[Congressional Record Volume 145, Number 142 (Tuesday, October 19, 1999)]
[House]
[Pages H10241-H10266]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999

  Mr. ARCHER. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1180) to amend the Social Security Act to expand the 
availability of health care coverage for working individuals with 
disabilities, to establish a Ticket to Work and Self-Sufficiency 
Program in the Social Security Administration to provide such 
individuals with meaningful opportunities to work, and for other 
purposes, as amended.
  The Clerk read as follows:

                               H.R. 1180

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Ticket to 
     Work and Work Incentives Improvement Act of 1999''.
       (b) Table of Contents.--The table of contents is as 
     follows:

Sec. 1. Short title; table of contents.

  TITLE I--TICKET TO WORK AND SELF-SUFFICIENCY AND RELATED PROVISIONS

            Subtitle A--Ticket to Work and Self-Sufficiency

Sec. 101. Establishment of the Ticket to Work and Self-Sufficiency 
              Program.

             Subtitle B--Elimination of Work Disincentives

Sec. 111. Work activity standard as a basis for review of an 
              individual's disabled status.
Sec. 112. Expedited reinstatement of disability benefits.

     Subtitle C--Work Incentives Planning, Assistance, and Outreach

Sec. 121. Work incentives outreach program.
Sec. 122. State grants for work incentives assistance to disabled 
              beneficiaries.

        TITLE II--EXPANDED AVAILABILITY OF HEALTH CARE SERVICES

Sec. 201. Expanding State options under the medicaid program for 
              workers with disabilities.
Sec. 202. Extending medicare coverage for OASDI disability benefit 
              recipients.
Sec. 203. Grants to develop and establish State infrastructures to 
              support working individuals with disabilities.
Sec. 204. Demonstration of coverage under the medicaid program of 
              workers with potentially severe disabilities.
Sec. 205. Election by disabled beneficiaries to suspend medigap 
              insurance when covered under a group health plan.

             TITLE III--DEMONSTRATION PROJECTS AND STUDIES

Sec. 301. Extension of disability insurance program demonstration 
              project authority.
Sec. 302. Demonstration projects providing for reductions in disability 
              insurance benefits based on earnings.
Sec. 303. Studies and reports.

            TITLE IV--MISCELLANEOUS AND TECHNICAL AMENDMENTS

Sec. 401. Technical amendments relating to drug addicts and alcoholics.
Sec. 402. Treatment of prisoners.
Sec. 403. Revocation by members of the clergy of exemption from social 
              security coverage.
Sec. 404. Additional technical amendment relating to cooperative 
              research or demonstration projects under titles II and 
              XVI.
Sec. 405. Authorization for State to permit annual wage reports.
Sec. 406. Assessment on attorneys who receive their fees via the Social 
              Security Administration.
Sec. 407. Prevention of fraud and abuse associated with certain 
              payments under the medicaid program.Extension of 
              authority of State medicaid fraud control units.
Sec. 408. Extension of authority of State medicaid fraud control units.
Sec. 409. Special allowance adjustment for student loans.

  TITLE I--TICKET TO WORK AND SELF-SUFFICIENCY AND RELATED PROVISIONS

            Subtitle A--Ticket to Work and Self-Sufficiency

     SEC. 101. ESTABLISHMENT OF THE TICKET TO WORK AND SELF-
                   SUFFICIENCY PROGRAM.

       (a) In General.--Part A of title XI of the Social Security 
     Act (42 U.S.C. 1301 et seq.) is amended by adding after 
     section 1147 (as added by section 8 of the Noncitizen Benefit 
     Clarification and Other Technical Amendments Act of 1998 
     (Public Law 105-306; 112 Stat. 2928)) the following:


           ``the ticket to work and self-sufficiency program

       ``Sec. 1148. (a) In General.--The Commissioner of Social 
     Security shall establish a Ticket to Work and Self-
     Sufficiency Program, under which a disabled beneficiary may 
     use a ticket to work and self-sufficiency issued by the 
     Commissioner in accordance with this section to obtain 
     employment services, vocational rehabilitation services, or 
     other support services from an employment network which is of 
     the beneficiary's choice and which is willing to provide such 
     services to such beneficiary.
       ``(b) Ticket System.--
       ``(1) Distribution of tickets.--The Commissioner of Social 
     Security may issue a ticket to work and self-sufficiency to 
     disabled beneficiaries for participation in the Program.
       ``(2) Assignment of tickets.--A disabled beneficiary 
     holding a ticket to work and self-sufficiency may assign the 
     ticket to any employment network of the beneficiary's choice 
     which is serving under the Program and is willing to accept 
     the assignment.
       ``(3) Ticket terms.--A ticket issued under paragraph (1) 
     shall consist of a document which evidences the 
     Commissioner's agreement to pay (as provided in paragraph 
     (4)) an employment network, which is serving under the 
     Program and to which such ticket is assigned by the 
     beneficiary, for such employment services, vocational 
     rehabilitation services, and other support services as the 
     employment network may provide to the beneficiary.
       ``(4) Payments to employment networks.--The Commissioner 
     shall pay an employment network under the Program in 
     accordance with the outcome payment system under subsection 
     (h)(2) or under the outcome-milestone payment system under 
     subsection (h)(3) (whichever is elected pursuant to 
     subsection (h)(1)). An employment network may not request or 
     receive compensation for such services from the beneficiary.
       ``(c) State Participation.--
       ``(1) In general.--Each State agency administering or 
     supervising the administration of the State plan approved 
     under title I of the Rehabilitation Act of 1973 may elect to 
     participate in the Program as an employment network with 
     respect to a disabled beneficiary. If the State agency does 
     elect to participate in the Program, the State agency also 
     shall elect to be paid under the outcome payment system or 
     the outcome-milestone payment system in accordance with 
     subsection (h)(1). With respect to a disabled beneficiary 
     that the State agency does not elect to have participate in 
     the Program, the State agency shall be paid for services 
     provided to that beneficiary under the system for payment 
     applicable under section 222(d) and subsections (d) and (e) 
     of section 1615. The Commissioner shall provide for periodic 
     opportunities for exercising such elections.
       ``(2) Effect of participation by state agency.--
       ``(A) State agencies participating.--In any case in which a 
     State agency described in paragraph (1) elects under that 
     paragraph to participate in the Program, the employment 
     services, vocational rehabilitation services, and other 
     support services which, upon assignment of tickets to work 
     and self-sufficiency, are provided to disabled beneficiaries 
     by the State agency acting as an employment network shall be 
     governed by plans for vocational rehabilitation services 
     approved under title I of the Rehabilitation Act of 1973.
       ``(B) State agencies administering maternal and child 
     health services programs.--Subparagraph (A) shall not apply 
     with respect to any State agency administering a program 
     under title V of this Act.
       ``(3) Agreements between state agencies and employment 
     networks.--State agencies and employment networks shall enter 
     into agreements regarding the conditions under which services 
     will be provided when an individual is referred by an 
     employment network to a State agency for services. The 
     Commissioner of Social Security shall establish by 
     regulations the timeframe within which such agreements must 
     be entered into and the mechanisms for dispute resolution 
     between State agencies and employment networks with respect 
     to such agreements.
       ``(d) Responsibilities of the Commissioner of Social 
     Security.--
       ``(1) Selection and qualifications of program managers.--
     The Commissioner of Social Security shall enter into 
     agreements with 1 or more organizations in the private or 
     public sector for service as a program manager to assist the 
     Commissioner in administering the Program. Any such program 
     manager shall be selected by means of a competitive bidding 
     process, from among organizations in the private or public 
     sector with available expertise and experience in the field 
     of vocational rehabilitation or employment services.
       ``(2) Tenure, renewal, and early termination.--Each 
     agreement entered into under paragraph (1) shall provide for 
     early termination upon failure to meet performance standards 
     which shall be specified in the agreement and which shall be 
     weighted to take into account any performance in prior

