[Congressional Record Volume 143, Number 17 (Tuesday, February 11, 1997)]
[Senate]
[Pages S1234-S1239]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. McCAIN:
  S. 301. A bill to authorize the Secretary of the Interior to set 
aside up to $2 per person from park entrance fees or assess up to $2 
per person visiting the Grand Canyon or other national park to secure 
bonds for capital improvements to the park, and for other purposes; to 
the Committee on Energy and Natural Resources.


                       NATIONAL PARKS LEGISLATION

   Mr. McCAIN. Mr. President, I introduce legislation that would allow 
us to make desperately needed improvements within America's national 
parks.
  The National Parks Capital Improvements Act of 1997 would allow 
private fundraising organizations to enter into agreements with the 
Secretary of the Interior to issue taxable capital development bonds. 
Bond revenues would then be used to finance park improvement projects. 
The bonds would be secured by an entrance fee surcharge of up to $2 per 
visitor at participating parks, or a set-aside of up to $2 per visitor 
from current entrance fees.
  Our national park system has enormous capital needs--by last 
estimate, over $3 billion for high priority projects such as improved 
transportation systems, trail repairs, visitor facilities, historic 
preservation, and the list goes on and on. The unfortunate reality is 
that even under the rosiest budget scenarios our growing park needs far 
outstrip the resources currently available.
  A good example of this funding gap is at Grand Canyon National Park. 
The park's recently approved park management plan calls for over $300 
million in capital improvements, including a desperately needed 
transportation system to reduce congestion. Despite this enormous need 
for funding, the Grand Canyon received only $12 million from the 
Federal Government last year for operating costs. The gap is as wide as 
the Grand Canyon itself. Clearly, we must find a new way to finance 
park needs.
  Revenue bonding would take us a long way toward meeting our needs 
within the national park system. Based on current visitation rates at 
the Grand Canyon, a $2 surcharge would enable us to raise $100 million 
from a bond issue amortized over 20 years. That is a significant amount 
of money which we could use to accomplish many critical park projects.
  I want to emphasize, however, the Grand Canyon would not be the only 
park eligible to benefit from this legislation. Any park unit with 
capital needs in excess of $5 million is eligible to participate. Among 
eligible parks, the Secretary of the Interior will determine which may 
take part in the program.
  I also want to stress that only projects approved as part of a park's 
general management plan can be funded through bond revenue. This 
proviso eliminates any concern that the revenue could be used for 
projects of questionable value to the park.

[[Page S1235]]

  In addition, only organizations under agreement with the Secretary 
will be authorized to administer the bonding, so the Secretary can 
establish any rules or policies he deems necessary and appropriate.
  Under no circumstances, however would, investors be able to attach 
liens against Federal property in the very unlikely event of default. 
The bonds will be secured only by the surcharge revenues.
  Finally, the bill specifies that all professional standards apply and 
that the issues are subject to the same laws, rules, and regulatory 
enforcement procedures as any other bond issue.
  The most obvious question raised by this legislation is: Will the 
bond markets support park improvement issues, guaranteed by an entrance 
surcharge? The answer is yes, emphatically. Americans are eager to 
invest in our Nation's natural heritage, and with park visitation 
growing stronger, the risks would appear minimal. For example, a recent 
Washington Times editorial printed on December 8, 1996, noted that park 
visitation has increased to nearly 280 million since 1983, so that now 
more than a quarter of a million people visit our national parks every 
year. That editorial went on to point out that attendance is expected 
to further increase to well over 300 million by the turn of the 
century.
  Are park visitors willing to pay a little more at the entrance gate 
if the money is used for park improvements? Again, yes. Time and time 
again, visitors have expressed their support for increased fees 
provided that the revenue is used where collected and not diverted for 
some other purpose devised by Congress.
  With the fee demonstration program currently being implemented at 
parks around the Nation, an additional $2 surcharge may not be 
necessary or appropriate at certain parks. Under the bill, those parks 
could choose to dedicate $2 per park visitor from current entrance fees 
toward a bond issue.
  Finally, I want to point out that the bill will not cost the Treasury 
any money? On the contrary, it will result in a net increase in Federal 
revenue. First, the bonds will be fully taxable. Second, making 
desperately needed improvements sooner rather than later will reduce 
total project costs.
  Mr. President, this legislation seeks to use park entrance fees to 
their fullest potential through bonds. I appreciate that some details 
may remain to be worked out in this bill and I encourage the 
administration and other interested groups to work with me to fine tune 
this legislation. But, I believe that use of revenue bonds to pay the 
staggering costs for capital improvements within our parks is an idea 
whose time has come.
  America has been blessed with a rich natural heritage. The National 
Park Service Organic Act, which created the National Park Service, 
enjoins us to protect our precious natural resources for future 
generations and to provide for their enjoyment by the American people. 
The National Parks Capital Improvements Act must pass if we are to 
successfully fulfill the enduring responsibilities of stewardship with 
which we have been vested. I urge my colleagues to support me in this 
important effort.
  I ask unanimous consent that copies of letters supporting this 
legislation from the Environmental Defense Fund, the National Trust for 
Historic Preservation, the Grand Canyon Fund, the National Park 
Foundation, the Grand Canyon Trust, the Friends of Acadia, Mount 
Rainier, North Cascades & Olympic Fund and the Rocky Mountain National 
Park Associates, Inc., be included in the Record.
  There being no objection, the letters were ordered to be printed in 
the Record, as follows:

