[Congressional Record Volume 144, Number 82 (Monday, June 22, 1998)]
[Senate]
[Pages S6767-S6769]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. D'AMATO:
  S. 2200. A bill to amend the Internal Revenue Code of 1986 to make 
the exclusion for amounts received under group legal services plans 
permanent; to the Committee on Finance.


     EXCLUSION FOR QUALIFIED EMPLOYER-PROVIDED GROUP LEGAL SERVICES

  Mr. D'AMATO. Mr. President, today I am introducing legislation to 
reinstate, and make permanent, the employee exclusion for amounts 
received under qualified employer-provided group legal services plans.
  This bill amends section 120 of the Internal Revenue Code and becomes 
effective for tax years beginning after June 30, 1998. It provides that 
an employee does not have to pay income and social security taxes for a 
qualified employer-provided group legal services plan. The annual 
premium is limited to $70 per person. In order to qualify, a plan must 
fulfill certain requirements, one of which states that benefits may not 
discriminate in favor of highly compensated employees.
  The tax exclusion of group legal services is not a new provision. In 
fact, prior to its expiration in June of 1992, employees had been 
allowed to exclude such benefits from their gross income since 1976, 
albeit through seven extensions from Congress. I believe it is time to 
reinstate this measure on a permanent basis.
  Employer-provided group legal plans have time and again proven their 
value in extending low-cost legal advice to working Americans. The 
reality for middle class wage earners is that they cannot afford the 
services of an attorney and thus cannot afford to obtain advice for 
issues relating to child support enforcement, adoptions, wills, 
landlord/tenant situations and consumer debt problems. Because it 
provides access to legal advice, this employer-provided benefit assists 
working Americans in avoiding the family disintegration and job 
disruption that can result from neglected legal issues.
  In New York, these plans affect hundreds of thousands of employees 
and members of their families. These New Yorkers are employed as school 
teachers, municipal workers, hotel and hospital employees, law 
enforcement personnel and thousands working in our many service 
industries. Many of our citizens, though employed, are earning enough 
only for basic necessities.
  A working mother seeking to enforce an order of child support gains 
access to the assistance of a lawyer through these legal benefit plans 
and avoids the need to rely on public assistance. A consumer debt 
problem can lead to a garnished salary, and eviction, the loss of a 
job, and dependency on public assistance. The relatively minor cost of 
providing this favorable tax treatment is repaid innumerable times by 
keeping the wage earner focused on his/her job, keeping a family in 
housing and intact, and removing the threat to moderate income workers 
to remaining self-sufficient.
  Employer-provided legal benefit packages produce economies in both 
the purchase of legal services for a large group and in the delivery of 
those services at a reduced price. Because they provide a cost-
effective approach, these employer-sponsored legal benefit plans are in 
the best American tradition of pragmatic, voluntary group action to 
meet common needs.
  Restoring equity to the tax treatment of this benefit by placing it 
on equal footing with other statutory fringe benefits is a goal worth 
achieving. As an aspect of middle class tax relief, a high return on 
the cost of this benefit is realized for the estimated 2.5 million 
working Americans who gain access to critical legal advice through its 
operation.
  Mr. President, there is no reason why we should not reinstate and 
make permanent this tax exclusion. In the past, the Senate repeatedly 
affirmed its commitment to assuring the availability of legal services. 
I urge my colleagues to join me in this effort to restore fair tax 
treatment of employer-provided group legal services.
  I ask unanimous consent that the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2200

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. PERMANENT EXTENSION OF EXCLUSION FOR EMPLOYER-
                   PROVIDED GROUP LEGAL SERVICE PLANS.

       (a) General Rule.--Subsection (e) of section 120 of the 
     Internal Revenue Code of 1986 (relating to amounts received 
     under qualified group legal services plans) is amended to 
     read as follows:
       ``(e) Termination.--This section and section 501(c)(20) 
     shall apply to--
       ``(1) taxable years beginning after December 31, 1976, and 
     before July 1, 1992, and
       ``(2) taxable years beginning after June 30, 1998.''
       (b) Effective Date.--The amendment made by this section 
     shall apply to taxable years beginning after June 30, 1998.
      By Mr. TORRICELLI (for himself, Mr. Gorton, Mr. Feingold, Mr. 
        Mack, Mr. Sessions, Mr. Thurmond, Ms. Landrieu, Mr. Breaux, Mr. 
        Hollings, Mr. Lautenberg, Mr. Kohl, Mr. Inhofe, Mr. Smith of 
        Oregon, and Mr. Shelby):
  S. 2201. A bill to delay the effective date of the final rule 
promulgated by the Secretary of Health and Human Services regarding the 
Organ Procurement and Transplantation Network, to the Committee on 
Labor and Human Resources.