[[Page H10242]]

     terms. Such performance standards shall include--
       ``(A) measures for ease of access by beneficiaries to 
     services; and
       ``(B) measures for determining the extent to which failures 
     in obtaining services for beneficiaries fall within 
     acceptable parameters, as determined by the Commissioner.
       ``(3) Preclusion from direct participation in delivery of 
     services in own service area.--Agreements under paragraph (1) 
     shall preclude--
       ``(A) direct participation by a program manager in the 
     delivery of employment services, vocational rehabilitation 
     services, or other support services to beneficiaries in the 
     service area covered by the program manager's agreement; and
       ``(B) the holding by a program manager of a financial 
     interest in an employment network or service provider which 
     provides services in a geographic area covered under the 
     program manager's agreement.
       ``(4) Selection of employment networks.--
       ``(A) In general.--The Commissioner shall select and enter 
     into agreements with employment networks for service under 
     the Program. Such employment networks shall be in addition to 
     State agencies serving as employment networks pursuant to 
     elections under subsection (c).
       ``(B) Alternate participants.--In any State where the 
     Program is being implemented, the Commissioner shall enter 
     into an agreement with any alternate participant that is 
     operating under the authority of section 222(d)(2) in the 
     State as of the date of enactment of this section and chooses 
     to serve as an employment network under the Program.
       ``(5) Termination of agreements with employment networks.--
     The Commissioner shall terminate agreements with employment 
     networks for inadequate performance, as determined by the 
     Commissioner.
       ``(6) Quality assurance.--The Commissioner shall provide 
     for such periodic reviews as are necessary to provide for 
     effective quality assurance in the provision of services by 
     employment networks. The Commissioner shall solicit and 
     consider the views of consumers and the program manager under 
     which the employment networks serve and shall consult with 
     providers of services to develop performance measurements. 
     The Commissioner shall ensure that the results of the 
     periodic reviews are made available to beneficiaries who are 
     prospective service recipients as they select employment 
     networks. The Commissioner shall ensure that the periodic 
     surveys of beneficiaries receiving services under the Program 
     are designed to measure customer service satisfaction.
       ``(7) Dispute resolution.--The Commissioner shall provide 
     for a mechanism for resolving disputes between beneficiaries 
     and employment networks, between program managers and 
     employment networks, and between program managers and 
     providers of services. The Commissioner shall afford a party 
     to such a dispute a reasonable opportunity for a full and 
     fair review of the matter in dispute.
       ``(e) Program Managers.--
       ``(1) In general.--A program manager shall conduct tasks 
     appropriate to assist the Commissioner in carrying out the 
     Commissioner's duties in administering the Program.
       ``(2) Recruitment of employment networks.--A program 
     manager shall recruit, and recommend for selection by the 
     Commissioner, employment networks for service under the 
     Program. The program manager shall carry out such recruitment 
     and provide such recommendations, and shall monitor all 
     employment networks serving in the Program in the geographic 
     area covered under the program manager's agreement, to the 
     extent necessary and appropriate to ensure that adequate 
     choices of services are made available to beneficiaries. 
     Employment networks may serve under the Program only pursuant 
     to an agreement entered into with the Commissioner under the 
     Program incorporating the applicable provisions of this 
     section and regulations thereunder, and the program manager 
     shall provide and maintain assurances to the Commissioner 
     that payment by the Commissioner to employment networks 
     pursuant to this section is warranted based on compliance by 
     such employment networks with the terms of such agreement and 
     this section. The program manager shall not impose numerical 
     limits on the number of employment networks to be recommended 
     pursuant to this paragraph.
       ``(3) Facilitation of access by beneficiaries to employment 
     networks.--A program manager shall facilitate access by 
     beneficiaries to employment networks. The program manager 
     shall ensure that each beneficiary is allowed changes in 
     employment networks without being deemed to have rejected 
     services under the Program. When such a change occurs, the 
     program manager shall reassign the ticket based on the choice 
     of the beneficiary. Upon the request of the employment 
     network, the program manager shall make a determination of 
     the allocation of the outcome or milestone-outcome payments 
     based on the services provided by each employment network. 
     The program manager shall establish and maintain lists of 
     employment networks available to beneficiaries and shall make 
     such lists generally available to the public. The program 
     manager shall ensure that all information provided to 
     disabled beneficiaries pursuant to this paragraph is provided 
     in accessible formats.
       ``(4) Ensuring availability of adequate services.--The 
     program manager shall ensure that employment services, 
     vocational rehabilitation services, and other support 
     services are provided to beneficiaries throughout the 
     geographic area covered under the program manager's 
     agreement, including rural areas.
       ``(5) Reasonable access to services.--The program manager 
     shall take such measures as are necessary to ensure that 
     sufficient employment networks are available and that each 
     beneficiary receiving services under the Program has 
     reasonable access to employment services, vocational 
     rehabilitation services, and other support services. Services 
     provided under the Program may include case management, work 
     incentives planning, supported employment, career planning, 
     career plan development, vocational assessment, job training, 
     placement, follow-up services, and such other services as may 
     be specified by the Commissioner under the Program. The 
     program manager shall ensure that such services are available 
     in each service area.
       ``(f) Employment Networks.--
       ``(1) Qualifications for employment networks.--
       ``(A) In general.--Each employment network serving under 
     the Program shall consist of an agency or instrumentality of 
     a State (or a political subdivision thereof) or a private 
     entity, that assumes responsibility for the coordination and 
     delivery of services under the Program to individuals 
     assigning to the employment network tickets to work and self-
     sufficiency issued under subsection (b).
       ``(B) One-stop delivery systems.--An employment network 
     serving under the Program may consist of a one-stop delivery 
     system established under subtitle B of title I of the 
     Workforce Investment Act of 1998.
       ``(C) Compliance with selection criteria.--No employment 
     network may serve under the Program unless it meets and 
     maintains compliance with both general selection criteria 
     (such as professional and educational qualifications, where 
     applicable) and specific selection criteria (such as 
     substantial expertise and experience in providing relevant 
     employment services and supports).
       ``(D) Single or associated providers allowed.--An 
     employment network shall consist of either a single provider 
     of such services or of an association of such providers 
     organized so as to combine their resources into a single 
     entity. An employment network may meet the requirements of 
     subsection (e)(4) by providing services directly, or by 
     entering into agreements with other individuals or entities 
     providing appropriate employment services, vocational 
     rehabilitation services, or other support services.
       ``(2) Requirements relating to provision of services.--Each 
     employment network serving under the Program shall be 
     required under the terms of its agreement with the 
     Commissioner to--
       ``(A) serve prescribed service areas; and
       ``(B) take such measures as are necessary to ensure that 
     employment services, vocational rehabilitation services, and 
     other support services provided under the Program by, or 
     under agreements entered into with, the employment network 
     are provided under appropriate individual work plans meeting 
     the requirements of subsection (g).
       ``(3) Annual financial reporting.--Each employment network 
     shall meet financial reporting requirements as prescribed by 
     the Commissioner.
       ``(4) Periodic outcomes reporting.--Each employment network 
     shall prepare periodic reports, on at least an annual basis, 
     itemizing for the covered period specific outcomes achieved 
     with respect to specific services provided by the employment 
     network. Such reports shall conform to a national model 
     prescribed under this section. Each employment network shall 
     provide a copy of the latest report issued by the employment 
     network pursuant to this paragraph to each beneficiary upon 
     enrollment under the Program for services to be received 
     through such employment network. Upon issuance of each report 
     to each beneficiary, a copy of the report shall be maintained 
     in the files of the employment network. The program manager 
     shall ensure that copies of all such reports issued under 
     this paragraph are made available to the public under 
     reasonable terms.
       ``(g) Individual Work Plans.--
       ``(1) Requirements.--Each employment network shall--
       ``(A) take such measures as are necessary to ensure that 
     employment services, vocational rehabilitation services, and 
     other support services provided under the Program by, or 
     under agreements entered into with, the employment network 
     are provided under appropriate individual work plans that 
     meet the requirements of subparagraph (C);
       ``(B) develop and implement each such individual work plan, 
     in partnership with each beneficiary receiving such services, 
     in a manner that affords such beneficiary the opportunity to 
     exercise informed choice in selecting an employment goal and 
     specific services needed to achieve that employment goal;
       ``(C) ensure that each individual work plan includes at 
     least--
       ``(i) a statement of the vocational goal developed with the 
     beneficiary, including, as appropriate, goals for earnings 
     and job advancement;
       ``(ii) a statement of the services and supports that have 
     been deemed necessary for the beneficiary to accomplish that 
     goal;

