[Congressional Record Volume 143, Number 91 (Wednesday, June 25, 1997)]
[Senate]
[Pages S6301-S6332]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      BALANCED BUDGET ACT OF 1997

  Mr. DOMENICI. Parliamentary inquiry. Is it not time to return to 
consideration of the bill?
  The PRESIDING OFFICER. Under the previous agreement, the Senate 
resumes consideration of S. 947. The Senator is correct.
  The Senate continued with the consideration of the bill.

[[Page S6302]]

                     Amendment No. 467, as Modified

       (Purpose: To preserve religious choice in long-term care)

  The PRESIDING OFFICER. The Senator from New Mexico.
  Mr. DOMENICI. Mr. President, in behalf of Senator Grassley, I submit 
a modified amendment, No. 467. It has been cleared on both sides. I ask 
for its immediate consideration.
  The PRESIDING OFFICER. Without objection, it is so ordered. The clerk 
will report.
  The assistant legislative clerk read as follows:

       The Senator from New Mexico [Mr. Domenici], for Mr. 
     Grassley, proposes an amendment numbered 467, as modified.

  Mr. DOMENICI. Mr. President, I ask unanimous consent that reading of 
the amendment be dispensed with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment, as modified, is 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 
     religiously-affiliated long-term care facilities that are not 
     pervasively sectarian and that provide comparable non-
     sectarian medical care. 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. Such 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. No 
     facility may be compelled to admit an individual if the 
     medical director of that facility believes that the facility 
     cannot provide the specific nursing care and services an 
     enrollee requires.

  Mr. DOMENICI. I yield any time we have on the amendment.
  The PRESIDING OFFICER. All time is yielded back. If there be no 
further debate, the question is on agreeing to the amendment.
  The amendment (No. 467), as modified, was agreed to.
  Mr. DOMENICI. Mr. President, I move to reconsider the vote.
  Mr. FORD. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                      Amendment No. 473, Withdrawn

  Mr. DOMENICI. Mr. President, in behalf of Senator Hutchison, I seek 
the withdrawal of amendment No. 473. I ask it be withdrawn.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 473) was withdrawn.


                           Amendment No. 493

  Mr. DOMENICI. Senator Kennedy has an amendment, No. 493, Kennedy-
Lautenberg. Senator Lautenberg introduced it for Senator Kennedy, to 
exempt severely disabled aliens from the ban on receipt of supplemental 
income. It is at the desk. I indicate from our side that there is no 
objection. I understand from the Democratic side there is no objection.
  Senator Kennedy, is that correct?
  Mr. KENNEDY. That is correct. I thank the chairman of the committee 
for his consideration. It is a serious issue and a heartrending issue 
for many different individuals. The willingness to accept this 
amendment is something we are very, very appreciative of. If I might 
just say a few words about it.
  Under the budget reconciliation bill, legal immigrants who are 
already in this country can keep their SSI benefits. But for those who 
come in the future, SSI is only for citizens. They have to become 
citizens to qualify in the future, so your sponsor must take care of 
you until then.
  This amendment creates a small exception to that rule. It enables 
immigrants who are too disabled to qualify for citizenship to retain 
their SSI eligibility.
  Some immigrants and refugees--though not many--become too disabled to 
qualify for citizenship. Under this bill, their sponsors have to care 
for them for life. If they don't have sponsors, they have nowhere to 
turn.
  One example is Vien Vu. His family fled Vietnam after years of 
serving side-by-side with the United States Armed Forces. But Vien Vu 
has Downs syndrome. He is 34 years old. The rest of his family has 
become American citizens but Vien will never qualify for citizenship. 
His family needs SSI to care for him for the rest of his life.
  Mendel Tsadovich is a Latvian Holocaust survivor who is too mentally 
retarded to qualify for naturalization. In 1992, he and his family 
escaped as refugees from the anti-Semitism of the former Soviet Union. 
He is now 61 and living in New York. He is the only surviving member of 
his family, and depends on SSI for assistance. He has no sponsor.
  Vien and Mendel are the lucky ones. They arrived before passage of 
last year's welfare law. So the reconciliation bill will continue their 
SSI coverage. But what about the Viens and Mendels who arrive in the 
future?
  With the passage of the Lautenberg amendment this morning, my 
amendment costs almost nothing. CBO scores it as having little budget 
impact. So, we can help all those like Vien and Mendel and still 
balance the budget by 2002.
  The number of immigrants this amendment affects is small, perhaps 
only a few thousand people a year. But these immigrants often depend on 
SSI benefits for their survival. If they do not have the ability to 
become citizens, Congress should not deny them the SSI benefits they 
need.
  Mr. DOMENICI. Mr. President, I have a couple of seconds. I want to 
say, some may ask why I accepted this. Actually, it's a very tiny group 
of people. It covers those who are so seriously disabled that the 
disability disqualifies them from completing their naturalization 
process. Therefore, they cannot become citizens. They are noncitizens, 
but legal. As a result, they are denied benefits described in the 
Kennedy amendment for only that reason. So I agree to accept that.
  THE PRESIDING OFFICER. If there be no further debate, the question is 
on agreeing to the amendment.
  The amendment (No. 493) was agreed to.
  Mr. DOMENICI. Mr. President, I move to reconsider the vote.
  Mr. KENNEDY. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 469

  Mr. DOMENICI. I understand the next amendment in order is by Senator 
Specter, No. 469. Is that correct?
  The PRESIDING OFFICER. That is correct.
  Mr. DOMENICI. I yield the floor.
  The PRESIDING OFFICER. The Senator from Pennsylvania is recognized.
  Mr. SPECTER. Mr. President, I am offering this amendment on behalf of 
Senator Rockefeller, Senator Santorum, Senator Snowe, Senator Collins, 
and Senator Campbell. It would ensure that $1.5 billion over 5 years of 
Medicare premium subsidies is provided to the low-income elderly with 
annual incomes up to $12,000 through expansion of the existing Medicaid 
Program, instead of what is in the current bill, to add $1.5 billion 
through a new State block grant program.
  This amendment is preferable, by doing it on an existing program 
instead of setting up a new bureaucracy. It is necessary because the 
premium increases in the bill are permanent, but there is no guarantee 
of permanent subsidies for the 3.2 million poor senior citizens covered 
unless this amendment would be adopted.
  I yield the remainder of my time to Senator Rockefeller.
  Mr. ROCKEFELLER. Mr. President, I point out that this amendment would 
help seniors making, on an annual basis, between $9,500 a year and 
$11,900 a year. It would simply take the principles of the Medicaid 
Program and carry them forward, and simply say those folks deserve to 
get help in the Medicare payment because they are so desperately poor. 
This is well established in Medicaid. We are now applying it to a new 
area and saying, rather than 120 percent of poverty, we are saying 120 
percent of poverty to 150 percent of poverty. It is very sensible. It 
helps people.
  This program is going to sunset in 5 years, but their costs are not 
going to sunset in 5 years. We think it is an amendment which both 
sides are willing to vote for.
  The PRESIDING OFFICER. The time has expired. The Senator from New 
Mexico.
  Mr. DOMENICI. Mr. President, first I make a point of order that the 
amendment is not germane.

[[Page S6303]]

  Mr. SPECTER. Mr. President, I move to waive.
  Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  Mr. DOMENICI. Mr. President, yesterday we provided $1.5 billion in 
new funds to assist Medicare beneficiaries between 120 and 150 percent 
of the poverty line with their part B premiums. That was expected under 
the agreement that we entered into with the White House. We provided 
these funds as a State program, providing maximum flexibility to reach 
these individuals in the greatest need. We do not need this additional 
program, which would create a new entitlement, which we can't afford. I 
urge my colleagues to oppose the amendment, or to support the point of 
order.
  I yield the floor.


                     Motion to Waive the Budget Act

  The PRESIDING OFFICER. The question is on the motion of the Senator 
from Pennsylvania to waive the Budget Act. The yeas and nays have been 
ordered.
  The clerk will call the roll.
  The bill clerk called the roll.
  The PRESIDING OFFICER (Mr. Gregg). Are there any other Senators in 
the Chamber who desire to vote?
  The yeas and nays resulted, yeas 52, nays 48, as follows:

                      [Rollcall Vote No. 121 Leg.]

                                YEAS--52

     Akaka
     Baucus
     Biden
     Bingaman
     Bond
     Boxer
     Breaux
     Bryan
     Bumpers
     Byrd
     Cleland
     Collins
     Conrad
     D'Amato
     Daschle
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Ford
     Glenn
     Graham
     Harkin
     Hollings
     Inouye
     Jeffords
     Johnson
     Kennedy
     Kerrey
     Kerry
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Reed
     Reid
     Robb
     Rockefeller
     Santorum
     Sarbanes
     Snowe
     Specter
     Torricelli
     Wellstone
     Wyden

                                NAYS--48

     Abraham
     Allard
     Ashcroft
     Bennett
     Brownback
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Coverdell
     Craig
     DeWine
     Domenici
     Enzi
     Faircloth
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Hatch
     Helms
     Hutchinson
     Hutchison
     Inhofe
     Kempthorne
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Roberts
     Roth
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner
  The PRESIDING OFFICER. On this vote, the yeas are 52, the nays are 
48. Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected. The point of order is 
sustained, and the amendment falls.
  Mr. DOMENICI. Mr. President, I move to reconsider the vote by which 
the motion was rejected.
  Mr. LAUTENBERG. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. DOMENICI. Mr. President, how much time did that vote take?
  The PRESIDING OFFICER. That vote took 17 minutes.
  Mr. DOMENICI. I understand the leader will be--
  The PRESIDING OFFICER. If the Senator will suspend, I ask that there 
be order in the Chamber and that Members wishing to pursue discussions, 
and especially staff wishing to pursue discussions, take those 
discussions to the Cloakroom. We are not going to proceed until there 
is order so the Senator from New Mexico can be heard.
  The Senator from New Mexico.
  Mr. DOMENICI. Mr. President, I repeat my question. How much time did 
the last vote take?
  The PRESIDING OFFICER. The last vote took approximately 17 minutes.
  Mr. DOMENICI. We are operating on a unanimous-consent agreement that 
says we will take 10 minutes for rollcall votes. I understand the 
leader will be along shortly and indicate we that will go to the 10-
minute rule. But I am not going to hold Senators to that unless the 
leader comes and confirms it. But 17 minutes, that is an extra hour for 
people today; it seems like to me maybe longer.

  We have a little business we can conduct at this point.


                           Amendment No. 495

  Mr. DOMENICI. We are willing to accept a Conrad amendment dealing 
with the nurse aide registry.
  I ask the Senator, are you willing to accept that on your side?
  Mr. LAUTENBERG. We are.
  Mr. DOMENICI. We yield back any time on the amendment.
  The PRESIDING OFFICER. Without objection, it is so ordered. The 
amendment is agreed to.
  The amendment (No. 495) was agreed to.
  Mr. DOMENICI. I move to reconsider the vote.
  Mr. LAUTENBERG. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 470

  Mr. DOMENICI. Mr. President, I ask unanimous consent that Senator 
Specter's next amendment, which is 470, that it be temporarily set 
aside. And the Senator would like 30 seconds to explain why he is 
agreeing to that.
  Mr. SPECTER. Mr. President, this is an amendment related to 
disproportionate share. Some States have been hit very hard because 
some of the funds have been used for mental health facilities. There 
has already been substantial improvement; illustratively, for 
Pennsylvania, which had been on the books to sustain a loss of $1.7 
billion, it is down to $750 million. And the managers are now 
considering an amendment which would improve that situation materially.
  So I agree with my distinguished colleague from New Mexico to set it 
aside temporarily with the hope we may be able to work it out, and 
ultimately have it withdrawn if a satisfactory resolution can be 
arrived at.
  The PRESIDING OFFICER. Without objection, it is set aside.
  Mr. DOMENICI. Mr. President, I ask one further unanimous consent, 
that Senator Mikulski's amendment No. 489 follow Senator Specter's 
amendment, which he will proceed with now, which is amendment 471.
  I yield the floor.
  The PRESIDING OFFICER. Is there objection?
  Mr. ROCKEFELLER addressed the Chair.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The Senator from West Virginia.


                             Point of Order

  Mr. ROCKEFELLER. Mr. President, I ask for the regular order with 
regard to the point of order under the Byrd rule which was raised on 
the balanced billing.
  The PRESIDING OFFICER. The Senator's point of order is the regular 
order.
  Mr. DOMENICI. Mr. President, might I ask, how is the Chair going to 
rule? Parliamentary inquiry. Can't do that? I withdraw the question.
  I move to waive the point of order and ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There is a 
sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. The question is on agreeing to the motion. The 
clerk will call the roll.
  Mr. BYRD. Mr. President, may we have some explanation what we are 
about to vote on?
  Mr. ROCKEFELLER addressed the Chair.
  The PRESIDING OFFICER. The Senator from West Virginia is recognized 
for 1 minute.
  Mr. ROCKEFELLER. I urge my colleagues to vote no, against the motion 
to waive the Budget Act, so that we protect patients in these sorts of 
very special Medicare Choice programs who, unless we give them the 
protection, unless we vote no, doctors are going to be able to charge 
whatever they want. Everybody else under Medicare is under something 
called balanced billing. Balanced billing means you can only charge 15 
percent more than what Medicare pays for it. This was agreed to in 1989 
when we did a massive Medicare reform.
  We should not be able to take a sort of special fee for service part 
of the new Medicare Choice and suddenly say that the doctor can charge 
them anything they want. They have no protection from balanced billing 
rules which protects all other people who are under Medicare. And it is 
the law of the land. It is a very important principle, a very important 
point. And since we have

[[Page S6304]]

done this in 1989, since we have put a cap on the balanced billing, 
which the other side would have us let go, seniors have saved $2 
billion since 1989.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. DOMENICI addressed the Chair.
  The PRESIDING OFFICER. The Senator from New Mexico has 1 minute.
  Mr. DOMENICI. Mr. President, I yield 40 seconds of that to Senator 
Gramm. I will use 20.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. GRAMM. Mr. President, by giving a broad range of choices to our 
seniors, we have given them the ability to opt into a private fee-for-
service health insurance policy.
  Now, if we come along and start restricting the way that a private 
health insurance policy can function, and tell them how they are to 
bill for physician services, we take away the whole competitive nature 
of what we are trying to create. I know some people do not like the 
idea of expanding choices for seniors.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. GRAMM. But that is what we have done, and we need to preserve the 
ability of these mechanisms to function. It is important we waive the 
point of order.
  Mr. DOMENICI. Mr. President, essentially this amendment will gut 
MSA's and private fee-for-service programs that come into this bill 
which permits seniors a wide array of options. They are gone 
essentially, for the regulatory mechanisms that will be imposed on them 
will make them a nullity.


                 Vote on Motion to Waive the Budget Act

  The PRESIDING OFFICER. The question is on agreeing to the motion. The 
yeas and nays have been ordered. The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. NICKLES. I announce that the Senator from Utah [Mr. Hatch] is 
necessarily absent.
  The yeas and nays resulted--yeas 62, nays, 37, as follows:

                      [Rollcall Vote No. 122 Leg.]

                                YEAS--62

     Abraham
     Allard
     Ashcroft
     Bennett
     Biden
     Bingaman
     Bond
     Breaux
     Brownback
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Collins
     Coverdell
     Craig
     D'Amato
     DeWine
     Domenici
     Enzi
     Faircloth
     Feinstein
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Helms
     Hutchinson
     Hutchison
     Inhofe
     Jeffords
     Kempthorne
     Kerrey
     Kyl
     Landrieu
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Moynihan
     Murkowski
     Nickles
     Roberts
     Roth
     Santorum
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Torricelli
     Warner

                                NAYS--37

     Akaka
     Baucus
     Boxer
     Bryan
     Bumpers
     Byrd
     Cleland
     Conrad
     Daschle
     Dodd
     Dorgan
     Durbin
     Feingold
     Ford
     Glenn
     Graham
     Harkin
     Hollings
     Inouye
     Johnson
     Kennedy
     Kerry
     Kohl
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Murray
     Reed
     Reid
     Robb
     Rockefeller
     Sarbanes
     Wellstone
     Wyden

                             NOT VOTING--1

       
     Hatch
       
  The PRESIDING OFFICER. On this question, the yeas are 62, the nays 
are 37. Three-fifths of the Senators duly chosen and sworn having voted 
in the affirmative, the motion is agreed to.
  Mr. DOMENICI. I move to reconsider the vote.
  Mr. NICKLES. I move to lay it on the table.
  The motion to lay on the table was agreed to.
  Mr. LOTT. Mr. President, the Democratic leader and I have talked 
about the necessity to try to complete votes in the time prescribed. We 
have been warning and urging Members to stay in the Chamber to do these 
votes. It has taken about 50 minutes to do two votes. We did cut that 
last vote off with one Member missing. This is the final warning. From 
here on in after 10 minutes we are going to turn in the vote.
  So please stay in the Chamber. Let's vote. We can save ourselves an 
hour or more if we do that. Please do that. Please cooperate with us 
and we can get our work done and get it done an hour or so earlier.
  I yield the floor.
  The PRESIDING OFFICER. Who seeks recognition?
  Mr. DOMENICI. Mr. President, I believe under the rule, Senator 
Specter is up.


                           Amendment No. 471

  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, this amendment eliminates the cuts on 
indirect grants in medical education. In 48 States there are 1,085 
teaching hospitals which perform very, very valuable services. In 
addition to teaching professionals, they give basic health services, 
customarily in the inner cities. With a disproportionate share coming 
into effect, their financing is very, very important.
  Beyond that, they give highly specialized patient care so that if you 
have some really extraordinary medical problem, where you go is to 
these graduate medical educational institutions.
  These cuts would be crippling. I suggest that as a matter of priority 
they be eliminated from this bill.
  Mr. DOMENICI. Mr. President, I yield 40 seconds of the 1 minute to 
Senator Roth.
  Mr. ROTH. Mr. President, I oppose this amendment. Simply put, 
according to most experts, Medicare today overpays for indirect medical 
education, which is a special Federal subsidy for training new doctors. 
We have substantially but responsibly reduced those payments in our 
bill, and, indeed, these payments will remain very generous. This 
amendment is not needed and would prevent us from meeting our budget 
instructions.
  Mr. DOMENICI. Mr. President, this amendment will cost us $5.6 billion 
in this bill alone. The explanation given by the distinguished chairman 
seems to me to indicate we are going to be more than fair with 
reference to the indirect payment.
  Mr. SPECTER. I believe I have 7 seconds remaining.
  Mr. President, this will not require a waiver of the Budget Act, and 
although the sum is not insignificant, this is really important for 
America.
  I ask that Senator D'Amato be listed as a cosponsor.
  Mr. DOMENICI. Some Senators might wonder why it is not subject to a 
point of order when it cuts $5.6 billion. That is because it is a 
motion to strike, and motions to strike are in order under the Budget 
Act regardless of their impact.
  I move to table the amendment, and I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. The question is on agreeing to the motion to 
lay on the table the amendment of the Senator from Pennsylvania.
  The clerk will call the roll.
  The legislative clerk called the roll.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 71, nays 29, as follows:

                      [Rollcall Vote No. 123 Leg.]

                                YEAS--71

     Abraham
     Allard
     Ashcroft
     Baucus
     Bennett
     Breaux
     Brownback
     Bryan
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Collins
     Conrad
     Coverdell
     Craig
     DeWine
     Dodd
     Domenici
     Dorgan
     Enzi
     Feingold
     Feinstein
     Ford
     Frist
     Glenn
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Hatch
     Helms
     Hollings
     Hutchinson
     Hutchison
     Inhofe
     Kempthorne
     Kerrey
     Kohl
     Kyl
     Landrieu
     Lautenberg
     Leahy
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Moseley-Braun
     Murkowski
     Nickles
     Reed
     Robb
     Roberts
     Rockefeller
     Roth
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Stevens
     Thomas
     Thompson
     Torricelli
     Warner

                                NAYS--29

     Akaka
     Biden
     Bingaman
     Bond
     Boxer
     Bumpers
     Byrd
     Cleland
     D'Amato
     Daschle
     Durbin
     Faircloth
     Harkin
     Inouye
     Jeffords
     Johnson
     Kennedy
     Kerry
     Levin
     Mikulski
     Moynihan
     Murray
     Reid
     Santorum
     Sarbanes
     Specter
     Thurmond
     Wellstone
     Wyden
  The motion to lay on the table the amendment (No. 471) was agreed to.

[[Page S6305]]

  Mr. DOMENICI. Mr. President, I move to reconsider the vote.
  Mr. LAUTENBERG. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  The PRESIDING OFFICER. The regular order would now be the Mikulski 
amendment.


                      Amendment No. 472, Withdrawn

  Mr. DOMENICI. Mr. President, on behalf of Senator Burns, I withdraw 
Senate amendment No. 472.
  The PRESIDING OFFICER. Without objection, the amendment is withdrawn.
  The amendment (No. 472) was withdrawn.


                      Amendment No. 494, Withdrawn

  Mr. DOMENICI. On behalf of Senator Conrad, I withdraw amendment No. 
494.
  The PRESIDING OFFICER. Without objection, the amendment is withdrawn.
  The amendment (No. 494) was withdrawn.


                           Amendment No. 489

  The PRESIDING OFFICER. The Senator from Maryland is recognized.
  Ms. MIKULSKI. Thank you very much. On behalf of Mr. Wellstone and 
myself, we have an amendment at the desk that will strike the committee 
action and restore something called the Boren amendment. The Boren 
amendment was passed and signed by President Reagan in 1981 to ensure 
adequate access to health care services for Medicaid beneficiaries.
  The Boren amendment simply stated that payment rates for hospitals 
and nursing homes must be reasonable and adequate to meet the cost of 
operating the facilities. That is reimbursements by Medicaid. Now, 
under the committee action, we would take that away. We would give 
permission to States to further reduce payment rates to nursing homes 
at this time. This would have a devastating affect on quality care, and 
it would have a devastating affect on access to care for beneficiaries.
  The simple fact is that Medicaid payment rates to nursing homes does 
affect quality and our ability to meet the standards that are mandated 
for health and safety. Nursing homes have stopped taking Medicaid 
patients. Because of that, I urge adoption of the amendment.
  The PRESIDING OFFICER. The Senator from New Mexico.
  Mr. DOMENICI. Mr. President, I yield 30 seconds of my minute to the 
Senator from Texas.
  Mr. GRAMM. Mr. President, we are always looking for bipartisanship. 
The President is in favor of repealing the Boren amendment. The 
National Governors' Association is in favor of repealing the Boren 
amendment. The amendment of the Senator from Maryland will raise the 
deficit and reduce our savings by $1.2 billion. How does anybody know 
what is reasonable and adequate? The Boren amendment has produced 
endless lawsuits. States want to negotiate with hospitals and get the 
best rate they can. Repealing the Boren amendment takes it out of the 
courts.
  Mr. DOMENICI. Mr. President, as we negotiated a balanced budget with 
the President and the Governors, the administration regularly said, 
``We want to provide flexibility.'' What is flexibility? Get rid of the 
Boren amendment. That is what they kept saying. Provide flexibility 
instead of the rigidity brought on by lawsuits. The Boren amendment 
should be dead. The President is not for it. Now someone wants to put 
it back in, and it will cost $1.2 billion to put something back in that 
didn't work.
  I move to table the Mikulski amendment and ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays are ordered, and the clerk will call the roll.
  The bill clerk called the roll.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 66, nays 34, as follows:

                      [Rollcall Vote No. 124 Leg.]

                                YEAS--66

     Abraham
     Allard
     Ashcroft
     Baucus
     Bennett
     Bingaman
     Bond
     Breaux
     Brownback
     Bryan
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Collins
     Conrad
     Coverdell
     Craig
     DeWine
     Domenici
     Enzi
     Faircloth
     Feingold
     Frist
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Hatch
     Helms
     Hollings
     Hutchinson
     Hutchison
     Inhofe
     Jeffords
     Kempthorne
     Kerrey
     Kohl
     Kyl
     Lautenberg
     Leahy
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Moynihan
     Murkowski
     Nickles
     Robb
     Roberts
     Roth
     Santorum
     Sessions
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond

                                NAYS--34

     Akaka
     Biden
     Boxer
     Bumpers
     Byrd
     Cleland
     D'Amato
     Daschle
     Dodd
     Dorgan
     Durbin
     Feinstein
     Ford
     Glenn
     Harkin
     Inouye
     Johnson
     Kennedy
     Kerry
     Landrieu
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Murray
     Reed
     Reid
     Rockefeller
     Sarbanes
     Shelby
     Torricelli
     Warner
     Wellstone
     Wyden
  So the motion to lay on the table the amendment (No. 489) was agreed 
to.
  Mr. DOMENICI. Mr. President, I move to reconsider the vote by which 
the motion to lay on the table was agreed to.
  Mr. LOTT. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. DOMENICI. Mr. President, how much time did we use on that vote?
  The PRESIDING OFFICER. Twelve minutes.
  Mr. DOMENICI. I thank the Chair.


                             Change of Vote

  The PRESIDING OFFICER. The Senator from Wisconsin.
  Mr. KOHL. Thank you, Mr. President.
  On rollcall vote 124, I voted ``no.'' It was my intention to vote 
``yes.'' Therefore, I ask unanimous consent that I be permitted to 
change my vote. This will in no way change the outcome of the vote.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The foregoing tally has been changed to reflect the above order.)
  Mr. DOMENICI. Regular order.


                           Amendment No. 488

  The PRESIDING OFFICER. Regular order is the amendment of the Senator 
from Minnesota, No. 488.
  Mr. WELLSTONE. Mr. President, may we have order?
  The PRESIDING OFFICER. The Senate will come to order.
  We can move this along if Members in the room would withdraw their 
conversations to the Cloakroom, and if the staff will reserve their 
conversations.
  The Senator from Minnesota is recognized.
  Mr. WELLSTONE. Mr. President, if I could just say to you, I am not 
going to start, if I could ask for order.
  The PRESIDING OFFICER. If the Senator will suspend, we are not going 
to proceed until the Senator from Minnesota can be fairly heard. The 
staff will reserve their conversations. It will help to move this 
along.
  The Senator from Minnesota is recognized for 1 minute.
  Mr. WELLSTONE. Mr. President, it is hard in this process because 
people want to talk. But these amendments have consequences for 
people's lives.
  I would like to wait until we have order.
  Mr. DOMENICI. Mr. President, we can't hear.
  Mr. WELLSTONE. I have people talking all around me.
  The PRESIDING OFFICER. The Senator from Minnesota is correct.
  The Senator from Minnesota is recognized.
  Mr. WELLSTONE. Thank you.
  Mr. President, I offer this amendment with Senator Mikulski. We just 
repealed the Boren provision, which was an effort to make sure that 
there was reasonable and adequate rates of reimbursement. This was for 
nursing homes, children's hospitals, group care for people with 
disabilities.
  What we do in this amendment is a compromise, colleagues. We just 
simply require that States provide assurance to the Secretary that the 
rates will be actuarially sufficient to ensure adequate care.
  We don't have any vague standard. This is an actuarially sufficiency 
standard. We are just saying to States, let's have some standard that 
you can say you have had an independent analysis done and that you are 
providing the resources so the children's hospitals and nursing homes 
and group

[[Page S6306]]

homes can provide adequate care to very vulnerable seniors, children 
and the disabled.
  Please vote for this compromise. We can't wipe out all of these 
standards.
  Other than that, I do not feel strongly about it.
  The PRESIDING OFFICER. Who rises in opposition?
  The Senator from New Mexico.
  Mr. DOMENICI. Would Senator Roth like some time on this?
  I will give you half the time.
  Mr. ROTH. All right. Mr. President, I rise in opposition to this 
amendment. It raises again the same questions that were raised in 
respect to the Boren amendment. The history of the Boren amendment is a 
classic example of unintended consequences as its been used to increase 
costs of the program rather than control costs. The Governors are in 
opposition as well as the administration.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. ROTH. I yield the floor.
  The PRESIDING OFFICER. The Senator from New Mexico has 30 seconds.
  Mr. DOMENICI. Mr. President, the Senate has just overwhelmingly 
agreed we do not need the Boren amendment back on the horizon, and I 
view this as a new, similar burden on trying to get reasonably priced 
care. Perhaps it will be known in the future not as the Boren amendment 
but the Wellstone amendment. But believe you me, it will be just as 
egregiously antiefficient as the previous one, for there will be many, 
many court interpretations of the language that is now going to be 
inserted as a test of whether or not the charges are fair.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. DOMENICI. I make a point of order that amendment violates section 
310 of the Budget Act.
  Mr. WELLSTONE. I move to waive that.
  The PRESIDING OFFICER. Is there a sufficient second on the motion to 
waive? There is a sufficient second.
  The yeas and nays were ordered.


