[Congressional Record Volume 142, Number 82 (Thursday, June 6, 1996)]
[Senate]
[Pages S5922-S5926]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    THE HEALTH INSURANCE REFORM BILL

  Mr. KENNEDY. Mr. President, earlier this afternoon, there were some 
comments made about where we are on the Kassebaum-Kennedy health reform 
bill. I wanted to just take a few moments of the Senate's time to 
review a little bit of the bidding on where we have been, where we are, 
and what the hope is in terms of the future.
  Mr. President, as we know, this legislation was developed by Senator 
Kassebaum, myself, and other members of our Labor and Human Resources 
Committee in the wake of the 1994 debate on comprehensive health care. 
It was really reflective of the expressions that were made by 
Republicans and Democrats alike, both the now majority leader, Senator 
Dole, and others on the Democratic side, who said, ``Let us try to find 
common ground together, areas where we agree. Let us try, if we cannot 
do a comprehensive program, to at least shape a proposal that can make 
a difference to millions of Americans--particularly those with 
preexisting conditions--recognizing the importance of portability, 
moving from one job to another, being able to carry the insurance if, 
for some reason, an individual loses their job, or the company closes 
down.''
  Over the period of really the last months, and even over recent 
years, that proposal has been working its way through the Labor and 
Human Resources Committee. It had virtually unanimous support of 
Republicans and Democrats alike, and it has worked its way through the 
Senate with 100 votes. Unanimity, Mr. President, 100 votes--a unanimous 
vote here in the Senate and in our committee. I find that to be an 
extraordinarily rare occasion, when you take something that can provide 
such a meaningful difference and provide relief for families and for 
working families, a measure that can make a very important difference, 
particularly to those with preexisting conditions.
  The efforts of Senator Kassebaum and myself have been to try to keep 
the legislation clean--that is, to try to resist various amendments, in 
spite of the fact that we might have agreed with some of those 
provisions at other times. That was certainly true in my case with 
regard to the excellent proposals that were added to the measure by 
Senator Domenici and Senator Wellstone on mental health. I feel very 
strongly that it is about time that we treat mental health in the way 
that we consider other serious illnesses, and not make the 
consideration of mental health a stepchild in our health care policy 
areas.
  Nonetheless, we had worked out a process where we were going to try 
to move ahead with the areas that we could agree on, so that we can 
move through this legislative process with that in mind. We accepted 
some matters that were overwhelmingly supported by Members of the 
Senate where there was no serious objection.
  We accepted the mental health provisions. But it has always been the 
position of the Senator from Kansas and myself that we were going to be 
committed to a proposal that would provide just the measures which 
initially came out of the committee unless we were going to be able to 
convince our Members in the conference that we needed to make at least 
some progress in the areas of mental health.
  Senator Domenici, Senator Wellstone, I must say Tipper Gore, who has 
been enormously interested in the areas of mental health, have all 
weighed in in terms of making the case once again of the importance of 
extending some protections to the area of mental health. That is an 
issue which I know is still under consideration by at least those that 
are meeting. I can point out for the Members of the Senate, that those 
meetings have not included the Members of this side of the aisle, but 
we have tried to work in a constructive way in at least getting some of 
these ideas forward for the consideration of those who are in the room.
  I want to just mention parenthetically that there were some comments

[[Page S5923]]