[[Page H10243]]

       ``(iii) a statement of any terms and conditions related to 
     the provision of such services and supports; and
       ``(iv) a statement of understanding regarding the 
     beneficiary's rights under the Program (such as the right to 
     retrieve the ticket to work and self-sufficiency if the 
     beneficiary is dissatisfied with the services being provided 
     by the employment network) and remedies available to the 
     individual, including information on the availability of 
     advocacy services and assistance in resolving disputes 
     through the State grant program authorized under section 
     1150;
       ``(D) provide a beneficiary the opportunity to amend the 
     individual work plan if a change in circumstances 
     necessitates a change in the plan; and
       ``(E) make each beneficiary's individual work plan 
     available to the beneficiary in, as appropriate, an 
     accessible format chosen by the beneficiary.
       ``(2) Effective upon written approval.--A beneficiary's 
     individual work plan shall take effect upon written approval 
     by the beneficiary or a representative of the beneficiary and 
     a representative of the employment network that, in providing 
     such written approval, acknowledges assignment of the 
     beneficiary's ticket to work and self-sufficiency.
       ``(h) Employment Network Payment Systems.--
       ``(1) Election of payment system by employment networks.--
       ``(A) In general.--The Program shall provide for payment 
     authorized by the Commissioner to employment networks under 
     either an outcome payment system or an outcome-milestone 
     payment system. Each employment network shall elect which 
     payment system will be utilized by the employment network, 
     and, for such period of time as such election remains in 
     effect, the payment system so elected shall be utilized 
     exclusively in connection with such employment network 
     (except as provided in subparagraph (B)).
       ``(B) No change in method of payment for beneficiaries with 
     tickets already assigned to the employment networks.--Any 
     election of a payment system by an employment network that 
     would result in a change in the method of payment to the 
     employment network for services provided to a beneficiary who 
     is receiving services from the employment network at the time 
     of the election shall not be effective with respect to 
     payment for services provided to that beneficiary and the 
     method of payment previously selected shall continue to apply 
     with respect to such services.
       ``(2) Outcome payment system.--
       ``(A) In general.--The outcome payment system shall consist 
     of a payment structure governing employment networks electing 
     such system under paragraph (1)(A) which meets the 
     requirements of this paragraph.
       ``(B) Payments made during outcome payment period.--The 
     outcome payment system shall provide for a schedule of 
     payments to an employment network, in connection with each 
     individual who is a beneficiary, for each month, during the 
     individual's outcome payment period, for which benefits 
     (described in paragraphs (3) and (4) of subsection (k)) are 
     not payable to such individual because of work or earnings.
       ``(C) Computation of payments to employment network.--The 
     payment schedule of the outcome payment system shall be 
     designed so that--
       ``(i) the payment for each month during the outcome payment 
     period for which benefits (described in paragraphs (3) and 
     (4) of subsection (k)) are not payable is equal to a fixed 
     percentage of the payment calculation base for the calendar 
     year in which such month occurs; and
       ``(ii) such fixed percentage is set at a percentage which 
     does not exceed 40 percent.
       ``(3) Outcome-milestone payment system.--
       ``(A) In general.--The outcome-milestone payment system 
     shall consist of a payment structure governing employment 
     networks electing such system under paragraph (1)(A) which 
     meets the requirements of this paragraph.
       ``(B) Early payments upon attainment of milestones in 
     advance of outcome payment periods.--The outcome-milestone 
     payment system shall provide for 1 or more milestones, with 
     respect to beneficiaries receiving services from an 
     employment network under the Program, that are directed 
     toward the goal of permanent employment. Such milestones 
     shall form a part of a payment structure that provides, in 
     addition to payments made during outcome payment periods, 
     payments made prior to outcome payment periods in amounts 
     based on the attainment of such milestones.
       ``(C) Limitation on total payments to employment network.--
     The payment schedule of the outcome milestone payment system 
     shall be designed so that the total of the payments to the 
     employment network with respect to each beneficiary is less 
     than, on a net present value basis (using an interest rate 
     determined by the Commissioner that appropriately reflects 
     the cost of funds faced by providers), the total amount to 
     which payments to the employment network with respect to the 
     beneficiary would be limited if the employment network were 
     paid under the outcome payment system.
       ``(4) Definitions.--In this subsection:
       ``(A) Payment calculation base.--The term `payment 
     calculation base' means, for any calendar year--
       ``(i) in connection with a title II disability beneficiary, 