                 Vote on Motion to Waive the Budget Act

  The PRESIDING OFFICER. The question is on agreeing to the motion to 
waive. The yeas and nays have been ordered. The clerk will call the 
roll.
  The legislative clerk called the roll.
  Mr. FORD. I announce that the Senator from Ohio [Mr. Glenn] is 
necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
who desire to vote?
  The yeas and nays resulted--yeas 39, nays 60, as follows:

                      [Rollcall Vote No. 125 Leg.]

                                YEAS--39

     Akaka
     Baucus
     Biden
     Bingaman
     Boxer
     Bumpers
     Byrd
     Chafee
     Cleland
     Conrad
     Daschle
     Dodd
     Dorgan
     Durbin
     Feinstein
     Ford
     Frist
     Graham
     Harkin
     Hollings
     Inouye
     Jeffords
     Johnson
     Kennedy
     Kerry
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Murray
     Reed
     Reid
     Rockefeller
     Sarbanes
     Torricelli
     Wellstone
     Wyden

                                NAYS--60

     Abraham
     Allard
     Ashcroft
     Bennett
     Bond
     Breaux
     Brownback
     Bryan
     Burns
     Campbell
     Coats
     Cochran
     Collins
     Coverdell
     Craig
     D'Amato
     DeWine
     Domenici
     Enzi
     Faircloth
     Feingold
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Hatch
     Helms
     Hutchinson
     Hutchison
     Inhofe
     Kempthorne
     Kerrey
     Kohl
     Kyl
     Landrieu
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Moynihan
     Murkowski
     Nickles
     Robb
     Roberts
     Roth
     Santorum
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner

                             NOT VOTING--1

       
       Glenn
       
  The PRESIDING OFFICER. On this vote the yeas are 38; the nays are 61. 
Three-fifths of the Senators duly chosen and sworn not having voted in 
the affirmative, the motion is not agreed to. The point of order is 
sustained and the amendment falls.
  Mr. DOMENICI. Mr. President, I move to reconsider the vote.
  The PRESIDING OFFICER. Without objection, the motion to reconsider is 
laid on the table.
  The motion to lay on the table was agreed to.
  Mr. FRIST addressed the Chair.
  The PRESIDING OFFICER. The Senator from Tennessee.


                             Change of Vote

  Mr. FRIST. Mr. President, on rollcall vote No. 125, it was my 
intention to vote nay. I ask unanimous consent that I be permitted to 
change my vote. This will in no way change the outcome of the vote.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The foregoing tally has been changed to reflect the above order.)
  The PRESIDING OFFICER. The Senator from New Mexico.


                      Amendment No. 497 Withdrawn

  Mr. DOMENICI. Mr. President, amendment No. 497, of Senator Kohl, I 
move to withdraw that in his behalf.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Amendment No. 497 was withdrawn.


                           Amendment No. 498

  Mr. DOMENICI. There are two amendments we are going to accept, and 
then we will proceed to a Kennedy education amendment. The first is a 
Harkin amendment, No. 498, on microdemonstration programs for welfare 
recipients under small business. Senator Harkin, we have agreed to 
accept that. There is no objection on either side.
  Mr. HARKIN. I appreciate that very much. I thank the chairman.
  Mr. DOMENICI. I ask consent Senator Bond, chairman of the Small 
Business Committee, and Senator Domenici, be cosponsors.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The PRESIDING OFFICER. If there be no further debate, the question is 
on agreeing to the amendment.
  The amendment (No. 498) was agreed to.
  Mr. DOMENICI. Mr. President, I move to reconsider the vote.
  The PRESIDING OFFICER. Without objection, that motion is laid on the 
table.
  The motion to lay on the table was agreed to.


                           Amendment No. 491

  Mr. DOMENICI. Senator Baucus has an amendment, No. 491, regarding 
cost-sharing provisions. We are prepared to accept that amendment at 
this time.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Mr. President, the chairman of the committee has 
adequately described the amendment. I very much appreciate that he will 
accept the amendment.
  THE PRESIDING OFFICER. If there be no further debate, the question is 
on agreeing to the amendment.
  The amendment (No. 491) was agreed to.
  Mr. DOMENICI. Mr. President, I move to reconsider the vote.
  The PRESIDING OFFICER. Without objection, the motion to reconsider is 
laid on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 490

  Mr. DOMENICI. Now I believe amendment No. 490 by Senator Kennedy is 
next.
  The PRESIDING OFFICER. We shall not proceed to it until we have 
order. The Senator from Massachusetts is recognized for 1 minute.
  Mr. DOMENICI. Will the Senator yield for a moment?
  Mr. KENNEDY. Yes.
  Mr. DOMENICI. Let me say for Senators' benefit, it looks like there 
are only three to four amendments left. So, if you can bear with us for 
just a little longer, I know this has been an ordeal. The only 
remaining thing after that would be the points of order, if any, that 
they might have on the Democrat side.
  Mr. LAUTENBERG. We have a few.
  Mr. DOMENICI. I yield the floor.
  The PRESIDING OFFICER. If we could get the attention of the Senate 
again. If we could have conversations removed to the Cloakroom.
  The Senator from Massachusetts.
  Mr. KENNEDY. Mr. President, I yield myself 40 seconds, 20 seconds to 
my colleague, Senator Dodd. We offered this together.
  This amendment is supported by the American Council on Education and 
virtually all of the higher education agencies and organizations, as 
well as the student organizations. Effectively, it will reduce tuitions 
by $1.4 billion over the next 5 years, and it is fully paid for by the 
reduction in terms of the guarantees to the guaranty agencies from 98 
to 95 percent of the loans.

[[Page S6307]]

 There are offsets there. The process that we have done in terms of the 
offsets is virtually identical to what was done by the Republican 
initiative in the reconciliation bill. I hope it will be successful. It 
will reduce student tuitions by at least $70.
  Mr. DODD. Mr. President, there are $26 billion outstanding in student 
loans. This amendment has two parts. It does away with the 
automatically required administrative cost allowance, which is 
unnecessary. That can be dealt with in the higher education bill. And 
it cuts in half the origination fees, 4 percent to 2. It is a very big 
issue for families.
  The PRESIDING OFFICER. Who rises in opposition?
  Mr. JEFFORDS. Mr. President, I rise in opposition to the amendment 
offered by the Senator from Massachusetts, [Mr. Kennedy]. Briefly, this 
amendment would rewrite title VII of the reconciliation bill, which 
includes the student loan provisions reported by the Committee on Labor 
and Human Resources by a vote of 17 to 1.
  I have two major reasons for opposing this amendment. First, it will 
harm students by destabilizing the guaranteed loan program; and, 
second, it addresses issues which belong in the debate of 
reauthorization of the Higher Education Act--not the budget 
reconciliation bill.
  Let me be clear. Adoption of the Kennedy amendment will harm 
students--not help them. No one in the Senate is more committed to 
improving educational opportunities than I am. I have worked to 
strengthen student loan programs for over 22 years. If I honestly 
believed that this amendment was in the best interests of students, I 
would support it. It is precisely because of my commitment to the well 
being of students, however, that I so strongly oppose this amendment.
  I want to take a few minutes to explain exactly why this amendment is 
not in the best interests of students or their families and why it was 
rejected when it was considered by the Labor Committee.
  First of all, it is important to understand that the proposal which 
was approved by the committee was carefully crafted to preserve two 
viable student loan programs--the Federal Family Education Loan [FFEL] 
Program, guaranteed loans, and the Federal Direct Loan Program. This 
proposal respects the so-called truce between the two programs which 
was reflected in the portion of the budget agreement calling for a fair 
distribution of savings between the two programs.
  The amendment of the Senator from Massachusetts breaks this truce. In 
the name of helping students, this amendment would drain such a 
substantial portion of funds from guaranty agencies that the 
Congressional Budget Office estimate of the amendment assumes the 
failure of many of these agencies.
  The provisions approved by the committee already recapture $1 billion 
in guaranty agency reserve funds over the next 5 years. The recall of 
these funds is conducted in such a way that guaranty agencies with low 
reserves--Arkansas, Connecticut, Georgia, Illinois, Massachusetts, 
Minnesota, Nebraska, New Hampshire, Oklahoma, Texas, Vermont, 
Washington, and Wisconsin--will not be forced to close their doors to 
the students who depend upon them.
  The Kennedy amendment would nearly double the savings expected from 
guaranty agencies--calling for an additional $960 million reduction 
over 5 years. Because the amendment eliminates any assurance that 
guaranty agencies will receive an administrative cost allowance [ACA] 
from section 458 funds, the reductions absorbed by guaranty agencies 
could well be even higher.
  The guaranteed student loan program serves 80 percent of the 
institutions of higher education in this country and provides over 60 
percent of total student loan volume. Yet, the Kennedy amendment makes 
no provision whatsoever for mitigating the severe disruption to student 
borrowers which will occur when agencies inevitably fail. If the goal 
is to enhance the direct loan program by crippling the guaranteed 
program, this amendment will be remarkably effective. However, if the 
goal truly is to help students, we should be working together in the 
appropriate forum--which is reauthorization, not reconciliation.
  Moreover, I would note that the proposed reduction in the loan 
origination fee charged to students would not take effect until July 
1998. There is no compelling reason to consider this provision outside 
of the current effort to reauthorize the Higher Education Act.
  Before closing, I would like to take a few minutes to discuss the 
proposal that was approved by the Labor Committee and provide the 
history and context for this debate.
  The budget agreement approved by the Senate reflects the strong 
bipartisan support for education. The agreement provides for $35 
billion in education related tax provisions, and assumes increased 
Federal support for special education, Head Start, and funding for 
literacy programs. The budget agreement supports providing an 
additional $7.6 billion for Pell grants allowing the maximum grant to 
grow from $2,700 to $3,000.
  In addition, the subsidy for student loans is assumed to grow from 
$3.9 billion in 1998 to $4.1 billion in 2002. This will support growth 
in Federal student loan volume from $28.8 billion in 1998 to $35.8 
billion in 2002. These provisions provide an unprecedented level of 
support for educational opportunity for students at all levels of 
education.
  In order to accommodate this unprecedented level of support for 
students, the Senate budget resolution requires $1.792 billion in 
savings over 5 years from mandatory spending under the jurisdiction of 
the Committee on Labor and Human Resources.
  The savings required by the agreement and submitted by the committee 
will not increase costs, reduce benefits, or limit access to loans for 
students and their families. In accordance with the budget agreement, 
this proposal attempts to maintain an equitable balance in the savings 
that are taken from the Federal Family Education Loan Program [FFEL] 
and the Federal Direct Lending Program [FDLP].
  The budget submission approved by the committee achieves the required 
savings by recalling $1.028 billion in excess guaranty agency reserves, 
eliminating the $10 direct loan origination fee, and reducing the 
Department of Education's entitlement for the administration of the 
Federal direct lending program by $604 million. This language preserves 
a very delicate balance--it achieves major savings and preserves the 
viability of both loan programs, so that students will not be at risk 
of losing access to loans. The key provisions of title VII as reported 
by the Committee on Labor and Human Resources include:


     A. Elimination of the Direct Lending Loan Origination Payment

  This proposal repeals the provision authorizing the Federal payment 
of $10 per loan to schools and/or alternate originators who make direct 
loans. This repeal will provide five-year savings of $160 million.


              B. Recall of Excess Guaranty Agency Reserves

  The committee proposal requires the recall of $1.028 billion in 
reserves and requires each guaranty agency to deposit its share of the 
total excess reserves into a newly created restricted account in annual 
payments over the next five years.


               C. Reductions in Section 458 Expenditures

  Section 458 of the Higher Education Act provides funds to the 
Secretary of Education for the administrative expenses associated with 
the direct lending program as well as the administrative cost allowance 
paid to guaranty agencies for administration of FFEL programs. The 
committee proposal reduces section 458 expenditures in conformity with 
the budget agreement resulting in savings of $603 million over 5 years. 
The Department will continue to receive over $3.3 billion in this 
account over the next 5 years.
  In order to ensure that these reductions are not redirected from 
direct lending to the FFEL program and to ensure that an equitable 
balance in savings is maintained between the two programs, the 
committee included a provision that reaffirms the Department of 
Education's obligation to continue to pay the administrative cost 
allowance to the guaranty agencies. This authority is capped at $170 
million in each of fiscal years 1998 and 1999 and at $150 million in 
fiscal years 2000, 2001, and 2002.
  In summary, these provisions reflect a commitment to preserving two 
viable student loan programs. Second, they reflect the belief that 
substantive

[[Page S6308]]

changes in student aid policy should not be included within 
reconciliation but should be fully and carefully considered as part our 
comprehensive effort to reauthorize the Higher Education Act. 
Consistent with these principles, our proposal meets our budget 
instruction, preserves two loan programs, and retains the framework of 
the budget agreement. It deserves the support of the full Senate.
  Finally, let me say that we are here today due to the budget 
agreement reached between the President and the leadership of the House 
and Senate. Whatever the disagreements may be about specific details, 
there is broad support for this agreement and its objectives. That is 
illustrated by the 17-to-1 vote for the Labor Committee's submission 
and by the similar margins of support for the proposals reported by 
other committees.
  Certainly, the agreement is a series of compromises. Implicit in 
compromise is the fact that neither party got everything it wanted. In 
the student loan area, the core compromise was that a truce was to be 
declared in the battle between the Federal Family Education Loan 
Program--guaranteed loans--and the Federal Direct Loan Program. The 
approximately $1.8 billion in savings was to be equitably divided 
between the two programs.
  The proposal reported by the committee honors that compromise: 57 
percent of the savings are made in the guaranteed loan program and the 
remaining 43 percent come from direct lending. The amendment of the 
Senator from Massachusetts would destroy that balance.
  When filling in the detail of a broad compromise, there is always the 
urge to push further toward one's preference. What the Senator is 
attempting to do is therefore understandable. But, we need to recognize 
the amendment for what it is. I urge my colleagues to join me in 
opposing it.
  Mr. DOMENICI. I thank the Senator, the chairman of the committee on 
Labor, Health and Human Resources. The chairman opposes this.
  Mr. President, the Kennedy amendment is a substitute to the Labor 
Committee's title. It violates the bipartisan agreement that we made 
with the President and with Democrats and Republicans. It is not 
germane to this bill before us. It violates the Byrd rule because it 
increases spending in the year 2002 and thereafter without any offsets. 
The Kennedy amendment reduces the student loan origination fees, and is 
offset by significant reductions in revenues to the lenders and 
guaranty agencies participating in student loan programs.
  With that, I make a point of order that the Kennedy amendment is a 
violation of the Budget Act and the Byrd amendment.
  Mr. DODD. I move to waive.
  Mr. President, I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.


                 Vote on Motion to Waive the Budget Act

  The PRESIDING OFFICER. The question is on agreeing to the motion. The 
yeas and nays have been ordered.
  The clerk will call the roll.
  The legislative clerk called the roll.
  The PRESIDING OFFICER. Are there any Senators in the Chamber who 
desire to change their vote?
  The yeas and nays resulted, yeas 43, nays 57, as follows:

                      [Rollcall Vote No. 126 Leg.]

                                YEAS--43

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

                                NAYS--57

     Abraham
     Allard
     Ashcroft
     Bennett
     Bond
     Brownback
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Collins
     Coverdell
     Craig
     D'Amato
     DeWine
     Domenici
     Enzi
     Faircloth
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Hatch
     Helms
     Hutchinson
     Hutchison
     Inhofe
     Jeffords
     Johnson
     Kempthorne
     Kyl
     Landrieu
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Roberts
     Roth
     Santorum
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner
  The PRESIDING OFFICER. On this vote, the yeas are 43, the nays are 
57. Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected. The point of order is 
sustained, and the amendment falls.
  Mr. DOMENICI. Mr. President, I move to reconsider the vote by which 
the motion was rejected.
  Mr. LAUTENBERG. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           amendment no. 490

  Mr. SPECTER. Mr. President, I want to address my vote on the Kennedy-
Dodd amendment regarding savings to be generated from direct and 
guaranteed loan programs. Although, I have ardently supported efforts 
to increase Pell grants and improve the ability of millions of American 
families to afford a college education for their children, the Kennedy-
Dodd amendment would have disrupted the guaranteed student loan program 
substantially. It would have upset the balanced approach in the budget 
agreement to derive savings equitably from both direct and guaranteed 
loan programs.
  I am advised that the Kennedy-Dodd amendment would create undue 
hardship on student borrowers by adversely impacting guaranteed 
lenders, which would lose part of their loan origination fees.
  I look forward to working with Chairman Jeffords, Senator Kennedy, 
and Senator Dodd as the Senate considers these issues in the context of 
the Higher Education Act reauthorization later in the 105th Congress.


                Motion to Waive the Budget Act Withdrawn

  Mr. DOMENICI. Mr. President, I ask that the motion of the Senator 
from Texas to waive the Budget Act with respect to the point of order 
lodged by Senator Conrad last night be withdrawn.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DOMENICI. Senator Conrad had lodged the point of order.
  The PRESIDING OFFICER. The regular order is the amendment by Senator 
McCain.
  Mr. DOMENICI. We have to complete business on this. We have withdrawn 
the waiver.
  Mr. CONRAD addressed the Chair.
  The PRESIDING OFFICER. The Senator from North Dakota.


                             Point of Order

  Mr. CONRAD. Mr. President, I make a point of order that section 5822 
of the bill violates section 313(b)(1)(D) of the Budget Act.
  The PRESIDING OFFICER. The point of order is sustained.
  Mr. DOMENICI. And the amendment falls?
  The PRESIDING OFFICER. That is correct.


                           Amendment No. 474

  Mr. DOMENICI. Mr. President, I believe the next order of business is 
Senator McCain's amendment. That is amendment No. 474. That is McCain-
Lott-Domenici.


                     Amendment No. 474, As Modified

  Mr. DOMENICI. I ask unanimous consent that I be permitted to modify 
that amendment by adding just the following words: ``. . . including 
emergency auto service by nonprofit organizations, that . . .'' I send 
the modification to the desk, and I understand the minority has no 
objection to the modification.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered. The amendment is so modified.
  The amendment, as modified, is as follows:

       On page 92, beginning with line 6, strike through line 24 
     on page 128 and insert the following:

     SEC. 3001. SPECTRUM AUCTIONS.

       (a) Extension and Expansion of Auction Authority.--
       (1) In general.--Section 309(j) of the Communications Act 
     of 1934 (47 U.S.C. 309(j)) is amended--
       (A) by striking paragraphs (1) and (2) and inserting in 
     lieu thereof the following:
       ``(1) General authority.--If mutually exclusive 
     applications are accepted for any initial license or 
     construction permit that will involve an exclusive use of the 
     electromagnetic spectrum, then, except as provided

[[Page S6309]]

     in paragraph (2), the Commission shall grant the license or 
     permit to a qualified applicant through a system of 
     competitive bidding that meets the requirements of this 
     subsection. The Commission, subject to paragraphs (2) and (7) 
     of this subsection, also may use auctions as a means to 
     assign spectrum when it determines that such an auction is 
     consistent with the public interest, convenience, and 
     necessity, and the purposes of this Act.
       ``(2) Exceptions.--The competitive bidding authority 
     granted by this subsection shall not apply to a license or 
     construction permit the Commission issues--
       ``(A) for public safety services, including private 
     internal radio services used by State and local governments 
     and non-government entities, including Emergency Auto Service 
     by non-profit organizations, that
       ``(i) are used to protect the safety of life, health, or 
     property; and
       ``(ii) are not made commercially available to the public;
       ``(B) for public telecommunications services, as defined in 
     section 397(14) of this Act, when the license application is 
     for channels reserved for noncommercial use;
       ``(C) for spectrum and associated orbits used in the 
     provision of any communications within a global satellite 
     system;
       ``(D) for initial licenses or construction permits for new 
     digital television service given to existing terrestrial 
     broadcast licensees to replace their current television 
     licenses;
       ``(E) for terrestrial radio and television broadcasting 
     when the Commission determines that an alternative method of 
     resolving mutually exclusive applications serves the public 
     interest substantially better than competitive bidding; or
       ``(F) for spectrum allocated for unlicensed use pursuant to 
     part 15 of the Commission's regulations (47 C.F.R. part 15), 
     if the competitive bidding for licenses would interfere with 
     operation of end-user products permitted under such 
     regulations.'';
       (B) by striking ``1998'' in paragraph (11) and inserting 
     ``2007''; and
       (C) by inserting after paragraph (13) the following:
       ``(14) Out-of-Band Effects.--The Commission and the 
     National Telecommunications and Information Administration 
     shall seek to create incentives to minimize the effects of 
     out-of-band emissions to promote more efficient use of the 
     electromagnetic spectrum. The Commission and the National 
     Telecommunications and Information Administration also shall 
     encourage licensees to minimize the effects of 
     interference.''
       (2) Conforming amendment.--Subsection (i) of section 309 of 
     the Communications Act of 1934 is repealed.
       (b) Auction of 45 Megahertz Located at 1,710-1,755 
     Megahertz.--
       (1) In general.--The Commission shall assign by competitive 
     bidding 45 megahertz located at 1,710-1,755 megahertz no 
     later than December 31, 2001, for commercial use.
       (2) Federal government users.--Any Federal government 
     station that, on the date of enactment of this Act, is 
     assigned to use electromagnetic spectrum located in the 
     1,710-1,755 megahertz band shall retain that use until 
     December 31, 2003, unless exempted from relocation.
       (c) Commission to Make Additional Spectrum Available by 
     Auction.--
       (1) In general.--The Federal Communications Commission 
     shall complete all actions necessary to permit the 
     assignment, by September 30, 2002, by competitive bidding 
     pursuant to section 309(j) of the Communications Act of 1934 
     (47 U.S.C. 309(j)), of licenses for the use of bands of 
     frequencies currently allocated by the Commission that--
       (A) in the aggregate span not less than 55 megahertz;
       (B) are located below 3 gigahertz; and
       (C) as of the date of enactment of this Act, have not 
     been--
       (i) designated by Commission regulation for assignment 
     pursuant to section 309(j);
       (ii) identified by the Secretary of Commerce pursuant to 
     section 113 of the National Telecommunications and 
     Information Administration Organization Act (47 U.S.C. 923); 
     or
       (iii) allocated for Federal Government use pursuant to 
     section 305 of the Communications Act of 1934 (47 U.S.C. 
     305).
       (2) Criteria for Reassignment.--In making available bands 
     of frequencies for competitive bidding pursuant to paragrph 
     (1), the Commission shall--
       (A) seek to promote the most efficient use of the 
     electromagnetic spectrum;
       (B) consider the cost of incumbent licensees of relocating 
     existing uses to other bands of frequencies or other means of 
     communication;
       (C) consider the needs of public safety radio services;
       (D) comply with the requirements of international 
     agreements concerning spectrum allocations; and
       (E) coordinate with the Secretary of Commerce when there is 
     any impact on Federal Government spectrum use.
       (3) Notification to the Secretary of Commerce.--The 
     Commission shall attempt to accommodate incumbent licenses 
     displaced under this section by relocating them to other 
     frequencies available to the Commission. The Commission shall 
     notify the Secretary of Commerce whenever the Commission is 
     not able to provide for the effective relocation of an 
     incumbent licensee to a band of frequencies available to the 
     Commission for assignment. The notification shall include--
       (A) specific information on the incumbent licensee;
       (B) the bands the Commission considered for relocation of 
     the licensee; and
       (C) the reasons the incumbent cannot be accommodated in 
     these bands.
       (4) Report to the Secretary of Commerce.--
       (A) Technical report.--The Commission in consultation with 
     the National Telecommunications and Information 
     Administration, shall submit a detailed technical report to 
     the Secretary of Commerce setting forth--
       (i) the reasons the incumbent licensees described in 
     paragraph (5) could not be accommodated in existing non-
     government spectrum; and
       (ii) the Commission's recommendations for relocating those 
     incumbents.
       (B) NTIA use of report.--The National Telecommunications 
     and Information Administration shall review this report when 
     assessing whether a commercial licensee can be accommodated 
     by being reassigned to a frequency allocated for government 
     use.
       (d) Indentification and Reallocation of Frequencies.--
       (1) In general.--Section 113 of the National 
     Telecommunications and Information Administration 
     Organization Act (47 U.S.C. 901 et seq.) is amended by adding 
     at the end thereof the following:
       ``(f) Additional Reallocation Report.--If the Secretary 
     receives a report from the Commission pursuant to section 
     3001(c)(6) of the Balanced Budget Act of 1997, the Secretary 
     shall submit to the President, the Congress, and the 
     Commission a report with the Secretary's recommendations.
       ``(g) Reimbursement of Federal Spectrum Users for 
     Relocation Costs.--
       ``(1) In general.--
       ``(A) Acceptance of compensation authorized.--In order to 
     expedite the efficient use of the electromagnetic spectrum, 
     and notwithstanding section 3302(b) of title 31, United 
     States Code, any Federal entity that operates a Federal 
     Government station that has been identified by NTIA for 
     relocation may accept payment, including in-kind compensation 
     and shall be reimbursed if required to relocate by the 
     service applicant, provider, licensee, or representative 
     entering the band as a result of a license assignment by the 
     Commission or otherwise authorized by Commission rules.
       ``(B) Duty to compensate ousted federal entity.--Any such 
     service applicant, provider, licensee, or representative 
     shall compensate the Federal entity in advance for relocating 
     through monetary or in-kind payment for the cost of 
     relocating the Federal entity's operations from one or more 
     electromagnetic Spectrum frequencies to any other frequency 
     or frequencies, or to any other telecommunications 
     transmission media.
       ``(C) Compensable costs.--Compensation shall include, but 
     not be limited to, the costs of any modification, 
     replacement, or reissuance of equipment, facilities, 
     operating manuals, regulations, or other relocation expenses 
     incurred by that entity.
       ``(D) Disposition of payments.--Payments, other than in-
     kind compensation, pursuant to this section shall be 
     deposited by electronic funds transfer in a separate agency 
     account or accounts which shall be used to pay directly the 
     costs of relocation, to repay or make advances to 
     appropriations or funds which do or will initially bear all 
     or part of such costs, or to refund excess sums when 
     necessary, and shall remain available until expended.
       ``(E) Application to certain other relocations.--The 
     provisions of this paragraph also apply to any Federal entity 
     that operates a Federal Government station assigned to use 
     electromagnetic spectrum identified for reallocation under 
     subsection (a), if before the date of enactment of the 
     Balanced Budget Act of 1997 the Commission has not identified 
     that spectrum for service or assigned licenses or otherwise 
     authorized service for that spectrum.
       ``(2) Petitions for relocation.--Any person seeking to 
     relocate a Federal Government station that has been assigned 
     a frequency within a band allocated for mixed Federal and 
     non-Federal use under this Act shall submit a petition for 
     relocation to NTIA. The NTIA shall limit or terminate the 
     Federal Government station's operating license within 6 
     months after receiving the petition if the following 
     requirements are met:
       ``(A) The proposed relocation is consistent with 
     obligations undertaken by the United States in international 
     agreements and with United States national security and 
     public safety interests.
       ``(B) The person seeking relocation of the Federal 
     Government station has guaranteed to defray entirely, through 
     payment in advance, advance in-kind payment of costs, or a 
     combination of payment in advance and advance in-kind 
     payment, all relocation costs incurred by the Federal entity, 
     including, but not limited to, all engineering, equipment, 
     site acquisition and construction, and regulatory fee costs.
       ``(C) The person seeking relocation completes all 
     activities necessary for implementing the relocation, 
     including construction of replacement facilities (if 
     necessary and appropriate) and identifying and obtaining on 
     the Federal entity's behalf new frequencies for use by the 
     relocated Federal Government station (if the station is not 
     relocating to spectrum reserved exclusively for Federal use).
       ``(D) Any necessary replacement facilities, equipment 
     modifications, or other changes

