[Congressional Record Volume 143, Number 90 (Tuesday, June 24, 1997)]
[Senate]
[Pages S6196-S6198]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    THE BALANCED BUDGET ACT OF 1997

                                 ______
                                 

                 ROTH (AND MOYNIHAN) AMENDMENT NO. 434

  Mr. ROTH (for himself and Mr. Moynihan) proposed an amendment to the 
bill, S. 947, supra; as follows:

       Strike section 5542 and insert the following:

     SEC. 5542. INCOME-RELATED REDUCTION IN MEDICARE SUBSIDY.

       (a) In General.--Section 1839 (42 U.S.C. 1395r) is amended 
     by adding at the end the following:
       ``(h)(1) Notwithstanding the previous subsections of this 
     section, in the case of an individual whose modified adjusted 
     gross income for a taxable year ending with or within a 
     calendar year (as initially determined by the Secretary in 
     accordance with paragraph (3)) exceeds the threshold amount 
     described in paragraph (5)(B), the Secretary shall increase 
     the amount of the monthly premium for months in the calendar 
     year by an amount equal to the difference between--
       ``(A) 200 percent of the monthly actuarial rate for 
     enrollees age 65 and over as determined under subsection 
     (a)(1) for that calendar year; and
       ``(B) the total of the monthly premiums paid by the 
     individual under this section (determined without regard to 
     subsection (b)) during such calendar year.
       ``(2) In the case of an individual described in paragraph 
     (1) whose modified adjusted gross income exceeds the 
     threshold amount by less than $50,000, the amount of the 
     increase in the monthly premium applicable under paragraph 
     (1) shall be an amount which bears the same ratio to the 
     amount of the increase described in paragraph (1) (determined 
     without regard to this paragraph) as such excess bears to 
     $50,000.
       ``(3) The Secretary shall make an initial determination of 
     the amount of an individual's modified adjusted gross income 
     for a taxable year ending with or within a calendar year for 
     purposes of this subsection as follows:
       ``(A) Not later than September 1 of the year preceding the 
     year, the Secretary shall provide notice to each individual 
     whom the Secretary finds (on the basis of the individual's 
     actual modified adjusted gross income for the most recent 
     taxable year for which such information is available or other 
     information provided to the Secretary by the Secretary of the 
     Treasury) will be subject to an increase under this 
     subsection that the individual will be subject to such an 
     increase, and shall include in such notice the Secretary's 
     estimate of the individual's modified adjusted gross income 
     for the year.
       ``(B) If, during the 30-day period beginning on the date 
     notice is provided to an individual under subparagraph (A), 
     the individual provides the Secretary with information on the 
     individual's anticipated modified adjusted gross income for 
     the year, the amount initially determined by the Secretary 
     under this paragraph with respect to the individual shall be 
     based on the information provided by the individual.
       ``(C) If an individual does not provide the Secretary with 
     information under subparagraph (B), the amount initially 
     determined by the Secretary under this paragraph with respect 
     to the individual shall be the amount included in the notice 
     provided to the individual under subparagraph (A).
       ``(4)(A) If the Secretary determines (on the basis of final 
     information provided by the Secretary of the Treasury) that 
     the amount of an individual's actual modified adjusted gross 
     income for a taxable year ending with or within a calendar 
     year is less than or greater than the amount initially 
     determined by the Secretary under paragraph (3), the 
     Secretary shall increase or decrease the amount of the 
     individual's monthly premium under this section (as the case 