made earlier today on the issue of appointing conferees. It has always 
been our position that we should have conferees that reflect at least 
the will of the Senate, but the various proposals that have been made 
here in terms of the conferees were not even close to the ratio of 
Republican to Democrat. We were not going to agree to a stacked deck 
and a position that would not reflect the will of the Senate.
  It always interests me how worked up some of our Members can become 
when they are talking with this righteous sense of indignation about 
the fact that there is some objection to the appointment of the 
conferees, particularly in the way and the numbers in which they were 
suggested. There has never been any reluctance to naming conferees that 
were going to be reflective and represent the committees that had the 
prime jurisdiction. That is the way it has been done here. The 
particular proportion that was suggested was completely out of order, 
which is why we are in that stalemate.
  Most importantly, we are prepared to see the measure that passed 100 
to nothing here on the floor of the U.S. Senate, or the measure that 
passed unanimously out of our committee, to pass out of the conference, 
to pass the House of Representatives, to pass the Senate and be signed 
by the President of the United States in the matter of the next day or 
two. That is what we are able to do as legislators. That would make a 
difference to the 25 million Americans each year who would be helped by 
this bill--who would find that they are able to be assured of 
continuing attention to their particular health needs as long as they 
were going to pay their participation in premiums.
  We have the opportunity to move on that legislation. It is still out 
there. We are caught in a situation evidently that unless we are 
prepared to accept other measures which have been controversial and 
divisive and recognized as such, or where at least very important 
questions have been raised about those matters, that we cannot make 
progress unless we are prepared to bend on those matters. It is still 
my hope that even at this very sensitive time in the discussions where 
leaders in the House and leaders in the Senate are attempting to try to 
make at least one additional effort to try to find the common ground, 
that we can still resolve this and be able to respond to the millions 
of our fellow citizens that have these preexisting conditions and want 
to be able to carry their health care measures with them.
  But I want to take just a few moments of the Senate's time this 
afternoon--I see other colleagues. Could I ask for 5 more minutes?
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered.
  Mr. KENNEDY. Mr. President, I appreciate it.
  Mr. President, I still hope that we will be able to achieve this 
measure.
  I have gone into, in some detail, the principal concerns of the 
issues on medical savings account. But there are a few items that have 
been mentioned with regard to medical savings accounts that were not 
mentioned here in the course of this afternoon.
  Let us understand that if insurance companies want to sell medical 
savings accounts, they can do that today. They do not need to have 
additional legislation. For those that say let us have the free choice, 
individuals can be out and purchase those measures at the present time. 
A number of States have begun to set up their own medical savings 
accounts. So the idea that we are denying some kind of free choice is 
virtually inaccurate and a distortion and a gross misrepresentation 
about where the medical savings account issue is.
  Individual companies--and there are the companies, for example, like 
the Golden Rule Insurance Co., that are out selling medical savings 
accounts today. Of course, it is true that Golden Rule Insurance Co. 
has been drummed out of the State of Vermont because of the way that 
they have exploited consumers. And it is true that Golden Rule 
Insurance Co., the principal company that would benefit from medical 
savings insurance companies, refuses to share market information with 
even the American Academy of Actuaries so that we could get a real 
reflection as to what has been the experience of that company. When 
asked by the American Academy to share their data, Golden Rule said, 
absolutely no, we will not do that, even though they have experienced 
extraordinary profits in this area.
  Nonetheless, Mr. President, one of the factors that was not raised 
this afternoon was the fact that we are talking about the cost to the 
American taxpayers by those that are proposing medical savings 
accounts. The Joint Tax Committee has estimated that if there were just 
to be 1 million Americans out of the pool of about 130 million 
Americans who purchase health insurance, if we have to have 1 million 
of those, the cost to the taxpayers and to the deficit would be $3 
billion for 1 million people. That is not what I am saying. That is 
what the Joint Tax Committee is saying.
  We are talking about when you are going from 1 million to 10 million 
to 20 million, or as the Rand Corp. considered, 70 million, you do not 
need much of a slide rule to understand what this is going to do to the 
Federal deficit, let alone health care policy.
  So it is so interesting to me to hear out there many of our Members 
saying, ``All we want is freedom. All we want is freedom.'' Sure it is 
all they want is freedom to put their hands into the till of the 
Federal Government and take out billions of dollars to subsidize what 
will be primarily a benefit for the richest individuals in this 
country; the richest individuals in this country. And we pointed that 
out over the course of the debate and the discussion. I heard one of my 
colleagues talk about the fact that there were some Democrats that 
wanted this at another time. At another time, we were talking in the 
context of a comprehensive health care reform where we were going to 
have effective cost controls, an entirely different situation than we 
have today.
  So those who are out on the floor with their big charts saying what 
is wrong with these words that were stated a few years ago, I daresay 
that is when we were talking about a comprehensive program with 
effective kinds of cost containment, which is not what we are dealing 
with today. Anyone should understand it. I question whether it would 
have been really justified even at that time. But, nonetheless, there 
were those that believed it ought to be given a try, and that was an 
issue within that context that I think was legitimate. But that is not 
what we are talking about.
  Make no mistake about it. We are talking about underwriting the 
health care insurance for the wealthiest individuals at the expense of 
the average taxpayer. The Joint Tax Committee has pointed out, well, if 
you spend $3 billion, how much of that would go to average working 
families? How much would they benefit from that? One percent of that $3 
billion would benefit average working families. Who gets the rest of 
the 99 percent? The ones that get the rest of the 99 percent are going 
to be in the highest income brackets. That is just one issue that ought 
to be debated and discussed.
  There is a body of opinion in the Senate and in the House of 
Representatives that support this concept. Certainly we ought to have 
an opportunity to review it. We ought to examine it. We ought to have 
at least an opportunity to see whether the greatest fears about what it 
would mean in terms of cost and what it would mean in terms of skewing 
the whole insurance system and what it would mean in terms of 
preventive care are true--we ought to at least have an opportunity to 
test that.
  The President of the United States has indicated that he would sign a 
bill, if there was a proposal that would really test this idea, in an 
area that provided a real test about medical theory and about the costs 
of this program over a reasonable period of time, which seems to me to 
be a reasonable position. Why we have to deal with this at this time is 
beyond me. But nonetheless, it is a matter which is at least before the 
House of Representatives.
  Mr. President, I will include in my full comments the various 
opinions that have been made about the American actuaries, what they 
believe will be the impact in terms of the cost of health insurance, 
the analysis which has been made about who would use this, who would 
benefit and who would suffer under this program, what the impact would 
be on children who are so often the ones who are left out and left