[[Page S6310]]

     have been implemented and tested by the Federal entity to 
     ensure that the Federal Government station is able to 
     accomplish successfully its purposes including maintaining 
     communication system performance.
       ``(E) The Secretary has determined that the proposed use of 
     any spectrum frequency band to which a Federal entity 
     relocates its operations is suitable for the technical 
     characteristics of the band and consistent with other uses of 
     the band. In exercising authority under this subparagraph, 
     the Secretary shall consult with the Secretary of Defense, 
     the Secretary of State, and other appropriate Federal 
     officials.
       ``(3) Right to reclaim.--If within one year after the 
     relocation of a Federal Government station, the Federal 
     entity affected demonstrates to the Secretary and the 
     Commission that the new facilities or spectrum are not 
     comparable to the facilities or spectrum from which the 
     Federal Government station was relocated, the person who 
     sought the relocation shall take reasonable steps to remedy 
     any defects or pay the Federal entity for the costs of 
     returning the Federal Government station to the 
     electromagnetic spectrum from which the station was 
     relocated.
       ``(h) Federal Action To Expedite Spectrum Transfer.--Any 
     Federal Government station which operates on electromagnetic 
     spectrum that has been identified for reallocation under this 
     Act for mixed Federal and non-Federal use in any reallocation 
     report under subsection (a), to the maximum extent 
     practicable through the use of subsection (g) and any other 
     applicable law, shall take prompt action to make 
     electromagnetic spectrum available for use in a manner that 
     maximizes efficient use of the electromagnetic spectrum.
       ``(i) Federal Spectrum Assignment Responsibility.--This 
     section does not modify NTIA's authority under section 
     103(b)(2)(A) of this Act.
       ``(j) Definitions.--As used in this section--
       ``(1) The term `Federal entity' means any department, 
     agency, or instrumentality of the Federal Government that 
     utilizes a Government station license obtained under section 
     305 of the 1934 Act (47 U.S.C. 305);
       ``(2) the term `digital television services' means 
     television services provided using digital technology to 
     enhance audio quality and video resolution, as further 
     defined in the Memorandum Opinion, Report, and Order of the 
     Commission entitled `Advanced Television Systems and Their 
     Impact Upon the Existing Television Service,' MM Docket No. 
     87-268 and any subsequent FCC proceedings dealing with 
     digital television; and
       ``(3) the term `analog television licenses' means licenses 
     issued pursuant to 47 CFR 73.682 et seq.''.
       (2) Section 114(a) of that Act (47 U.S.C. 924(a)) is 
     amended by striking ``(a) or (d)(1)'' and inserting ``(a), 
     (d)(1), or (f)''.
       (e) Identification and Reallocation of Auctionable 
     Frequencies.--
       (1) Second report required.--Section 113(a) of the National 
     Telecommunications and Information Administration 
     Organization Act (47 U.S.C. 923(a)) is amended by inserting 
     ``and within 6 months after the date of enactment of the 
     Balanced Budget Act of 1997'' after ``Act of 1993''.
       (2) In general.--Section 113(b) of the National 
     Telecommunications and Information Administration 
     Organization Act (47 U.S.C. 923(b)) is amended--
       (A) by striking the caption of paragraph (1) and inserting 
     ``Initial reallocation report.--'';
       (B) by inserting ``in the initial report required by 
     subsection (a)'' after ``recommend for reallocation'' in 
     paragraph (1);
       (C) by inserting ``or (3)'' after ``paragraph (1)'' each 
     place it appears in paragraph (2); and
       (D) by adding at the end thereof the following:
       ``(3) Second reallocation report.--The Secretary shall make 
     available for reallocation a total of 20 megahertz in the 
     second report required by subsection (a), for use other 
     than by Federal Government stations under section 305 of 
     the 1934 Act (47 U.S.C. 305), that is located below 3 
     gigahertz and that meets the criteria specified in 
     paragraphs (1) through (5) of subsection (a).''.
       (3) Allocation and assignment.--Section 115 of that Act (47 
     U.S.C. 925) is amended--
       (A) by striking ``the report required by section 113(a)''; 
     in subsection (b) and inserting ``the initial reallocation 
     report required by section 113(a)''; and
       (B) by adding at the end thereof the following:
       ``(c) Allocation and Assignment of Frequencies Identified 
     in the Second Allocation Report.--
       ``(1) Plan.--Within 12 months after it receives a report 
     from the Secretary under section 113(f) of this Act, the 
     Commission shall--
       ``(A) submit a plan, prepared in coordination with the 
     Secretary of Commerce, to the President and to the Senate 
     Committee on Commerce, Science, and Transportation and the 
     House of Representatives Committee on Commerce, for the 
     allocation and assignment under the 1934 Act of frequencies 
     identified in the report; and
       ``(B) implement the plan.
       ``(2) Contents.--The plan prepared by the Commission under 
     paragraph (1) shall consist of a schedule of reallocation and 
     assignment of those frequencies in accordance with section 
     309(j) of the 1934 Act in time for the assignment of those 
     licenses or permits by September 30, 2002.''.

     SEC. 3002. DIGITAL TELEVISION SERVICES.

       Section 309(j) of the Communications Act of 1934 (47 U.S.C. 
     309(j)) is amended by adding at the end thereof the 
     following:
       ``(15) Auction of recaptured broadcast television spectrum 
     and potential digital television license fees.--
       ``(A) Limitations on terms of terrestrial television 
     broadcast licenses.--
       ``(i) A television license that authorizes analog 
     television services may not be renewed to authorize such 
     services for a period that extends beyond December 31, 2006. 
     The Commission shall extend or waive this date for any 
     station in any television market unless 95 percent of the 
     television households have access to digital local television 
     signals, either by direct off-air reception or by other 
     means.
       ``(ii) A commercial digital television license that is 
     issued shall expire on September 30, 2003. A commercial 
     digital television license shall be re-issued only subject to 
     fulfillment of the licensee's obligations under subparagraph 
     (C).
       ``(iii) No later than December 31, 2001, and every 2 years 
     thereafter, the Commission shall report to Congress on the 
     status of digital television conversion in each television 
     market. In preparing this report, the Commission shall 
     consult with other departments and agencies of the Federal 
     government. The report shall contain the following 
     information:
       ``(I) Actual consumer purchases of analog and digital 
     television receivers, including the price, availability, and 
     use of conversion equipment to allow analog sets to receive a 
     digital signal.
       ``(II) The percentage of television households in each 
     market that has access to digital local television signals as 
     defined in paragraph (a)(1), whether such access is attained 
     by direct off-air reception or by some other means.
       ``(III) The cost to consumers of purchasing digital 
     television receivers (or conversion equipment to prevent 
     obsolescence of existing analog equipment) and other related 
     changes in the marketplace, such as increases in the cost of 
     cable converter boxes.
       ``(B) Spectrum reversion and resale.--
       ``(i) The Commission shall--
       ``(I) ensure that, as analog television licenses expire 
     pursuant to subparagraph (A)(i), each broadcaster shall 
     return electromagnetic spectrum according to the Commission's 
     direction; and
       ``(II) reclaim and organize the electromagnetic spectrum in 
     a manner to maximize the deployment of new and existing 
     services.
       ``(ii) Licensees for new services occupying electromagnetic 
     spectrum previously used for the broadcast of analog 
     television shall be selected by competitive bidding. The 
     Commission shall start the competitive bidding process by 
     July 1, 2001, with payment pursuant to the competitive 
     bidding rules established by the Commission. The Commission 
     shall report the total revenues from the competitive bidding 
     by January 1, 2002.
       ``(D) Definitions.--As used in this paragraph--
       ``(i) the term `digital television services' means 
     television services provided using digital technology to 
     enhance audio quality and video resolution, as further 
     defined in the Memorandum Opinion, Report, and Order of the 
     Commission entitled `Advanced Television Systems and Their 
     Impact Upon the Existing Television Service,' MM Docket No. 
     87-268 and any subsequent Commission proceedings dealing with 
     digital television; and
       ``(ii) the term `analog television licenses' means licenses 
     issued pursuant to 47 CFR 73.682 et seq. .''.

     SEC. 3003. ALLOCATION AND ASSIGNMENT OF NEW PUBLIC SAFETY AND 
                   COMMERCIAL LICENSES.

       (a) In General.--The Federal Communications Commission, not 
     later than January 1, 1998, shall allocate from 
     electromagnetic spectrum between 746 megahertz and 806 
     megahertz--
       (1) 24 megahertz of that spectrum for public safety 
     services according to terms and conditions established by the 
     Commission, in consultation with the Secretary of Commerce 
     and the Attorney General; and
       (2) 36 megahertz of that spectrum for commercial purposes 
     to be assigned by competitive bidding.
       (b) Assignment.--The Commission shall--
       (1) commence assignment of the licenses for public safety 
     created pursuant to subsection (a) no later than September 
     30, 1998; and
       (2) commence competitive bidding for the commercial 
     licenses created pursuant to subsection (a) no later than 
     March 31, 1998.
       (c) Licensing of Unused Frequencies for Public Safety Radio 
     Services.--
       (1) Use of unused channels for public safety.--It shall be 
     the policy of the Federal Communications Commission, 
     notwithstanding any other provision of this Act or any other 
     law, to waive whatever licensee eligibility and other 
     requirements (including bidding requirements) are applicable 
     in order to permit the use of unassigned frequencies for 
     public safety purposes by a State or local government agency 
     upon a showing that--
       (A) no other existing satisfactory public safety channel is 
     immediately available to satisfy the requested use;
       (B) the proposed use is technically feasible without 
     causing harmful interference to existing stations in the 
     frequency band entitled to protection from such interference 
     under the rules of the Commission; and
       (C) use of the channel for public safety purposes is 
     consistent with other existing public safety channel 
     allocations in the geographic area of proposed use.

[[Page S6311]]

       (2) Applicability.--Paragraph (1) shall apply to any 
     application--
       (A) is pending before the Commission on the date of 
     enactment of this Act;
       (B) was not finally determined under section 402 or 405 of 
     the Communications Act of 1934 (47 U.S.C. 402 or 405) on May 
     15, 1997; or
       (C) is filed after May 15, 1997.
       (D) Protection of Broadcast TV Licensees During Digital 
     Transition.--Public safety and commercial licenses granted 
     pursuant to this subsection--
       (1) shall enjoy flexibility in use, subject to--
       (A) interference limits set by the Commission at the 
     boundaries of the electromagnetic spectrum block and service 
     area; and
       (B) any additional technical restrictions imposed by the 
     Commission to protect full-service analog and digital 
     television licenses during a transition to digital 
     television;
       (2) may aggregate multiple licenses to create larger 
     spectrum blocks and service areas;
       (3) may disaggregate or partition licenses to create 
     smaller spectrum blocks or service areas; and
       (4) may transfer a license to any other person qualified to 
     be a licensee.
       (e) Protection of Public Safety Licensees During Digital 
     Transition.--The Commission shall establish rules insuring 
     that public safety licensees using spectrum reallocated 
     pursuant to subsection (a)(1) shall not be subject to harmful 
     interference from television broadcast licensees.
       (f) Digital Television Allotment.--In assigning temporary 
     transitional digital licenses, the Commission shall--
       (1) minimize the number of allotments between 746 and 806 
     megahertz and maximize the amount of spectrum available for 
     public safety and new services;
       (2) minimize the number of allotments between 698 and 746 
     megahertz in order to facilitate the recovery of spectrum at 
     the end of the transition;
       (3) consider minimizing the number of allotments between 54 
     and 72 megahertz to facilitate the recovery of spectrum at 
     the end of the transition; and
       (4) develop an allotment plan designed to recover 78 
     megahertz of spectrum to be assigned by competitive bidding, 
     in addition to the 60 megahertz identified in paragraph (a) 
     of this subsection.
       (g) Incumbent Broadcast Licensees.--Any person who holds an 
     analog television license or a digital television license 
     between 746 and 806 megahertz--
       (1) may not operate at that frequency after the date on 
     which the digital television services transition period 
     terminates, as determined by the Commission; and
       (2) shall surrender immediately the license or permit to 
     construct pursuant to Commission rules.
       (h) Definitions.--For purposes of this section--
       (1) Commission.--The term ``Commission'' means the Federal 
     Communications Commission.
       (2) Digital television (DTV) service.--The term ``digital 
     television (DTV) service'' means terrestrial broadcast 
     services provided using digital technology to enhance audio 
     quality and video resolution, as further defined in the 
     Memorandum Opinion, Report, and Order of the Commission 
     entitled ``Advanced Television Systems and Their Impact Upon 
     the Existing Television Service,'' MM Docket No. 87-268, or 
     subsequent findings of the Commission.
       (3) Digital television license.--The term ``digital 
     television license'' means a full-service license issued 
     pursuant to rules adopted for digital television service.
       (4) Analog television license.--The term ``analog 
     television license'' means a full-service license issued 
     pursuant to 47 CFR 73.682 et seq.
       (5) Public safety services.--The term ``public safety 
     services'' means services whose sole or principal purpose is 
     to protect the safety of life, health, or property.
       (6) Service area.--The term ``service area'' means the 
     geographic area over which a licensee may provide service and 
     is protected from interference.
       (7) Spectrum block.--The term ``spectrum block'' means the 
     range of frequencies over which the apparatus licensed by the 
     Commission is authorized to transmit signals.

     SEC. 3004. FLEXIBLE USE OF ELECTROMAGNETIC SPECTRUM.

       Section 303 of the Communications Act of 1934 (47 U.S.C. 
     303) is amended by adding at the end thereof the following:
       ``(y) Shall allocate electromagnetic spectrum so as to 
     provide flexibility of use, except--
       ``(1) as required by international agreements relating to 
     global satellite systems or other telecommunication services 
     to which the United States is a party;
       ``(2) as required by public safety allocations;
       ``(3) to the extent that the Commission finds, after notice 
     and an opportunity for public comment, that such an 
     allocation would not be in the public interest;
       ``(4) to the extent that flexible use would retard 
     investment in communications services and systems, or 
     technology development thereby lessening the value of the 
     electromagnetic spectrum; or
       ``(5) to the extent that flexible use would result in 
     harmful interference among users.''.

  Mr. DOMENICI. 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. DOMENICI. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DOMENICI. Mr. President, this amendment is acceptable to the 
other side. It is the best we can do to try to achieve spectrum 
consistency with the Budget Act, and even with this amendment, we are 
somewhat short.
  Senator McCain does not insist on speaking. If he does, we yield to 
him right now.
  The PRESIDING OFFICER. The question is on agreeing to the amendment.
  Mr. BYRD. Mr. President, what does the amendment do?
  Mr. DOMENICI. Mr. President, this substitute amendment for title III 
offered by Senator McCain, Senator Lott, and myself, will help the 
committee get $4 billion closer toward its instruction on spectrum 
fees, and it does this without any fees. It has been approved by the 
Commerce Committee on both sides, Democrat and Republican, and there is 
no objection from the minority side with reference to this amendment.
  The PRESIDING OFFICER. The question is on agreeing to amendment No. 
474, as modified.
  The amendment (No. 474), as modified, was agreed to.
  Mr. LAUTENBERG. Mr. President, I move to reconsider the vote by which 
the amendment was agreed to.
  Mr. DOMENICI. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. DOMENICI. Can I ask the minority, there is a D'Amato amendment we 
are asking if you can clear. We are getting close to the end here.
  Mr. LAUTENBERG. We will accept that.


                           Amendment No. 502

  Mr. DOMENICI. I ask the D'Amato amendment No. 502, Medicare 
antiduplication provisions, be called up. We have agreed with the 
minority and they with us that this is acceptable.
  The PRESIDING OFFICER. Without objection, the amendment is agreed to.
  The amendment (No. 502) was agreed to.
  Mr. LAUTENBERG. Mr. President, I move to reconsider the vote by which 
the amendment was agreed to.
  Mr. DOMENICI. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. DOMENICI. Mr. President, according to our records, we have four 
amendments, but they are all waiting to see what the managers' 
amendment includes in it. If it includes the proper subject matter, 
then there will not be a presentation of those four amendments. So I 
think the managers are working on that, and maybe we need a little bit 
of time while they finish it, and the four Senators can look at it to 
see if it takes care of their concerns.
  The PRESIDING OFFICER. The regular order is the Kennedy amendment No. 
492.
  Mr. DOMENICI. Yes, that is correct.
  Senator Kennedy desires to withhold his amendment to see what the 
managers' amendment does; is that correct?
  Mr. LAUTENBERG. Yes.
  Mr. DOMENICI. Senator Kerry's amendment No. 496. I gather that you 
want to wait.
  Mr. LAUTENBERG. Senator Kerry wants to wait and see what the 
managers' amendment does.
  Mr. DOMENICI. And Senator Rockefeller's amendment No. 503, we believe 
the same holds, and Senator Kennedy's amendment regarding part B.
  Might I discuss a few matters with the ranking minority member? I 
believe when we finish this, we will be finished with amendments. The 
only thing I can imagine left would be points of order to be lodged by 
anyone. We have none on our side.
  Mr. LAUTENBERG. Mr. President, we have five in total that we will be 
happy to show the majority. I think Senator Murray has a point of 
order, and then we have the four remaining.
  Mr. DOMENICI. I wonder if the time would be best spent if you let us 
see those. Maybe we can dispose of those and maybe agree we not have 
any votes, depending on what they are.

[[Page S6312]]

  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. DOMENICI. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Coats). Without objection, it is so 
ordered.


                           Amendment No. 506

  Mr. DOMENICI. I understand that the chairman of the Finance Committee 
is ready with the managers' amendment, and I yield the floor. The 
amendment is numbered 506.
  The PRESIDING OFFICER. The Senator from Delaware.


                   Modification to Amendment No. 506

  Mr. ROTH. Mr. President, I ask unanimous consent that amendment No. 
506, the managers' amendment, be called up, and I send a modification 
to the desk.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Under a previous order, the Senator has a right to modify his 
amendment, and the amendment is so modified.
  The modification follows:
       At the end of the amendment, add the following:
       On page 774, strike lines 13 through 15, and insert the 
     following:
       ``(A) for fiscal year 1999, 92 percent;
       ``(B) for fiscal year 2000, 85 percent; and
       ``(C) for fiscal years 2001 and 2002, 80 percent.
       On page 775, strike lines 21 through 25 and insert the 
     following:
       ``(C) States with state 1995 dsh spending amounts above 3 
     percent.--In the case of any State with a State 1995 DSH 
     spending amount that is more than 3 percent of the Federal 
     medical
       On page 779, line 10, strike ``2000'' and insert ``2001''.
       On page 779, line 11, strike ``2001'' and insert ``2002''.
       On page 779, line 10, strike ``2002'' and insert ``2003 and 
     thereafter''.

  Mr. ROTH. Mr. President, the managers' amendment with the 
modification has been approved on both sides of the aisle. I urge its 
adoption.
  Mr. BYRD. Mr. President, could someone explain what is in the 
managers' amendment?
  Mr. ROTH. Yes, I am happy to explain to my distinguished friend from 
West Virginia. It includes two Medicare hospital-related provisions. 
The first is a modification to the Medicare PPS, exempt hospital 
payments, and the second is a hospital wage index classification.
  The second makes three additions to the Medicaid provisions. These 
include a Grassley amendment that was adopted in committee on the 
effect of managed care on individuals with special needs, a 
clarification on the definition of provider taxes, and continuation of 
certain 1115 waivers. There are four provisions on welfare, 
clarification of the language on SSI, and Medicaid benefits of certain 
Indians. It makes a conforming amendment on work activities, and it 
confirms the maintenance-of-effort requirement to the existing welfare 
block grant. It also requires that half of the payments for job 
placement be provided after an individual has been placed in the work 
force for at least 6 months.
  Finally, the modification to the managers' amendment also modifies 
the formula for achieving savings in the Disproportionate Share 
Hospital Program. The amendment provides a smoother transition for the 
States and delays the restrictions on payment to mental health 
facilities.
  As I said, Mr. President, all these amendments have been cleared by 
both sides of the aisle. I urge their adoption.
  Mr. MOYNIHAN. Mr. President, may I simply affirm the statement of the 
distinguished chairman. These are agreed to on both sides of the aisle.
  The PRESIDING OFFICER. Is there further debate on the amendment as 
modified?
  Mr. BYRD. Mr. President, I am not on the Budget Committee, I am not 
on the Finance Committee, but I do have a right to have a little 
knowledge of what we are voting on. By my not being a member of those 
committees--it might very well be stated as to what we are voting on--I 
may yet not understand it, but there are Senators in this body who can 
understand. It seems to me we are going a little fast.
  Is this amendment divisible?
  The PRESIDING OFFICER. In the opinion of the Chair, the amendment 
would be divisible.
  Mr. BYRD. How many divisions would there be?
  The PRESIDING OFFICER. There would be numerous divisions because the 
amendment hits the bill in a number of diverse places. We are 
attempting to assert the exact number.
  The Senator from West Virginia is recognized.
  Mr. BYRD. I yield to the distinguished Senator.
  Mr. DOMENICI. Might I say to the distinguished Senator from West 
Virginia, I think you have been in this position and the position of 
this chairman many, many times. I do not know whether we ever have a 
chance to be in exactly this position when we have a reconciliation 
bill like this.
  I might say, I think this amendment fits together a lot of concerns 
and fulfills a lot of concerns about the bill by many, many Senators. I 
hope the Senator would not ask for its division, but rather ask us to 
spend more time discussing it, which I believe, even though the consent 
agreement says a minute on a side, I think you might be clearly within 
your rights to say: This is a managers' amendment. Could we have some 
additional time? Certainly I would not object.
  I objected one time in my life to giving the distinguished Senator 
from West Virginia additional time when time had run out, and I vividly 
remembered that for at least 5 years. It seemed like every time you 
looked at me it was reminding me that I had jumped up and objected to 
your getting time, additional time. I have never done that again, so I 
would not do it now.
  I just wonder if that makes any sense to my friend from West 
Virginia.
  Mr. BYRD. Mr. President, let me attempt to respond to the 
distinguished Senator.
  I have a sense of what my responsibility is. I do not know what is in 
the managers' amendment. I have understood, in listening here, that 
there are various Senators who have amendments which are qualified and 
which are listed that they will call up unless the managers' amendment 
is satisfactory to them in respect to their several amendments.
  Now, if each amendment is called up, we at least get 2 minutes for an 
explanation. We get no explanation here of what is in this managers' 
amendment. It is not my desire to hold up action on this measure. It is 
somewhat embarrassing to me to have to stand and admit that I don't 
know what is in this amendment. I have voted on amendments today that I 
had very, very slender knowledge as to what I was voting on.
  I am not blaming anyone for this. I am not saying this to be critical 
of anyone. But I am concerned that here we are, before the American 
people, and it should be obvious to anyone who is viewing these actions 
that we are taking that many of us do not know what we are doing, what 
we are voting on, and these are very complex amendments. This is a very 
complex bill.

  We are at a great disadvantage because we have only 20 hours on a 
reconciliation measure. I tried last year to get 50 hours on a 
reconciliation bill, and I believe I got a majority of votes, but I 
believe I lost because it ran afoul of the Byrd rule. Therefore, it 
required 60 votes. Thank heavens for the Byrd rule.
  But, Mr. President, I do have a duty to my own conscience, if to no 
one else, and I am pretty sure I have a great duty to my constituents, 
to try to find out what's in the amendment we are about to vote on. In 
doing so, I am holding up the measure, I am delaying action on this 
measure. I am very well aware of it.
  I know the burdens that are upon the leadership, the joint 
leadership. I know the burdens that are on the managers of this bill. 
I, at least, have some idea. They have done well. They have had heavy 
burdens. They have spent hours, they have spent hours when I was at 
home with my wife, Lady Byrd, and my little dog, Billy Byrd. But they 
have spent hours. I saw them working here last night. I cannot 
understand a great deal in watching that tube as to what is at issue 
here.
  So I am considering asking for a division here. I think we have to 
shock this Senate one way or another into a realization that we have to 
change the rules with regard to reconciliation so that Members will 
have more time

[[Page S6313]]

than we have. Here we are, we have run out of time, yet Senators have 
amendments that they want votes on. It is by unanimous consent that we 
have 2 minutes of explanation between each amendment. That is no way to 
operate.
  I cannot help it, Mr. Domenici cannot help it, Mr. Lautenberg cannot 
help it, the two leaders can't help it. That's the rule, 20 hours.
  There are Senators who insist on having votes on their amendments, 
and I think they have a right to have votes on their amendment. We are 
constrained by a rule here that just does not make sense. It may have 
made sense at one time. It does not anymore. We are living at a 
different time when we are under severe budget constraints and when the 
administration and the leadership enter into some kind of agreement of 
which I am not a part and about which I know little, other than what I 
read in the newspaper.
  So I have taken the floor here today to call attention to this very 
sad situation in which we are expected to vote on something without 
knowing what we are voting on. As I say, we are caught on the horns of 
the dilemma, and I do not feel right within myself about raising these 
points of concern.
  Now, the distinguished manager of the measure has suggested that we 
have an explanation of the amendments. That is all I am seeking in this 
instance. But I think we ought to get our collective heads together and 
try to work out some change in the rules whereby we will not be caught 
in this kind of situation.
  The American people would be ashamed of us. I think they would be 
very disappointed, and disappointed in me, too. They sent me up here to 
represent the people of West Virginia, and I don't know what I am 
voting on here. Who can blame me? My staff can't find out overnight. 
This morning when I came in, some of my staff stayed late into the 
evening hours. When I came in this morning, they didn't have the 
amendments available. They hadn't been printed. We just can't operate 
wisely and with any kind of solid judgment in that fashion.