     may be) for months during the following calendar year by an 
     amount equal to \1/12\ of the difference between--
       ``(i) the total amount of all monthly premiums paid by the 
     individual under this section during the previous calendar 
     year; and
       ``(ii) the total amount of all such premiums which would 
     have been paid by the individual during the previous calendar 
     year if the amount of the individual's modified adjusted 
     gross income initially determined under paragraph (3) were 
     equal to the actual amount of the individual's modified 
     adjusted gross income determined under this paragraph.
       ``(B)(i) In the case of an individual for whom the amount 
     initially determined by the Secretary under paragraph (3) is 
     based on information provided by the individual under 
     subparagraph (B) of such paragraph, if the Secretary 
     determines under subparagraph (A) that the amount of the 
     individual's actual modified adjusted gross income for a 
     taxable year is greater than the amount initially determined 
     under paragraph (3), the Secretary shall increase the amount 
     otherwise determined for the year under subparagraph (A) by 
     interest in an amount equal to the sum of the amounts 
     determined under clause (ii) for each of the months described 
     in clause (ii).
       ``(ii) Interest shall be computed for any month in an 
     amount determined by applying the underpayment rate 
     established under section 6621 of the Internal Revenue Code 
     of 1986 (compounded daily) to any portion of the difference 
     between the amount initially determined under paragraph (3) 
     and the amount determined under subparagraph (A) for the 
     period beginning on the first day of the month beginning 
     after the individual provided information to the Secretary 
     under subparagraph (B) of paragraph (3) and ending 30 days 
     before the first month for which the individual's monthly 
     premium is increased under this paragraph.
       ``(iii) Interest shall not be imposed under this 
     subparagraph if the amount of the individual's modified 
     adjusted gross income provided by the individual under 
     subparagraph (B) of paragraph (3) was not less than the 
     individual's modified adjusted gross income determined on the 
     basis of information shown on the return of tax imposed by 
     chapter 1 of the Internal Revenue Code of 1986 for the 
     taxable year involved.
       ``(C) In the case of an individual who is not enrolled 
     under this part for any calendar year for which the 
     individual's monthly premium under this section for months 
     during the year would be increased pursuant to subparagraph 
     (A) if the individual were enrolled under this part for the 
     year, the Secretary may take such steps as the Secretary 
     considers appropriate to recover from the individual the 
     total amount by which the individual's monthly premium for 
     months during the year would have been increased under 
     subparagraph (A) if the individual were enrolled under this 
     part for the year.
       ``(D) In the case of a deceased individual for whom the 
     amount of the monthly premium under this section for months 
     in a year would have been decreased pursuant to subparagraph 
     (A) if the individual were not deceased, the Secretary shall 
     make a payment to the individual's surviving spouse (or, in 
     the case of an individual who does not have a surviving 
     spouse, to the individual's estate) in an amount equal to the 
     difference between--
       ``(i) the total amount by which the individual's premium 
     would have been decreased for all months during the year 
     pursuant to subparagraph (A); and
       ``(ii) the amount (if any) by which the individual's 
     premium was decreased for months during the year pursuant to 
     subparagraph (A).
       ``(5) In this subsection, the following definitions apply:
       ``(A) The term `modified adjusted gross income' means 
     adjusted gross income (as defined in section 62 of the 
     Internal Revenue Code of 1986)--