                       organ donation legislation

  Mr. TORRICELLI. Mr. President, I rise today to introduce legislation 
that addresses a potential crisis in our organ donation system. 
Proposed regulations by the U.S. Department of Health and Human 
Services (HHS) would have devastating effects on community-based 
transplant programs by prohibiting states from offering organs to their 
own sickest residents before making them available nationwide.
  There is no more noble a deed than donating one's organs so that 
another may live. In the past 15 years, the national transplant system 
has saved over 200,000 lives. In my state of New Jersey, over 10,000 
people in the past 10 years have received life-saving transplants.
  Notwithstanding this success, there is a critical shortage of organs 
for donation. Less than one percent of Americans offer their organs for 
donation upon their death. Eleven people die every day in this country 
waiting for an organ.
  The changes proposed by HHS, however well intentioned, fail to 
adequately address the national shortage of donated organs and create a 
system which may actually increase waiting times in many areas of the 
country. By directing the United Network for Organ Sharing (UNOS) to 
develop a system which removes geography as a

[[Page S6768]]

factor in organ donation, the regulations will significantly increase 
waiting times in states with efficient systems. For instance, at 
University Hospital in New Jersey, the State's largest liver transplant 
center, the waiting period for a liver in 1997 was only 26 days, 
compared to a 250 day national waiting period. Forcing facilities, like 
University Hospital, to first offer donated organs nationwide will 
undoubtedly lead to longer waiting periods.
  These unintended consequences will be felt most greatly among 
patients with disadvantaged backgrounds. In my State of New Jersey, we 
are extremely fortunate to have a system that is fair and efficient. 
New Jersey's unique system of certificate of need and charity care 
ensures that the most critical patients get organs first regardless of 
insurance. A national organ donation system will force the smaller 
transplant centers that serve the uninsured and underinsured to close 
as the vast majority of organs go to the handful of the nation's 
largest transplant centers with the longest waiting lists. Without 
access to smaller programs, many patients will be faced with the 
hardship of registering with out-of-state programs that may turn them 
away due to lack of insurance. Those who are accepted will be forced to 
travel out of state at great medical risk and financial hardship.
  Mr. President, the legislation I introduce today is a bipartisan 
effort. I am pleased to be joined by my colleagues, Senators Gorton, 
Feingold, Mack, Sessions, Thurmond, Landrieu, Breaux, Hollings, 
Lautenberg, Kohl, Inhofe, G. Smith, and Shelby. Our bill will delay for 
one year the Secretary's ability to issue regulations regarding the 
nation's organ donation system. The delay will allow HHS to further 
consult with the medical community, particularly those serving low-
income patients, to develop workable guidelines for organ donation. In 
addition, the legislation calls on HHS to conduct a pilot study to 
determine the impact of any regulations before implementation. Finally, 
the legislation finds that provisions of the proposed changes with 
respect to standardized ranking and listing criteria, enforcement 
measures, and disclosure requirements are a potential good first step 
in improving the nation's organ donation system.
  For the past 15 years, the national organ procurement and allocation 
system has existed without federal regulation. During this time, each 
State has developed a unique system to meet their individual needs. 
Many states, such as New Jersey, have focused on serving uninsured and 
underprivileged populations. Clearly, improvements can be made to 
increase the efficiency and effectiveness of organ donation nationwide. 
The legislation I am introducing today will allow us to meet these 
objectives by providing greater time for a more thoughtful debate.
  Mr. President, I ask at this time that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2201

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. FINDINGS.

       Congress makes the following findings:
       (1) The national transplant system, established by the 
     National Organ Transplant Act of 1984, has saved over 200,000 
     lives. In 1998, 20,000 lives were saved by donated organs. 
     Approximately 60,000 Americans currently are awaiting an 
     organ transplant.
       (2) Every 16 minutes a new name is added to the national 
     organ waiting list.
       (3) Every day in the United States, 11 people on the 
     national waiting list die (more than 4,000 every year) 
     because there are not enough donated organs.
       (4) Eliminating the geographic criteria for donor organ 
     allocation, as proposed by the Department of Health and Human 
     Services, will have potentially negative consequences for the 
     nation.
       (5) Eliminating the geographic criteria for donor organ 
     allocation will make organ transplants economically 
     prohibitive for a large percentage of the population, 
     especially for the 22 percent of transplant recipients 
     covered under the medicaid program.
       (6) The following provisions proposed by the Department of 
     Health and Human Services with respect to organ donation are 
     appropriate and workable and should be studied--
       (A) the standardized listing criteria for patient placement 
     on lists;
       (B) the standardized criteria for determining current 
     medical status based on objective and measurable medical 
     criteria;
       (C) the provision of enforcement authority; and
       (D) the requirement of full and timely disclosure by 
     transplant centers of waiting list times and survival 
     statistics to potential patients.