     the average disability insurance benefit payable under 
     section 223 for all beneficiaries for months during the 
     preceding calendar year; and
       ``(ii) in connection with a title XVI disability 
     beneficiary (who is not concurrently a title II disability 
     beneficiary), the average payment of supplemental security 
     income benefits based on disability payable under title XVI 
     (excluding State supplementation) for months during the 
     preceding calendar year to all beneficiaries who have 
     attained 18 years of age but have not attained 65 years of 
     age.
       ``(B) Outcome payment period.--The term `outcome payment 
     period' means, in connection with any individual who had 
     assigned a ticket to work and self-sufficiency to an 
     employment network under the Program, a period--
       ``(i) beginning with the first month, ending after the date 
     on which such ticket was assigned to the employment network, 
     for which benefits (described in paragraphs (3) and (4) of 
     subsection (k)) are not payable to such individual by reason 
     of engagement in substantial gainful activity or by reason of 
     earnings from work activity; and
       ``(ii) ending with the 60th month (consecutive or 
     otherwise), ending after such date, for which such benefits 
     are not payable to such individual by reason of engagement in 
     substantial gainful activity or by reason of earnings from 
     work activity.
       ``(5) Periodic review and alterations of prescribed 
     schedules.--
       ``(A) Percentages and periods.--The Commissioner shall 
     periodically review the percentage specified in paragraph 
     (2)(C), the total payments permissible under paragraph 
     (3)(C), and the period of time specified in paragraph (4)(B) 
     to determine whether such percentages, such permissible 
     payments, and such period provide an adequate incentive for 
     employment networks to assist beneficiaries to enter the 
     workforce, while providing for appropriate economies. The 
     Commissioner may alter such percentage, such total 
     permissible payments, or such period of time to the extent 
     that the Commissioner determines, on the basis of the 
     Commissioner's review under this paragraph, that such an 
     alteration would better provide the incentive and economies 
     described in the preceding sentence.
       ``(B) Number and amount of milestone payments.--The 
     Commissioner shall periodically review the number and amounts 
     of milestone payments established by the Commissioner 
     pursuant to this section to determine whether they provide an 
     adequate incentive for employment networks to assist 
     beneficiaries to enter the workforce, taking into account 
     information provided to the Commissioner by program managers, 
     the Ticket to Work and Work Incentives Advisory Panel 
     established by section 101(f) of the Ticket to Work and Work 
     Incentives Improvement Act of 1999, and other reliable 
     sources. The Commissioner may from time to time alter the 
     number and amounts of milestone payments initially 
     established by the Commissioner pursuant to this section to 
     the extent that the Commissioner determines that such an 
     alteration would allow an adequate incentive for employment 
     networks to assist beneficiaries to enter the workforce. Such 
     alteration shall be based on information provided to the 
     Commissioner by program managers, the Ticket to Work and Work 
     Incentives Advisory Panel established by section 101(f) of 
     the Ticket to Work and Work Incentives Improvement Act of 
     1999, or other reliable sources.
       ``(C) Report on the adequacy of incentives.--The 
     Commissioner shall submit to Congress not later than 36 
     months after the date of the enactment of the Ticket to Work 
     and Work Incentives Improvement Act of 1999 a report with 
     recommendations for a method or methods to adjust payment 
     rates under subparagraphs (A) and (B), that would ensure 
     adequate incentives for the provision of services by 
     employment networks of--
       ``(i) individuals with a need for ongoing support and 
     services;
       ``(ii) individuals with a need for high-cost 
     accommodations;
       ``(iii) individuals who earn a subminimum wage; and
       ``(iv) individuals who work and receive partial cash 
     benefits.
     The Commissioner shall consult with the Ticket to Work and 
     Work Incentives Advisory Panel established under section 
     101(f) of the Ticket to Work and Work Incentives Improvement 
     Act of 1999 during the development and evaluation of the 
     study. The Commissioner shall implement the necessary 
     adjusted payment rates prior to full implementation of the 
     Ticket to Work and Self-Sufficiency Program.
       ``(i) Suspension of Disability Reviews.--During any period 
     for which an individual is using, as defined by the 
     Commissioner, a ticket to work and self-sufficiency issued 
     under this section, the Commissioner (and any applicable 
     State agency) may not initiate a continuing disability review 
     or other review under section 221 of whether the individual 
     is or is not under a disability or a review under title XVI 
     similar to any such review under section 221.
       ``(j) Authorizations.--
       ``(1) Payments to employment networks.--
       ``(A) Title ii disability beneficiaries.--There are 
     authorized to be transferred from the Federal Old-Age and 
     Survivors Insurance Trust Fund and the Federal Disability 
     Insurance Trust Fund each fiscal year such sums