[[Page S6197]]

       ``(i) determined without regard to sections 135, 911, 931, 
     and 933 of such Code, and
       ``(ii) increased by the amount of interest received or 
     accrued by the taxpayer during the taxable year which is 
     exempt from tax under such Code.
       ``(B) The term `threshold amount' means--
       ``(i) except as otherwise provided in this paragraph, 
     $50,000,
       ``(ii) $75,000, in the case of a joint return (as defined 
     in section 7701(a)(38) of such Code), and
       ``(iii) zero in the case of a taxpayer who--
       ``(I) is married at the close of the taxable year but does 
     not file a joint return (as so defined) for such year, and
       ``(II) does not live apart from his spouse at all times 
     during the taxable year.
       ``(6)(A) The Secretary shall transfer amounts received 
     pursuant to this subsection to the Federal Hospital Insurance 
     Trust Fund.
       ``(B) In applying section 1844(a), amounts attributable to 
     clause (i) shall not be counted in determining the dollar 
     amount of the premium per enrollee under paragraph (1)(A) or 
     (1)(B).''.
       (b) Conforming Amendments.--(1) Section 1839 (42 U.S.C. 
     1395r) is amended--
       (A) in subsection (a)(2), by inserting ``or section 
     subsection (h)'' after ``subsections (b) and (e)'';
       (B) in subsection (a)(3) of section 1839(a), by inserting 
     ``or subsection (h)'' after ``subsection (e)'';
       (C) in subsection (b), inserting ``(and as increased under 
     subsection (h))'' after ``subsection (a) or (e)''; and
       (D) in subsection (f), by striking ``if an individual'' and 
     inserting the following: ``if an individual (other than an 
     individual subject to an increase in the monthly premium 
     under this section pursuant to subsection (h))''.
       (2) Section 1840(c) (42 U.S.C. 1395r(c)) is amended by 
     inserting ``or an individual determines that the estimate of 
     modified adjusted gross income used in determining whether 
     the individual is subject to an increase in the monthly 
     premium under section 1839 pursuant to subsection (h) of such 
     section (or in determining the amount of such increase) is 
     too low and results in a portion of the premium not being 
     deducted,'' before ``he may''.
       (c) Reporting Requirements for Secretary of the Treasury.--
       (1) In general.--Subsection (l) of section 6103 of the 
     Internal Revenue Code of 1986 (relating to confidentiality 
     and disclosure of returns and return information) is amended 
     by adding at the end the following new paragraph:
       ``(16) Disclosure of return information to carry out 
     income-related reduction in medicare part b premium.--
       ``(A) In general.--The Secretary may, upon written request 
     from the Secretary of Health and Human Services, disclose to 
     officers and employees of the Health Care Financing 
     Administration return information with respect to a taxpayer 
     who is required to pay a monthly premium under section 1839 
     of the Social Security Act. Such return information shall be 
     limited to--
       ``(i) taxpayer identity information with respect to such 
     taxpayer,
       ``(ii) the filing status of such taxpayer,
       ``(iii) the adjusted gross income of such taxpayer,
       ``(iv) the amounts excluded from such taxpayer's gross 
     income under sections 135 and 911,
       ``(v) the interest received or accrued during the taxable 
     year which is exempt from the tax imposed by chapter 1 to the 
     extent such information is available, and
       ``(vi) the amounts excluded from such taxpayer's gross 
     income by sections 931 and 933 to the extent such information 
     is available.
       ``(B) Restriction on use of disclosed information.--Return 
     information disclosed under subparagraph (A) may be used by 
     officers and employees of the Health Care Financing 
     Administration only for the purposes of, and to the extent 
     necessary in, establishing the appropriate monthly premium 
     under section 1839 of the Social Security Act.''
       (2) Conforming amendment.--Paragraphs (3)(A) and (4) of 
     section 6103(p) of such Code are each amended by striking 
     ``or (15)'' each place it appears and inserting ``(15), or 
     (16)''.
       (d) Effective Date.--
       (1) In general.--The amendments made by subsections (a) and 
     (b) shall apply to the monthly premium under section 1839 of 
     the Social Security Act for months beginning with January 
     1998.
       (2) Information for prior years.--The Secretary of Health 
     and Human Services may request information under section 
     6013(l)(16) of the Social Security Act (as added by 
     subsection (c)) for taxable years beginning after December 
     31, 1994.

     SEC. 5543. DEMONSTRATION PROJECT ON INCOME-RELATED PART B 
                   DEDUCTIBLE.

       (a) Establishment of Project.--
       (1) In general.--Notwithstanding any other provision of 
     law, the Secretary of Health and Human Services (in this 
     section referred to as the ``Secretary'') shall conduct a 
     demonstration project (in this section referred to as the 
     ``project'') in which individuals otherwise responsible for 
     an income-related premium by reason of section 1839(h) of the 
     Social Security Act (42 U.S.C. 1395r(h)) (as added by section 
     5542 of this Act) would instead be responsible for an income-
     related deductible using the same income limits and 
     administrative procedures provided for in such section 
     1839(h).
       (2) Sites.--The Secretary shall conduct the project in a 
     representative number of sites and shall include a sufficient 
     number of individuals in the project to ensure that the 
     project produces statistically satisfactory findings.
       (3) Participation.--
       (A) In general.--Participation in the project shall be on a 
     voluntary basis.
       (B) Medigap.--No individual shall be eligible to 
     participate in the project if such individual is covered 
     under a medicare supplemental policy under section 1882 of 
     the Social Security Act (42 U.S.C. 1395ss).
       (4) Consultation.--In conducting the project, the Secretary 
     shall consult with appropriate organizations and experts.
       (5) Duration.--The project shall be conducted for a period 
     not to exceed 5 years.
       (b) Waiver Authority.--The Secretary shall waive compliance 
     with the requirements of titles XI, XVIII, and XIX of the 
     Social Security Act (42 U.S.C. 1301 et seq., 1395 et seq., 
     1396 et seq.) to such extent and for such period as the 
     Secretary determines is necessary to conduct the project.
       (c) Reports to Congress.--
       (1) In general.--Not later than 2 and 5 years after the 
     date of enactment of this Act, and biannually thereafter, the 
     Secretary shall submit to Congress a report regarding the 
     project.
       (2) Contents of report.--The reports in paragraph (1) shall 
     include the following:
       (A) A description of the demonstration projects conducted 
     under this section.
       (B) A description of the utilization and health care status 
     of individuals participating in the project.
       (C) Any other information regarding the project that the 
     Secretary determines to be appropriate.