  So I won't take more of the Senate's time now. But I do raise the 
specter of asking for a division, and a request for a division under 
the rules means that we vote on every divisible provision in that 
measure. And if I understood the Chair in response to my parliamentary 
inquiry, there must be scores of provisions which would be subject to 
division.
  I am not going to put the Senate through that today, but I warn the 
Senate that we had better do something about this because, otherwise, 
some Senator is going to feel conscience-stricken enough one day to 
stand up and use the rules, and there are some Senators who know 
something about the rules. So I raise that question here just to put 
Senators on notice that one Senator--one Senator--can cause all 
Senators to sit back and realize what we are doing and the way we are 
doing it is not good, not good for the Senate, not good for the 
American people.
  Mr. DOMENICI. Will the Senator yield?
  Mr. BYRD. Yes, I will be happy to yield.
  Mr. DOMENICI. Mr. President, I could not agree with the Senator more. 
But I think we have followed the rules--the general rules of the Budget 
Act, plus the Byrd rule interpretations--as best we can. I think 
everyone should know that one of the problems on any reconciliation 
bill is that when the time has run, people can still offer amendments. 
That is written right into the statute. It says that when the time has 
run, you can send amendments to the desk, and I assume one could stay 
forever--I don't mean literally--and they shall be voted on then and 
there. I believe it says there is no time on the amendment. We have 
gone from allowing 1 minute to 2 minutes to 3 minutes per amendment. We 
decided we would allow Senators to offer their amendments last night, 
thinking they would stay and offer them. We got caught in a trap 
because Senators started walking up to me and Senator Lautenberg and 
giving us their amendments and asking us, as managers, to introduce 
them for them. I guess I could have said no, and the literal 
interpretation would have been that if you are not going to be around 
here, you are not going to offer them.
  That was the genesis of what happened this morning. We put them all 
in order and tried to encapsulate them so you could understand them, 
and there were 64 of them, plus a couple of points of order. So we have 
done the best we could. As a matter of fact, I am very grateful. I 
would guess that more than 30 amendments were withdrawn--maybe 35. 
Others were clearly very simple amendments, and maybe in adopting them 
we should have used a little more words of explanation than we did. If 
that is the case, as to any Senator or anybody listening, we will just 
try to do better. But that situation is the law.
  Now, the law is, as you say it also. You can still divide those 
amendments and have that minute on every one, I assume. You know the 
rules better than I. I have learned them a little bit now. But I 
believe, from this point on, we only have a few left. We would be very 
glad on this one--I asked the chairman, and he would be glad to explain 
it now as much as you would like and answer any questions. I understand 
we would only have a few more, and three or four points of order, and, 
finally, this ordeal will be behind us. Again, you have reminded us of 
our responsibility. I thank the Senator for that.
  Mr. BYRD. Mr. President, I don't need to remind the distinguished 
Senator from New Mexico of his responsibility or any other Senator of 
his or her responsibility. As I said earlier, I am not complaining 
about anyone. I sympathize and empathize with the managers of the 
measure. They have done the best they could. You can't do any better. 
We have all been caught in this situation. It is not to our liking. But 
the distinguished manager, the chairman of the Finance Committee, 
sought to explain to me a minute ago, in 2 minutes, what was in this 
managers' packet. I didn't know anything, and when he completed, I 
didn't know any more than when he started. As a matter of fact, I was 
probably more confused. I think we would have had a little better 
explanation if we had a division and had each amendment explained.
  Mr. LAUTENBERG. If the Senator will yield, I would like to make a 
comment. When Senator Byrd makes a statement, talks about a rule, talks 
about the process, I think it is kind of like the investment banker's 
advertising slogan that ``when they talk, everybody listens.'' When 
Senator Byrd speaks here, everybody listens, and much of the country at 
the same time, because of the experience and knowledge that he brings 
to this body and the concern that he has for being forthright with our 
constituents.
  I would just like to say this to the Senator. There was a degree of 
diligence--excessive haste, I agree. I will say one thing. I think that 
we appropriately learned a lesson about the process of stacking votes. 
I even suggested to the distinguished Senator from West Virginia that 
perhaps another Byrd rule could be put into place. I don't have the 
courage to offer it in my own name. But another Byrd rule might say 
that no more than 5 amendments, or 4 or 5 votes, or something like 
that, could be stacked at any time so that we would not get ourselves 
into this mad dash not to deceive and not to obscure, but rather to 
accommodate this very complicated process.

  As the Senator from West Virginia knows, the Senator from New Mexico 
and I spent roughly 2 months, almost every day, reviewing and 
negotiating the points in the budget agreement. We tried--I speak for 
myself, and I am sure the same situation occurred on the Republican 
side of the aisle--to keep our members on the committee informed 
because, as the distinguished former chairman of the Appropriations 
Committee knows, it is very hard to conduct an honest negotiation and 
debate when there are 20 people in the room. So what we tried to do is 
consolidate a consensus view and do it that way. So we met with the 
committee members and then we met with the members of the Democratic 
Caucus, because there were questions that arose.
  So I have to say this to the distinguished Senator. In my 15 years 
here, I honestly don't think that there has been a tighter review of 
matters related to the budget resolution than I have seen, because I 
have been on the Budget Committee almost all of the time that I have 
been here. We kept learning

[[Page S6314]]

each year. I found the chairman of the Budget Committee, the Senator 
from New Mexico, good to work with. We had lots of different views, but 
the one thing that we didn't differ on is that the other person had a 
right to respect, a right to offer their opinion, and we did it that 
way. It got tedious at times, especially when one could not listen to 
one's self. On the other hand, we did gain, seriously, a lot of 
knowledge during that period.
  I would say this. As I look around the room, we have experts in 
specific areas. If you want to talk about health, you know you would be 
talking quickly to the Senator from Massachusetts, and others on 
different matters of concern. And these matters were reviewed, not 
perhaps as thoroughly as we would have liked because we were committed 
to a time constraint overall. But, last night, I was here with the 
distinguished chairman of the Finance Committee until past 10 o'clock--
about 10:30--and we were hung up on a single amendment, reviewing it 
and trying to get into a position that we felt would satisfy our 
respective constituencies in the Senate, and back home, and across the 
country, as well. So the effort was put in.
  I think there is a mistake in the process, or a fault in the process, 
that needs to be corrected. I thank the Senator for raising the issue 
because, in these last hours, I have heard complaints from other 
Members of the Senate, as well, about this being too quick, too rushed. 
But we had a commitment. This is an unusual budget, a budget committed 
to a goal of zero deficit in 5 years. A lot was packed into it. The 
negotiations included members of the administration. It has been a very 
complicated, very tedious process, but no one, in my view shirked their 
responsibility.
  I hope that, from this point forward, we will remember another Byrd 
lesson. I remember many of them. Despite my white hair, I feel like I 
am going to ``professor'' Byrd's class when I do attend appropriations 
meetings or other meetings. I would say this, ``professor": I don't 
know what kind of a report card I have gotten, but I hope that it is 
better than a failing one and that you will say, OK, go forward and 
learn from this and next time I want to see a better performance. Thank 
you very much.
  Mr. BYRD. Mr. President, I don't propose to have the answer to this 
problem. But it just seems to me that we are always caught up against a 
holiday, where we have a break the next week. And here we have this 
bill, and we will have the tax portion of the reconciliation process 
that will follow after that. And we are asked to cut a little of the 
time off here, cut a little off there. It would seem to me that if we 
could get started on these measures earlier, we would not be faced with 
a situation in which the managers have to stay here far into the 
evening hours, while other Senators go home. It seems to me that if we 
had been able to get to this measure earlier, we could have had more 
time. But here we are, and it seems to work out this way upon every 
occasion, where we are backed up to a wall of some kind, where there is 
the attempt to cut 20 hours down to 15, 12, or 10, or an attempt to cut 
50 down to 40 on the budget resolution. We always get the question, 
``Would you be willing to cut some time off of the 40 hours, cut it 
down to 30?'' ``Would you be willing to go home and come back Monday 
and say that 15 of the hours, or 10 hours, or 20 hours have been 
consumed?'' So I suppose these situations could be avoided.
  Let me get down to the point. Would someone explain what is in this 
amendment? As I explained, four or five Senators had amendments that 
they wanted to call up, but they were waiting to see what was in the 
managers' amendment. Those amendments must have been pretty important; 
otherwise, if they weren't in the managers' amendment, there would be a 
vote on each, some kind of vote, a vote by voice, a vote by division, 
or a vote by rollcall. There would be a vote and an explanation. 
Perhaps if we knew what was in those four or five major amendments, 
that would help.
  Mr. REID. Will my friend yield?
  Mr. BYRD. Yes.
  Mr. REID. I say this to my friend from West Virginia and to the two 
managers of the bill. Speaking from my perspective only, I think that 
the explanations that have been given in 1 minute have been quite good. 
I am glad that the Senator from West Virginia asked for that, because I 
felt pretty comfortable voting on each amendment. I say this to my 
friend from West Virginia. If we look down the road to making this 
process better, we are not going to improve it by adding hours; we are 
going to improve it by making sure that amendments are offered before 
we finish the debate. If we have 50 hours, people are still going to 
offer all of these amendments at the end, if you have a loophole like 
this. I look forward to improving the system, but that we do it in 
whatever hours we have, and amendments should be offered during that 
time.
  Mr. BUMPERS. Mr. President, will the Senator yield?
  Mr. BYRD. Yes.
  Mr. BUMPERS. Mr. President, we are all speaking here at the 
indulgence of the managers of the bill because there is no time left on 
this bill. I will not delay it for long.
  First, I want to say that I have never been as happy with my decision 
not to seek reelection as I have been today. I have been voting on 
amendments that involve billions of dollars today with only a 
superficial or cursory knowledge of what I was voting on. I would not 
like to go home--and I don't speak for the rest of you but I expect I 
am speaking for the rest of you, too--I would hate to have to go home 
and explain to people what was involved in all of these amendments, 
particularly this one which I do not have a clue about.
  But we must not lose sight of the point that the distinguished 
Senator from West Virginia made in the opening part of his statement a 
moment ago. That is, it is the rule that is the tyrant here with 20 
hours to debate this part of the reconciliation bill and 20 hours to 
debate the tax portion of it, which is monumental and most probably 
will be the most significant important legislation we will deal with 
all year--20 hours. We will wind up at the end of that 20 hours 
precisely the way we have with this one. There will be a long list of 
amendments down there. Maybe we will have another unanimous-consent 
agreement where you are allowed 60 seconds to explain a bill that 
involves $10 billion.
  We are not doing the people of this Nation a service as long as we 
allow this kind of a rule to put us in this kind of a straitjacket 
where we have to get up and openly confess that this system is not 
working as it ought to.
  So, I applaud the Senator from West Virginia for his comments. He is 
right on target. Fifty hours ought to be a minimum for the 
consideration of a reconciliation bill.
  I thank the Senator for making everybody aware of our shortcomings on 
this day.
  Mr. BYRD. I thank the Senator.
  Mr. President, I do not want to hold the floor longer. I apologize to 
the managers of the measure for imposing on them.
  Is there some way that the distinguished Senator from New Mexico or 
the distinguished Senator from New Jersey can enlighten Senators as to 
what is in this managers' amendment--particularly, if I may say, with 
reference to the four or five amendments that have qualified and were 
being held back to see if the managers' amendment took care of those 
amendments?
  As I understood it, Mr. Kennedy had one amendment.
  Mr. DOMENICI. On those four amendments we will try, if the chairman 
of the Finance Committee will explain, we will try to ask the Senators 
the relationship. It is not obvious on two of them that they are 
related at all, from what I could see. I think they were just trying to 
see how these major health matters are going to get clarified here, 
which is not in this amendment. I don't believe they are even in this 
amendment. So we will find that out, and before we vote, we will try to 
have an explanation.
  Mr. BYRD. All right.
  Mr. DOMENICI. Would the chairman like to explain in the best way 
possible what is in the amendment?
  Is that what we would like to do next?
  Mr. BYRD. That is what I would like.
  May I say to the distinguished leader that he is frustrated with this 
process also. He said to me earlier today that we have to find some 
better way.
  I do not want to be a part of a problem. I am hoping we can at least 
get some response from those who understand what is in the amendment so

[[Page S6315]]

that the rest of us will at least go home feeling we did our best in 
understanding it and that we at least made it clear that something is 
wrong with the way the process is working.
  Mr. DOMENICI addressed the Chair.
  The PRESIDING OFFICER. The Senator from New Mexico.
  Mr. DOMENICI. Mr. President, I want to yield all of the time to the 
chairman of the Finance Committee. But I do want to make one statement.
  My friend from Arkansas said, I guess, that today made him happy that 
he would soon stop being a Senator.
  Let me make sure, if there are only six people listening on 
television, that this Senator would like to say that it makes me very 
proud what we are doing here. I am very proud of this bill. I am very 
proud of the balanced budget. I am very proud of how we got here and 
what we are doing here.
  Frankly, if things keep going as well as this, I may break all 
longevity and stay here for a lot longer.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Delaware.
  Mr. ROTH. Mr. President, if I may say so, I am encouraged very 
greatly by the news that the Senator from New Mexico will stay as long 
as possible, as does our distinguished friend and leader from West 
Virginia.
  I say to my good friend from West Virginia, as he well knows, in 
every major piece of legislation there are a lot of technicalities and 
complexities involved in the legislation. In the efforts to draft them 
and put them in final shape, it becomes necessary to have a number of 
technical modifications at the end.

  I would also say that in developing this legislation, it has been my 
intention to work with everyone, both in committee and on the floor. We 
have tried to include everybody--Republican, Democrats, senior Members, 
and junior Members.
  So I think the process has been all-inclusive. Basically, what we 
have here in the so-called managers' amendment is sort of a cleanup of 
a number of matters that had to be modified to make them technically 
correct to take care in some cases of some of the concerns of 
individual Members. Each of these have been reviewed very carefully by 
the technicians who understand it.
  I think part of the problem is that these are very complex matters 
that aren't easy to explain or even to understand. But let me point 
out, for example, that in the managers' amendment, the first section 
that deals with what is known as ``PPS-exempt'' hospital changes, it 
deals with technical changes as to how they are reimbursed.
  For example, the first says strike the update formula and substitute 
with a zero; update for fiscal years 1998, 2001, and market basket, 
minus 3 percent in 2002.
  In trying to reach the $115 billion savings that we are supposed to 
make in Medicare, we reduce payments to the providers. Normally the 
reimbursement each year reflects the cost-of-living or inflation. But 
in this particular case, in order to make savings and because the 
hospitals are doing reasonably well, we are reducing the reimbursement.
  It is that kind of technical change that much of this deals with.
  In another situation, we are--again in efforts to save money--
reducing what is known as disproportion payment and we have based the 
recommendations on what an independent commission has recommended, and 
I might say that is what the administration has recommended as well. 
These, again, are all basically very technical.
  But going back to the reduction of the disproportion, because both 
Democrat and Republican Members were concerned about reducing as much 
as was recommended by this independent board, we have slowed that 
phase-in a little bit to make it easier for those organizations to 
adjust.
  So essentially I would say it is this kind of technical change that 
we are trying to deal with here rather than major policy.
  I assure you that we have dealt with both managers--the Republican 
manager, the Democrat, and, of course, I might say that we have been 
working very closely with my good friend and colleague, Pat Moynihan.
  Mr. MOYNIHAN. You most assuredly have, sir.
  Mr. ROTH. So I don't have any disagreement with our distinguished 
friend and leader as to the whole process, but we have in good faith 
tried to deal with the process and meet the time schedules that 
everybody has wanted us to achieve.
  I could go on and read all of these, if you like, sir. But I will say 
they are highly technical.
  The first one, I might point out, included two Medicare hospital-
related provisions. As I said, the first is a modification as to how we 
reimburse what are called Medicare PPS-exempt hospitals. A PPS hospital 
is paid on a prospective payment basis. That was a means that was 
adopted many years ago to try to gain better control of expenditures 
than you have when you have cost reimbursements. The hospital knows 
that for a certain kind of function, they will be able to receive so 
much money--say, $1,000. And they know they have to live within that. 
So they have an incentive to try to keep those costs down. But now we 
are cutting because we have to make greater savings. The hospitals, 
according to our independent panel, are doing relatively well, and we 
are trying to cut it more.
  The second is a hospital wage index classification and reimbursement. 
We deal or address the wage index, and a highly technical modification 
takes place there.
  So, as I say, they are this kind of technical change basically in an 
effort to make legislative language accurate and achieve the goals that 
were intended by the policy.
  Mr. BYRD. Mr. President, the distinguished Senator is certainly doing 
everything that he can in the best of faith to try to explain some 
things about this amendment. I am sure this could go on quite a long 
time. It is not that kind of detail that this Senator is seeking.
  Let me say again that I am not accusing anyone of acting in bad 
faith. Everybody is acting in good faith.
  May I ask the distinguished manager of the bill: What were the four 
amendments that I understood Senators were holding back on to see what 
was in the managers' amendment? If we could have some indication of 
what they were about, that would be satisfactory with me.

  Mr. DOMENICI. Sure.
  Let me say, Mr. President, to the Senator from West Virginia that 
there was a Hutchison amendment. It had to do disproportionate share of 
payments to hospitals, and there is a modification of that which had 
adversely affected Texas that is apparently somewhat ameliorated there. 
Senator Specter had the exact issue, and he had a disproportionate 
share of payments amendment. He is part of this overall agreement that 
is in this managers' amendment.
  Then there was a Bob Kerrey abortion amendment that had nothing to do 
with this amendment. But I asked him to wait for the managers' 
amendment before he did something on it.
  I assume that Senator Murray is going to make the point of order on 
that issue. But I am not certain of that.
  Mr. KERREY. That is close enough. There was actually a modification 
that requires me to wait before I offer my amendment. Otherwise I will 
have to offer it twice.
  Mr. DOMENICI. OK. Unless he waits for that, he will have to offer it 
again.
  Then there was a Senator Kennedy uninsured children's amendment that 
also seems unrelated. But he indicated that he would like to wait and 
see what happened to this amendment.
  That was the four that I mentioned.
  I think that is the full stint of those amendments and the stories 
behind them.
  I yield the floor.
  Mr. BYRD. Mr. President, I thank all Senators, particularly the 
managers of the bill, the Senator from Delaware, and also the 
distinguished Senator from New York [Mr. Moynihan]. I thank them all. I 
thank all of them.
  I don't have any other questions to raise. I will not ask for a 
division. Senators have certainly done the best they could to go as far 
as they could in answer to this Senator's frustration. That is what we 
are talking about. We are all frustrated. It is the rule, and we ought 
to try to find some way to change it. I don't have any quarrel with any 
Senator in particular.
  I thank all Senators.

[[Page S6316]]

  The PRESIDING OFFICER. The pending question is the amendment, as 
modified, No. 506.
  Is there further debate? If not, the question is on agreeing to the 
amendment.
  The amendment (No. 506), as modified, was agreed to.
  Mr. LAUTENBERG. Mr. President, I move to reconsider the vote by which 
the amendment, as modified, was agreed to.
  Mr. DOMENICI. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  The PRESIDING OFFICER. The Senator from New Mexico.
  Mr. DOMENICI. Now, Mr. President, do we have the child health 
amendment ready?
  Mr. JEFFORDS. Mr. President, I believe we are all set with a colloquy 
that has clarified the language.
  Mr. DOMENICI. I would like to proceed with that. We are very, very 
close to having no amendments left except a Murray point of order and a 
Kennedy point of order.
  Mr. KENNEDY. Mr. President, if is agreeable with the floor manager, I 
would call up our Medicare home health benefit transfer from part A to 
part B and proceed with that.
  Mr. DOMENICI. I say to the Senator, I was trying, if I could, to get 
one amendment before you, but if it is not ready, we will go right to 
you.
  Mr. KENNEDY. That is all right. We are here so we will accommodate 
whatever.
  Mr. DOMENICI. Mr. President, the amendment, which is a product of 
many Senators on both sides, with reference to child health is not 
ready. Therefore, we would like to move to the point of order either by 
Senator Murray or Senator Kennedy.
  Is Senator Murray ready?
  Mrs. MURRAY addressed the Chair.
  The PRESIDING OFFICER. The Senator from Washington is recognized.


                             Point of Order

  Mrs. MURRAY. Mr. President, I make a point of order that section 
1949(a)(2) of this act violates section 313(b)(1)(A) of the 
Congressional Budget Act.
  Mr. President, as an appropriator, I object to the language included 
in this legislation by the Finance Committee that would make permanent 
a prohibition against Medicaid managed care funds being used for 
abortion services except in the cases of rape, incest, or where the 
woman's life is in danger. This is, for all intents and purposes, a 
permanent extension of the so-called Hyde amendment that has been 
included in every Labor-HHS and education appropriations bill since 
1987. A reconciliation bill is not the proper vehicle for major 
abortion policy decisions. This is not how Congress has traditionally 
dealt with such decisions, and this is not how we should begin to deal 
with such decisions.
  I know that some of my colleagues disagree----
  Mr. LAUTENBERG. If the Senator will yield, Mr. President, this place 
is not in order. It is terribly unfair to the Senator. Her voice is 
soft, and we ought to make sure that we can hear it. She has an 
important message for all of us, and I resent the fact that people are 
talking and laughing and doing what they are doing.
  Please, Mr. President, let us get order.
  The PRESIDING OFFICER. Before the Senator from Washington proceeds, 
let me ask all Senators, if they would, to please take their 
conversations to the Cloakroom and give the Senator from Washington the 
courtesy of everyone hearing her remarks.
  Mr. DOMENICI. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The absence of a quorum is suggested. The 
clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. DOMENICI. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DOMENICI. I might explain to the Senators the reason for the 
delay and the quorum call is that we are discussing with Senator 
Murray, with reference to a point of order, we are discussing exactly 
what it means and what it doesn't mean, and she has requested that we 
set it aside pending further discussion. So I so propose a unanimous-
consent request to the Senate.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered.
  The point of order will be set aside.


                           Amendment No. 504

  Mr. DOMENICI. I understand Senator Kennedy has two remaining 
amendments. One has to do with home health care and the trust fund. I 
believe he is going to take that up now.
  The PRESIDING OFFICER. The Senator from Massachusetts is recognized.
  Mr. KENNEDY. Mr. President, if we could have the attention of the 
Senate.
  The PRESIDING OFFICER. The Senate will be in order.
  Mr. KENNEDY. Mr. President, this amendment would speed up the agreed-
upon transfer of a portion of the Medicare home health benefit from 
part A to part B. This acceleration would extend the solvency of the 
Medicare trust fund by 2 years. It would not affect the deficit or 
seniors' premiums. We have maintained in our amendment that the 
premiums that have been agreed to would be maintained, or it would not 
affect the total amount of the benefit ultimately transferred.
  It is strictly a bookkeeping transaction, but it will help save 
Medicare. It extends the solvency of the Medicare Program by 2 years. 
It was in the President's budget. It is a desired outcome for those who 
are interested in the financial security of the Medicare trust fund. We 
debated the stability and the security of the Medicare trust fund at 
length yesterday. This is a way of extending it by 2 years.
  The PRESIDING OFFICER. Is there further debate on the amendment?
  Mr. DOMENICI. I yield time in opposition to Senator Roth, chairman of 
the Finance Committee.
  The PRESIDING OFFICER. The Senator from Delaware.
  Mr. ROTH. Mr. President, I object to the amendment. We are 
transferring, over 7 years, home health care to part B, but we want to 
do it in seven segments because it is agreed that the beneficiaries 
should continue to pay 25 percent of the cost of the part B services. 
We do not want to put it all over the first year because we do not want 
to raise the premiums that rapidly.
  So in order to be consistent, what we provide in the legislation is 
that the home health care will be transferred over 7 years. Each year 
an additional seventh will be included in the cost of the premium, so 
that will make the phasein much lower.
  The PRESIDING OFFICER. Is there further debate?
  The Senator from New Mexico.
  Mr. KENNEDY. Mr. President, do I have any further time?
  The PRESIDING OFFICER. Both sides have used their allotted time.
  Mr. DOMENICI. Mr. President, I make a point of order that the Kennedy 
amendment violates the Budget Act in that the amendment is subject to 
the Byrd rule.
  Mr. KENNEDY. Mr. President, I move to waive the point of order as 
made.
  The PRESIDING OFFICER. The question is on agreeing to the motion to 
waive the point of order. All those in favor say yea.
  Mr. KENNEDY. I ask for the yeas and nays, Mr. President.
  The PRESIDING OFFICER. The yeas and nays have been requested. Is 
there a sufficient second? There is a sufficient second.
  The yeas and nays were ordered.


                 Vote on Motion to Waive the Budget Act

  The PRESIDING OFFICER. The question is on agreeing to the motion to 
waive the Budget Act. The yeas and nays have been ordered. The clerk 
will call the roll.
  The bill clerk called the roll.
  The yeas and nays resulted--yeas 38, nays 62, as follows:

                      [Rollcall Vote No. 127 Leg.]

                                YEAS--38

     Akaka
     Bingaman
     Boxer
     Breaux
     Bryan
     Bumpers
     Byrd
     Cleland
     Conrad
     Daschle
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Ford
     Glenn
     Graham
     Harkin
     Inouye
     Johnson
     Kennedy
     Kerry
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Murray
     Reed
     Reid
     Robb
     Rockefeller
     Sarbanes
     Torricelli
     Wellstone
     Wyden

[[Page S6317]]



                                NAYS--62

     Abraham
     Allard
     Ashcroft
     Baucus
     Bennett
     Biden
     Bond
     Brownback
     Burns
     Campbell
     Chafee
     Coats
     Cochran
     Collins
     Coverdell
     Craig
     D'Amato
     DeWine
     Domenici
     Enzi
     Faircloth
     Frist
     Gorton
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Hatch
     Helms
     Hollings
     Hutchinson
     Hutchison
     Inhofe
     Jeffords
     Kempthorne
     Kerrey
     Kohl
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Moseley-Braun
     Moynihan
     Murkowski
     Nickles
     Roberts
     Roth
     Santorum
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner
  The PRESIDING OFFICER. On this vote, the yeas are 38, the nays are 
62. Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected.
  The point of order is sustained and the amendment falls.
  Mr. LAUTENBERG. Mr. President, I move to reconsider the vote.
  Mr. LOTT. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           amendment no. 504

  Mr. SPECTER. Mr. President, I have sought recognition to explain my 
views concerning the Kennedy amendment 504, which would have 
immediately transferred to Medicare part B the home health benefits 
currently paid for under the Medicare part A trust fund.
  Payment for home health care is made from the part A trust fund for 
home health services such as part-time or intermittent nursing care 
provided by or under the supervision of a registered nurse or home 
health aide.
  To protect the solvency of the part A trust fund, the bill shifts 
some of the home health costs on a 7-year phased-in basis from part A 
to part B.
  The budget reconciliation bill reflects a careful compromise on 
protecting the solvency of the part A trust fund for all seniors 
without unduly burdening the taxpayers. Under the Kennedy amendment 
some of the bill's fiscal protections would have been dropped, and 
taxpayers would have effectively funded 100 percent of the home health 
services in fiscal year 1998, which would be unprecedented under 
Medicare. In my judgment that goes too far and adversely affects the 
present preferable balance.
  The PRESIDING OFFICER. The majority leader.
  Mr. LOTT. Mr. President, throughout the day I have been working with 
Senator Chafee and others with regard to amendments.
  Mr. LAUTENBERG. May we have order, Mr. President?
  The PRESIDING OFFICER. The Senate is not in order. The Senate will 
please come to order.
  The majority leader.