[[Page S5924]]

behind, and the fact that medical savings accounts will effectively 
discourage all preventive care in terms of needy children in our 
society and what the Congressional Research Service said was going to 
be the health implications. These are important matters. I believe that 
the Senate, before it is going to jump into this program, ought to have 
very complete answers to it.
  So I hope if we are going to have an opportunity--and certainly we 
should at some time--to get to the issue of medical savings account, 
the American people ought to understand that we have the opportunity in 
the House of Representatives and the Senate of the United States to do 
something meaningful for millions and millions and millions of American 
families today. We have a proposal that will make a difference to those 
families--more than 25 million of those families. It passed unanimously 
in the House and the Senate of the United States, with broad bipartisan 
support. Our urging is that we take that very important, modest but 
very, very important proposal and that we move it down to the 
President's desk and we get on with it. If there are other measures 
that ought to be debated, let us debate them but not on this bill.
  Mr. President, if we follow that recommendation of the Senator from 
Kansas [Mrs. Kassebaum] and those of us who are members of the 
committee, we can do something truly worthy to be remembered in the 
area of health care reform.
  Mr. President, medical savings accounts do not belong in the 
Kassebaum-Kennedy health insurance reform bill. They have already been 
rejected by the Senate. A bill containing them cannot be enacted into 
law and signed by the President. They are an untried idea with the 
potential to destroy the access to affordable, comprehensive coverage 
that tens of millions of Americans now enjoy.
  Millions of Americans need insurance reform, so that they can be 
secure in the knowledge that their health care, coverage cannot be 
taken away because they become sick, because they change jobs, or 
because they lose their job. Their hopes should not be held hostage to 
this extremist, special interest proposal. But because the Republican 
leadership in the House and Senate is pursuing a rule or ruin approach 
to this legislation, their hopes may be dashed once again.
  Medical savings accounts sound good in theory. Why not encourage 
businesses and individuals to buy less costly high-deductible health 
insurance policies and put the premium savings into a tax-free account 
that can be used to pay some routine medical costs? But in this case, 
what sounds like good medicine in theory is quack medicine in practice.
  Medical savings accounts are an idea whose time should never come. 
Under conservative estimates by the Joint Tax Committee they are a $3 
billion tax break for the wealthy and healthy. As the Center on Budget 
and Policy Priorities said, ``MSAs create new tax shelter 
opportunities. Use of an MSA would be highly advantageous to 
substantial numbers of higher income taxpayers. Low and moderate-income 
taxpayers would receive little or no tax benefits from using MSAs 
because they either do not pay income taxes or pay taxes at much lower 
rates.'' The American Academy of Actuaries concluded that medical 
savings accounts are ``Taxing money from the unhealthy and giving it to 
the healthy.'' The Joint Tax Committee estimated that only 1 percent of 
the tax benefits would go to people with incomes of less than $30,000.
  If more people enroll in these accounts than Joint Tax has estimated, 
as many analysts believe will happen, the cost could rise to the tens 
of billions. How ironic that those who are loudest in their clamor to 
reduce the deficit are willing to waste these vast sums on this 
destructive special interest boondoggle. If we have billions to spare, 
they should be spent on reducing the cost of coverage for hard-working 
American families or on deficit reduction--not on a perverse income 
transfer from the poor and sick to the healthy and rich.
  Medical savings accounts raise premiums for the vast majority of 
Americans--especially those who are sick and need coverage the most--by 
siphoning the healthiest people out of the insurance pool. As premiums 
rise, more and more working families will be forced to drop coverage. 
In the words of the Congressional Budget Office, medical savings 
accounts ``could threaten the existence of standard health insurance.'' 
Mary Nell Lenhardt, Senior Vice-President of Blue Cross and Blue Shield 
concluded, that MSAs destroy ``the whole principle of insurance.'' A 
new report by the Urban Institute concludes that, even under 
conservative assumption, premiums for comprehensive coverage could rise 
by 40 percent. If a higher proportion of people shift to MSAs, the cost 
of comprehensive coverage could rise by more than 300 percent.
  Moderate income people who choose medical savings accounts could be 
exposed to financial disaster if someone in the family becomes 
seriously ill. As the American Academy of Actuaries said, ``individuals 
and families who experience significant medical expenses soon after the 
establishment of MSA programs will face high out-of-pocket costs. These 
high out-of-pocket costs will not be randomly distributed. They will be 
concentrated among older workers and their families and among those 
with disabilities and chronic illness.'' The last thing that the 
American people need--especially those who need health care the most--
is another massive increase in the cost of medical care.
  Because they encourage high deductible plans, medical savings 
accounts discourage preventive care. According to the Congressional 
Research Service, high deductible plans that come with MSAs have meant 
that poor children are 40 percent less likely to get the care they need 
as compared to fully-insured children. This is the wrong direction for 
health policy.
  Medical savings accounts are a giveaway to the insurance companies 
who have the worst record of profiting from the abuses of the current 
system. But the American people should not have to pay such a high 
price to reward them--even in return for $1.5 million in campaign 
contributions over the last 5 years. It is no accident that a company 
like Golden Rule Insurance favors medical savings accounts. This is a 
company that is ranked near the bottom by consumer reports because of 
its inadequate coverage, frequent rate increases, and readiness to 
cancel policies. When Golden Rule withdrew from Vermont because they 
were unwilling to compete on the level playing field created by 
insurance reform, Blue Cross and Blue Shield took over their policies. 
They found that one in four policies included an exemption. Whole body 
parts, like arms, backs, breasts, and even skin were written out of 
coverage. Newborns were excluded unless they were born healthy.
  The Republican medical savings account plan includes absolutely no 
guarantees that companies profiting from selling these policies will be 
prevented from abuses like this in the individual market. Moreover, 
although MSA's are billed as providing catastrophic protection, there 
is no requirement that they have reasonable life-time limits or not 
impose excessive co-payments when the deductible level is reached.
  It is shocking that the very company that has provided the financial 
engine behind this right-wing proposal has refused to share any data 
about its plans with the American Academy of Actuaries or other 
impartial analysts. Golden Rule knows that medical savings accounts 
can't stand the light of day--and that's why they are tying to ram them 
through on a bill that the American people want.
  Some Republicans are anxious to include MSA's in the insurance reform 
bill because MSA's are part of their long-run plan to dismantle 
Medicare and turn it over to private insurance companies. This is a 
foot in the door for that item on the right-wing agenda--and this, too, 
has no place in an insurance reform program.
  No respectable health policy analyst supports medical savings 
accounts. Newspapers from the Washington Post to the New York Times to 
the Los Angeles Times to the Boston Globe have condemned them. The 
President has said that they could doom the bill's prospects for 
becoming law. They don't belong in this bill--and I urge my colleagues 
to reject them.
  Finally, Mr. President, I would like to say a word about the charge 
that I