                                      Rocky Mountain National Park


                                             Associates, Inc.,

                                 Estes Park, CO, February 3, 1997.
     Senator John McCain,
     U.S. Senate,
     Washington, DC.
       Dear Senator McCain, Permit me to add a voice of support 
     for the bill you are reintroducing known as the National 
     Parks Capital Improvement Act.
       Many of us affiliated as non profit and philanthropic 
     partners working to improve and enhance America's National 
     Park System are searching for innovative solutions to address 
     the pressing needs of our parks. The concept of the National 
     Parks Capital Improvements Act may be innovative within the 
     context of national parks, but it is clearly a well-tested 
     tool in the private sector and it is needed now for our park 
     fix-up kits. It is my understanding that it permits bonds to 
     be issued at our parks--at least those areas having special 
     long-term needs and those adept at revenue generation. This 
     legislation is not designed to address every need of the 
     maintenance backlog which is fast accumulating within the 
     National Park System. But in specific parks--like that of 
     Grand Canyon or others with carefully defined Master Plans--
     this authority to issue bonds could be put to beneficial use 
     immediately, addressing critically important infrastructure 
     and visitor services improvement programs.
       I hasten to add that not many parks have non profit 
     partnerships as strong as Grand Canyon National Park has with 
     its affiliates, the Grand Canyon Association and the Grand 
     Canyon Fund. The key to making this bond issuance authority 
     work effectively is the leadership and managerial competence 
     coming from these non profit partners. The National Park 
     Service is fortunate to have such strong non profit friends 
     who are able to both create and manage this financing plan 
     within the context of our National Park System.
       I applaud your foresight and your leadership in 
     reintroducing the National Parks Capital Improvements Act in 
     this current session of Congress. I heartily endorse your 
     concern and your continued efforts in seeking new solutions 
     to help our national parks.
           Kindest regards,
                                                   C.W. Buchholtz,
     Executive Director.
                                  ____

                                       National Trust for Historic


                                                 Preservation,

                                 Washington, DC, February 3, 1997.
     Hon. John McCain,
     U.S. Senate,
     Washington, DC.
       Dear Senator McCain: On behalf of the more than 250,000 
     members of the National Trust for Historic Preservation, I am 
     writing to express our support for the National Parks 
     Improvements Act of 1997. This legislation creates, in the 
     form of revenue bonds, an innovative mechanism for funding 
     the backlog of capital investment and deferred maintenance 
     needs in our National Park System.
       Recently, Senator Craig Thomas, the new Chairman of the 
     Subcommittee on Parks, Historic Preservation and Recreation, 
     expressed the view that the challenges facing the National 
     Parks System--specifically the backlog of deferred 
     maintenance, repair and restoration needs--must be addressed 
     outside that normal annual appropriation process. The 
     National Trust for Historic Preservation has a particular 
     interest in finding sources of funding for the $1 to $2 
     billion backlog of restoration and rehabilitation needs for 
     the 20,000 historic structures in our National Parks. The 
     National Parks Improvement Act of 1997 provides a solution to 
     the complex problem, and we look forward to working with you 
     on this legislation.
           Sincerely,
     Edward M. Norton, Jr.
                                  ____