                      Unanimous Consent Agreement

  Mr. LOTT. Mr. President, I have been working with Senator Chafee and 
others, including Senator Jeffords, on a number of amendments that were 
offered last night as first- or second-degree amendments. I think we 
have worked out a process, now, that we are all comfortable with. Let 
me enter this unanimous-consent request and then we will have a brief 
colloquy also.
  I ask unanimous consent the following amendments be withdrawn: Chafee 
amendment No. 448, Chafee amendment No. 500, Chafee amendment No. 501, 
Lott amendments Nos. 505, 507, 508, 509, Rockefeller amendment No. 510 
and the Roth amendment No. 513;
  I further ask unanimous consent that the Senate turn to the Roth 
amendment No. 511, and that all between lines 23 on page 22 and line 3 
on page 23 be stricken;
  I further ask the Senate then call up the Chafee amendment No. 512 to 
the Roth amendment No. 511, as modified, that the Chafee amendment be 
agreed to, and the Roth amendment, as amended, then be agreed to;
  I further ask unanimous consent that when the committee amendment to 
S. 949, the Taxpayer Relief Act, is before the Senate, Senator Roth be 
recognized to offer an amendment which is the text of the Roth 
amendment No. 511, as modified and amended, and the text of the Kennedy 
amendment, No. 492, if adopted by the Senate, to S. 947, to the 
language regarding the children's health initiative, and the amendment 
be agreed to;
  Finally, I ask unanimous consent that it not be in order during the 
pendency of S. 949 to offer further amendments or motions regarding 
title XXI of the Social Security Act, except amendments regarding 
revenues and outlays.
  The PRESIDING OFFICER. Is there objection?
  Mr. CHAFEE. Reserving the right to object.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. JEFFORDS. Reserving the right to object.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. JEFFORDS. The Senator from Delaware----
  The PRESIDING OFFICER. The Senator from Vermont will suspend. The 
Senate is not in order. Senators please take their conversations off 
the Senate floor. The Senator from Vermont.
  Mr. JEFFORDS. If the chairman of the Finance Committee would give me 
his attention, as I read the unanimous consent request, States would 
not be able to use the new funds under the children's health insurance 
initiative to provide health care coverage under either the block grant 
or to provide Medicaid for children over 200 percent of poverty.
  This creates a real problem for a number of States. Vermont is 
currently covering all children aged 18 that have family incomes of 225 
percent of poverty through its Medicaid Program. I would like to be 
assured that we will work to address this concern in the conference so 
that States have the ability to use the new funds to provide health 
care coverage for children over 200 percent of poverty. There are 
children above this level that need the help badly.
  Mr. ROTH. Mr. President, I say to the Senator from Vermont, he has my 
assurance that we will discuss this concern in the conference 
committee. It is not my intent to penalize those States that have done 
a good job in covering their low-income children or to exclude needy 
children from coverage.
  Mr. CHAFEE. I would like to address this, Mr. President, if I might, 
to the distinguished chairman of the Finance Committee. It is also my 
understanding that a State would be able to use any new funds to 
provide health coverage for children under 200 percent of poverty and 
use existing State dollars, normally used for this purpose, in order to 
provide health care coverage for children over 200 percent of poverty.
  Mr. ROTH. Mr. President, section 2102 allows for the use of existing 
State funds to provide additional health care coverage for children 
over 200 percent of poverty.
  Mr. CHAFEE. I thank the chairman for that. I also extend my thanks to 
the distinguished majority leader for helping us reach this unanimous-
consent agreement. I believe the resolution of this problem has been a 
very good one. I thank, as I say, the majority leader and the chairman 
of our Finance Committee and other Senators who have worked on this, 
particularly on our side, Senator Jeffords.
  Mr. GREGG. Reserving the right to object.
  The PRESIDING OFFICER. The Senator from New Hampshire reserves the 
right to object.
  Mr. GREGG. Is the practical effect of this amendment that there will 
only be two options available now to States: One would be to put the 
child in Medicaid, and the other would be to use a Blue Cross/Blue 
Shield standard option plan with hearing and eyeglasses?
  Mr. ROTH. No; the choice is not limited to that. Under the option, 
the States must provide benefits that are the equivalent of a Blue 
Cross standard plan. But I emphasize the word ``equivalent,'' because 
it means considerable flexibility. I should point out, it also includes 
vision and hearing services.
  Mr. CHAFEE. That is right. The State can use its own funds. If it has 
been using its funds for other types of services, they can continue 
using their State funds for those other types of services.
  Mr. GREGG. Further reserving the right to object.
  The PRESIDING OFFICER. The Senator from New Hampshire further 
reserves the right to object.
  Mr. GREGG. The practical effect of this then is that the programmatic 
activities are specifically mandated as being either a Medicaid Program 
or a

[[Page S6318]]

Blue Cross/Blue Shield equivalent program, is that not correct?
  Mr. ROTH. That is correct.
  Mr. GREGG. I have very serious reservations about this. I presume the 
leaders worked hard on reaching this agreement, and I presume that 
there is going to be further consideration of this issue.
  Mr. LOTT. As a matter of fact, Mr. President, if I can respond to the 
Senator's reservation, I noted when I read through this that there were 
a series of amendments that had been offered in a variety of ways 
affecting this particular area: Three by Senator Chafee, four by 
myself, one by Senator Roth, one by Senator Rockefeller. So this is 
quite a laboriously worked-out process.
  The Senator from Vermont, as a matter of fact, is not particularly 
happy with some provisions still remaining, and he had an amendment 
that would have tried to change that. A number of others--Senator 
Nickles of Oklahoma--I believe, had something. But this unanimous-
consent agreement was worked out in a way that a number of Senators 
decided not to go forward with their objections.
  I personally don't agree with this, but it is the best way that we 
could work through about six or eight amendments that were pending in a 
reasonable and fair way, and it certainly will have another day in 
court.
  Mr. GREGG. Well, on that representation, I won't object, but I have 
serious reservations, I must say.
  Mr. ROCKEFELLER addressed the Chair.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mr. ROCKEFELLER. Mr. President, I say to my colleagues, I think the 
majority leader is exactly right, and I congratulate him, as well as 
Senator Roth and his excellent staff, as well as Senators Chafee, 
Jeffords and many others who worked on it.
  As the majority leader has indicated, it has been a very laborious, 
long process in which things sort of just gradually, tectonically moved 
together, but very, very slowly.
  The point is that we can say now children are going to have good 
benefits, and that doesn't mean that they have to pick a particular 
plan. There is not a mandate in this that they have to pick this plan 
or that plan, but they will be able to get the kinds of benefits that 
we have as Senators, as Federal workers.
  I think, frankly, we have an obligation to make sure our children 
have plans. Preventive care, hospital care, doctor care, prescription, 
vision and hearing is in this. That is very important for early years, 
preventive care.
  So I think, frankly, it has been extremely complicated, it has taken 
a long time, but I think it is a good compromise, a good agreement, and 
I congratulate those who brought it together.
  Mr. LOTT. Mr. President, also, before I renew my unanimous-consent 
request, Senator Breaux was also involved in this exercise and was 
helpful. I express my appreciation to him.
  I renew my unanimous-consent request.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. LOTT. I yield the floor, Mr. President.
  Mr. CHAFEE addressed the Chair.
  The PRESIDING OFFICER. The Senator from Rhode Island.
  Mr. CHAFEE. Mr. President, I thank the distinguished Senator from 
West Virginia, Senator Rockefeller, for his help in this. As he 
mentioned, this has been a very long, long difficult process. He has 
been very helpful.
  Mr. KENNEDY addressed the Chair.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Mr. KENNEDY. Mr. President, if it is agreeable with the floor 
managers, I am prepared to move ahead with my amendment dealing with 
children's benefits.
  Mr. DOMENICI. I believe that is the last amendment, except the three 
points of order that are going to be submitted by the Democratic floor 
leader en bloc.
  Mr. KERREY. I still have my amendment.
  Mr. DOMENICI. Sorry, I forgot. I thought that was going with Senator 
Murray when she withdraws her point of order. It is different?
  Mr. KERREY. Yes.
  Mr. DOMENICI. Can we recognize Senator Murray for a moment? She 
intends to speak to the Senate with reference to her previous point of 
order.


                       Point of Order, Withdrawn

  Mrs. MURRAY. Mr. President, I withdraw my previous point of order, 
but I want this body to know that I object to the language in this bill 
that essentially makes Hyde permanent and affects those States whose 
managed care plans now cover medically necessary abortions. 
Unfortunately, the way the language was cleverly drafted, my point of 
order would have unintended consequences.
  I go back to what my colleague from West Virginia said to all of us a 
few minutes ago. I think as we move toward final passage, I hope we all 
understand the severe consequences of the many different arenas in this 
bill.
  I withdraw my point of order.
  The PRESIDING OFFICER. The Senator has a right to withdraw her point 
of order. The point of order is withdrawn.
  The Senator from Massachusetts.


                           Amendment No. 492

  Mr. KENNEDY. Mr. President, I call up our amendment dealing with the 
special health needs of children. I call up the amendment on behalf of 
myself and Senator Harkin.
  First of all, I commend the Senators for getting us where we are in 
terms of the new health benefits package for children, but there are 
some very critical needs for children, children with disabilities, 
children who are developmentally delayed and children with special 
needs.
  Those needs are not attended to, and that is why this amendment is 
supported by the Consortium of Citizens with Disabilities, the American 
Academy of Pediatrics, the American Association of Retarded Citizens 
and the National Alliance for the Mentally Ill.
  This will ensure that, in those particular areas, the children will 
receive what is medically necessary. The Federal employees program is 
targeted to adults and not toward children. This recognizes that there 
are special needs for children in these areas, and it permits what is 
medically necessary. It is a limited program, but it is vital in terms 
of the special needs of those children. I hope that it will be agreed 
to.
  Mr. DOMENICI addressed the Chair.
  The PRESIDING OFFICER. The Senator from New Mexico.
  Mr. DOMENICI. I yield 40 seconds of our time to Senator Roth, and I 
will use 20 seconds.
  Mr. ROTH. Mr. President, I oppose the Kennedy amendment. As we have 
just been discussing, we have carefully crafted and negotiated the 
issue of the benefits package for the new children's health initiative. 
This amendment would break that agreement by requiring additional 
benefits. It does the very opposite of what we want to do. We want to 
provide flexibility to the States, and this would be a major step in 
the wrong direction.
  Mr. DOMENICI addressed the Chair.
  The PRESIDING OFFICER. The Senator from New Mexico.
  Mr. DOMENICI. Mr. President, this would change a bipartisan 
compromise in the committee and make a long list of benefits mandatory. 
Thus, it would fly in the face of reform and make it more difficult for 
the States to deliver quality care for less money. In essence, it is 
apt to produce less quality care under the rubric of supplying all of 
the specifics, even if you could get better care with less specifics.
  I move to table the Kennedy amendment and ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. The question is on agreeing to the motion to 
lay on the table amendment No. 492. The yeas and nays have been 
ordered. The clerk will call the roll.
  The assistant legislative clerk called the roll.
  The result was announced--yeas 57, nays 43, as follows:

                      [Rollcall Vote No. 128 Leg.]

                                YEAS--57

     Abraham
     Allard
     Ashcroft
     Baucus
     Bennett
     Bond
     Breaux
     Brownback
     Burns
     Campbell
     Coats
     Cochran
     Collins
     Coverdell
     Craig
     D'Amato
     DeWine
     Domenici
     Enzi
     Faircloth
     Frist
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Hatch
     Helms

[[Page S6319]]


     Hutchinson
     Hutchison
     Inhofe
     Kempthorne
     Kerrey
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Moynihan
     Murkowski
     Nickles
     Roberts
     Roth
     Santorum
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner

                                NAYS--43

     Akaka
     Biden
     Bingaman
     Boxer
     Bryan
     Bumpers
     Byrd
     Chafee
     Cleland
     Conrad
     Daschle
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Ford
     Glenn
     Harkin
     Hollings
     Inouye
     Jeffords
     Johnson
     Kennedy
     Kerry
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Murray
     Reed
     Reid
     Robb
     Rockefeller
     Sarbanes
     Specter
     Torricelli
     Wellstone
     Wyden
  The motion to lay on the table the amendment (No. 492) was agreed to.
  Mr. DOMENICI. I move to reconsider the vote.
  Mr. FORD. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


                           Amendment No. 427

  Mr. DOMENICI. Mr. President, there is an amendment pending at the 
desk, an amendment for Senator DeWine that is No. 427.
  I am going to send, at his request and with the approval of the 
minority, a modification. This amendment, as modified, will amend the 
Social Security Act to continue full-time equivalent resident 
reimbursement for 1 additional year under Medicare for direct graduate 
medical education for residents enrolled in combined approved primary 
care medical residency training programs.


                     Amendment No. 427, As Modified

  Mr. DOMENICI. I send the modification to the desk, and ask unanimous 
consent that we call up the amendment as modified.
  The PRESIDING OFFICER. Is there objection to modifying the amendment?
  Without objection, it is so ordered. The amendment is modified.
  The amendment (No. 427), as modified, is as follows:

       At the appropriate place in chapter 3 of subtitle F of 
     division 1 of title V, insert the following:

     SEC.   . MEDICARE SPECIAL REIMBURSEMENT RULE FOR PRIMARY CARE 
                   COMBINED RESIDENCY PROGRAMS.

       (a) In General.--Section 1886(h)(5)(G) of the Social 
     Security Act (42 U.S.C. 1395ww(h)(5)(G)) is amended--
       (1) in clause (i), by striking ``and (iii)'' and inserting 
     ``, (iii), and (iv)''; and
       (2) by adding at the end the following:
       ``(iv) Special rule for primary care combined residency 
     programs.--(I) In the case of a resident enrolled in a 
     combined medical residency training program in which all of 
     the individual programs (that are combined) are for training 
     a primary care resident (as defined in subparagraph (H)), the 
     period of board eligibility shall be the minimum number of 
     years of formal training required to satisfy the requirements 
     for initial board eligibility in the longest of the 
     individual programs plus one additional year.
       ``(II) A resident enrolled in a combined medical residency 
     training program that includes an obstetrics and gynecology 
     program qualifies for the period of board eligibility under 
     subclause (I) if the other programs such resident combines 
     with such obstetrics and gynecology program are for training 
     a primary care resident.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     apply to combined medical residency training programs in 
     effect on or after January 1, 1998.

  Mr. DOMENICI. I believe that amendment is acceptable.
  I yield back any time I might have.
  The PRESIDING OFFICER. Is there further debate on the amendment? If 
not, the question is on agreeing to the amendment.
  The amendment (No. 427), as modified, was agreed to.
  Mr. DOMENICI. I move to reconsider the vote.
  Mr. LAUTENBERG. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.


Amendments Nos. 447, 464, 470, 477, and No. 503, As Modified, Withdrawn

  Mr. DOMENICI. I ask unanimous consent to withdraw five amendments 
that remain: 447, Senator Hutchison; 464, Senator Brownback; 470, 
Senator Specter; 477, Senator Durbin; and 503, Senator Rockefeller.
  The PRESIDING OFFICER. Is there objection?
  Without objection, the amendments are withdrawn.
  The amendments (Nos. 447, 464, 470, 477, and No. 503), as modified, 
were withdrawn.
  Mr. DOMENICI. Mr. President, there is one additional amendment by 
Senator Kerrey.
  The PRESIDING OFFICER. The Senate will come to order.
  Mr. DOMENICI. One additional amendment by Senator Kerrey, which will 
require a vote. Then there will be three points of order en bloc by the 
minority. We will not seek to overrule them. We will accept them. The 
provisions will then cause those portions of the bill to fail, to drop. 
Following that, we will have final passage.
  Mr. KERREY addressed the Chair.
  The PRESIDING OFFICER. The Senator from Nebraska.


                     Amendment No. 496, As Modified

  Mr. KERREY. Mr. President, I ask unanimous consent to modify my 
originally filed amendment since the managers' amendment changes the 
language that my amendment seeks to strike.
  The PRESIDING OFFICER. Is there objection to the modification?
  Without objection, the amendment is modified.
  The amendment (No. 496), as modified, is as follows:

       At the appropriate place in section 2106, as added by 
     section 5801, strike all matter related to ``use limited to 
     State Program Expenditures'' and insert the following:
       ``(d) Use Limited to State Program Expenditures.--Funds 
     provided to an eligible State under this title shall only be 
     used to carry out the purposes of this title.''

  Mr. KERREY. Mr. President, there is language in the bill that imposes 
what has been imposed typically in the appropriations process, 
permanently imposing a restriction on the use of Federal money for 
payment for abortions. I know it is very controversial, a lot of fun to 
debate. But by putting it in permanent law, we are doing something 
entirely different than has been done before.
  Second, I would say to my colleagues, this affects only low-income 
teenagers. That is basically what we are doing, saying to low-income 
teenagers that we are not going to allow taxpayer money to be used for 
abortions.
  Third, I would say, for those who say, ``Well, that's right, we don't 
want to use taxpayer money for abortions,'' we do not have a similar 
restriction on our salaries, we do not have a similar restriction on 
any other Federal employee's salary. If we have income coming to us, 
that is taxpayer income.
  If you want to be consistent here, you want to say you are going to 
treat low-income teenagers the same as our teenagers are treated, then 
you would have to put restrictions on how we can spend our salaries as 
well.
  I hope that this amendment will pass and we will strike this 
language. If you want to bring the Hyde amendment up, I think it is 
much more appropriate to do so not on appropriations bills.
  Mr. DOMENICI. I yield time in opposition to Senator Nickles.
  Mr. NICKLES. Mr. President, I rise in opposition to the amendment of 
Senator Kerrey. We put in language in this bill to make sure in this 
new program--we created a new program for health care for kids, for 
teenagers. What we are doing in this amendment is saying this health 
care program should not include abortion or money for elective 
abortion.
  We basically said no public funds would be used for abortion --only 
if the abortion is necessary to save the life of the mother or in cases 
of rape or incest. That is consistent with the Medicaid Program. That 
is consistent with Federal health care policies that we have for 
Federal employees right now, and we certainly should not create a new 
program that says, ``Oh, you can have abortion on demand, paid for by 
taxpayers.'' We will spend billions of dollars. We should not be saying 
those billions are eligible for teenagers for elective abortion.
  I urge my colleagues to vote no on the Kerrey amendment.
  Mr. KERREY. I ask for the yeas and nays.
  The PRESIDING OFFICER (Mr. Abraham). Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays have been ordered.
  The PRESIDING OFFICER. The question is on agreeing to the amendment 
No. 496, as modified.
  The clerk will call the roll.
  The legislative clerk called the roll.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?

[[Page S6320]]

  The result was announced--yeas 39, nays 61, as follows:

                      [Rollcall Vote No. 129 Leg.]

                                YEAS--39

     Akaka
     Baucus
     Bingaman
     Boxer
     Bryan
     Bumpers
     Campbell
     Chafee
     Daschle
     Dodd
     Durbin
     Feingold
     Feinstein
     Glenn
     Harkin
     Hollings
     Inouye
     Jeffords
     Kennedy
     Kerrey
     Kerry
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Mikulski
     Moseley-Braun
     Moynihan
     Murray
     Reed
     Robb
     Rockefeller
     Sarbanes
     Specter
     Stevens
     Torricelli
     Wellstone
     Wyden

                                NAYS--61

     Abraham
     Allard
     Ashcroft
     Bennett
     Biden
     Bond
     Breaux
     Brownback
     Burns
     Byrd
     Cleland
     Coats
     Cochran
     Collins
     Conrad
     Coverdell
     Craig
     D'Amato
     DeWine
     Domenici
     Dorgan
     Enzi
     Faircloth
     Ford
     Frist
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Hatch
     Helms
     Hutchinson
     Hutchison
     Inhofe
     Johnson
     Kempthorne
     Kohl
     Kyl
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Murkowski
     Nickles
     Reid
     Roberts
     Roth
     Santorum
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Thomas
     Thompson
     Thurmond
     Warner

  The amendment (No. 496) as modified, was rejected.
  Mr. DOMENICI. Mr. President, I move to reconsider the vote.
  Mr. KERREY. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. DOMENICI. Mr. President, may we have order?
  The PRESIDING OFFICER. The Senate will please come to order.
  The Senator from New Mexico.
  Mr. DOMENICI. Mr. President, I am just waiting for the minority 
manager to make a point of order, and we will be ready to go to final 
passage.


                             Point of Order

  Mr. DASCHLE. Mr. President, pursuant to section 313 of the 
Congressional Budget Act, I make a point of order that the following 
sections of the pending bill are extraneous to the reconciliation 
instructions of the respective committee of jurisdiction: section 5713, 
section 5833, and section 5987.
  The PRESIDING OFFICER. The Chair sustains the points of order.
  Mr. ROBB. Mr. President, I rise today to discuss S. 947, the Balanced 
Budget Act of 1997. I'm pleased that we've come together in a 
bipartisan way--both sides of the aisle, both sides of the Capitol, and 
both ends of Pennsylvania Avenue--to craft a plan that brings us a step 
closer to fiscal sanity.
  The good news, Mr. President, is that the bill before us realizes 
roughly $137 billion in savings over the next 5 years. And that's good 
news for our country and for our children and our grandchildren.
  S. 947 provides additional years of solvency to the Medicare hospital 
trust fund, reforms payment methodologies for skilled nursing 
facilities, home health, and outpatient entities, and includes greater 
choice--and expanded preventive benefits--for millions of Medicare 
beneficiaries. As a cosponsor of the original Chafee-Rockefeller child 
health bill, I'm delighted that this bill contains $16 billion to 
expand access to health care for America's children, most of whom live 
in the home of an American worker.
  Someday, our children will be grateful for the $16 billion we 
invested in their health care, Mr. President. And they will be grateful 
that we succeeded today in saving $137 billion in future debt--debt we 
will not ask them to pay.
  But our children will not be grateful if we don't take this 
opportunity in this budget to tackle long-term entitlement reform in a 
systemic way.
  We all know the statistics. While entitlements and interest on the 
national debt represented just 30 percent of our budget in l963, they 
will absorb 70 percent by the year 2002. And even more alarmingly, if 
we don't make changes in the way we do business around here, 
entitlements and interest on the debt will absorb the entire Federal 
revenue base by the year 2012. How then can we responsibly invest in 
our children? How can we sustain the transportation infrastructure 
needed to support a thriving economy in the next century? How do we pay 
our soldiers, repair our subs and carriers, and invest in the 
technology we need to remain the last great superpower on Earth?
  Mr. President, despite the fact that the vast majority of economists 
have told us that we need to adjust the consumer price index to 
accurately reflect inflation, we have no legislative CPI adjustment in 
this package. Opponents say that since we don't need a legislative CPI 
adjustment to balance the budget in 5 years, it's not in this plan. But 
what about when the baby boom generation retires, Mr. President, when 
just three workers--and then two--will support each Social Security 
beneficiary?
  The Finance Committee had the courage to include a provision in this 
bill to gradually increase the eligibility age for Medicare from 65 
today to 67 by the year 2027. This provision has been under assault--
and will continue to be--from many sides. Some who oppose it argue that 
this is not the time. And while I'm committed to identifying methods to 
provide access for those who may encounter a lapse in coverage--and 
this bill creates a bi-partisan commission that will look at the 
feasibility of a Medicare buy-in program--when will the time be right? 
We had a good vote in support of this eligibility increase in the 
Senate and we have to fight to retain it in conference.
  Finally, the home health copay and the affluence testing for wealthy 
seniors which were included in the committee mark and which were 
supported by the majority of the Senate during two rollcall votes held 
yesterday will likely not survive conference as well, Mr. President. 
These provisions are in danger even though we all know we have to find 
responsible ways to reduce the Federal cost of Medicare. While 
affluence testing of part B premiums is a political lightning rod, it 
is good public policy. It is simply indefensible to require lower 
income families, many who cannot afford health insurance for their own 
children today, to continue to help subsidize 75 percent of the 
Medicare premiums of wealthy seniors.
  We have much to do, Mr. President, to fulfill our obligation to leave 
our children a strong economic future and a quality of life equal to 
the one we inherited from our own parents. The first step is to balance 
our budget--and I hope the bill before us accomplishes that goal. The 
next step--and it is an essential one--is to tackle long term, systemic 
entitlement reform that will protect both the solvency of Medicare and 
Social Security and the economic security of the generations that 
follow us.
  I hope the conferees will not make those goals even harder to achieve 
in the future.
  With that plea Mr. President, I yield the floor.


      THE BUDGET RECONCILIATION BILL MUST PROTECT LEGAL IMMIGRANTS

  Mr. KENNEDY. Mr. President, I continue to be concerned about actions 
by Congress that hurt legal immigrants.
  Last year, Congress passed a so-called welfare reform bill. This 
harsh bill cut off legal immigrants from most Federal assistance 
programs for the first time in history. It permanently banned legal 
immigrants from SSI and food stamps. It banned them for 5 years from 
AFDC, Medicaid, and other programs. And, it gave the States the option 
of permanently banning them from these programs.
  We quickly saw the effect of these extreme provisions. Panic spread 
through the immigrant community. The Social Security Administration 
sentnotices to legal elderly and disabled immigrants that they would 
soon lose their SSI benefits. Numerous reports in the press told of 
legal immigrants who would be turned out of nursing homes, or cut off 
from disability payments. Some legal immigrants took their own lives, 
rather than burden their families. Thankfully, many Members of Congress 
realized that these provisions went too far.
  This budget reconciliation bill corrects many of those mistakes. 
Members of the Finance Committee and Budget Committee showed impressive 
leadership in developing this bill. They recognized that the immigrants 
affected by last year's harsh cuts are individuals and families who 
came here legally. By and large, they are family members--mothers, 
fathers, and sons, daughters--of American citizens. They play by the 
rules, pay their taxes, and serve in the Armed Forces. They can be 
drafted. They can volunteer. We have hundreds of them in Bosnia today.

[[Page S6321]]

They are future citizens trying to make new lives for themselves and 
their families in this country. I commend the committees for working so 
hard to come up with a bipartisan proposal.
  This bill allows legal immigrants who are already receiving SSI to 
continue their SSI payments. It preserves SSI coverage for immigrants 
already in the United States who become disabled in the future, and for 
future immigrants who are too severely disabled to go through the 
process of naturalization to become citizens. It extends the exemption 
for refugees from 5 to 7 years. It exempts children from the 5-year ban 
on Medicaid eligibility.
  There is still much more to be done to correct the problems created 
for immigrants by last year's welfare reform law. But, overall, this 
bill makes worthwhile progress toward restoring a safety net for 
immigrants who fall on hard times. I hope that Senators will do all 
they can to see that the immigrant provisions in this bill are retained 
in the Senate-House conference and final bill.


                            Medicare Reform

  Mr. GRAMS. Mr. President, I rise today in support of some very 
important Medicare reforms made within the reconciliation package 
before us. Specifically, I am pleased the committee included reforms to 
the formula used to determine the reimbursement rate for health plans 
under the Medicare Program to make it fairer and more equitable for 
States like Minnesota and other parts of rural America, changes to 
ensure better access to emergency medical services, and an expansion of 
Medical Savings Accounts.
  Reform of the Adjusted Average Per Capita Cost formula has been 
needed for years because the formula has discriminated against seniors 
who choose to live and retire in rural communities. It has penalized 
States like Minnesota which are efficient in delivering health care 
services, and in doing so, discouraged quality health care. Since being 
elected to the Senate in 1994, I have made restoring fairness and 
equity to Medicare recipients in Minnesota and other parts of rural 
America a top priority.
  Mr. President, we are all aware of the fact that the current Medicare 
reimbursement formula discriminates against Minnesota by giving our 
State the second-lowest payment rates in the Nation. Not one county in 
the entire State of Minnesota, or in 15 other States, receives the 
national average of $467 in AAPCC payment per month.
  Because of these low reimbursement rates, managed care organizations 
have been discouraged from offering our senior citizens many of the 
alternative health plans available in other parts of the country, plans 
which offer additional benefits such as eyeglasses and prescription 
drugs. Clearly, this is a problem which should have been addressed long 
ago.
  In February, several of my colleagues and I introduced S. 359, the 
Medicare Payment Equity Act, which would have established a floor of 80 
percent of the national adjusted capitation rate for the year and made 
the AAPCC formula more equitable by blending the national and county 
specific percentage. More recently, I cosponsored S. 862, authored by 
Senator Grassley, which followed the same lines of reform and even more 
closely resembles what was ultimately passed by the Finance Committee. 
Under the leadership of Finance Chairman Roth and through the tireless 
efforts of Senators Thomas, Burns, Grassley, and Roberts, we have 
succeeded in beginning to fix the Medicare formula to make it fairer 
for Minnesota's seniors and right some of the wrongs against us.
  The AAPCC reforms contained in the reconciliation bill are a very 
important step in restoring fairness and providing greater choices for 
Medicare recipients who live in Minnesota, particularly in rural 
communities. This truly represents a great victory for Minnesota's 
senior citizens as we close the longstanding gap of inequity in the 
Medicare Program.
  Mr. President, this legislation also addresses another important 
issue in which I have been deeply involved. In January, Senator Graham 
of Florida and I introduced S. 238, the Emergency Medical Services 
Efficiency Act, to establish a reasonable standard for determining 
Medicare reimbursement for EMS services. Our bill would ensure that EMS 
providers would be reimbursed based upon a prudent layperson standard, 
rather than the ultimate diagnosis of a physician. This revised 
definition will ensure that EMS providers are prepared to meet the 
challenges facing them as they work to improve their services.
  All of us depend daily on the readiness, efficiency, and immediate 
response of our emergency medical system. And while many of us take it 
for granted, we all want it to work well when we need it. Many of the 
men and women who risk their lives delivering emergency care have told 
me the system can be improved, yet their desire to improve the services 
they provide has rarely been recognized by Congress. This provision in 
the reconciliation bill is the first step in helping EMS providers help 
themselves become more efficient. I would like to thank Senator Graham 
for his efforts in the Finance Committee to see that this important 
issue was included in the package.
  Finally, I would like to thank Chairman Roth for his efforts to 
include an expansion of Medical Savings Accounts. In developing a 
Medicare Choice Program modeled on the Federal Employee Health Benefits 
plan, this will offer, for the first time, a real choice to America's 
seniors.
  Again, I commend and thank Chairman Roth and his Finance Committee 
colleagues for including these important changes in the reconciliation 
spending package.


