[Congressional Record Volume 145, Number 91 (Thursday, June 24, 1999)]
[Senate]
[Page S7600]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. GRASSLEY (for himself, Mr. Baucus, Mr. Murkowski, Mr. 
        Rockefeller, Mr. Conrad, Mr. Harkin, and Mr. Robb):
  S. 1277. A bill to amend title XIX of the Social Security Act to 
establish a new prospective payment system for Federally-qualified 
health centers and rural health clinics; to the Committee on Finance.


                  safety net preservation act of 1999

 Mr. GRASSLEY. Mr. President, I rise today to introduce a bill 
co-sponsored by Senator Baucus to preserve hundreds of community health 
centers and rural health clinics across the country. Our bill, The 
Safety Net Preservation Act of 1999, would remedy a phase-out of the 
payment system that covers the clinics' cost of caring for Medicaid 
patients. Congress approved the phase-out of cost-based reimbursement 
during the Balanced Budget Act of 1997.
  The phase-out was meant to save Medicaid money and respond to those 
who felt cost-based reimbursement imposed an expensive mandate on 
states. Scheduled to begin on October 1, the phase-out will force the 
clinics to use scarce federal grants intended to provide care for the 
uninsured to prop up Medicaid under-payments. The change could force 
health centers to lose as much as $1.1 billion over the next five 
years.
  Our bill would establish a prospective payment system to ensure that 
health centers and clinics receive sufficient Medicaid funding. The 
bill would protect the federal investment in health centers while 
giving states the flexibility to design their own payment systems for 
health centers and clinics.
  There's no doubt that community health centers and rural health 
clinics serve a unique and essential role in getting high-quality 
health care services to those in need. They are the backbone of 
America's health care infrastructure for millions of medically under-
served rural and urban communities, where access to health care is 
often limited. I've seen first hand the valuable services provided by 
these centers and the obstacles the providers overcome to do so. Last 
year, I visited a center in Des Moines. They serve patients who speak 
nine different languages. In many cases, these clinics are often the 
difference between seeing a doctor and forgoing treatment. We can't 
allow money shortfalls to force them to shut down. We have to preserve 
this safety net for millions of Americans.
  I am pleased for the support of Senators Murkowski, Rockefeller, 
Conrad, Robb and Harkin as original co-sponsors of The Safety Net 
Preservation Act of 1999. I look forward to passage of this important 
legislation in the 106th Congress.
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