                                      Grand Canyon Fund, Inc.,

                               Grand Canyon, AZ, January 31, 1997.
     Hon. John McCain,
     U.S. Senate,
     Washington, DC.
       Dear Senator McCain: We are very pleased to offer our 
     enthusiastic support of your new legislation, which will 
     enable the National Park Service and private partners to use 
     taxable revenue bond funding for the benefit of our 
     irreplaceable national parks. We understand the new 
     legislation incorporates the necessary changes to accommodate 
     the recreation fee demonstration project and other interests.
       Revenue bonding is an additional tool for private partners 
     to utilize in assisting the National Park Service with 
     meeting the overwhelming backlog of unfunded capital needs. 
     We appreciated your support of the parks with your bill S. 
     1695 (National Parks Capital Improvements Act of 1996) and 
     were very pleased to testify before the United States Senate 
     Subcommittee on Parks, Historic Preservation and Recreation 
     last September. We stand ready to assist you in any 
     appropriate way.
           Sincerely,
     Eugene P. Polk,
       Chairman.
     Robert W. Koons,
       President.
                                  ____



                                            Friends of Acadia,

                                          Maine, February 3, 1997.
     Re S. 1695--National Parks Capital Improvements Act of 1997.
     Senator John McCain,
     Senator Ben Nighthorse Campbell,
     Subcommittee on Parks, Historic Preservation, and Recreation.
       Dear Sen. McCain, Sen. Campbell and Committee Members: 
     Friends of Acadia enthusiastically supports S. 1695, the 
     National Parks Capital Improvements Act of 1997. Please add 
     these comments directly to the record.
       The bill would allow as much as a $2.00 user surcharge for 
     visitors to Grand Canyon National Park and allow the issuance 
     of bonds by a nonprofit park cooperator. The bill can apply 
     to other, unspecified parks as well.

[[Page S1236]]

       Friends of Acadia endorses this resourceful idea and thinks 
     it may be applicable to Acadia National Park, which has an 
     approved general management plan and currently has capital 
     needs exceeding $5 million.
       We respectfully request that, based on conditions unique to 
     a given park, an individual park may be allowed to set the 
     surcharge within or above the fee demonstration amount, if it 
     is a fee demonstration park.
       Friends of Acadia is an independent nonprofit organization 
     whose mission is to protect and preserve Acadia National Park 
     and the surrounding communities. We recently raised $4 
     million in private funds to leverage a $4-million park 
     capital appropriation.
       This was a model private-public partnership. Its success 
     demonstrates that federal dollars can be effectively 
     multiplied by innovative use of philanthropic nonprofits, as 
     is envisioned in this bill.
       Friends of Acadia urges passage of S. 1695.
       Thank you for your consideration of and support for this 
     effort.
           Sincerely,
                                                    Heidi A. Beal,
     Director of Programs.
                                  ____



                                     National Park Foundation,

                                 Washington, DC, February 3, 1997.
     Hon. John McCain,
     U.S. Senate, Washington, DC.
       Dear Senator McCain: Last year the National Park Foundation 
     enjoyed working with you on several pieces of legislation, 
     including a bill you authored which would have allowed the 
     use of taxable bonds to finance long-term capital 
     improvements within the National Park System. This bill, the 
     National Parks Capital Improvements Act, would have generated 
     additional revenue for America's natural, cultural and 
     historic treasures through an innovative public-private 
     partnership.
       As the 105th Congress begins, we look forward to working 
     closely with you and your staff on legislation designed to 
     help conserve and protect National Parks.
       Thank you for your consistent, thoughtful support of Grand 
     Canyon National Park and the leadership you have shown in 
     developing solutions to help the entire National Park System.
           Sincerely,
                                                        Jim Maddy,
     President.
                                  ____



                                           Grand Canyon Trust,

                                                 February 6, 1997.
     Hon. John McCain,
     Washington, DC.
       Dear Senator McCain: I am writing to express Grand Canyon 
     Trust's support for the National Parks Capital Improvements 
     Act of 1997, legislation to authorize a $2.00-per-person 
     surcharge on entrance fees at Grand Canyon and other national 
     parks to secure bonds for capital improvements.
       We believe the proposed legislation will greatly assist the 
     efforts of the National Park Service and other entities to 
     generate the additional funding so urgently needed to 
     maintain, repair and enhance the infrastructure of Grand 
     Canyon National Park and others in the National Park System. 
     We support the proposed use of the $2.00-per-person surcharge 
     to generate incremental revenue for park capital projects.
       Grand Canyon Trust shares your concerns that the park 
     system's, and particularly Grand Canyon National Park's, 
     pressing infrastructure and resource management needs will 
     not be met unless Congress acts to provide the new authority 
     proposed in this legislation. If those needs are not met, the 
     environment in the parks and visitors' experiences will 
     continue to deteriorate, an unacceptable and unnecessary fate 
     for America's ``crown jewels,'' the national parks.
       We look forward to working with you to achieve passage of 
     this important legislation.
           Sincerely,
                                              Geoffrey S. Barnard,
     President.
                                  ____