  BIPARTISAN BUDGET AGREEMENT ITEMS TO BE ACHIEVED IN APPROPRIATIONS 
                                PROCESS

  Mr. DOMENICI. Mr. President, I rise to address some concerns 
expressed by the administration with regard to two items they believe 
should be in this reconciliation bill. I would like to clarify what we 
assumed in the 1998 budget resolution for those items.
  The bipartisan budget agreement did include assumptions on additional 
funding for unemployment insurance benefits integrity and on extension 
of fees for SSI State supplemental benefit administration. In both 
instances, the budget resolution assumed that these proposals would be 
implemented by the Appropriations Committee, and therefore the 
authorizing committees were not instructed to achieve these savings in 
reconciliation. The budget resolution is the basis for scoring 
congressional action and cannot be changed in an ad hoc manner, that 
is, without passing another concurrent resolution to change it.
  I would ask the chairman of the Appropriations Committee if it is not 
also his understanding that these proposals are to be considered by his 
committee?
  Mr. STEVENS. As chairman of the Appropriations Committee, I am 
committed to working with the chairman, and the administration 
regarding the levels of funding assumed in the bipartisan budget 
agreement that are within purview of the Appropriations Committee. It 
is my understanding that the Subcommittee on Labor, Health and Human 
Services, and Education has been working with the Office of Management 
and Budget with regard to the proposals you have mentioned.
  Mr. DOMENICI. I thank the Senator for helping clarify this matter.


   COVERAGE OF CERTAIN SERVICES IN RELIGIOUS NONMEDICAL HEALTH CARE 
         INSTITUTIONS UNDER THE MEDICARE AND MEDICAID PROGRAMS

  Mr. KENNEDY. Mr. President, I strongly support the provisions in this 
bill to ensure the continuation of Medicare and Medicaid reimbursement 
for secular nursing services in religious nonmedical health care 
institutions. These provisions ensure that strong religious beliefs are 
not a barrier to Medicare and Medicaid benefits.
  When Medicaid and Medicare were enacted over 30 years ago, Congress 
included a special provision granting a religious accommodation for 
members of the church, so that they could receive benefits for care in 
their facilities comparable to the benefits available to others for 
similar cases.
  For 30 years, the Christian Science Church relied on Medicare and 
Medicaid benefits and built a health care system that assists thousands 
of men and women. At a time when the Health Care Finance Administration 
has expressed increasing concerns about fraud and abuse in Medicare and 
Medicaid, there are no complaints about the Christian Science Church. 
Members of the church only ask to practice their religion without 
unnecessary interference.

[[Page S6322]]

  Last summer, however, a Minnesota district court determined that the 
provisions in the Medicare and Medicaid statutes onto the Christian 
Science Church are unconstitutional. As Judge Kyle stated in his 
opinion, ``legislative accommodation of religious beliefs is a valuable 
and worthy enterprise, but here * * * the accommodation has gone too 
far and too strongly favors the convictions of one particular sect.''
  However, the court also recognized the fundamental injustice that 
Christian Scientists were required to pay the taxes for Medicare and 
Medicaid, but could not receive the benefits of these programs. The 
court also recognized the purpose underlying the original statutes. The 
court clearly identified the statutory language referring to the church 
as the problem, not the goal of providing comparable benefits to those 
who disavow traditional medical treatment because of their religious 
beliefs.
  The provision in the reconciliation bill meets this goal without 
undermining the Constitution. All references to the Christian Science 
Church are eliminated. The provision will grant reimbursement for 
secular nonmedical nursing services to any person who, because of 
religious beliefs, does not believe in medical care and relies on faith 
healing in a religious nonmedical health care institution. As with 
other aspects of this health care system, the Health Care Finance 
Administration will closely monitor the provision for fraud, abuse, and 
public health concerns.
  The chairmen of the House and Senate Judiciary Committees, the 
chairman of the House Ways and Means Committee, the chairman of the 
Senate Finance Committee, and I have worked closely to ensure the 
constitutionality of this provision.
  This provision meets the worthwhile goals of the original Medicare 
and Medicaid laws, while meeting constitutional concerns. It deserves 
to be enacted into law so that the needed benefits will continue to be 
available.


             food stamps for cross-border native americans

  Mr. JEFFORDS. Mr. President, I know it is too late for Chairman Roth 
to include this change in the manager's amendment, but I did want to 
raise it before we finish here today.
  As the chairman knows, thanks to a provision in both the Finance and 
Ways and Means packages, native Americans who are entitled to cross the 
U.S. border under the Jay Treaty are not affected by last year's 
welfare law restrictions on providing SSI to aliens. Unfortunately, due 
to jurisdictional considerations, neither the Finance nor the Ways and 
Means Committees included food stamps in this provision. Preliminary 
estimates indicate that such an inclusion would not incur significant 
cost.
  I understand Senator Lugar is supportive of the inclusion of food 
stamps and I hope the chairman and ranking member will work with me and 
other Members during conference with the House to include a food stamp 
modification.
  Mr. SMITH of New Hampshire. Mr. President, I rise today to commend my 
colleagues on the Armed Services Committee and the Finance Committee 
for having the courage to follow through on a promise the Government 
made long ago to career military personnel. I know the future of health 
care for elderly military retirees is an issue that deeply concerns 
many of us, and I am pleased that we have found a financially 
responsible solution to the growing problem of health care access for 
this group of retired personnel.
  With the Defense Department expected to complete full implementation 
of the Tricare medical plan within the year, many retirees, who made it 
their lives' work to defend our freedom, face the certain loss of 
medical benefits when they turn 65 unless Congress acts now. As a 
member of the Armed Services Committee, I am deeply disturbed by this 
prospect. That is why I have consistently supported responsible 
initiatives to guarantee the future of DOD health care for Medicare-
eligible military retirees.
  In New Hampshire, I have witnessed firsthand the impact of defense 
downsizing on health care resources for this vulnerable population. 
When Pease Air Force Base closed in 1991, thousands of aging retirees 
were left to compete with active duty personnel and military retirees 
from neighboring States for fewer spaces in the New England DOD health 
care system. Once Tricare takes hold, this group will lose any 
remaining access to the military system they now enjoy because the 
Defense Department can no longer afford to offer these retirees the 
medical benefits they were promised. This is unacceptable.
  After 4 years of meetings, hearings, and failed legislative 
initiatives, the Senate has finally reached a workable solution to the 
health care crisis now facing Medicare-eligible military retirees. 
Medicare subvention, as the plan is known, will allow the Defense 
Department to seek reimbursement from Medicare for the cost of treating 
eligible retired military personnel. By authorizing the DOD to carry 
out a 3-year Medicare subvention test program, the Senate has taken a 
decisive step toward restoring military retirees' faith in the country 
they honorably served. I am pleased to have supported Medicare 
subvention since the proposal's inception, and I look forward to 
working with my colleagues in the coming years to ensure that our 
Government does not shirk the responsibility of providing elderly 
military retirees with the quality, affordable health care they 
deserve.
  I thank the chair and I yield the floor.


                          MEDICARE SUBVENTION

  Mr. INHOFE. Mr. President, throughout each year we address a number 
of Medicare issues. This year, we have a Medicare issue within the 
reconciliation bill which is related to military health care, 
specifically, Medicare subvention. Without Medicare subvention, 
military treatment facilities cannot receive reimbursement from 
Medicare for care the facilities provide to military retirees who are 
also eligible for Medicare. With Medicare subvention, we can continue 
to improve the quality of life for military personnel, their families, 
and retired service members and their families by providing them with 
alternative access to treatment.
  Because health care is such an important aspect of quality of life in 
the military, it is imperative that we continue to provide our military 
personnel and retirees with the access which they were promised. 
Currently, because the access of military retirees age 65 and over is 
on a space-available basis and due to overcrowding of military 
treatment facilities, finding adequate medical care has proven 
increasingly difficult if not impossible. Clearly, this is not a trend 
we want to continue if we hope to retain and recruit the quality and 
quantity of men and women needed to fight and win wars in the future.
  Medicare subvention would fulfill the commitment made to our former 
service members by allowing Medicare to reimburse the Department of 
Defense [DOD] for care provided to members who are Medicare-eligible 
beneficiaries. I believe that Medicare subvention would be fiscally 
beneficial to Medicare and would make available an important revenue 
source that will enable and encourage DOD to provide care to over-65 
retirees. Further, Medicare will save money because DOD can provide 
care less expensively than civilian providers. This is clearly a win-
win situation for both the DOD and Medicare.
  Clearly, ending access to military medical facilities when 
beneficiaries reach an age when they will most need it is fundamentally 
unfair. Our veterans have earned our support, and they deserve the best 
access to medical care that we can make available. I believe that 
Medicare subvention is a necessary step in the right direction, and I 
fully support the Medicare subvention provisions found in the 
reconciliation bill.


                     Food Stamp Nutrition Education

  Mr. SANTORUM. Mr. President, I support the amendment offered by the 
Senator from Texas, and I commend her for her diligent work in fighting 
fraud in the Food Stamp Program. I would also like to thank her for 
working with me to address a concern of mine with regard to food stamp 
nutrition education.
  For 2 years, the Reading Terminal Farmers' Market trust participated 
in a partnership with the USDA to develop a community-based nutrition 
education program in Philadelphia. Using a Federal share to match 
private grants from the Knight, Pew and Kellogg Foundations, the trust 
established

[[Page S6323]]

the Philadelphia nutrition education network to integrate nutrition 
education into ongoing food distribution and health programs. The 
Philadelphia School District, Allegheny University of Health Sciences, 
WIC, the Archdiocese of Philadelphia and others were engaged as 
partners in the network, which reached over 17,000 children and adults 
in 1996.
  By all accounts, this program was a success; and last summer, when 
the one-time cooperative agreement with USDA expired, the trust sought 
to continue their important work under the existing food stamp 
nutrition education program. In June 1996, the trust submitted a food 
stamp nutrition education plan requesting matching funds for a 
nutrition education plan in four low-income communities and at the 
Reading Terminal Market. Unfortunately, USDA regulations only permit a 
Federal match for local or State government funding. Since the Reading 
Terminal Farmers' Market Trust relies upon private contributions to 
fund their programs, USDA determined that they were not eligible to 
participate in the food stamp nutrition education program.
  Since last summer, my office has been working with Reading Terminal 
Farmers' Market Trust to find a way for this program to continue. It is 
my understanding that nutrition education programs in Vermont and New 
York City have encountered similar problems with USDA matching funds. I 
have worked with Chairman Lugar of the Agriculture Committee and 
Senator Leahy to craft an amendment that will address these problems, 
and I am grateful to the Senator from Texas for including this language 
as section 2 of her amendment.
  The language in this amendment will enable nonprofits and State 
agencies to receive grants in order to operate nutrition education 
programs that are coordinated among a broad range of food distribution 
and social service providers. In order to reach the maximum amount of 
eligible individuals and to leverage private funds for this endeavour, 
private donations will be made eligible to match the Federal grant.
  The amendment provides $600,000 for grants for each of fiscal years 
1998 through 2001, and no individual grant may exceed $200,000.
  This provision has the support of Agriculture Committee Chairman 
Lugar and Senator Leahy.


   FINAL REGULATIONS ON SOCIAL SECURITY INSURANCE DETERMINATIONS FOR 
                                CHILDREN

  Mr. JEFFORDS. Mr. President, during the consideration of this 
important bill, I would like to bring to your attention developments 
regarding the administration's recently released SSI regulations for 
children. Through sections 211 and 212 of Public Law 104-193, the 
Personal Responsibility and Work Opportunity Act of 1996, Congress 
established a new eligibility test requiring that children show the 
presence of ``marked and severe functional limitations'' to become 
eligible for Supplemental Security Income [SSI] disability benefits. 
Additionally, under these new rules up to 300,000 children who are 
currently eligible for SSI will undergo a redetermination assessment 
over the next several months.
  On February 11, 1997, in an attempt to implement these provisions, 
the Social Security Administration issued interim final regulations 
that require a level of disability that meets or equals the listings of 
impairments criteria. As stated in a letter written by nine of my 
colleagues and me to the President in April, I believe this regulation 
establishes an overly severe standard that misinterprets the intent of 
Congress to reform the SSI program for children with disabilities. 
SSA's test would remove up to 135,000 SSI disabled children this year 
alone. Thus, thousands of severely disabled children would face a loss 
of needed SSI benefits--contrary to the will of Congress.
  I believe the Social Security Administration should establish a 
comprehensive functional test at a stricter severity level than the 
former individualized functional assessment test, but one that does not 
harm children with serious disabilities. A test protecting children 
with severely disabling conditions--including those with one marked and 
one moderate condition--would accurately reflect the intent of 
Congress. The administration has estimated this test would terminate 
45,000 children this year, and close to 250,000 over 6 years.
  Mr. President, I have already heard from constituents in my State of 
Vermont whose children will soon lose their SSI benefits. These 
families have nowhere else to turn. Such predicaments present troubling 
moral and budgetary questions--how to provide for those families who 
are shut off from desperately needed SSI benefits, and whether these 
regulations will simply shift the costs of providing for children with 
disabilities from SSI to other Federal entitlement programs, or to the 
States as communities react to these troubling cases. Such cost 
shifting would eliminate any significant savings gained. Additionally, 
the loss of SSI benefits will force families to move their children to 
costly out-of-home placement, as parents would no longer have the 
financial support to stay at home and care for the disabled child.
  This is a matter that I will be pursuing with the Administration with 
the intent of reconciling the Administration's interpretation with the 
regulations passed by Congress during the welfare debate last fall.


                     Welfare-to-Work Grant Program

  Mr. HARKIN. The pending legislation provides $3 billion to establish 
a Welfare-To-Work Program and specifies the activities for which the 
funding may be used. The list of allowable activities does not allow 
assistance for education or training activities with the exception of 
on-the-job-training.
  Mr. ROTH. That is correct.
  Mr. HARKIN. Over the past several years I have met with a number of 
welfare recipients, caseworkers and others to discuss the issue of 
welfare reform in the State of Iowa. The discussions have also included 
a number of individuals who have successfully made the transition from 
welfare to self-sufficient employment. In many cases, the key to this 
successful transition was participation in post-secondary classroom 
training. I understand that the pending legislation prohibits use of 
the Welfare-To-Work Programs funds for this purpose but want to clarify 
that States may continue to use Federal funds received under the 
temporary Assistance for Needy Families Program or their own resources 
for post-secondary classroom training.
  Mr. ROTH. The Senator is correct. TANF does have some restrictions on 
vocational education activities, however States may use these funds or 
their own State funds for the education and training activities 
described by the Senator.
  Mr. HARKIN. I thank the Senator for making that clear. I have another 
question.
  The Welfare-To-Work Program provides formula grants to States and 
requires States to develop a formula for distribution of the funds 
within the State in consultation with sub-State areas. However, it is 
not clear what types of entities are eligible to provide the welfare-
to-work services and that States have flexibility on this score.
  In 1989, Iowa established 11 Family Development and Self-Sufficiency 
Programs to work with welfare recipients with a history of long-term 
dependency on the program and those who were at risk of long term 
dependency. These projects, 10 at nonprofit organizations, have been 
evaluated and have demonstrated success in moving welfare recipients 
off of welfare and into self-sufficient employment. In addition, a 
number of community action agencies and community development 
corporations have also been working with welfare recipients on exactly 
the kind of activities envisioned by the pending legislation.
  I just want to make sure that a State may provide funding from the 
Welfare-To-Work Program to entities such as community action agencies, 
community development corporations and other nonprofit organizations.
  Mr. ROTH. That is correct. States may provide funding to these types 
of organizations.
  Mr. HARKIN. I thank the Senator.
  Mr. GRAMS. Mr. President, when Congress and the President reached 
agreement on the broad outlines of plan to balance the Federal budget, 
I had hoped that I could stand before the Senate during debate on the 
reconciliation legislation and proudly announce my full support. It is 
with deep regret, Mr. President, that I cannot. After careful 
examination of S. 947, the Balanced Budget Act of 1997, I have come

[[Page S6324]]

to the conclusion that this legislation is good for Washington but bad 
for the taxpayers, and because it is not in the best interests of the 
working Americans we represent, I must reluctantly oppose it. Here are 
the major grounds on which I base my decision.
  As I have said in previous statements before this Chamber, I have 
made the pursuit of a balanced budget my top priority in Congress, and 
have always said that I would support a budget plan that meets three 
specific criteria: First, it must shrink the size and scope of 
Government and return money--and the power those dollars represent--to 
the taxpayers; second, it must balance the budget by the year 2002 with 
steadily declining deficits each year without the use of rosy economic 
scenarios; and third, it must provide meaningful, broad-based tax 
relief to working families.
  Tax relief, of course, will be dealt with in the other half of the 
reconciliation package. While there are many good provisions included 
in the bill, this so-call spending reduction legislation still fails to 
meet those pro-taxpayer standards.
  First and foremost, like the budget agreement on which this 
reconciliation legislation is based, this bill does not shrink 
Government and return power to the taxpayers. In fact, it does the 
opposite; it increases mandatory spending. In the next 5 years, total 
mandatory spending would increase from $825 billion in 1997 to $1.1 
trillion in 2002, a growth of 32 percent. Over the next five years, 
Medicare will increase at a rate of 6.1 percent and Medicaid will 
increase nearly 7 percent each year from the inflated baseline. Instead 
of eliminating wasteful spending to reduce the Federal deficit, this 
budget plan actually creates numerous new programs, including $34 
billion in new entitlement programs funded by the taxpayers' hard-
earned dollars.
  In doing so, the plan has erased all of the savings achieved in last 
year's landmark welfare reform legislation. The reconciliation 
legislation includes about $24 billion in spending for new children's 
health care initiatives, while adding back $14.2 billion in welfare 
benefits for legal aliens and food stamp recipients.
  Under this legislation, the Federal Government will spend $1.2 
trillion on welfare alone over the next 5 years. That is $15 billion 
higher than the CBO projected. Of every dollar collected by the IRS, 14 
cents goes to welfare programs, with less than 1 cent dedicated to tax 
relief for working families.
  The fundamental flaw of the bill and the major source of my 
opposition to it is the new entitlement programs it creates. Such 
spending is a serious mistake at a time when we should control the 
explosive growth of mandatory spending and reduce the size of the 
Federal Government. History tells us that earlier entitlement programs 
started small, with perhaps the best of intentions, but have since 
exploded and now consume about 70 percent of all Federal revenues. To 
my disappointment, Washington has still not learned its lesson.
  Second, Mr. President, despite some positive changes, including 
structure changes in Medicare, the entitlement programs remain intact. 
This not only breaks our promise to the American people on fundamental 
entitlement restructuring, but also ensures that big Government lives 
on by allowing Washington to avoid the hard choices it must make to 
address our long-term fiscal imbalances.
  Without fundamental changes, the imbalance between the Government's 
entitlement promises and the funds it will have available to pay for 
them will eventually shatter our economy. In its recent report, ``Long-
Term Budgetary Pressures and Policy Options,'' the Congressional Budget 
Office warns us that if these long-term budgetary pressures are not 
relieved, Federal budget deficits would mount and could seriously erode 
future economic growth. The Federal deficit would increase from 1.4 
percent of GDP, or $107 billion today to 30 percent of GDP in 2035, 
nearly $11 trillion. The debt held by the public would increase from 50 
percent of GDP, or $3.9 trillion in 1996 to 250 percent of GDP, $91 
trillion in 2035. Such rapid growth of the Federal debt and deficit 
will bankrupt this great Nation.
  This gloomy picture has been confirmed by the recently released 
report of the Social Security and Medicare boards of trustees. Without 
clear changes in public policy to address the financial imbalance, the 
hospital insurance fund, one of the Medicare trust funds, will be 
bankrupt in just 4 years. The Medicare trust fund will run a deficit of 
$13 billion this year. By 2001, it will run a deficit of $49 billion 
and go broke. The disability insurance trust fund will be bankrupt in 
2015, and Social Security trust funds will be bankrupt in 2029. And we 
do not have any clear and agreed public policy to address this 
imbalance.
  Although the proponents of the legislation claim that it will avert 
the crisis of Medicare bankruptcy until 2007, the fix is temporary and 
is no more than tinkering with the system. Accounting gimmicks are also 
applied to extend the life of Medicare. It shifts home health care from 
part A to part B and use the general account to cover the deficits of 
the trust fund. This means a surge of new spending in Medicare in the 
future that taxpayers will be obligated to fund.
  Third, unlike the Balanced Budget Act produced by the Republican 
Congress in 1996, this Balanced Budget Act does not result in steadily 
declining deficits, because the savings are achieved not through honest 
accounting but through rosy economic scenarios. Although this 
legislation claims over $117 billion savings in Medicare and $8 billion 
in Medicaid, all of the spending cuts result from a baseline projection 
of Government spending in which programs are assumed to grow according 
to such factors as the rate of inflation, population growth, and 
formulas written into the law.
  Any honest budget plan must reach balance through steadily declining 
deficits every year; in other words, the deficit must be lower each 
year than the preceding one. This 5-year budget agreement actually 
increases the deficit for the first 2 years, then projects enough of a 
reduction in the final 2 years to reach balance. The deficit under this 
budget will go up by $23 billion next year, from $67 billion this year 
to $90 billion, and remain as high as $90 billion in 1999. Over 70 
percent of the deficit reduction will not occur until after President 
Clinton leaves the White House. A significant percentage of the plan's 
deficit reduction results from optimistic economic assumptions, not 
sound policy changes.
  A budget plan must also be based on real numbers and not the inflated 
budget estimates that have been used in the past to justify more 
spending and higher taxes. This budget agreement fails on that score as 
well by continuing to use the inflated budget estimates of the past to 
mask the spending increases it contains. I cannot support a budget that 
uses such gimmicks simply to make the numbers add up on paper.
  In its analysis of the budget, the Heritage Foundation concluded that 
``a credible plan to balance the Federal budget must result in a 
smaller Government that costs less and leaves much more money in the 
pockets of working Americans. The current reconciliation bill not only 
fails these important tests, but in many cases would implement policies 
that are worse than taking no action at all.''
  Our current sound economic growth has reduced the budget deficit to a 
17-year low without any fiscal constrains and reforms. We should use 
this historic opportunity to balance the budget in less than 5 years, 
start to pay back our $5.4 trillion national debt, and address our 
long-term fiscal imbalances. Unfortunately, we have once again missed 
this opportunity.
  Mr. President, under the legislation before us, Washington will spend 
more of the taxpayers' hard-earned dollars creating new entitlement 
programs, while expanding old programs just to please the big-spending 
politicians and the special interest groups they feed. That is not the 
budget the taxpayers of Minnesota are expecting. That is not the budget 
Congress owes America's working families. But that is the budget 
Washington claims is the right answer. I regret that I do not agree, 
and cannot therefore support the spending portion of the budget 
reconciliation legislation.


                           amendment no. 445

  Mr. SPECTER. Mr. President, I would like to take this opportunity to 
explain my vote in opposition to the motion to waive the Budget Act for

[[Page S6325]]

consideration of the substitute amendment offered by Senator Reed.
  To its credit, the Reed substitute did not contain the Medicare home 
health care/copayment language or the 65-67 Medicare age eligibility 
language in the reported bill. I voted against both of those provisions 
on independent votes yesterday and continue to be concerned about their 
inclusion in S. 947.
  Notwithstanding those elements of the Reed amendment, I could not 
support it because it failed to include an important provision or 
medical savings accounts for Medicare beneficiaries.


exemption from auctions for public safety radio services and allocation 
       of spectrum for public safety and public service entities

  Mr. BRYAN. Mr. President, I rise in support of the proposal to ensure 
that sufficient radio spectrum is made available for public safety and 
maintenance of the Nation's critical infrastructure, such as pipeline, 
railroad, and electric, gas and water utility services. With the 
success of spectrum auctions for commercial radio services, the FCC has 
been reluctant to allocate sufficient spectrum for these vital 
services. This legislation will expand the FCC's authority to auction 
spectrum, but not at the expense of entities that we have entrusted to 
protect the safety of life, health and property and to provide 
essential public services.
  In adopting rules for the use of this new spectrum, I hope the FCC 
will promote the development of shared public safety/public service 
radio systems. In Nevada, it was recognized several years ago that it 
would be prohibitively expensive for any one public safety agency or 
public service utility to build and maintain a state-of-the-art 2-way 
radio system to cover this vast territory and provide the service 
features these various agencies need. Several key public service and 
public safety organizations took the initiative to pool their resources 
to build a system that would share backbone infrastructure, such as 
mountaintop repeater sites and radio frequencies. Through software 
partitioning, each user has its own discreet and secure virtual private 
network on this shared infrastructure. The parties first had to secure 
waivers of the FCC's rules so that nongovernment entities could share 
public safety frequencies on a not-for-profit basis. Initial system 
users include the Nevada Department of Transportation, University of 
Nevada law enforcement personnel, City of North Las Vegas, Sierra 
Pacific Power Company, and the Nevada Power Company. Other utilities 
and state and local government agencies are also looking to partner in 
the system, which currently covers more than half of the State's 
geography.
  Shared public safety/public safety radio networks such as the one we 
have pioneered in Nevada have many advantages: First, joint use of a 
system is a spectrally efficient; second, during disasters and 
emergencies, there is a great need for interoperability between 
emergency response agencies and public service utilities that is easily 
accommodated on the shared system; third, equipment can be loaned from 
one entity to another on an as-needed basis during specific emergencies 
or special situations; fourth, other agencies and utilities can be 
added to the system without system duplication of facilities; fifth, 
smaller, rural agencies can access state-of-the-art technology that 
would otherwise be beyond their reach; and sixth, taxpayer and utility 
ratepayer costs can be significantly reduced.
  Does the Senator from Arizona agree that these shared public safety/
public service radio networks should be promoted?
  Mr. McCAIN. Yes, I agree. I would also like to offer my support for 
the allocation of new spectrum for use by public safety and public 
service organizations, and would urge the FCC to adopt rules that would 
facilitate, if not promote, the development of shared radio systems by 
such entities. I also know that Senators Stevens, Lott, and Burns have 
been very concerned and involved in this issue. I look forward to 
working with them and Senator Bryan to ensure that the Commission takes 
such action as necessary to deal with this subject and I am also 
hopeful that we can, if needed, clarify any problem with this language 
in conference.