[[Page H10244]]

     as may be necessary to make payments to employment networks 
     under this section. Money paid from the Trust Funds under 
     this section with respect to title II disability 
     beneficiaries who are entitled to benefits under section 223 
     or who are entitled to benefits under section 202(d) on the 
     basis of the wages and self-employment income of such 
     beneficiaries, shall be charged to the Federal Disability 
     Insurance Trust Fund, and all other money paid from the Trust 
     Funds under this section shall be charged to the Federal Old-
     Age and Survivors Insurance Trust Fund.
       ``(B) Title xvi disability beneficiaries.--Amounts 
     authorized to be appropriated to the Social Security 
     Administration under section 1601 (as in effect pursuant to 
     the amendments made by section 301 of the Social Security 
     Amendments of 1972) shall include amounts necessary to carry 
     out the provisions of this section with respect to title XVI 
     disability beneficiaries.
       ``(2) Administrative expenses.--The costs of administering 
     this section (other than payments to employment networks) 
     shall be paid from amounts made available for the 
     administration of title II and amounts made available for the 
     administration of title XVI, and shall be allocated among 
     such amounts as appropriate.
       ``(k) Definitions.--In this section:
       ``(1) Commissioner.--The term `Commissioner' means the 
     Commissioner of Social Security.
       ``(2) Disabled beneficiary.--The term `disabled 
     beneficiary' means a title II disability beneficiary or a 
     title XVI disability beneficiary.
       ``(3) Title ii disability beneficiary.--The term `title II 
     disability beneficiary' means an individual entitled to 
     disability insurance benefits under section 223 or to monthly 
     insurance benefits under section 202 based on such 
     individual's disability (as defined in section 223(d)). An 
     individual is a title II disability beneficiary for each 
     month for which such individual is entitled to such benefits.
       ``(4) Title xvi disability beneficiary.--The term `title 
     XVI disability beneficiary' means an individual eligible for 
     supplemental security income benefits under title XVI on the 
     basis of blindness (within the meaning of section 1614(a)(2)) 
     or disability (within the meaning of section 1614(a)(3)). An 
     individual is a title XVI disability beneficiary for each 
     month for which such individual is eligible for such 
     benefits.
       ``(5) Supplemental security income benefit.--The term 
     `supplemental security income benefit under title XVI' means 
     a cash benefit under section 1611 or 1619(a), and does not 
     include a State supplementary payment, administered federally 
     or otherwise.
       ``(l) Regulations.--Not later than 1 year after the date of 
     the enactment of the Ticket to Work and Work Incentives 
     Improvement Act of 1999, the Commissioner shall prescribe 
     such regulations as are necessary to carry out the provisions 
     of this section.''.
       (b) Conforming Amendments.--
       (1) Amendments to title ii.--
       (A) Section 221(i) of the Social Security Act (42 U.S.C. 
     421(i)) is amended by adding at the end the following:
       ``(5) For suspension of reviews under this subsection in 
     the case of an individual using a ticket to work and self-
     sufficiency, see section 1148(i).''.
       (B) Section 222(a) of such Act (42 U.S.C. 422(a)) is 
     repealed.
       (C) Section 222(b) of such Act (42 U.S.C. 422(b)) is 
     repealed.
       (D) Section 225(b)(1) of such Act (42 U.S.C. 425(b)(1)) is 
     amended by striking ``a program of vocational rehabilitation 
     services'' and inserting ``a program consisting of the Ticket 
     to Work and Self-Sufficiency Program under section 1148 or 
     another program of vocational rehabilitation services, 
     employment services, or other support services''.
       (2) Amendments to title xvi.--
       (A) Section 1615(a) of such Act (42 U.S.C. 1382d(a)) is 
     amended to read as follows:
       ``Sec. 1615. (a) In the case of any blind or disabled 
     individual who--
       ``(1) has not attained age 16; and
       ``(2) with respect to whom benefits are paid under this 
     title,
     the Commissioner of Social Security shall make provision for 
     referral of such individual to the appropriate State agency 
     administering the State program under title V.''.
       (B) Section 1615(c) of such Act (42 U.S.C. 1382d(c)) is 
     repealed.
       (C) Section 1631(a)(6)(A) of such Act (42 U.S.C. 
     1383(a)(6)(A)) is amended by striking ``a program of 
     vocational rehabilitation services'' and inserting ``a 
     program consisting of the Ticket to Work and Self-Sufficiency 
     Program under section 1148 or another program of vocational 
     rehabilitation services, employment services, or other 
     support services''.
       (D) Section 1633(c) of such Act (42 U.S.C. 1383b(c)) is 
     amended--
       (i) by inserting ``(1)'' after ``(c)''; and
       (ii) by adding at the end the following:
       ``(2) For suspension of continuing disability reviews and 
     other reviews under this title similar to reviews under 
     section 221 in the case of an individual using a ticket to 
     work and self-sufficiency, see section 1148(i).''.
       (c) Effective Date.--Subject to subsection (d), the 
     amendments made by subsections (a) and (b) shall take effect 
     with the first month following 1 year after the date of the 
     enactment of this Act.
       (d) Graduated Implementation of Program.--
       (1) In general.--Not later than 1 year after the date of 
     the enactment of this Act, the Commissioner of Social 
     Security shall commence implementation of the amendments made 
     by this section (other than paragraphs (1)(C) and (2)(B) of 
     subsection (b)) in graduated phases at phase-in sites 
     selected by the Commissioner. Such phase-in sites shall be 
     selected so as to ensure, prior to full implementation of the 
     Ticket to Work and Self-Sufficiency Program, the development 
     and refinement of referral processes, payment systems, 
     computer linkages, management information systems, and 
     administrative processes necessary to provide for full 
     implementation of such amendments. Subsection (c) shall apply 
     with respect to paragraphs (1)(C) and (2)(B) of subsection 
     (b) without regard to this subsection.
       (2) Requirements.--Implementation of the Program at each 
     phase-in site shall be carried out on a wide enough scale to 
     permit a thorough evaluation of the alternative methods under 
     consideration, so as to ensure that the most efficacious 
     methods are determined and in place for full implementation 
     of the Program on a timely basis.
       (3) Full implementation.--The Commissioner shall ensure 
     that ability to provide tickets and services to individuals 
     under the Program exists in every State as soon as 
     practicable on or after the effective date specified in 
     subsection (c) but not later than 3 years after such date.
       (4) Ongoing evaluation of program.--
       (A) In general.--The Commissioner shall design and conduct 
     a series of evaluations to assess the cost-effectiveness of 
     activities carried out under this section and the amendments 
     made thereby, as well as the effects of this section and the 
     amendments made thereby on work outcomes for beneficiaries 
     receiving tickets to work and self-sufficiency under the 
     Program.
       (B) Consultation.--The Commissioner shall design and carry 
     out the series of evaluations after receiving relevant advice 
     from experts in the fields of disability, vocational 
     rehabilitation, and program evaluation and individuals using 
     tickets to work and self-sufficiency under the Program and 
     consulting with the Ticket to Work and Work Incentives 
     Advisory Panel established under section 101(f), the 
     Comptroller General of the United States, other agencies of 
     the Federal Government, and private organizations with 
     appropriate expertise.
       (C) Methodology.--
       (i) Implementation.--The Commissioner, in consultation with 
     the Ticket to Work and Work Incentives Advisory Panel 
     established under section 101(f), shall ensure that plans for 
     evaluations and data collection methods under the Program are 
     appropriately designed to obtain detailed employment 
     information.
       (ii) Specific matters to be addressed.--Each such 
     evaluation shall address (but is not limited to)--