                                     Mount Rainier, North Cascades


                                               & Olympic Fund,

                                    Seattle, WA, January 31, 1997.
     Senator John McCain,
     Washington, DC.
       Dear Senator McCain: On behalf of the Mount Rainier, North 
     Cascades & Olympic Fund, I would like to state our strong 
     support for the upcoming bill that is replacing S. 1695.
       The Fund is a non-profit organization, dedicated to the 
     preservation and restoration of Washington's National Parks. 
     Organizations such as the Fund, have been created throughout 
     the United States to help fill the increasing gap between 
     national park needs and funds. In 1995, these non-profits 
     contributed approximately $16 million dollars to national 
     parks throughout the nation. However, even this impressive 
     figure is only scratching the surface of the National Park 
     Services needs.
       ``The National Park Service was created in 1916, with a 
     mandate to manage the national parks in such a manner . . . 
     as will leave them unimpaired for the enjoyment of future 
     generations.'' As financial pressures have mounted, it has 
     become increasingly difficult for the parks to fulfill this 
     mission.
       I believe that passage of the National Parks Capital 
     Improvements Act, will help parks such as the Grand Canyon, 
     fulfill their mission to protect our national treasures for 
     present and future generations.
       Thank you for your efforts to preserve and protect our 
     natural heritage.
           Sincerely,
                                                     Kim M. Evans,
     Executive Director.
                                  ____



                                   Environmental Defense Fund,

                                    Boulder, CO, February 9, 1997.
     Hon. John McCain,
     U.S. Senate,
     Washington, DC.
       Dear Senator McCain: In a recent report, the General 
     Accounting Office told the United States Congress that ``the 
     national park system is at a crossroads.'' The General 
     Accounting Office confirmed what many of us have known for 
     some time: while the national park system is growing and 
     visitation is increasing, the resources available to manage 
     and protect these resources are falling far short of what is 
     needed to preserve America's natural and historical heritage. 
     As a result, the backlog of repairs and maintenance needed 
     throughout the national park system has grown to $4 billion.
       Last year, you proposed legislation that would have 
     authorized a limited number of not-for-profit entities to 
     issue taxable bonds, the proceeds of which would have been 
     used to make critically needed investment in units of the 
     national park system. Without creative and innovative 
     approaches such as this, we very likely will never close the 
     gap between the financial resources that are needed to manage 
     and protect our national park system, and the resources that 
     are available.
       I understand that you plan to introduce a similar bill in 
     the 105th Congress, and I am writing to offer the 
     Environmental Defense Fund's support for this undertaking. 
     While no one piece of legislation will solve all of the 
     problems confronted by the national park system, your 
     legislation is a big step in the right direction.
       I look forward to working with you as your proposal works 
     its way through the legislative process.
           Respectfully,
                                                  James B. Martin,
                                          Senior Attorney.

 By Mr. CHAFEE (for himself, Mr. Rockefeller, Mr. Frist, Mr. Jeffords, 
                           and Ms. Collins):

  S. 302. A bill to amend title XVIII of the Social Security Act to 
provide additional consumer protections for Medicare supplemental 
insurance; to the Committee on Finance.