[[Page S5925]]

am blocking the appointment of conferees. The fact is that the list of 
proposed conferees the Republican leadership has offered is 
unprecedented in its unfairness. In the last three Congresses, there 
has been no conference that has been so stacked. The only reason for 
this unacceptable proposal is to try to ram medical savings accounts--a 
proposal the Senate has already rejected and which will kill the bill--
into insurance reform.
  Republicans leaders know that Americans want the reforms promised in 
this bill and have little interest in medical savings accounts. That is 
why Representative Kasich said, on March 24, ``We will not let medical 
savings accounts destroy the ability to give people portability and 
eliminate pre-existing conditions.'' On March 29, Speaker Gingrich said 
he would not let medical savings accounts stand in the way of a 
Presidential signature. But the American people should know that there 
is a vast gap between the words and the reality. In spite of repeated 
offers from the Democrats to sit down and discuss the issues in the 
bill, in spite of three separate Democratic proposals for a sensible 
compromise on medical savings accounts, Republican leaders have been 
unwilling to negotiate and unwilling to back off their insistence on 
this poison pill.
  Whether the issue is tax fairness, preservation of comprehensive 
health insurance for the vast majority of Americans, or the special 
interests versus the general interests, medical savings accounts are 
bad medicine for our health care system. They are a poison pill that 
would kill health insurance reform. The Senate has already spoken. It 
is time to send a clean bill to President Clinton without further 
delay. The American people are waiting.