       (I) the annual cost (including net cost) of the Program and 
     the annual cost (including net cost) that would have been 
     incurred in the absence of the Program;
       (II) the determinants of return to work, including the 
     characteristics of beneficiaries in receipt of tickets under 
     the Program;
       (III) the types of employment services, vocational 
     rehabilitation services, and other support services furnished 
     to beneficiaries in receipt of tickets under the Program who 
     return to work and to those who do not return to work;
       (IV) the duration of employment services, vocational 
     rehabilitation services, and other support services furnished 
     to beneficiaries in receipt of tickets under the Program who 
     return to work and the duration of such services furnished to 
     those who do not return to work and the cost to employment 
     networks of furnishing such services;
       (V) the employment outcomes, including wages, occupations, 
     benefits, and hours worked, of beneficiaries who return to 
     work after receiving tickets under the Program and those who 
     return to work without receiving such tickets;
       (VI) the characteristics of individuals in possession of 
     tickets under the Program who are not accepted for services 
     and, to the extent reasonably determinable, the reasons for 
     which such beneficiaries were not accepted for services;
       (VII) the characteristics of providers whose services are 
     provided within an employment network under the Program;
       (VIII) the extent (if any) to which employment networks 
     display a greater willingness to provide services to 
     beneficiaries with a range of disabilities;
       (IX) the characteristics (including employment outcomes) of 
     those beneficiaries who receive services under the outcome 
     payment system and of those beneficiaries who receive 
     services under the outcome-milestone payment system;
       (X) measures of satisfaction among beneficiaries in receipt 
     of tickets under the Program; and
       (XI) reasons for (including comments solicited from 
     beneficiaries regarding) their choice not to use their 
     tickets or their inability to return to work despite the use 
     of their tickets.

       (D) Periodic evaluation reports.--Following the close of 
     the third and fifth fiscal years ending after the effective 
     date under subsection (c), and prior to the close of the 
     seventh fiscal year ending after such date, the Commissioner 
     shall transmit to the Committee on Ways and Means of the 
     House of Representatives and the Committee on Finance of the 
     Senate a report containing the

[[Page H10245]]