                  THE MEDIGAP PORTABILITY ACT OF 1997

  Mr. CHAFEE. Mr. President. Last year, the President signed into law 
bipartisan legislation that provides greater portability of health 
insurance for working Americans. Today, I join with my colleagues, 
Senator Rockefeller, Senator Frist, Senator Jeffords, and Senator 
Collins, in the introduction of a bipartisan bill that will provide 
some of the same guarantees for Medicare beneficiaries who buy Medicare 
supplemental insurance or MediGap policies.
  Of the 38 million Medicare beneficiaries, about 80 percent, or 31 
million, have some form of Medicare supplemental insurance, whether 
covered through an employer-sponsored health plan, Medicaid or another 
public program, or a private MediGap policy. Our bill does several 
important things for Medicare beneficiaries who have had continuous 
coverage:
  First, it guarantees that if their plan goes out of business or the 
beneficiary moves out of a plan service area, he or she can buy another 
comparable policy. These rules also would apply to a senior who has had 
coverage under a retiree health plan or Medicare Select if their plan 
goes out of business.
  Second, it encourages beneficiaries to enroll in Medicare managed 
care by guaranteeing that they can return to Medicare fee-for-service 
and, during the first year of enrollment, get back their same MediGap 
policy if they decide they do not like managed care. Under current law, 
if a senior wishes to enroll in a Medicare managed care plan, he or she 
has two options. The MediGap policy may be dropped if the senior 
chooses a managed care program, or the individual can continue to pay 
MediGap premiums in the event that the policy is needed again some 
day--a very costly option for those on fixed incomes. Many seniors fear 
that if they lose their supplemental policy after entering a managed 
care plan, it may be financially impossible for them to reenroll in 
MediGap.
  Third, it bans preexisting condition exclusion periods for Medicare 
beneficiaries who obtain MediGap policies when they are first eligible 
for Medicare. Under current law, any time insurers sell a MediGap 
policy, they can limit or exclude coverage for services related to 
preexisting health conditions for a 6-month period.
  Fourth, it establishes a guaranteed open enrollment period for those 
under

[[Page S1237]]

