden

                                NAYS--53

     Abraham
     Ashcroft
     Bennett
     Bond
     Brown
     Burns
     Byrd
     Campbell
     Chafee
     Coats
     Cochran
     Cohen
     Coverdell
     Craig
     D'Amato
     DeWine
     Dole
     Domenici
     Faircloth
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hatch
     Hatfield
     Helms
     Hutchison
     Inhofe
     Jeffords
     Kempthorne
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Pressler
     Roth
     Santorum
     Shelby
     Simpson
     Smith
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner

                             NOT VOTING--2

     Kassebaum
     Pryor
       
  The amendment (No. 3965), as amended, was rejected.
  Mr. EXON. Mr. President, I move to reconsider the vote by which the

[[Page S5176]]

amendment was rejected, and I move to lay that motion on the table.
  The motion to lay on the table was agreed to.

                          ____________________