     Commissioner's evaluation of the progress of activities 
     conducted under the provisions of this section and the 
     amendments made thereby. Each such report shall set forth the 
     Commissioner's evaluation of the extent to which the Program 
     has been successful and the Commissioner's conclusions on 
     whether or how the Program should be modified. Each such 
     report shall include such data, findings, materials, and 
     recommendations as the Commissioner may consider appropriate.
       (5) Extent of state's right of first refusal in advance of 
     full implementation of amendments in such state.--
       (A) In general.--In the case of any State in which the 
     amendments made by subsection (a) have not been fully 
     implemented pursuant to this subsection, the Commissioner 
     shall determine by regulation the extent to which--
       (i) the requirement under section 222(a) for prompt 
     referrals to a State agency; and
       (ii) the authority of the Commissioner under section 
     222(d)(2) of the Social Security Act to provide vocational 
     rehabilitation services in such State by agreement or 
     contract with other public or private agencies, 
     organizations, institutions, or individuals,
     shall apply in such State.
       (B) Existing agreements.--Nothing in subparagraph (A) or 
     the amendments made by subsection (a) shall be construed to 
     limit, impede, or otherwise affect any agreement entered into 
     pursuant to section 222(d)(2) of the Social Security Act 
     before the date of the enactment of this Act with respect to 
     services provided pursuant to such agreement to beneficiaries 
     receiving services under such agreement as of such date, 
     except with respect to services (if any) to be provided after 
     3 years after the effective date provided in subsection (c).
       (e) Specific Regulations Required.--
       (1) In general.--The Commissioner of Social Security shall 
     prescribe such regulations as are necessary to implement the 
     amendments made by this section.
       (2) Specific matters to be included in regulations.--The 
     matters which shall be addressed in such regulations shall 
     include--
       (A) the form and manner in which tickets to work and self-
     sufficiency may be distributed to beneficiaries pursuant to 
     section 1148(b)(1) of the Social Security Act;
       (B) the format and wording of such tickets, which shall 
     incorporate by reference any contractual terms governing 
     service by employment networks under the Program;
       (C) the form and manner in which State agencies may elect 
     participation in the Ticket to Work and Self-Sufficiency 
     Program pursuant to section 1148(c)(1) of such Act and 
     provision for periodic opportunities for exercising such 
     elections;
       (D) the status of State agencies under section 1148(c)(1) 
     of such Act at the time that State agencies exercise 
     elections under that section;
       (E) the terms of agreements to be entered into with program 
     managers pursuant to section 1148(d) of such Act, including--
       (i) the terms by which program managers are precluded from 
     direct participation in the delivery of services pursuant to 
     section 1148(d)(3) of such Act;
       (ii) standards which must be met by quality assurance 
     measures referred to in paragraph (6) of section 1148(d) of 
     such Act and methods of recruitment of employment networks 
     utilized pursuant to paragraph (2) of section 1148(e) of such 
     Act; and
       (iii) the format under which dispute resolution will 
     operate under section 1148(d)(7) of such Act;
       (F) the terms of agreements to be entered into with 
     employment networks pursuant to section 1148(d)(4) of such 
     Act, including--
       (i) the manner in which service areas are specified 
     pursuant to section 1148(f)(2)(A) of such Act;
       (ii) the general selection criteria and the specific 
     selection criteria which are applicable to employment 
     networks under section 1148(f)(1)(C) of such Act in selecting 
     service providers;
       (iii) specific requirements relating to annual financial 
     reporting by employment networks pursuant to section 
     1148(f)(3) of such Act; and
       (iv) the national model to which periodic outcomes 
     reporting by employment networks must conform under section 
     1148(f)(4) of such Act;
       (G) standards which must be met by individual work plans 
     pursuant to section 1148(g) of such Act;
       (H) standards which must be met by payment systems required 
     under section 1148(h) of such Act, including--
       (i) the form and manner in which elections by employment 
     networks of payment systems are to be exercised pursuant to 
     section 1148(h)(1)(A) of such Act;
       (ii) the terms which must be met by an outcome payment 
     system under section 1148(h)(2) of such Act;
       (iii) the terms which must be met by an outcome-milestone 
     payment system under section 1148(h)(3) of such Act;
       (iv) any revision of the percentage specified in paragraph 
     (2)(C) of section 1148(h) of such Act or the period of time 
     specified in paragraph (4)(B) of such section 1148(h) of such 
     Act; and
       (v) annual oversight procedures for such systems; and
       (I) procedures for effective oversight of the Program by 
     the Commissioner of Social Security, including periodic 
     reviews and reporting requirements.
       (f) The Ticket to Work and Work Incentives Advisory 
     Panel.--
       (1) Establishment.--There is established within the Social 
     Security Administration a panel to be known as the ``Ticket 
     to Work and Work Incentives Advisory Panel'' (in this 
     subsection referred to as the ``Panel'').
       (2) Duties of panel.--It shall be the duty of the Panel 
     to--
       (A) advise the President, the Congress, and the 
     Commissioner of Social Security on issues related to work 
     incentives programs, planning, and assistance for individuals 
     with disabilities, including work incentive provisions under 
     titles II, XI, XVI, XVIII, and XIX of the Social Security Act 
     (42 U.S.C. 401 et seq., 1301 et seq., 1381 et seq., 1395 et 
     seq., 1396 et seq.); and
       (B) with respect to the Ticket to Work and Self-Sufficiency 
     Program established under section 1148 of such Act--
       (i) advise the Commissioner of Social Security with respect 
     to establishing phase-in sites for such Program and fully 
     implementing the Program thereafter, the refinement of access 
     of disabled beneficiaries to employment networks, payment 
     systems, and management information systems, and advise the 
     Commissioner whether such measures are being taken to the 
     extent necessary to ensure the success of the Program;
       (ii) advise the Commissioner regarding the most effective 
     designs for research and demonstration projects associated 
     with the Program or conducted pursuant to section 302 of this 
     Act;
       (iii) advise the Commissioner on the development of 
     performance measurements relating to quality assurance under 
     section 1148(d)(6) of the Social Security Act; and
       (iv) furnish progress reports on the Program to the 
     Commissioner and each House of Congress.
       (3) Membership.--
       (A) Number and appointment.--The Panel shall be composed of 
     12 members as follows:
       (i) 4 members appointed by the President, not more than 2 
     of whom may be of the same political party;
       (ii) 2 members appointed by the Speaker of the House of 
     Representatives, in consultation with the Chairman of the 
     Committee on Ways and Means of the House of Representatives;
       (iii) 2 members appointed by the minority leader of the 
     House of Representatives, in consultation with the ranking 
     member of the Committee on Ways and Means of the House of 
     Representatives;
       (iv) 2 members appointed by the majority leader of the 
     Senate, in consultation with the Chairman of the Committee on 
     Finance of the Senate; and
       (v) 2 members appointed by the minority leader of the 
     Senate, in consultation with the ranking member of the 
     Committee on Finance of the Senate.
       (B) Representation.--Of the members appointed under 
     subparagraph (A), at least 8 shall have experience or expert 
     knowledge as a recipient, provider, employer, or employee in 
     the fields of, or related to, employment services, vocational 
     rehabilitation services, and other support services, of 
     whom--
       (i) at least 2 shall represent the interests of recipients 
     of employment services, vocational rehabilitation services, 
     and other support services;
       (ii) at least 2 shall represent the interests of providers 
     of employment services, vocational rehabilitation services, 
     and other support services;
       (iii) at least 2 shall represent the interests of private 
     employers; and
       (iv) at least 2 shall represent the interests of employees.
     At least \1/2\ of the members described in each clause of 
     subparagraph (A) shall be individuals with disabilities, or 
     representatives of individuals with disabilities, with 
     consideration to current or former title II disability 
     beneficiaries or title XVI disability beneficiaries (as such 
     terms are defined in section 1148(k) of the Social Security 
     Act (as added by subsection (a)).
       (C) Terms.--
       (i) In general.--Each member shall be appointed for a term 
     of 4 years (or, if less, for the remaining life of the 
     Panel), except as provided in clauses (ii) and (iii). The 
     initial members shall be appointed not later than 90 days 
     after the date of the enactment of this Act.
       (ii) Terms of initial appointees.--As designated by the 
     President at the time of appointment, of the members first 
     appointed--

       (I) \1/2\ of the members appointed under subparagraph (A) 
     shall be appointed for a term of 2 years; and
       (II) the remaining members appointed under subparagraph (A) 
     shall be appointed for a term of 4 years.