65 who become Medicare beneficiaries because they are disabled. Under 
current Federal law, Medicare beneficiaries are offered a 6-month open 
enrollment period only if they are 65. There are approximately 5 
million Americans who are under 65 years of age and are enrolled in the 
Medicare program. Currently, they do not have access to MediGap 
policies unless State laws require insurers to offer policies to them. 
Our bill provides for a one-time open enrollment period for the current 
Medicare disabled, which will guarantee access to all MediGap plan 
options for almost 5 million disabled Americans.
  It is true that this bill does not go as far as some would like. Our 
bill leaves to the states more controversial issues, such as continuous 
open enrollment and community rating of MediGap premiums. I believe, 
however, that this legislation will provide seniors similar guarantees 
to those that we provided to working Americans under the Kassebaum-
Kennedy legislation.
  Mr. FRIST. Mr. President, I rise to speak in support of the MediGap 
Portability Act of 1997. The importance of this legislation is best 
expressed by the many stories of individuals who have unsuccessfully 
tried to obtain adequate Medicare supplemental coverage. Therefore, I 
would like to share with you the experience of one of my constituents--
Gary Purcell, a 60-year-old retired professor from the University of 
Tennessee.
  To say the least, Dr. Purcell's health status has been a challenge 
for him. Despite a history of multiple illnesses including lupus, 
hypertension, diabetes, severe heart and kidney disease, and recurrent 
life-threatening skin infections, this man kept working. Even after 
suffering a stroke, he kept working. Dr. Purcell fought to remain 
productive, but as his condition deteriorated, he was forced to retire 
on disability. He subsequently developed prostate cancer and recently 
suffered an amputation of the left leg.
  One day last fall, he received a letter saying he was eligible for 
Medicare due to disability. In fact, the situation was a little more 
complicated than that. Since he had not yet reached his 65th birthday, 
Dr. Purcell was actually being reassigned to Medicare, thus losing his 
private health insurance coverage. Due to the fact he is eligible for 
Medicare because of disability and not age, and because of preexisting 
medical conditions, Dr. Purcell could not obtain MediGap coverage and 
he had no other insurance options. As a result, he will incur high out-
of-pocket costs to fill the many gaps in Medicare's coverage. Although 
Dr. Purcell will be eligible for supplemental coverage at age 65, 5 
years from now, until then he will have to spend $500 per month or 25 
percent of his income on medications to make up for what Medicare does 
not cover.
  Dr. Purcell explored other options--ways of obtaining less expensive 
drugs, but the bottom line is, he will still have to pay massive sums 
of money for his medications, money which he does not have. 
Unfortunately, his situation is not unique. Many seniors, as well as 
other individuals with disabilities, are suffering as well.
  How did this happen? What is the real issue? MediGap insurance 
policies offer coverage for Medicare's deductibles and coinsurance and 
pay for many services not covered by Medicare. However, for several 
reasons, the current MediGap laws do not always meet the needs of 
Medicare beneficiaries--especially individuals with disabilities.
  First, under current law, individuals with disabilities who qualify 
for full Medicare benefits before the age of 65 must wait to purchase 
MediGap coverage until they reach that age. At that time, they are 
given a 6-month period of open enrollment. This means that unlike the 
elderly, they cannot obtain MediGap insurance when they become eligible 
for Medicare.
  Second, even when obtainable, MediGap coverage may be limited. During 
the open enrollment period, insurers may not use a preexisting 
condition to refuse a policy for an individual. However, coverage for a 
specific preexisting condition can be delayed for up to 6 months. This 
is called underwriting. Even though alternative policies which do not 
use the underwriting process are available, they do not necessarily 
offer comparable coverage. Further, Federal law does not guarantee that 
these alternatives will continue in the future. Thus, individuals with 
disabilities on Medicare may not receive the same choices of MediGap 
plans as their senior counterparts.
  Third, such stringent requirements hinder the efforts of seniors who 
wish to try a Medicare managed care option. They are afraid of not 
being able to receive comparable supplemental coverage should they 
decide to return to the traditional fee-for-service Medicare. 
Accordingly, they do not take the risk of changing. This is perhaps one 
reason that enrollment in Medicare managed care lags far behind the 
rest of the population. We must encourage this transition if we are to 
slow the growth of Medicare costs.
  Fourth, those Medicare beneficiaries whose employer-provided wrap-
around plans are reducing or dropping benefits after they become 
eligible for Medicare will have difficulties purchasing additional 
coverage.
  Finally, we must consider those who have enrolled in Medicare managed 
care plans which terminate contracts with Medicare or whom move outside 
the service area of their plan. In these circumstances, beneficiaries 
often need to return to the traditional Medicare program and may again 
wish to obtain supplemental coverage.
  To summarize, although our current policies may encourage many 
members of the aging population to obtain continuous coverage, they are 
deficient in encouraging the same for individuals with disabilities who 
are unable to obtain supplemental coverage even if they have had 
continuous insurance coverage. They also limit the choices of seniors 
who wish to switch plans or whose retiree plans terminate or limit 
coverage. The situation is simply unfair.
  Last fall, the President signed the Health Insurance Portability and 
Accountability Act of 1996 (the ``Kassebaum-Kennedy'' bill) which 
addressed health insurance portability for the small group market. The 
Medigap Portability Act addresses similar issues for seniors and 
individuals with disabilities.
  First, seniors will now have more choices than were available before. 
They will be able to explore the managed care options now available, 
yet still return to their original Medigap plans if they change their 
minds.
  Second, if their retiree health plans terminate or substantially 
reduce benefits, seniors will still have access to supplemental health 
insurance without regard to previous health status.
  Finally, if their insurance plans should go out of business, seniors 
will still have Medigap options.
  In other words, it guarantees choice and security for senior citizens 
on Medicare.
  In addition, the bill guarantees access to the same coverage 
available to seniors for individuals with disabilities in three ways:
  First, it insures that anyone will be able to enroll in a Medigap 
plan of their choosing without discrimination during the first 6 months 
of their eligibility for full Medicare benefits, regardless of age.
  Second, the bill guarantees that the disabled will still have the 
same access to the array of Medigap choices that are available to 
seniors after the enrollment period ends, although restrictions may 
apply.
  And, third, individuals with disabilities who are currently enrolled 
in the Medicare program will have a one-time open enrollment period to 
guarantee their access to all Medigap plan options.
  Dr. Purcell is a responsible middle income American who fell through 
the safety net. He lost both rights and choices. In his own words, ``I 
find it so frustrating that I had really planned for the retirement 
period and had tried to prepare myself as prudently as possible * * * 
Yet, I had no idea that my comprehensive coverage would cease after 
only 2 years. Even though I have always done my best to be a good 
worker and to provide for my family, the rug was pulled out from under 
me anyway. I feel so helpless.''
  Dr. Purcell went on to say, ``I thought the issue through and tried 
to determine where I might have the most impact just as one person * * 
* I felt that my best option was to go to the people who represent me * 
* * in the national legislature.''