     SEC. 5544. LOW-INCOME MEDICARE BENEFICIARY BLOCK GRANT 
                   PROGRAM.

       (a) In General.--Title XVIII (42 U.S.C. 1395 et seq.), as 
     amended by section 5047, is amended by adding at the end the 
     following:


         ``low-income medicare beneficiary block grant program

       ``Sec. 1898. (a) Establishment.--The Secretary shall 
     establish a program to award block grants to States for the 
     payment of medicare cost sharing described in section 
     1905(p)(3)(A)(ii) on behalf of eligible low-income medicare 
     beneficiaries.
       ``(b) Application.--To be eligible to receive a block grant 
     under this section, a State shall prepare and submit to the 
     Secretary an application at such time, in such manner, and 
     containing such information as the Secretary may require.
       ``(c) Payments.--
       ``(1) Amount of grant.--From amounts appropriated under 
     subsection (d) for a fiscal year, the Secretary shall award a 
     grant to each State with an application approved under 
     subsection (b), in an amount that bears the same ratio to 
     such amounts as the total number of eligible low-income 
     medicare beneficiaries in the State bears to the total number 
     of eligible low-income medicare beneficiaries in all States.
       ``(2) 100 percent fmap.--Notwithstanding section 1905(b), 
     the Federal medical assistance percentage for any State that 
     receives a grant under this section shall be 100 percent.
       ``(d) Appropriations.--
       ``(1) In general.--The Secretary is authorized to transfer 
     from the Federal Supplementary Medical Insurance Trust Fund 
     under section 1841 for the purpose of carrying out this 
     section, an amount equal to $200 million in FY 1998, $250 
     million in FY 1999, $300 million in FY 2000, $350 million in 
     FY 2001, and $400 million in FY 2002, to remain available 
     without fiscal year limitation.
       ``(2) State entitlement.--This section constitutes budget 
     authority in advance of appropriations Acts and represents 
     the obligation of the Federal Government to provide for the 
     payment to States of amounts provided in accordance with the 
     provisions of this section.
       ``(e) Definitions.--In this section:
       ``(1) Eligible low-income medicare beneficiary.--The term 
     `eligible low-income medicare beneficiary' means an 
     individual who is described in 1902(a)(10)(E)(iii) but whose 
     family income is greater than or equal to 120 percent of the 
     poverty line and does not exceed 150 percent of the poverty 
     line for a family of the size involved.
       ``(2) State.--The term `State' means each of the 50 States, 
     the District of Columbia, Puerto Rico, Guam, the Virgin 
     Islands, American Samoa, and the Northern Mariana Islands.''.
                                 ______
                                 

                   HUTCHINSON AMENDMENTS NOS. 435-439

  (Ordered to lie on the table.)
  Mr. HUTCHINSON submitted five amendments intended to be proposed by 
him to the bill, S. 947, supra; as follows:

                           Amendment No. 435

       On page 889, line 1, strike ``90'' and insert ``50''.
                                                                    ____


                           Amendment No. 436

       On page 888, strike line 23 and insert the following:
       ``(VI) Work experience and community service programs, 
     including the costs of administration and operation of such 
     programs and benefits provided to participants.