     SEC. 2. DELAY OF EFFECTIVE DATE OF FINAL RULE REGARDING ORGAN 
                   PROCUREMENT AND TRANSPLANTATION NETWORK.

       (a) In General.--During the 1-year period beginning on the 
     date of the enactment of this Act, the Secretary of Health 
     and Human Services may not modify regulations that, as of 
     such date, are in effect with respect to the operation of the 
     Organ Procurement and Transplantation Network under section 
     372 of the Public Health Service Act (42 U.S.C. 274), 
     including regulations under section 1138 of the Social 
     Security Act (42 U.S.C. 1320b-8) with respect to such 
     Network. During such 1-year period, the final rule published 
     in the Federal Register to establish part 121 in title 42, 
     Code of Federal Regulations, has no legal effect.
       (b) Guidelines.--During the 1-year period described in 
     subsection (a), the Secretary of Health and Human Services 
     shall consult with appropriate individuals and organizations 
     in the medical community, including national and local organ 
     donation organizations (including those serving low-income 
     patients), to develop workable guidelines with respect to the 
     operation of the Organ Procurement and Transplantation 
     Network.
       (c) Study.--Prior to the implementation of any 
     modifications to the regulations described in subsection (a), 
     the Secretary of Health and Human Services shall conduct a 
     study to determine the impact of such proposed modifications 
     on indigent care, economic and geographic access to 
     transplantation services, transplantation outcome and 
     survival rate, and waiting list time by organ. The Secretary 
     shall ensure that any such modifications, together with the 
     results of the study, are open for public comment for a 
     period of at least 90-days prior to the effective date of 
     such modifications.

  Mr. FEINGOLD. Mr. President, I join my colleagues, Senator 
Torricelli, Senator Gorton, and others in introducing legislation to 
delay the effective date of the final rule promulgated by the Secretary 
of HHS regarding the Organ Procurement and Transplantation Network. 
This legislation is a crucial step in ensuring that implementation of 
the Department of Health and Human Services' Interim Final Rule 
regarding does not jeopardize patients' access to life-saving human 
organs in regions of the country that have been providing organ 
transplantation services efficiently.
  Mr. President, organ donation, allocation and transplantation are 
extremely sensitive issues. They are issues that patients, families and 
health professionals agonize over because they quite literally can 
determine who lives and who dies. They agonize over these decisions 
because there are so many more people in need of organs than there are 
organs to transplant.
  Mr. President, I want to share with my colleagues a fact that may not 
be well known, and that is that, according to statistics gathered by 
the United Network for Organ Sharing, UNO, Wisconsin's two organ 
procurement organizations--or ``OPOs'' as they are called--are two of 
the most successful in the entire country with respect to the ratio of 
organs procured per million in the population. Those two OPOs, one at 
the University of Wisconsin Medical School in Madison, the other at 
Froedtert Hospital in Milwaukee, have a truly impressive track record 
for conducting the community education and outreach that is so 
important in helping people make the decision about whether or not to 
donate organs. Through the tremendous work of Wisconsin's OPOs and our 
4 transplant centers, nearly 700 Wisconsinites received life-saving 
kidney, heart, liver, lung and pancreas transplants in 1997 alone.
  Mr. President, as you and many other colleagues may already know, the 
Secretary of Health and Human Services proposed a rule earlier this 
year to revamp the way the nations donated organs are allocated.
  Mr. President, the legislation my colleagues and I are introducing 
today would delay implementation of the Department of Health and Human 
Services' final rule on organ allocation pending further, more detailed 
examination of the impact of that rule on regional dislocation, 
transplantation outcome and survival rate, and waiting list time. While 
I have the highest regard for the intent behind the rule's issuance--
the promoting of fairness--I nevertheless have serious concerns about 
the impact many of the proposed changes are going to have for states 
like Wisconsin that are served by

[[Page S6769]]

smaller, community-based transplant centers. It is simply not clear to 
me that using a so-called ``National list'' for potential organ 
recipients would improve upon the current system for allocation or make 
the system more ``fair.'' In fact, what specialists in the Wisconsin 
transplant community have told me is that the opposite is true: that a 
``National list'' could dramatically increase ``cold ischemic time'' 
leading to higher rates of transplant rejection, and that a ``National 
list'' would likely result in longer waiting times in areas such as 
Wisconsin that have operated efficiently and successfully.
  Mr. President, additionally study prior to implementation of the rule 
is vitally important to ensure that a federal agency doesn't take 
action that--while well-intentioned--inadvertently harms populations 
served by smaller, community-based organizations. My hope is that 
further study over the course of the one year delay, combined with 
further cooperation between HHS, professional and community-based 
organizations will result in a final rule whose implementation will not 
harm regions of the country that--because of a tremendous amount of 
grassroots work, patient and family education, and deep personal 
involvement by health care professionals--are currently well-served 
under the current system.

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