                       What is Right for Medicare

  Mr. DORGAN. Mr. President, the votes on this reconciliation bill 
included two votes on spending cuts in the Medicare Program. The two 
controversial amendments dealt with increasing the eligibility age for 
Medicare from age 65 to 67 and income-testing of Medicare for upper 
income beneficiaries.
  I support the change that will result in substantial savings through 
reduction of Medicare reimbursements to providers. I also agree with 
other changes that will improve and streamline the program.
  However, I voted against the proposal included in the Committee's 
bill which would increase the eligibility age from 65 to 67 and the 
proposal to impose a means-test for higher-income beneficiaries.
  I am willing to consider supporting both of these proposals under the 
right conditions, which I will describe below but I think it is 
inappropriate to be making Medicare cuts on the spending side of 
reconciliation in order to make room for larger tax cuts on the revenue 
side of reconciliation.
  Whatever changes are made in Medicare should be made exclusively and 
specifically for the purpose of extending the solvency of Medicare--not 
for the purpose of providing additional room for tax cuts, the bulk of 
which are proposed to go to upper income earners in the United States. 
We must look at the right ways to keep Medicare solvent without 
breaking faith with the country's senior citizens.
  Asking senior citizens who make more than $50,000 to pay higher 
prices for their Medicare policies so that investors who make $500,000 
can be given tax cuts seems inappropriate to me. There's no denying a 
direct connection when the Medicare proposals are made in the context 
of a reconciliation bill that includes spending and taxing. The act of 
achieving Medicare savings then becomes intertwined with the desire for 
tax cuts on the revenue side.
  The reconciliation bill specifically calls for a commission to make 
recommendations on long term changes necessary to ensure the solvency 
of the Medicare Program. I support that and I hope that such a 
commission will be established quickly and will ultimately result in 
solid recommendations which the Congress can then act on quickly.
  When we are able to look at recommendations which are developed 
specifically for the purpose of extending Medicare solvency, then I am 
willing to consider changes to Medicare, including means-testing and/or 
increasing the eligibility age under the following conditions.
  First, with respect to increasing the eligibility age, if and when we 
do that, we must be prepared to respond to the question of what happens 
to those senior citizens whose incomes are inadequate to pay the higher 
cost of private health care insurance between age 65 and 67 when they 
would no longer be covered. Changing the eligibility age from 65 to 67 
without providing some mechanism to provide for the availability of 
affordable insurance coverage for the citizens in that age group would 
simply mean we have millions more uninsured Americans. Low income 
senior citizens between the ages of 65 and 67 will never be able to 
afford the kind of premiums that will be assessed by the health care 
industry to insure people of that age. So, the eligibility age increase 
cannot simply be considered on its own as it was in the reconciliation 
bill. Nor can it be argued that the increase in the eligibility age 
parallels the increase in the social security retirement age. The 
ramifications are very different for increasing the medicare 
eligibility age.
  Second, with respect to means-testing or income-testing, as it is 
called, I am willing to support means-testing for Medicare, but again, 
only on the condition that the means-testing itself is done for the 
purpose of extending the solvency of Medicare and not part of a 
reconciliation bill that is designed to cut spending in a way that will 
accommodate additional tax cuts.
  The temptation is too great for those in Congress who never supported 
the Medicare bill in the first place. It is a concern of mine that the 
proposed changes to Medicare in this bill are there not for the purpose 
of increasing the solvency of Medicare, but rather are there to 
accommodate tax cuts for upper income Americans. This, in my judgement, 
undercuts the Medicare Program.

[[Page S6326]]

                           AMENDMENT NO. 428

  Mr. McCAIN. Mr. President, I am proud to have cosponsored amendment 
No. 428, which will significantly reduce fraud, abuse, and waste in the 
Medicare system. This is an issue which I have been working on for many 
years and I am pleased to have been joined in this battle to combat 
fraud and abuse in our health care system by my colleague from Iowa, 
Senator Tom Harkin.
  This important amendment introduced by Senator Harkin incorporates 
portions of my legislation, the Medicare Whistleblower Act S. 235, 
which would assist Medicare beneficiaries with identifying provider 
fraud in the Medicare system.
  Over and over again, I have heard from seniors about their personal 
experiences with fraudulent and negligent billings throughout the 
Medicare Program. Many of these seniors say that their Medicare bills 
frequently include charges for medical services which they never 
received, double billings for a specific treatment, or charges which 
are disproportionate and severely marked up. Usually, most of these 
seniors have no idea what Medicare is being billed on their behalf, and 
they have no way to obtain a detailed explanation from the Medicare 
providers.
  These personal stories from senior citizens are confirmed by analyses 
and detailed studies. According to the General Accounting office, fraud 
and abuse in our Nation's health care system costs taxpayers as much as 
$100 billion each year. Medicare fraud alone costs about $17 billion 
per year which is about 10 percent of the program's costs.
  This is quite disconcerting, especially in light of the financial 
problems facing our Medicare system.
  A fundamental problem with the Medicare system is that most 
beneficiaries are not concerned with the costs of the program because 
the Government is responsible for them. One of my constituents shared 
with me an experience he had when his provider double-billed Medicare 
for his treatment and the provider told him not to be concerned about 
it because ``Medicare is paying the bill.'' This is an outrage and we 
cannot allow this flagrant abuse of taxpayer dollars to continue. 
Remember, when Medicare overpays, we all over-pay, and costs to 
beneficiaries and the taxpayers spiral while the financial 
sustainability of the program is violated.
  The amendment addresses this fundamental problem in the Medicare 
program by strengthening the procedures for detecting and identifying 
fraud and waste in the Medicare system. Beneficiaries would be given 
the right to request and receive a written itemized copy of their 
medical bill from their Medicare health care provider. This itemized 
bill should be provided to the beneficiary within 30 days of the 
provider's receipt of their request. If anyone knowingly fails to 
provides a beneficiary with an itemized bill they will be subject to a 
civil fine. Once the beneficiary receives the itemized bill they would 
have 90 days to report any inappropriate billings to Medicare. The 
Medicare intermediaries and carriers would then have to review the 
bills and determine whether an inappropriate payment has been made and 
what amount should be reimbursed to the Medicare system.
  I recognize that provider fraud is not the sole source of waste and 
abuse in the Medicare system, and I wholeheartedly support other 
initiatives which address beneficiary fraud. However, studies indicate 
that provider fraud is most prevalent and the greatest concern for the 
system, making initiatives such as this one which specifically target 
provider fraud very important.
  It is imperative that we put an end to the rampant abuse and fraud in 
the Medicare system. I wholeheartedly believe that this provision would 
contribute significantly to this effort.
  Mr. LIEBERMAN. Mr. President, the reconciliation bill contains 
provisions that impact most of the programs and services provided by 
the Federal Government. Few people in the United States are not touched 
in some way by the changes we have voted for during this debate. I 
would like to touch upon just a few of the provisions.
  The bill includes significant progress toward protecting the Medicare 
Program. Without the changes included in this legislation, the Medicare 
trust fund would go bankrupt in 2001. The changes include the first 
major structural changes to Medicare in its 30-year history. The Senate 
bill modernizes Medicare by offering seniors the option of choosing 
from among a range of quality private health plans in addition to 
existing fee-for-service Medicare. It includes important new health 
insurance coverage for the Nation's children. It returns a degree of 
protection for people who live and work in our country, but because of 
foreign birth are not citizens of the United States.
  The bill makes substantial advances in ensuring that Medicare and 
Medicaid beneficiaries can get comparative information to help them 
choose the best available health care plan for their needs. An 
amendment I sponsored with Senators Chafee, Jeffords, Kerrey, Breaux, 
Wyden, and Kennedy requires that includes comparative information on 
benefits, cost sharing, premiums, service area, quality and performance 
including disenrollment, satisfaction, health process and outcomes, 
grievance procedures, supplemental benefits, and physician 
reimbursement method be provided to Medicaid recipients in managed 
care. In many cases, Medicaid managed care plans have significant 
differences in the treatment of asthma, immunization, heart disease, 
diabetes, and other problems endemic to the Medicaid population. This 
amendment should assist Medicaid beneficiaries in choosing high-quality 
plans, and through competition among plans, increase the quality of 
all.
  The bill also included an important demonstration program for 
Medicare based on the Government's own employee health care plan. That 
demonstration program includes provisions to improve the quality of 
health care for Americans based on a bill I sponsored, S. 795, the 
Federal Health Care Quality, Consumer Information and Protection Act.
  The dramatic drive of millions of people into managed care was all 
geared toward stopping unacceptable cost increases in healthcare. Now 
cost increases have slowed and it is time to focus on quality. Congress 
has made some initial, spasmodic efforts, such as last year's drive-
through delivery legislation. The health care quality provisions in 
this demonstration program represents an effort to take a more 
comprehensive and durable approach to improving health care quality.
  The Government has a powerful tool we think has gone unused--its 
purchasing power. The Federal Government is the single biggest 
purchaser of health care in the country. If we use that purchasing 
power wisely, the quality of health care in the country will be pulled 
upward dramatically. If we don't, the Federal Government will drag down 
the efforts the private sector is making to improve their employee's 
quality of health care.

  If the bill passes, the Government will only purchase Medicare 
coverage in this demonstration program that satisfies two requirements:
  First, plans will have to provide information that allows people to 
make straightforward plan-to-plan comparisons of health care quality. 
With that information, Medicare beneficiaries could look up the plans 
in their area to see which had the best record of care for the elderly. 
Empowering consumers with comparative quality information would force 
health care plans to compete continuously and aggressively on quality 
resulting in ongoing health care improvements.
  Second, all health care plans in the demonstration would have to meet 
certain minimum criteria or they couldn't be purchased by the Federal 
Government. Setting uniform federal criteria provides a powerful tool 
to address quality issues that emerge from the rapidly evolving health 
care industry. Existing accrediting agencies like the National 
Committee on Quality Assurance for Quality Assurance [NCQA] or the 
Joint Commission on Accreditation of Healthcare Organizations [JCAHO] 
could be licensed to certify that the health care plans are in 
compliance with the minimum criteria which should minimize bureaucratic 
duplication.
  Finally, to hold this proposed system together and prevent the 
standards from becoming outdated, an Office of Competition is created 
within the U.S. Department of Health and Human

[[Page S6327]]

Services. The Director of the Office of Competition will set and update 
the basic requirements for comparative data and minimum criteria. They 
will also work out a formula to pay for value. High quality plans will 
get paid slightly more than low quality plans.
  The Director will draw on the expertise already developed by large 
private purchasers and coordinate with them in improving the purchasing 
requirements over time.
  The stakes are high. This year over $1 trillion, almost one-seventh 
of the economy, will go toward health care services. Purchasers, both 
private and public, need to demand quality from the health care 
marketplace. Today you can identify a good stereo, a good car, or a 
good shampoo. But, you can't get the most basic information about the 
quality of your healthcare. That lack of information on health care 
quality is no longer acceptable, it can be fixed, and the Government 
should join the best corporate purchasers in the repair effort.
  I am deeply concerned about one aspect of the Medicare package that 
is included in this budget reconciliation bill. The Senate Finance 
Committee has enacted a series of reforms that would dramatically 
change the methodology by which payments are made to Medicare managed 
care plans as well as the new plans envisioned in the bill. This new 
payment structure would result in a redistribution of Medicare 
resources that is very beneficial to areas that have low health care 
costs and very damaging to areas where the delivery of health care 
services is much more costly.
  In my home State of Connecticut, seniors in four of our eight 
counties would suffer from Medicare managed care payments that, under 
this bill, would decline by more than 20 percent relative to current 
law. Don't misunderstand--I support actions to keep the Medicare trust 
fund solvent. But these reformulations don't just produce savings--they 
fundamentally shift expenditures from high cost to low cost areas. In 
one Connecticut county, this legislation would extract 57 times more 
savings from seniors enrolled in managed care than would the House Ways 
and Means Committee bill, which achieves similar savings. These are 
sobering figures--and they do not even take into account the impact of 
the bill's risk adjustment mechanism, which would automatically reduce 
Medicare payments by an additional 5 percent for all new managed care 
enrollees in their first year of enrollment.

  This legislation over-reaches in seeking to achieve a greater measure 
of geographic equity in the Medicare payment system. Instead of making 
the modest adjustments that are needed to improve the fairness of the 
current system, this bill calls for sweeping reforms that would disrupt 
the coverage of many seniors in order to help others.
  Tragically, many of those who would be hurt the most are low-income 
seniors who already have selected Medicare managed care plans because 
they need the additional benefits--such as prescription drug coverage, 
and dental and vision care--and the low out-of-pocket costs that many 
of these plans offer. These low-income seniors cannot afford to expose 
themselves to the high deductibles and copayments of the Medicare fee-
for-service system, nor can they afford to purchase an expensive 
supplemental Medigap policy.
  As I consider this issue, I think about the many areas in Connecticut 
that have suffered from economic downturns in recent years and, even 
today, are not enjoying the strong economic growth that is evident 
throughout much of the country. Seniors in these areas are particularly 
vulnerable. Considering that a disproportionate number of Medicare 
managed care enrollees are low-income seniors, I believe we should 
proceed carefully as we contemplate reforms that affect their coverage. 
For many of these seniors, a reduction in their Medicare benefits would 
cause severe financial hardship.
  I want to emphasize that I have no desire to be involved in any 
contest that pits the Medicare beneficiaries of Connecticut against 
those of Iowa, Nebraska or any other State. I completely support the 
expansion of new health care choices to all seniors, regardless of 
where they live. I am convinced, however, that this can be accomplished 
without awarding 60-percent payment increases for certain low-cost 
areas--many of which tend to be sparsely populated--at the expense of 
other areas where large numbers of seniors are already enrolled in 
private health plan options. The number of seniors who would be 
penalized by this shortsighted approach far exceeds the number who 
would benefit.
  I strongly believe that a more cautious, thoughtful approach is 
warranted. For example, a 70/30 blend between local and national 
payment rates would go a long ways toward eliminating the disparities 
that currently exist--without causing massive cuts in certain areas. In 
addition, a minimum annual update for all plans, combined with some 
kind of link between growth in fee-for-service spending and managed 
care spending, would help to assure that the resources available to 
Medicare managed care plans do not fall hopelessly behind the growth in 
medical inflation. It is totally unrealistic to think that we can allow 
payments to decrease in certain areas--while actual costs are 
increasing by 5 or 6 percent annually--without having any adverse 
affect on seniors.

  As we move forward with Medicare reform, we need to acknowledge that 
it is, in fact, more costly to serve Medicare beneficiaries in some 
areas of the country than others. There are legitimate reasons why it 
costs more to deliver health care services in densely populated urban 
areas. The wages of medical personnel and the capital costs of medical 
facilities differ considerably from region to region and from State to 
State. Even within individual States, medical costs vary from county to 
county. To discount this economic reality, as this legislation does, is 
sheer folly.
  Perhaps the most troublesome component of this Medicare payment 
proposal is the new enrollee risk adjustment mechanism. This provision 
arbitrarily and automatically reduces Medicare payments by 5 percent 
for all new managed care enrollees--regardless of their age or health 
status--in their first year of enrollment. I have serious concerns 
about the implications of this proposal. How are we supposed to promote 
competition within the Medicare Program if we begin by saying that 
everyone who leaves the fee-for-service system will be subject to a 5 
percent penalty? This new enrollee tax will limit beneficiary choice by 
discouraging health plans from entering markets in which seniors do not 
have private health plan options at this time. Everyone in this chamber 
should be deeply alarmed by this misguided provision.
  Having given this Medicare payment proposal an honest and thoughtful 
evaluation, I am convinced that we should work toward a more sensible 
and well-reasoned approach when this legislation is considered in the 
Senate-House conference committee. I want to state very clearly that I 
do not have a problem with the amount of Medicare savings this 
legislation would achieve; I just believe we have an obligation to 
achieve these savings in ways that do not disrupt the coverage of 
seniors. I urge my colleagues to join me in calling for a new approach.


                           AMENDMENT NO. 460

  Mr. McCAIN. Mr. President, I am proud to have offered an amendment to 
the budget reconciliation package which provides incentives for States 
with expanding access to health care coverage under the Medicaid system 
to devise innovative and cost effective programs. This amendment is 
important to any State interested in best serving the health care needs 
of its people.
  My amendment authorizes the continuation of a State's Medicaid 
managed care program operating under a section 1115 waiver. States 
would have the option of requesting an automatic extension of their 
waiver program for 3 years or permanently continuing their waiver 
managed care program if it has successfully operated for at least 5 
years and has demonstrated an ability to successfully contain costs and 
provide access to health care.
  In addition, this amendment allows these same States to utilize their 
own resources to revise their programs and expand coverage, while 
reducing both State and Federal costs.
  The amendment will assist States in expanding health care coverage to 
their most vulnerable populations. This is something Congress has spent 
a great deal of time talking about during this session of Congress in 
terms of

[[Page S6328]]

children. But children are not the only ones for whom health coverage 
is a priority. There are still millions of people in this country who 
live below the poverty line who do not have coverage. Unfortunately, we 
often forget about these individuals.
  Several States have led the way in innovation for expanding coverage 
through cost containment: Tennessee, Oregon, Rhode Island, Hawaii, and 
Arizona. My home State, Arizona, was the first to recognize that 
improved quality, better access and reduced costs could be achieved 
through the appropriate use of managed care as an integrated approach 
to health care for low income people.
  These States have summoned the political will and marshaled their 
State resources to improve their health care programs while reducing 
both State and Federal costs. Many new States are now following the 
examples set by the pioneers and have filed statewide section 1115 
waiver requests to move their programs into managed care.
  In Arizona, 72 percent of the voters decided last fall that health 
care should be available to everyone under the poverty line. Arizona 
already covers children up to 133 percent over the poverty line. This 
means Arizona decided to cover the 50,000 men and women without 
children who live under the poverty line. This is their only hope of 
health care coverage.
  Unfortunately, the administration has recently erected additional 
barriers to Arizona's initiative. In spite of the substantial savings 
documented by Health Care Financing Administration [HCFA] evaluators 
since the program began in 1982, more than enough to offset the cost of 
expanding coverage, the administration would not allow Arizona to 
reinvest these savings it achieved over a traditional fee-for-service 
program in expanded coverage. Nor will HCFA allow the State credit for 
their program's expected savings over the next 5 years.
  States like Arizona which have successfully been operating under an 
1115 Medicaid waiver should not be penalized for a change in Federal 
guidelines which occurred after the program began. No one is 
questioning whether these States have saved the Federal Government 
millions. Arizona, Tennessee, Hawaii, Rhode Island, and any other State 
with such a proven track record, should be allowed to use the managed 
care savings it achieved over a traditional fee-for-service program to 
expand coverage for their most vulnerable populations.
  This important amendment assists States in providing access to health 
care for the most vulnerable populations.


                            medical research

  Mr. HARKIN. Mr. President, I would like to submit for the Record some 
of the many letters I have received in support of Senator D'Amato's and 
my amendment to S. 947, the Balanced Budget Act of 1997, to create a 
medical research fund. These letters show the widespread grassroots 
support for this amendment which would expand support for medical 
research above and beyond what is currently being done at the National 
Institutes of Health [NIH].
  The people behind these letters understand what many recent studies 
have demonstrated--that investments in medical research can both save 
lives and lower Medicare costs through the development of more cost-
effective treatments and by delaying the onset of illness. They 
understand that while health care spending devours nearly $1 trillion 
annually, the United States devotes less than 2 percent of its total 
health care budget to health research. These letters are from people 
that understand the importance of increased funding for biomedical 
research. I ask unanimous consent that these letters in support of the 
medical research amendment be submitted for the Record.
  There being no objection, the letters were ordered to be printed in 
the Record, as follows:
  Thank you.
                                          American Association for


                                        Cancer Research, Inc.,

                                  Philadelphia, PA, June 25, 1997.
     Hon. Tom Harkin,
     Hon. Al D'Amato,
     Hon. Arlen Specter,
     Hon. Connie Mack,
     Hon. Tom Daschle,
     Hon. Barbara Boxer,
     Hon. Jay Rockefeller.
       Dear Senators: Bluntly, while debate rages over the budget, 
     1 mother, father, brother, sister or friend dies every 57 
     seconds in this country from cancer.
       On behalf of the 14,000 cancer researchers searching for 
     treatments, cures and prevention weapons in this country and 
     the 1.3 million people who get cancer every year, we urge you 
     on in your quest to find more funding for research and 
     education!
       The medical research amendment you are proposing is 
     essential to continue to find resources to support the 
     growing underfunded research programs at the NIH.
       It is essential amendments like this pass to support all of 
     our efforts to build a healthy America.
           Sincerely,

                                          Donald S. Coffey, Ph.D.,

     President.
                                                                    ____



                                   Parkinson's Action Network,

                                     Santa Rosa, CA June 25, 1997.
     Hon. Tom Harkin,
     Hon. Arlen Specter,
     Hon. Connie Mack,
     Hon. Alfonse D'Amato,
     Hon. John D. Rockefeller,
     Hon. Barbara Boxer,
     Hon. Tom Daschle.
       Dear Senators: Thank you for your efforts to increase funds 
     provided to the National Institutes of Health through the 
     creation of a Health Research Fund.
       A million Americans suffer from Parkinson's disease, a 
     neurological disorder that causes increasing tremor, 
     stiffness and slowness of movement, eventually leaving us 
     unable to move or speak. I have lived with Parkinson's for 
     ten years, watching Parkinson's increasingly disable me, and 
     seeing others like former Congressman Mo Udall lose the 
     battle to the point of total immobility. The human suffering 
     that results from Parkinson's is immense and incalculable, 
     but this condition also produces a fiscal nightmare: 
     Parkinson's is estimated to cost at least $25 billion a year 
     in medical care, disability benefits, assisted living and 
     lost productivity. The cost is so high because we typically 
     live in a disabled state for a long time, and the battle 
     against less of function is ongoing and expensive.
       Meanwhile, there is immense scientific promise, with 
     Parkinson's described by scientists as ``one of the brightest 
     spots in brain research.'' Nonetheless, the research is in 
     slow motion, stymied by inadequate funding: the federal 
     research budget for Parkinson's totals only about $30 million 
     or $30 per American afflicted. The current federal policy on 
     Parkinson's wastes billions in public and private dollars 
     coping with the effects of the disease, when millions of 
     dollars could be put toward finding a cure.
       The Congress is moving toward a dramatic reversal in this 
     policy, by support for the Udall Parkinson's Research bill, 
     which would authorize $100 million to adequately invest in 
     this research. The bill is co-sponsored by 57 Senators and 
     202 Congressmembers, and we expect to see it enacted very 
     soon. This momentum could be derailed by the present 
     allocation for health programs in the 1998 budget agreement. 
     If not corrected this year in appropriations for the National 
     Institutes of Health, the present funding disparity almost 
     surely will continue, leaving the human and fiscal nightmare 
     to go on unabated.
       Your amendment can fix this funding problem, return fiscal 
     sanity to this policy, and give hope to our struggling and 
     desperate community today.
       Thank you from the bottom of our hearts for your efforts.
           Sincerely,
                                                Joan I. Samuelson,
     President, Parkinson's Action Network.
                                                                    ____



                                   Cystic Fibrosis Foundation,

                                      Bethesda, MD, June 25, 1997.
     Hon. Thomas Harkin,
     Hon. Alfonse D'Amato,
     Hon. Arlen Specter,
     Hon. Connie Mack,
     Hon. Thomas Daschle,
     Hon. Barbara Boxer,
     Hon. John Rockefeller.
       Dear Senators, Today, there are more than 30,000 children 
     and young adults in the United States suffering as a result 
     of cystic fibrosis. There is a way to stop this--Medical 
     Research.
       Your amendment is vital to the support of finding 
     treatments and ultimately the cure for this devastating 
     disease.
       Just at a time when there are so many possible 
     breakthroughs, grants cannot be funded, contracts are not 
     given, clinical trials go unfunded, and education programs do 
     not begin.
       As a nation, as parents, we simply cannot let nearly 80 
     percent of our research opportunities slip away or be 
     delayed.
       The one approved program that we do not fund may hold the 
     cure.
           Sincerely yours,
                                           Robert J. Beall, Ph.D.,
     President and CEO.
                                                                    ____



                               Research Society on Alcoholism,

                                        Austin, TX, June 24, 1997.
     Hon. Tom Harkin, Hon. Alfonse D'Amato, Hon. Arlen Specter, 
       Hon. Connie Mack, Hon. Tom Daschle, Hon. Barbara Boxer, 
       Hon. John Rockefeller,
     U.S. Senate,
     Washington, DC.
       Dear Senators: On behalf of the 1,100 members of the 
     Research Society on Alcoholism, I am writing to unequivocally 
     support the Medical Research Amendment. The

[[Page S6329]]

     Research Society on Alcoholism is a professional research 
     society whose members conduct basic, clinical, and 
     psychosocial research on alcoholism and alcohol abuse.
       Alcoholism is a tragedy that touches all Americans. One in 
     ten Americans will suffer from alcoholism or alcohol abuse. 
     It's cost to the nation is nearly $100 billion annually. 
     Research holds the promise of developing effective methods 
     for the prevention and treatment of this far reaching 
     disease.
       The Medical Research Amendment is an answer to the problem 
     of desperately needed research funds. An investment of this 
     type will create the ability for the National Institutes of 
     Health to fund grant applications that will lead to 
     advancements in all areas of health research. At this time of 
     unprecedented opportunities in alcohol research, this 
     amendment provides much needed assistance.
       Thank you for your support of the research community. 
     Please do not hesitate to contact me if I can be of 
     assistance in any way.
           Sincerely,
                                              Ivan Diamond, Ph.D.,
     President.
                                                                    ____

                                            College on Problems of


                                        Drug Dependence, Inc.,

                                      Richmond, VA, June 24, 1997.
     Hon. Tom Harkin,
     Hon. Alfonse D'Amato,
     Hon. Arlen Specter,
     Hon. Connie Mack,
     Hon. Tom Daschle,
     Hon. Barbara Boxer,
     Hon. John Rockefeller,
     U.S. Senate, Washington, DC.
       Dear Senators: The College on Problems of Drug Dependence 
     (CPDD) is the leading scientific society in the field of drug 
     abuse. On behalf of our nationwide membership I am writing to 
     lend our support to the Medical Research Amendment. Our 
     commitment to research advances and their positive 
     implication for the future is strengthened by this amendment 
     and its commitment to the research community.
       An estimated 30 million Americans suffer from drug and 
     alcohol addiction. Alarmingly, of the 59 million women of 
     child bearing age, nearly 5 million are using illicit drugs 
     such as marijuana, cocaine, and heroin. Economically, drug 
     and alcohol abuse cost this country more than $1600 billion 
     annually. Research is the answer to understanding this 
     complex and devastating problem.
       The Medical Research Amendment is the answer to a long 
     standing problem facing the United States, the undervalued 
     commodity of research. Research can provide us with the 
     elusive answers to questions of addiction, drug abuse, and 
     treatment. This amendment is an investment in the future of 
     America and not just the National Institutes of Health.
       Thank you for your support of research and its advances. 
     Please do not hesitate to contact me if I can be of 
     assistance in the future.
           Sincerely,
                                         Robert L. Balster, Ph.D.,
     Public Policy Officer.
                                                                    ____