                 problems with medical savings accounts

                   1. lavish tax breaks for the rich

       The $1.7 billion revenue loss will go almost exclusively to 
     the highest income and healthiest Americans.
       Joint Tax Committee Analysis concludes that less than 1% of 
     those who will purchase MSAs under this amendment will make 
     less than $30,000 a year. Virtually no one will purchase 
     these plans who makes less than $20,000 a year.
       The well-to-do will be able to use MSA as a second IRA, 
     except that this IRA will have no income limits and will 
     accrue disproportionately to the extremely wealthy. People 
     choosing this option with large assets can use their own 
     money to pay their medical bills and protect their tax 
     deferred MSA savings.
       Health care analysts are virtually unanimous in their 
     opposition to MSAs.
       The American Academy of Actuaries says that MSAs are, 
     ``Taking money from the unhealthy and giving it to the 
     healthy.''
       The Center on Budget and Policy Priorities says, ``MSAs 
     create new tax shelter opportunities. Use of an MSA would be 
     highly advantageous to substantial members of high income 
     taxpayers.''


              2. hand-out to golden rule insurance company

       To select MSAs, an individual is required to select a 
     catastrophic insurance plan, and Golden Rule is one of the 
     largest marketers of catastrophic plans in the country. MSAs 
     would simply allow Golden Rule to greatly enlarge their 
     market.
       The company has given $1.6 million in political 
     contributions to Republicans over the last 5 years.
       They are near the bottom of insurance company rankings done 
     by consumer groups, such as Consumers' Union, because they 
     provide inadequate coverage, frequent rating increases, very 
     aggressive underwriting, and readiness to contest claims and 
     cancel policies.


    3. unravels health insurance and increases premiums for working 
                               americans

       Because healthy and wealthy individuals are most likely to 
     purchase MSAs, those who remain behind in the traditional 
     insurance plans will likely face higher premiums because the 
     insurance pool has been weakened.
       The premium increases could be high enough to force lower 
     income working people to drop their coverage.
       Insurance pool for ordinary Americans without MSAs will 
     suffer both from healthy people pulling out to obtain MSAs 
     and also from individuals with MSAs who become sick going 
     back into the traditional insurance pools.


       4. part of the republican plan to ``wither away'' medicare

       This Golden Rule plan is the tool that Republicans want to 
     use to have Medicare ``wither on the vine.'' It is advocated 
     by Speaker Gingrich--who coined this phrase and by Leader 
     Dole, who proudly talks about his vote against the original 
     enactment of the Medicare program.
       Clearly, Medicare MSAs have an even greater potential to 
     undermine the financial stability of the Medicare program to 
     both beneficiaries and the taxpayers who support it by 
     exposing the program to an option that rewards cherry-picking 
     healthy beneficiaries--not competition over cost and quality. 
     Medicare MSAs were included in the Republican reconciliation 
     bill vetoed by President Clinton in December, 1995.
       Today's amendment is just the first step back toward the 
     Republicans and Golden Rule's ultimate goal of putting in 
     MSAs into the Medicare program. They were rejected doing 
     Medicare MSAs when the President vetoed their excessive 
     Medicare cuts; now--through today's amendment--they are 
     setting the stage for pushing Medicare MSAs as the next 
     logical step.