[[Page S1238]]

  Dr. Purcell and the 4 million other disabled Americans he represents 
have legitimate concerns. So do the 34 million senior citizens who are 
also affected by this issue. They are only asking for the same rights 
given to working Americans. They are coming to us, their elected 
representatives, for help. Mr. President, I challenge my colleagues and 
the insurance industry to respond to these beneficiaries. This bill 
will provide freedom of choice for seniors and individuals with 
disabilities. It is a step forward in our battle to improve health care 
access for all of our citizens and I give it my full support.
  Mr. ROCKEFELLER. Mr. President, I am pleased to be reintroducing a 
bill with my colleague from Rhode Island, Senator Chafee, to improve 
the security and protection of Medicare supplemental policies, so-
called MediGap policies. I am especially pleased that Senator Jeffords, 
both the new chairman of the Labor and Human Resources Committee and 
one of the newest members of the Finance Committee, Senator Frist, and 
Senator Collins have joined us this year as original cosponsors of our 
legislation. And I continue to be pleased that similar legislation has 
been introduced in the House of Representatives by the bipartisan team 
of Representatives Nancy Johnson and John Dingell.
  When enacted, our bipartisan, bicameral bill will make MediGap 
policies more portable, more reliable, and more accessible for almost 
40 million Medicare beneficiaries, including 5 million disabled 
Medicare beneficiaries.
  Last year, when we introduced this bill, we were not terribly 
optimistic that it would get enacted before the end of the 104th 
Congress. But we put forward our legislation anyway to share our 
proposal and objectives, begin building momentum for changes we feel 
are necessary, and to preview the fact that we would be back in the 
105th Congress with a concerted effort to make this a legislative 
priority. As it turns out, having identified MediGap improvements as an 
area of bipartisan concern, President Clinton has responded directly by 
adding the same goal of new MediGap protections as a priority he shares 
and included it in his recently submitted budget proposal. We are very 
happy that our bipartisan support for improved MediGap protections got 
noticed by the President and will be pursued by his administration in 
the upcoming budget process.
  Mr. President, too many Americans are falling through the gaps in our 
health care system. For example, consider the situation of a 44-year-
old disabled man from Capon Bridge, WV. He earns too much money to 
qualify for Medicaid and is unable to buy a private MediGap policy 
because of his medical condition. And, there is the 47-year-old woman 
from Slanesville, WV, who is in a similar situation. She was uninsured 
before qualifying for Medicare because of kidney disease. She and her 
husband have too many assets to qualify for Medicaid and they can't 
afford the $300-a-month health insurance policy offered by her 
husband's employer. They have not been able to find an insurer willing 
to sell them a MediGap policy to help with Medicare's hefty cost-
sharing requirements. A MediGap policy would be more affordable for 
them than the insurance policy offered by her husband's employer which 
duplicates, rather than supplements, Medicare's benefits. Many of the 
50,000 disabled West Virginians who qualify for Medicare are in a 
similar situation. This is wrong and we can do better.

  Mr. President, almost 8 in 10 older Americans have opted to purchase 
policies through private insurance companies to fill gaps in their 
Medicare benefits. This MediGap insurance commonly covers the $756 
deductible required for each hospital stay, the part B deductible for 
doctor visits and doctor copayments. MediGap policies also cover 
copayments for nursing home care, extended rehabilitation, or for 
emergency care received abroad. Some MediGap policies cover 
prescription drugs.
  But even MediGap policies have gaps because of insurance underwriting 
practices which prevent beneficiaries from switching MediGap insurers 
or, as in the case of the Medicare disabled, from even initially 
purchasing MediGap protection.
  Employers, looking to lower their health care costs, are increasingly 
cutting back on retiree health benefits. In just 2 years, employer-
sponsored retiree health benefits has dropped by 5 percent. These 
retirees are forced to go out on the private market and purchase 
individual MediGap coverage. Those lucky enough to find insurance will 
find their coverage compromised by preexisting condition limitations. 
Some won't find an insurer willing to sell them a policy at any price.
  In 1990, I worked with Senator Chafee, the minority leader, Senator 
Daschle, and the then-chairman of the Finance Committee, Senator 
Bentsen, On enacting a number of measures to improve the value of 
MediGap policies. We also successfully enacted legislation that 
standardized MediGap policies so that seniors could more easily compare 
the prices and benefits provided by MediGap insurers.
  At that time, Congress also mandated that insurers must sell a 
MediGap policy to any senior wishing to buy coverage when that person 
first becomes eligible for Medicare, without being subject to medical 
underwriting. At the time, there was a worry that including the 
Medicare disabled population in this open enrollment period would 
escalate premiums for current MediGap policyholders. As a result, the 
disabled were not included in this guaranteed issue requirement. Since 
then, 12 States have moved ahead and required insurers to issue 
policies to all Medicare beneficiaries in their States, including the 
disabled. To my knowledge, not one State has reported large hikes in 
premiums as a result of their new laws.
  We have also asked the American Academy of Actuaries for an 
independent analysis of our legislation. We are confident that their 
evaluation of our bill will lay to rest any concerns about wild hikes 
in MediGap premiums because of our provision to end the current law 
discrimination against the disabled.

