[Congressional Record Volume 145, Number 129 (Wednesday, September 29, 1999)]
[House]
[Pages H8998-H8999]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 REFINEMENTS TO THE BALANCED BUDGET ACT

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Minnesota (Mr. Ramstad) is recognized for 5 minutes.
  Mr. RAMSTAD. Mr. Speaker, today I rise in frustration, frustration 
with the government agency that may even be more unpopular than the 
IRS, if you can believe it. My friends on the Health Subcommittee of 
Ways and Means and many other colleagues on both sides of the aisle 
know exactly who I am talking about, the Healthcare Financing 
Administration, or HCFA.
  Mr. Speaker, on Friday of this week our Health Subcommittee will be 
holding a hearing on refinements to the Balanced Budget Amendment, or 
BBA. As we plan for this hearing, I hope the administration will not 
appear before us again in the subcommittee and insult our intelligence. 
I will be asking some tough questions about their handling of the 
Medicare program recently, and I hope I do not hear that the agency is 
unable to address the concerns we are hearing about from seniors across 
the Nation, and also from Medicare providers, because the agency's 
hands are completely tied by prescriptive BBA language. That is the 
constant refrain we get from HCFA, the agency's hands are completely 
tied by prescriptive BBA language.
  We hear these lines about prescriptive language and Congressional 
intent when the administration does not want to do things, but when it 
does want to act, when it does want to do something, it is perfectly 
comfortable with

[[Page H8999]]

ignoring bill language or Congressional intent.
  Some of the problems we are hearing about in Medicare from health 
care providers are all results of actual BBA language. Yes, they are. 
The Health Subcommittee is planning to provide relief in those areas. 
But, as Senator Roth and Chairman Thomas have said recently, there is 
also a lot HCFA can do.
  The BBA gives HCFA significant power over how things are implemented. 
The risk adjuster for Medicare+Choice payments is a perfect example. 
Many of my colleagues and I have heard concerns about the risk adjuster 
the administration has designed. One very important concern is how this 
risk adjuster will impact some very special programs, especially 
innovative programs that seniors want and that the frail elderly 
seniors need so desperately.
  HCFA obviously understands the grave impact the interim risk adjuster 
will have on these programs. In fact, HCFA exempted them from the risk 
adjuster for the first year. But the argument which compelled the 
agency to exempt them for one year remains the same and just as 
powerful for all the years under the interim risk adjuster.
  Now, I might be just a plain Norwegian from Lake Woebegone, Mr. 
Speaker, but even I cannot understand why the agency is not exempting 
them for the entire interim period. That just makes good common 
Governor Jessie Ventura sense. If they have the authority to do it for 
1 year, it seems they have the authority to do it for multiple years. 
Conversely, if they do not have authority for all the years, then how 
do they have the authority to do it for one?
  I see nothing in the BBA which prohibits the agency from exempting 
them for more than 1 year. Even if I were to accept HCFA's claim that 
only Congressional action allows a multiple-year exemption, that still 
would not allow me to understand why HCFA is not supporting the bill I 
introduced to provide the multiple exemption. They tell providers, 
well, we need Congress to pass a bill. So I introduced one. Then they 
come up with the multiple weak arguments against the bill.
  Mr. Speaker, I am offering to address any substantive concerns in a 
reasonable way, in a reasonable common-sense way, and I hope we will be 
having such an exchange on Friday in the Health Subcommittee. I invite 
the administration to join me for the sake of frail, eligible, elderly 
beneficiaries in Minnesota and across this Nation.

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