                                           College of Physicians &


                              Surgeons of Columbia University,

                                      New York, NY, June 25, 1997.
     Hon. Alfonse D'Amato,
     U.S. Senate, Hart Senate Office Building, Washington, DC.
     Hon. Tom Harkin,
     U.S. Senate, Hart Senate Office Building, Washington, DC.
       Dear Senators Al and Tom: On behalf of Columbia University 
     College of Physicians and Surgeons, I wish to express our 
     support for the amendment offered by Senators D'Amato, 
     Harkin, Specter, and Mack to provide additional funds over 
     appropriated amounts for the National Institutes of Health 
     that is being offered to the Budget Reconciliation Bill.
       Current amounts for NIH are truly insufficient to fulfill 
     the objectives of NIH and the promise of biomedical research. 
     We have the opportunity to find the genetic basis of disease 
     and cures for illnesses such as Parkinson's, cancer, 
     diabetes, and others that afflict millions of Americans. The 
     contributions potentially offered by this amendment will save 
     millions of lives and billions of dollars.
       Support for biomedical research is one of the most 
     important investments Congress can make in the health and 
     welfare of our citizens. All of us in academic medicine thank 
     you for your leadership and vision.
           Sincerely,

                                         Herbert Pardes, M.D.,

                               Vice President for Health Sciences,
     and Dean of the Faculty of Medicine.
                                                                    ____

                                            The National Coalition


                                          for Cancer Research,

                                    Washington, DC, June 25, 1997.
     Hon. Tom Harkin,
     Hon. Alfonse D'Amato,
     Hon. Arlen Specter,
     Hon. Connie Mack,
     Hon. John D. Rockefeller,
     Hon. Barbara Boxer,
     Hon. Tom Daschle,
     U.S. Senate,
     Washington, DC.
       Dear Senators: The 55,000 cancer researchers, nurses, 
     physicians, and health care workers, tens of thousands of 
     cancer survivors and their families; 40,000 children with 
     cancer and their families, 82 cancer hospitals and cancer 
     centers across the country, and more than 2 million 
     volunteers who make up the National Coalition for Cancer 
     Research commend your medical research amendment to the 
     fiscal year 1998 Senate Reconciliation Bill.
       It is the Coalition's central conviction that the solution 
     to the complex problems surrounding cancer--the reduction in 
     morbidity, mortality, and the high costs of medical care--
     will come in a stepwise manner from the generation of new 
     knowledge through research. Additional federal support for 
     cancer research as provided by your Health Research Fund will 
     abet the human and financial costs of cancer.
       We must remember that despite the declining death rates of 
     the past few years, in the United States, men have a 1 in 2 
     lifetime risk of developing cancer, and women have a 1 in 3 
     risk. Cancer is still the second leading cause of death and 
     is expected to be the leading cause of death by the turn of 
     the century. The direct costs of health care services to 
     cancer patients is currently estimated at more than $104 
     billion annually and is increasing each year. The generation 
     of new knowledge through research into the molecular events 
     involved in the cause and progression of cancer should lead 
     to increasingly effective means of protection and treatment, 
     the only means to stop the spread of disease, and curtail 
     these costs.
       The Coalition recognizes that the Congress is pressed with 
     securing savings in the Medicare and Medicaid programs, and 
     applauds your attention to the need to invest in biomedical 
     research to stop the spread of diseases which cause long term 
     care costs. The Coalition commends your amendment which 
     secures additional resources for biomedical research because, 
     without doubt, research is the gateway to progress against 
     cancer.
       Thank you for seizing this opportunity now to do something 
     of utmost importance for our country.
           Sincerely,
                                             Albert H. Owens, Jr.,
     President.
                                                                    ____



                               National Down Syndrome Society,

                                      New York, NY, June 25, 1997.
     Hon. Tom Harkin,
     Hon. Alfonse D'Amato,
     Hon. Arlen Specter,
     Hon. Connie Mack,
     Hon. Thomas Daschle,
     Hon. Barbara Boxer,
     Hon. John Rockefeller.
       Dear Senators: One in every 800 children is born with Down 
     Syndrome and there are over 350,000 people with this 
     condition in the U.S. today. It is the most commonly 
     occurring chromosomal abnormality, resulting when an 
     individual possesses three, rather than usual two, copies of 
     the 21st chromosome.
       Medical research supported by the National Institutes of 
     Health is our only hope in developing better therapeutics to 
     treat those individuals who have Down syndrome and to help us 
     better understand the causes of this disease so we can one 
     day prevent it from occurring. The National Down Syndrome 
     Society has just entered a historic public-private research 
     initiative with the National Institutes of Child Health and 
     Human Development to examine behavior and cognitive 
     development of individuals with Down syndrome. This project 
     is an important first step in increasing our understanding of 
     this disease.
       Thank you for your efforts and commitment to ensuring the 
     longterm viability of our medical research infrastructure. We 
     support your efforts to establish a National Fund for Health 
     Research to ensure the NIH has the resources necessary to 
     continue to advance medical science in the United States.
           Sincerely,
                                                  Myra E. Madnick,
     Executive Director.
                                                                    ____



                                  Alliance for Aging Research,

                                    Washington, DC, June 25, 1997.
     Hon. Tom Harkin,
     Hart Senate Office Building,
     Washington, DC.
       Dear Senator Harkin: The Alliance for Aging Research, an 
     independent not-for-profit organization working to improve 
     the health and independence of older Americans, applauds and 
     strongly supports an amendment to establish a National Fund 
     for Health Research. We understand this fund would be 
     established in the Treasury to expand support for medical 
     research through the National Institutes of Health.
       As you know, the Alliance has consistently made the case 
     that the most effective means to achieve savings in Medicare 
     and Medicaid is by improving the health status of older 
     Americans. The most effective long-term strategy is to 
     advance biomedical research and to apply what we learn to 
     improved geriatric health management and prevention of 
     chronic disease. Studies released this year from Duke 
     University show a steady decline in chronic disability since 
     the 1980s among this nation's older population, saving 
     Medicare billions of dollars.
       In a special report presented by the Alliance to the White 
     House Conference on Aging, we stated that by postponing 
     physical dependency for older Americans by just one month 
     would save the nation $5 billion a year in health care and 
     nursing home costs. Postponing the onset of Alzheimer's 
     Disease by just five years would, in time, save $50 billion a 
     year in health care costs. And a

[[Page S6330]]

     five-year delay in the onset of cardiovascular disease could 
     save an estimated $69 billion a year.
       Your amendment would be a first step toward fulfilling the 
     commitment made by the Senate through the Mack Sense of the 
     Senate calling for a doubling of the NIH in the next five 
     years. We understand this would in no way take the place of 
     the Congressional appropriations to the NIH.
       Unless we discover better ways to treat, prevent or 
     postpone diseases of aging, the costs to the nation will grow 
     exponentially in the decades ahead. Again, I commend you and 
     your colleagues invaluable support for a strong national 
     investment in medical research.
           Best regards,
                                                     Daniel Perry,
     Executive Director.
                                                                    ____



                                    Autism Society of America,

                                      Bethesda, MD, June 25, 1997.
     Hon. Tom Harkin,
     Hon. Alfonse D'Amato,
     Hon. Arlen Specter,
     Hon. Connie Mack,
     Hon. Thomas Daschle,
     Hon. Barbara Boxer,
     Hon. John Rockefeller.
       Dear Senators: I am writing on behalf of the Autism Society 
     of America to support your amendment to establish a National 
     Fund for Health Research with additional savings that may 
     result from changes made by the Balanced Budget Act which 
     exceed the savings called for in the Budget Resolution. As 
     the amount of discretionary funds available for medical 
     research funding continues to shrink, we must find other ways 
     to ensure that our research infrastructure is maintained.
       Autism is a developmental disability that typically appears 
     during the first three years of life. It is believed to be a 
     genetically-based neurological disorder that affects more 
     than 400,000 individuals in the United States, making it the 
     third most prevalent developmental disability. Autism is four 
     times more prevalent in boys than girls, and knows no racial, 
     ethnic nor social boundaries. Family income, lifestyle, and 
     educational levels do not affect the chance of autism's 
     occurrence. The estimated health care cost associated with 
     autism is greater than $13 billion a year.
       At the present time, there is no prevention, treatment, or 
     cure for autism. Our only hope in better understanding autism 
     is through research. NIH is embarking on many exciting 
     research endeavors focused on autism. In fact, NIH Director 
     Harold Varmus has said numerous times that the time is right 
     for autism research--we now have the tools to help us begin 
     to unlock the mysteries of this disorder.
       We appreciate your commitment to identify an additional 
     source of funding for medical research and for giving 
     individuals with autism the hope that through research we 
     will find a treatment and cure.
           Sincerely,
                                               Sandra H. Kownacki,
     President.
                                                                    ____

                                             Depressive and Manic-


                                       Depressive Association,

                                       Chicago, IL, June 25, 1997.
     Hon. Tom Harkin,
     Hon. Alfonse D'Amato,
     Hon. Arlen Specter,
     Hon. Connie Mack,
     Hon. Thomas Daschle,
     Hon. Barbara Boxer,
     Hon. John Rockefeller.
       Dear Senators: Medical Research is critical to individuals 
     suffering for depressive illnesses. On behalf of the more 
     than 65,000 members of the National Depressive and Manic-
     Depressive Association I am writing to support your amendment 
     to establish a National fund for Health Research.
       Depressive illnesses are treatable diseases. Without the 
     research advances we have seen over the last 20 years, many 
     individuals suffering from depressive illnesses would not 
     have the opportunities they have today to participate as 
     contributing members of our society. New therapeutics which 
     have been developed through research are giving them this 
     chance.
       In any given year, 17.4 million American adults have some 
     form of depressive illness such as major depression, bipolar 
     disorder, or chronic, moderate depression. These conditions 
     account for more than $148 billion in direct health care 
     costs, and indirect costs. Such as lost work days for 
     patients and care givers. Investments in biomedical and 
     behavioral research on mental disorders are imperative for 
     preventing and treating these debilitating illnesses and 
     controlling the costs associated with them.
       Thank you for your efforts to expand our national 
     commitment to medical research!
           Sincerely,
                                                      Lydia Lewis,
                                               Executive Director.

  Mr. BIDEN. Mr. President, this budget bill--which would put us on a 
path to eliminating the budget deficit in the year 2002--contains 
numerous reforms of the Medicare program. In addition, the bill would 
restore short-term solvency to Part A of Medicare--the part that pays 
hospital bills and will otherwise be bankrupt in four years. I have no 
objection to most of the Medicare reform provisions, and I will vote 
for this bill overall.
  However, I want to talk briefly about two provisions that I oppose 
and explain why I voted to take them out of this bill.
  First, Mr. President, this bill would raise the age at which a person 
becomes eligible for Medicare from the current age 65 to age 67. I 
voted to keep the eligibility age at 65. While this increase would be 
gradual and would be phased in over the next 30 years--so it would not 
affect any current seniors--I think it moves us in the wrong direction. 
What we should be doing is making sure that more, not fewer, people 
have health insurance.
  Changing the current law so that today's workers will have to wait 
until they are 66 or 67 before they become eligible for Medicare 
threatens to add millions of people to the rolls of the uninsured. It 
is my understanding that 70 percent of Americans who retire between the 
ages of 60 and 65 will have no health insurance through their 
employers. If they have health insurance at all, they are paying 
exorbitant rates to buy it on their own.
  Increasing the eligibility age for Medicare by 2 years would leave 
most of these people unprotected for 2 more years. This result is 
totally counter to why we created Medicare in the first place: To make 
sure that older Americans have access to health care services when they 
are likely to need it the most. Raising the eligibility age for 
Medicare without addressing the issue of those who will lose--or those 
who will continue not to have--health insurance is a glaring gap in 
this proposal.
  Now, it has been argued by supporters of this change that because the 
Social Security retirement age will gradually increase to age 67, the 
eligibility age for Medicare should increase at the same time. But, Mr. 
President, there is no rational basis for linking Social Security and 
Medicare. They are two separate and distinct programs. If it is good 
policy to raise the Medicare eligibility age to 67--which I do not 
think it is at this time--then those arguments need to be presented. It 
is not good enough simply to say, ``Well, that's what we're doing with 
Social Security.'' And, I should note, that even when the Social 
Security retirement age increases, people will still have the option of 
early retirement at age 62. That is not the case with Medicare. It is 
all or nothing. And, we should not tell people between 65 and 67 that 
they get nothing.
  The second provision that I opposed would have--for the first time--
imposed means testing on higher income seniors. Under the plan, the 
monthly premiums for Medicare part B, which pays for doctor services, 
would have been based on how much income a person has. Now, I have long 
said that I believe it is not unfair or inappropriate to have wealthy 
seniors pay more for their Medicare coverage. So I support means 
testing in principle. But I am not sure that the means testing scheme 
in this bill is either fair or appropriate--and I think we ought to be 
sure of both before we make such a significant change in this program.
  This legislation was just drafted last week. Until noon yesterday--
Tuesday--this bill would have charged wealthier seniors higher 
deductibles under part B. But, then at midday, just a couple of hours 
before we voted on this issue, the bill was changed so that retirees 
with greater income would pay higher premiums, not higher deductibles. 
The fact that this last minute change was made just exemplifies the 
problem of trying to address this issue with haste.
  The premium increases in this budget bill are very substantial, and 
they would hit individuals with incomes over $50,000 and couples with 
incomes over $75,000. But we really do not know yet what the effect of 
these increases would be on these families, or on the Medicare system 
itself. This is why we need to proceed with greater caution.
  What we do in this budget bill--and what we must do--is what we have 
done many times in the last 30 years: Make the changes necessary to 
ensure the solvency of the Medicare Hospital Trust Fund over the next 
10 years. To address the long-term concerns once the baby boom 
generation reaches retirement age, I have previously called for the 
establishment of a bipartisan commission to study the situation and 
make recommendations. This bill establishes just such a commission, and 
instructs it to report back to Congress in a year.

[[Page S6331]]

  My point is that neither the increase in the Medicare eligibility age 
nor means testing are necessary to solve the short-term financial 
problems of the Medicare system. Instead, these are issues that the new 
commission should look at. In making significant changes to the 
Medicare program--among the most successful Federal programs ever--we 
need to do so with great thoughtfulness and deliberation.
  These changes have no immediate impact on the Medicare trust fund or 
on our general goal of balancing the overall Federal budget by 2002. In 
short, there is no reason why we cannot wait until we have the benefit 
of the recommendations of the bipartisan commission--within the next 
year--before we take action of this nature. That is why I supported 
taking these changes out of the budget bill, and why I supported 
Senator Reed's alternative Medicare proposal to make only those changes 
needed to make sure that Medicare remains financially solvent.


                          MEDICARE PROVISIONS

  Mr. McCAIN. Mr. President, the Senate took several difficult votes in 
the last two days related to Medicare reform. After carefully 
considering each of the amendments offered in the Senate, I cast my 
vote in favor of preserving and protecting the long-term solvency of 
the Medicare system.
  I voted for an amendment to eliminate the bill's provisions which 
would require means testing of Medicare premiums. I also voted for an 
amendment which would have simply delayed the implementation of premium 
means testing until the year 2000. I believe it is foolish to hastily 
make such a drastic change as this without the benefit of an indepth 
study of the entire Medicare Program. Unfortunately, both of these 
amendments failed.
  I am concerned about the bill's provisions which would delay the 
eligibility age for Medicare to 67 from the current age of 65. However, 
the bill would not implement this change until the year 2003, which 
will not affect current beneficiaries and, I believe, will allow us to 
assess this change within the context of a larger study of the program.
  The bill does establish a bipartisan commission to study the entire 
Medicare Program and make recommendations for the changes necessary to 
keep the program solvent beyond the year 2001, which is when the 
trustees have reported the program will be bankrupt. I believe we 
should wait for the commission's recommendations before enacting any 
fundamental changes to the program. However, I felt it was important to 
show a willingness to consider taking a first step toward long-term 
structural changes in order to give impetus to the commission's work.
  The budget reconciliation bill before the Senate contains many key 
provisions to expand benefits under Medicare and incorporate choice and 
competition into the current program. For example, the bill authorizes 
Medicare coverage of mammography screening, colorectal screening, bone 
mass measurement, and diabetes management. It also creates a Medicare 
Choice Program and a demonstration program for medical savings accounts 
for seniors. It contains provisions designed to eliminate waste and 
fraud in the Medicare system which could result in significant savings. 
These are improvements to Medicare for which I have fought for many 
years.
  I believe firmly that our priority must remain protecting the 
Medicare system from bankruptcy by the year 2001, and I will continue 
to work toward that goal.


                           Amendment No. 482

  Mr. LEVIN. Mr. President, the Levin-Jeffords amendment increases from 
12 to 24 months the limit on the amount of vocational education 
training that a State can count toward meeting its work requirement 
under the new Temporary Assistance for Needy Families Program. Under 
the old welfare law, recipients could attend postsecondary vocational 
education training for up to 24 months. I strongly support the new 
law's emphasis on moving welfare recipients more quickly into jobs, but 
I am troubled by the law's restriction on vocational education 
training, limiting it to 12 months. Two-year community college study, 
for instance, would not meet the requirement.
  Mr. President, the limitation on postsecondary education training 
raises a number of concerns, not the least of which is whether persons 
may be forced into low-paying, short-term employment that will lead 
them back onto public assistance because they are unable to support 
their families.
  Study after study indicates that short-term training programs raise 
the income of workers only marginally, while completion of at least a 
2-year associate degree has greater potential of breaking the cycle of 
poverty for welfare recipients. According to the U.S. Census Bureau, 
the median earnings of adults with an associate degree are 30 percent 
higher than adults with only a high school diploma or its recognized 
equivalent.
  Mr. President, let me just give some examples. The following are jobs 
that a person could prepare for in a two-year community college program 
and the salary range generally applicable to the positions:


                               NATIONWIDE

       Accounting, $14,000-$28,000.
       Computer technician, $14,000-$31,000.
       Law enforcement, $13,500-$25,000.
       Dental hygiene, $18,000-$60,000.
       Respiratory therapy tech, $21,000-$32,000.


                                MICHIGAN

       Computer programing, $24,800-$42,900.
       Radiology technician, $22.235-$32.425.
       Legal assistant, $28,630-$30,000.
       Child care development (supervisor), $23,590-$29,724.
       Registered nurse, $24,400-$38,135.

  Mr. President, the National Governors Association recognizes the 
merits of this amendment and has called for its passage. I urge my 
colleagues to support it because it will help us reach the new law's 
intended goal of getting families permanently off of welfare and onto 
self-sufficiency.
  In closing, I ask unanimous consent to have printed in the Record two 
articles that are relevant to this issue which appeared in the February 
17, 1997, USA Today and the June 1, 1996, New York Times.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                    [From USA Today, Feb. 17, 1997]

                   College Off Limits in Welfare Plan

                            (By John Ritter)

       States rushing to get welfare recipients off the rolls and 
     into jobs are telling some college students on public 
     assistance to drop out and find work.
       Under the old welfare system, recipients of cash grants 
     could go to school full-time. The new law, with its emphasis 
     on moving welfare recipients quickly into jobs, restricts 
     educational options.
       Short-term job training and a year of vocational education 
     are approved ``work activities'' under the new federal law, 
     passed last year, but regular college and community college 
     study are not.
       So even as President Clinton preaches education as the 
     route to prosperity, welfare reform is forcing recipients--
     predominantly single mothers--to forsake school for low-
     paying jobs.
       States must put bigger proportions of their welfare 
     caseloads to work--25% this year, 50% by 2002--or lose funds.
       ``The emphasis has shifted from how can we retrain people 
     or pick up where their education left off to how can we move 
     them into work,'' says Elaine Ryan of the American Public 
     Welfare Association.
       By one estimate, as many as 700,000 single parents on 
     welfare are enrolled in higher education and training.
       In California, 125,000 welfare recipients attend community 
     colleges. The City University of New York system has 20,500 
     welfare students.
       Schools already are lobbying state legislatures to find 
     ways to keep these students and their tuition reimbursements.
       But prospects are not bright.
                                                                    ____


                [From the New York Times, June 1, 1996]

           Workfare Rules Cause Enrollment to Fall, CUNY Says

                         (By Karen W. Orenson)

       New rules introduced by New York City Mayor Rudolph 
     Giuliani's administration that require all welfare recipients 
     to work have led thousands of students to drop out of college 
     or not enroll, according to officials at the City University 
     of New York. The decline in enrollment is significant, CUNY 
     officials say, because studies show that college gives people 
     on welfare a good chance to get better jobs at higher pay.
  Mr. DOMENICI addressed the Chair.
  The PRESIDING OFFICER. The Senator from New Mexico is recognized.
  Mr. DOMENICI. Mr. President, let me take 1 minute, and then we are 
going to final passage. I want to thank everybody for their 
cooperation. Under a very difficult process and procedure, I think we 
did very well. On a number of issues, there was great bipartisan 
support. I thank those on the other side of the aisle who have 
supported this overall package, and I hope the vote is overwhelming. 
Tonight we complete

[[Page S6332]]

the first step of three legs. The three legs are to get the deficit 
down by reducing spending; second is for us to get a good tax bill for 
all Americans; third is to do the appropriations bills in a manner that 
is consistent with the agreement and which doesn't violate the Budget 
Act.
  I believe this is a historic beginning, and I am very pleased to be 
part of it. I thank everyone here for their role. I thank all eight 
committees that assumed their burden and produced their reconciliation 
package. Mostly, I thank Senator Roth, the chairman of the Finance 
Committee, and Senator Moynihan, his Democratic manager, and all those 
on the Finance Committee who worked to produce a bipartisan bill.
  The lesson learned is that we can get things done that are difficult 
but good for the American people in a bipartisan way if we just work at 
it. I believe the best example we have of that is the Finance Committee 
this year. All the other committees had lesser responsibilities, but 
they provided their savings without rancor and with almost unanimity 
and, if not, a unanimity of spirit. I believe there is no process that 
would have let us in the U.S. Senate get this much work done. If this 
bill were freestanding and the tax bill were freestanding without the 
protections of the Budget Act, I just ask you to dream about what might 
happen. First, I think each bill could take 4 or 5 weeks, I think the 
amendments could run into the hundreds, and the bill could look like 
something completely different by the time we finished than what we 
started with. So we take some bad with the good in this difficult 
process called the reconciliation bill.
  I thank the ranking member of the Budget Committee not only for the 
work here on the floor, but actually as we moved through the last 3\1/
2\ months, Senator Lautenberg has been very good to work with, and we 
produced a good package, which will show up here in a bipartisan vote 
tonight. I thank the Senator. We produced a good bill.
  Mr. LAUTENBERG addressed the Chair.
  The PRESIDING OFFICER. The Senator from New Jersey is recognized.
  Mr. LAUTENBERG. Mr. President, I will be brief. I sense that 
everybody would like to hear a long speech, but I am going to 
disappoint them. I just want to say, Mr. President, that I, too, 
enjoyed my work with the distinguished chairman of the Budget 
Committee. We managed to resolve all of our problems without too much 
dispute, without any confrontation. There wasn't a moment that we 
walked out on anything. This reconciliation bill is consistent with 
that. We did, as it was appropriately noted, rush through some things. 
But that does not at all, in my view, suggest that we rushed through 
and didn't have the appropriate knowledge or review of the items that 
we were processing.
  I thought it was a job very well done. I must say, if we didn't have 
some time constraint on this, Heaven knows how long we would all be 
here. We would see summer come and go and we would still be debating.
  Again, I enjoyed the process and my first time at bat with the Budget 
Committee in the position that I have. I thoroughly enjoyed it. I hope 
that Senator Domenici will, as my ranking member in the not-too-distant 
future, also enjoy it. I promise to be cooperative.
  I want to thank the staff of the Policy Committee, but particularly 
my senior staff here--Bruce King, Sander Lurie, Nell Mays, Marty 
Morris, Amy Abraham, John Cahill, Jodi Grant, Matt Greenwald, Phil 
Karsting, Sue Nelson, Jon Rosenwasser, Jim Klumpner, and Mitch Warren--
who did a terrific job, as I know Bill Hoagland and his team did. I 
won't go through the names, but I will say that I have gotten to know 
them and respect them and admire the work they have done. I thank 
everybody for their cooperation, particularly my colleagues on this 
side.

  Mr. DOMENICI. Mr. President, Senator Gramm would like 30 seconds.
  The PRESIDING OFFICER. The Senator from Texas is recognized.
  Mr. GRAMM. Mr. President, I have heard a lot of people speak in my 13 
years in the Senate, but I don't think I have ever seen anybody do a 
better job of taking complicated issues and explaining them in a very 
short time as Senator Domenici has done in the last 2 days. I think we 
have made history on this bill, and I think the Senator from New Mexico 
has been a very important part of that.
  Mr. DOMENICI. I ask for the yeas and nays on final passage.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The yeas and nays were ordered.
  The PRESIDING OFFICER. The question is on the engrossment and third 
reading of the bill.
  The bill was ordered to be engrossed for a third reading and was read 
the third time.
  The PRESIDING OFFICER. The bill having been read the third time, the 
question is, Shall the bill pass?
  The yeas and nays have been ordered and the clerk will call the roll.
  The legislative clerk called the roll.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 73, nays 27, as follows:

                      [Rollcall Vote No. 130 Leg.]

                                YEAS--73

     Abraham
     Allard
     Ashcroft
     Baucus
     Bennett
     Biden
     Bond
     Breaux
     Brownback
     Bryan
     Burns
     Campbell
     Chafee
     Cleland
     Coats
     Cochran
     Collins
     Conrad
     Coverdell
     Craig
     D'Amato
     DeWine
     Domenici
     Enzi
     Feingold
     Feinstein
     Ford
     Frist
     Glenn
     Gorton
     Graham
     Gramm
     Grassley
     Gregg
     Hagel
     Hatch
     Hutchinson
     Hutchison
     Inhofe
     Jeffords
     Kempthorne
     Kerrey
     Kohl
     Kyl
     Landrieu
     Leahy
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Moseley-Braun
     Moynihan
     Murkowski
     Nickles
     Robb
     Roberts
     Rockefeller
     Roth
     Santorum
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Warner
     Wyden

                                NAYS--27

     Akaka
     Bingaman
     Boxer
     Bumpers
     Byrd
     Daschle
     Dodd
     Dorgan
     Durbin
     Faircloth
     Grams
     Harkin
     Helms
     Hollings
     Inouye
     Johnson
     Kennedy
     Kerry
     Lautenberg
     Levin
     Mikulski
     Murray
     Reed
     Reid
     Sarbanes
     Torricelli
     Wellstone
  The bill (S. 947), as amended, was passed.
  (The text of the bill will be printed in a future edition of the 
Record.)
  Mr. ROTH. Mr. President, I move to reconsider the vote by which the 
bill was passed.
  Mr. MOYNIHAN. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. ROTH. Mr. President, in my opening statement, I thanked my good 
friend and colleague, Senator Moynihan, my colleague on the Finance 
Committee, and our staff for their excellent work. I would be remiss, 
however, if I failed to conclude without again expressing my 
appreciation for these diligent professionals--men and women who work 
into the wee, wee hours, late nights, early mornings, and weekends to 
help us craft a bill that could find the kind of success that this has 
found on the Senate floor.
  I would like to particularly thank the following majority and 
minority staff of the Finance Committee who worked so hard on this 
bill, including Lindy Paull, Frank Polk, Julie James, Dennis Smith, 
Gioia Bonmartini, Alexander Vachon, Dee Dee Spitznagel, Joan Woodward, 
Brig Gulya, Mark Patterson, David Podoff, Faye Drummond, Kristen Testa, 
Doug Steiger, Rick Werner, and Rakesh Singh.
  Again, I am grateful for the outstanding work that they did. And I 
believe that it merits the thanks and gratitude of all of us.

                          ____________________