  Mr. President, our bill would protect all Medicare beneficiaries by 
guaranteeing them MediGap coverage if they are forced to change their 
MediGap insurer, or if their employer stops providing retiree health 
benefits. Specifically, our bill would require MediGap insurers to sell 
Medicare beneficiaries a new MediGap policy without any preexisting 
condition limitations if an individual moves outside the State in which 
the insurer is licensed, or the health plan goes out of business; if an 
individual loses their employer-sponsored retiree health benefits; if 
an individual enrolled in a health maintenance organization [HMO] or 
Medicare Select policy moves outside of a health plan's service area, 
or if the HMO's contract is canceled; or if an individual enrolled in a 
HMO or a Medicare Select policy decides during their first 12 months of 
enrollment to return to a MediGap fee-for-service policy.
  Mr. President, our bill gives Medicare beneficiaries an opportunity 
to try out a managed care plan without worrying about losing their 
option to return to fee-for-service medicine. Understandably, many 
seniors worry about enrolling in a managed care organization if it 
means losing access to their lifelong doctor. Our bill would encourage 
Medicare beneficiaries to try out a managed care plan to see if it 
suits them, but our bill gives them a way back to fee-for-service 
medicine, if that ends up being their personal preference.
  Our legislation bans insurance companies from imposing any 
preexisting condition limitation during the 6-month open enrollment 
period for MediGap insurance when a person first qualifies for 
Medicare. This change from current law makes the rules for MediGap 
policies consistent with the recently enacted Kassebaum-Kennedy bill 
for the under-65 population, and with Medicare coverage which begins 
immediately, regardless of any preexisting conditions.
  Mr. President, our bill also includes a section to help seniors 
choose the right health plan for them by ensuring that they get good 
information on what plans are available in their area. It allows them 
to compare different health plans based on results of consumer 
satisfaction surveys, and will include information on benefits and 
costs.
  Our bill does not directly address affordability. And, even since we 
introduced our original bill last September, there is growing evidence 
that MediGap premiums are skyrocketing. I am hopeful that the Finance 
Committee will take a closer look at this issue

[[Page S1239]]

during its deliberations on other Medicare reform initiatives. Between 
1995 and 1996, large numbers of seniors received double-digit increases 
in their MediGap premiums. These increases were far in excess of Social 
Security cost-of-living increases and varied dramatically across 
States. In my own State of West Virginia, MediGap policies sold by the 
Prudential Insurance Co. increased by 17 percent between 1995 and 1996. 
In Ohio, premiums increased by 30 percent and in California by 37 
percent.

  Congress has considerable history in trying to guarantee at least a 
minimal level of value across all MediGap policies. Under the current 
law, individual and group MediGap policies must spend at least 65 and 
75 percent, respectively, of all premium dollars collected, on 
benefits. If a MediGap plan fails to meet these minimum loss ratios, 
they must issue refunds or credits to their customers.
  Mr. President, while Federal loss ratio standards help assure a 
minimum level of value, they do not prevent insurance companies from 
annually upping premiums as a senior ages. This practice, known as 
attained age-rating, results in the frailest and the lowest income 
seniors facing large, annual premium hikes as they age. I would hope 
that more States would follow the lead of the 10 States that have 
already banned attained age-rating. This would vastly improve the 
affordability of MediGap for the oldest and frailest of our seniors.
  Mr. President, to repeat what I said last year, our bill is a 
targeted, modest, proposal. But it would provide very real and very 
significant help to millions of Medicare beneficiaries who, year in and 
year out, pay out billions of dollars in premiums to have peace of mind 
when it comes to the cost of their health care. It is wrong and unfair 
when senior and disabled citizens in West Virginia and across the 
country are suddenly dropped by insurers or denied a MediGap policy 
just because they move to another State, or their employer cuts back on 
promised retiree health benefits, or because they're disabled.
  Mr. President, it is always a pleasure to be working on legislation 
with the Senator from Rhode Island. Senator Chafee has a long, 
impressive, and, more important, successful record in enacting 
legislation that has helped millions of seniors, children, and 
disabled. I urge my colleagues to join Senators Jeffords, Frist, and 
Collins in cosponsoring this bill, and to help us extend more of the 
health care peace of mind that older and disabled Americans ask for and 
deserve.
                                 ______