[[Page S6198]]

       ``(VII) Self-Sufficiency First programs or other programs 
     designed to reduce dependence by reducing the number of 
     future entrants into the Temporary Assistance to Needy 
     Families program.
       ``(ii) Required beneficiaries.--Except with regard to funds 
     expended on activities described in subclauses (VI) and (VII) 
     of clause (i), an''.
                                                                    ____


                           Amendment No. 437

       On page 947, between lines 2 and 3, insert the following:
       (n) Adjusting the matching requirement.--Section 
     409(a)(7)(B)(ii) (42 U.S.C. 609(a)(7)(B)(ii)) is amended by--
       (1) striking ``80'' and inserting ``70''; and
       (2) striking ``75'' and inserting ``65''.
                                                                    ____


                           Amendment No. 438

       Beginning on page 929, strike line 20 and all that follows 
     through line 14, page 930 and insert the following:
       (k) Clarification of Number of Individuals Counted as 
     Participating in Work Activities.--Section 407(c)(2) (42 
     U.S.C. 607(c)(2)) is amended--
       (1) by striking subparagraph (C); and
       (2) in subparagraph (D)--
       (A) in the heading, by striking ``or being a teen head of 
     household who maintains satisfactory school attendance''; and
       (B) by striking ``or deemed to be engaged in work by reason 
     of subparagraph (C) of this paragraph''.
                                                                    ____


                           Amendment No. 439

       Beginning on page 929, strike line 20 and all that follows 
     through page 930, line 14 and insert the following:
       (i) Clarification of Number of Individuals Counted as 
     Participating in Work Activities.--Section 407 (42 U.S.C. 
     607) is amended--.
       (1) in subsection (c)--
       (A) in paragraph (1)(A), by striking ``(8)''; and
       (B) in paragraph (2)(D)--
       (i) in the heading, by striking ``participation in 
     vocational education activities''; and
       (ii) by striking ``determined to be engaged in work in the 
     State for a month by reason of participation in vocational 
     educational training or''; and
       (2) by striking subsection (d)(8).
                                 ______
                                 

                KENNEDY (AND MIKULSKI) AMENDMENT NO. 440

  Mr. KENNEDY (for himself and Ms. Mikulski) proposed an amendment to 
the bill, S. 947, supra; as follows:

       On page 1047, between lines 5 and 6, insert the following:

     SEC. 6004. MEDICARE MEANS TESTING STANDARD APPLICABLE TO 
                   SENATORS' HEALTH COVERAGE UNDER THE FEHBP.

       (a) Purpose.--The purpose of this section is to apply the 
     Medicare means testing requirements for part B premiums to 
     individuals with adjusted gross incomes in excess of $100,000 
     as enacted under section 5542 of this Act, to United States 
     Senators with respect to their employee contributions under 
     the Federal Employees Health Benefits Program.
       (b) In General.--Section 8906 of title 5, United States 
     Code, is amended by adding at the end the following:
       ``(j) Notwithstanding any other provision of this section, 
     each employee who is a Senator and is paid at an annual rate 
     of pay exceeding $100,000 shall pay the employee contribution 
     and the full amount of the Government contribution which 
     applies under this section. The Secretary of the Senate shall 
     deduct and withhold the contributions required under this 
     section and deposit such contributions in the Employees 
     Health Benefits Fund.''.
       (c) Effective Date.--This section shall take effect on the 
     first day of the first pay period beginning on or after the 
     date of enactment of this Act.
                                 ______
                                 

                       GRASSLEY AMENDMENT NO. 441

  (Ordered to lie on the table.)
  Mr. GRASSLEY submitted an amendment intended to be proposed by him to 
the bill, S. 947, supra; as follows:

       On page 689, between lines 2 and 3, insert the following:
       ``(iii) Religious choice.--The State, in permitting an 
     individual to choose a managed care entity under clause (i) 
     shall permit the individual to have access to appropriate 
     faith-based facilities. With respect to such access, the 
     State shall permit an individual to select a facility that is 
     not a part of the network of the managed care entity if such 
     network does not provide access to appropriate faith-based 
     facilities. A faith-based facility that provides care under 
     this clause shall accept the terms and conditions offered by 
     the managed care entity to other providers in the network.

                          ____________________