                     5. discourages preventive care

       MSAs may discourage cost-saving preventive care, such as 
     annual check-ups, immunizations and other wellness efforts. 
     The high deductible coverage associated with MSAs may lead to 
     delayed care and under-utilization of routine and preventive 
     health care services.
       MSAs divert participation from managed care. Capitated 
     plans and other managed care arrangements hold the promise of 
     coordinated, quality-tested care and cost efficiency not 
     provided through MSAs.
       MSAs will not promote cost containment in the long-run. By 
     allowing people to have MSAs when they are healthy but switch 
     to more traditional coverage when they become ill, the MSAs 
     simply become a vehicle for sheltering income, not a means of 
     promoting more cost-conscious consumers.
  Mr. MURKOWSKI addressed the Chair.
  The PRESIDING OFFICER (Mr. Thompson). The Senator from Alaska.
  Mr. MURKOWSKI. I thank the Chair.
  Mr. President, yesterday the trustees of the Medicare and Social 
Security trust funds released their long-awaited annual report, and 
that report confirms our worst fears that the Medicare Hospital 
Insurance trust fund--which pays for the hospital bills of our Nation's 
elderly--will be bankrupt in nearly 4 years, in the year 2001. This is 
a year earlier than the trustees predicted in their last report.
  The report, which by law, Mr. President, was due April 1 but only 
received yesterday, 10 weeks late, indicates that the Medicare trust 
fund ran a deficit of $2.6 billion in 1995 and that the deficit will 
nearly quadruple to $9.2 billion this year. By the year 2001, the fund 
will have a deficit of $56 billion, and, having exhausted all accrued 
interest, it will be bankrupt.
  That is what we are looking at. The Trustees report provides a 
striking reminder that this crisis which the Medicare system faces did 
not disappear with the President's veto of the Balanced Budget Act of 
1995--the one honest attempt to make structural reforms to the Medicare 
Program. To the contrary, this report shows us that Medicare is going 
broke at even a faster rate than previously predicted.
  What are we doing about it? Last year, Congress passed a 7-year 
balanced budget plan--the first in a generation--that included Medicare 
reforms that would have extended the life of the hospital insurance 
trust fund for a decade and also addressed long-term structural reforms 
to help preserve the program for the critical time when the baby 
boomers begin to retire. This proposal was vetoed by the President.
  The plan passed by Congress allowed Medicare to grow at a rate of 
over 6 percent a year--not cut, Mr. President, but grow at a rate of 
over 6 percent a year--with the spending per beneficiary growing from 
$5,300 to $7,000 by the year 2002.
  It has been characterized by some on the other side that these are 
draconian cuts. Is a 6-percent increase a draconian cut? Is an increase 
in payments for beneficiaries from $5,300 to $7,000 by the year 2002 a 
cut? It certainly is not, Mr. President.
  The Medicare reforms passed by Congress last year made changes to the 
system that reflect the way health is practiced in the 1990's, offering 
for the first time real health care choice to seniors. What is wrong 
with choice? We proposed insurance options that would allow doctors and 
hospitals to integrate and provide affordable coordinated care to 
seniors. We proposed medical savings accounts as an option--an option, 
not a mandate--for Medicare beneficiaries giving individuals the 
ability to manage their own health care dollars, choose any doctor they 
want, and shop around for the best quality care at the best price.
  Congress acted. The President chose to abdicate. We responded to the 
urgency to save the program. The President chose to veto our proposals, 
thus ensuring that the crisis in Medicare is simply going to continue. 
Understanding the political risks involved in engaging in a debate over 
Medicare, I

[[Page S5926]]

think we acted responsibly. I think we negotiated in good faith. I 
would hate to think that this was all just an exercise in futility.
  Yet, we have seen more of the same from this administration this 
year. The President's budget includes Medicare gimmicks, not Medicare 
reforms. As we all know, the Medicare problem is not just a crisis of 
the much talked about pending insolvency of the Medicare Hospital 
Insurance--HI--trust fund, it is a fiscal crisis affecting all areas of 
the Medicare program, with Federal spending increasing by 12 percent in 
1995 and projected to grow 8.6 and 10 percent from now until the year 
2005.
  The administration attempts to be deceptive by proposing to move 
spending obligations for home health care from part A, where outlays 
are limited by incoming receipts from the Medicaid HI tax, to part B, 
where 72 percent of the funds come from general revenues and where, 
theoretically, there are no limits on growth in spending or solvency 
problems. I think it is deceiving to make this accounting move and mask 
it as reforms that ``save'' the Medicare Program.
  This gimmick does add life to the part A trust fund ensuring solvency 
to the year 2005 as opposed to 2001, but it is simply that, Mr. 
President. It is a gimmick. It does nothing to address the true problem 
of the Medicare system which is basically the absence of market 
influences and a lack of alternatives to the current one-size-fits-all 
program. Seniors need and deserve the same choices in health care plans 
available to the rest of us. Why should they not have it?
  Mr. President, we are going to attempt again to put forth real 
Medicare reforms this year. It is my hope the President will stop 
proposing gimmicks, stop scaring the seniors, and start dealing 
honestly with true Medicare reforms that everybody can understand. At 
the end of the day, we are not all that far apart. I believe we share 
the same goals of saving the Medicare Program for future generations. 
So let us get on with it in real, honest reforms.
  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. KENNEDY. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________