       (iii) Vacancies.--Any member appointed to fill a vacancy 
     occurring before the expiration of the term for which the 
     member's predecessor was appointed shall be appointed only 
     for the remainder of that term. A member may serve after the 
     expiration of that member's term until a successor has taken 
     office. A vacancy in the Panel shall be filled in the manner 
     in which the original appointment was made.
       (D) Basic pay.--Members shall each be paid at a rate, and 
     in a manner, that is consistent with guidelines established 
     under section 7 of the Federal Advisory Committee Act (5 
     U.S.C. App.).
       (E) Travel expenses.--Each member shall receive travel 
     expenses, including per diem in lieu of subsistence, in 
     accordance with sections 5702 and 5703 of title 5, United 
     States Code.

[[Page H10246]]

       (F) Quorum.--8 members of the Panel shall constitute a 
     quorum but a lesser number may hold hearings.
       (G) Chairperson.--The Chairperson of the Panel shall be 
     designated by the President. The term of office of the 
     Chairperson shall be 4 years.
       (H) Meetings.--The Panel shall meet at least quarterly and 
     at other times at the call of the Chairperson or a majority 
     of its members.
       (4) Director and staff of panel; experts and consultants.--
       (A) Director.--The Panel shall have a Director who shall be 
     appointed by the Panel, and paid at a rate, and in a manner, 
     that is consistent with guidelines established under section 
     7 of the Federal Advisory Committee Act (5 U.S.C. App.).
       (B) Staff.--Subject to rules prescribed by the Commissioner 
     of Social Security, the Director may appoint and fix the pay 
     of additional personnel as the Director considers 
     appropriate.
       (C) Experts and consultants.--Subject to rules prescribed 
     by the Commissioner of Social Security, the Director may 
     procure temporary and intermittent services under section 
     3109(b) of title 5, United States Code.
       (D) Staff of federal agencies.--Upon request of the Panel, 
     the head of any Federal department or agency may detail, on a 
     reimbursable basis, any of the personnel of that department 
     or agency to the Panel to assist it in carrying out its 
     duties under this Act.
       (5) Powers of panel.--
       (A) Hearings and sessions.--The Panel may, for the purpose 
     of carrying out its duties under this subsection, hold such 
     hearings, sit and act at such times and places, and take such 
     testimony and evidence as the Panel considers appropriate.
       (B) Powers of members and agents.--Any member or agent of 
     the Panel may, if authorized by the Panel, take any action 
     which the Panel is authorized to take by this section.
       (C) Mails.--The Panel may use the United States mails in 
     the same manner and under the same conditions as other 
     departments and agencies of the United States.
       (6) Reports.--
       (A) Interim reports.--The Panel shall submit to the 
     President and the Congress interim reports at least annually.
       (B) Final report.--The Panel shall transmit a final report 
     to the President and the Congress not later than eight years 
     after the date of the enactment of this Act. The final report 
     shall contain a detailed statement of the findings and 
     conclusions of the Panel, together with its recommendations 
     for legislation and administrative actions which the Panel 
     considers appropriate.
       (7) Termination.--The Panel shall terminate 30 days after 
     the date of the submission of its final report under 
     paragraph (6)(B).
       (8) Authorization of appropriations.--There are authorized 
     to be appropriated from the Federal Old-Age and Survivors 
     Insurance Trust Fund, the Federal Disability Insurance Trust 
     Fund, and the general fund of the Treasury, as appropriate, 
     such sums as are necessary to carry out this subsection.

             Subtitle B--Elimination of Work Disincentives

     SEC. 111. WORK ACTIVITY STANDARD AS A BASIS FOR REVIEW OF AN 
                   INDIVIDUAL'S DISABLED STATUS.

       (a) In General.--Section 221 of the Social Security Act (42 
     U.S.C. 421) is amended by adding at the end the following:
       ``(m)(1) In any case where an individual entitled to 
     disability insurance benefits under section 223 or to monthly 
     insurance benefits under section 202 based on such 
     individual's disability (as defined in section 223(d)) has 
     received such benefits for at least 24 months--
       ``(A) no continuing disability review conducted by the 
     Commissioner may be scheduled for the individual solely as a 
     result of the individual's work activity;
       ``(B) no work activity engaged in by the individual may be 
     used as evidence that the individual is no longer disabled; 
     and
       ``(C) no cessation of work activity by the individual may 
     give rise to a presumption that the individual is unable to 
     engage in work.
       ``(2) An individual to which paragraph (1) applies shall 
     continue to be subject to--
       ``(A) continuing disability reviews on a regularly 
     scheduled basis that is not triggered by work; and
       ``(B) termination of benefits under this title in the event 
     that the individual has earnings that exceed the level of 
     earnings established by the Commissioner to represent 
     substantial gainful activity.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect on January 1, 2003.

     SEC. 112. EXPEDITED REINSTATEMENT OF DISABILITY BENEFITS.

       (a) OASDI Benefits.--Section 223 of the Social Security Act 
     (42 U.S.C. 423) is amended--
       (1) by redesignating subsection (i) as subsection (j); and
       (2) by inserting after subsection (h) the following:

                     ``Reinstatement of Entitlement

       ``(i)(1)(A) Entitlement to benefits described in 
     subparagraph (B)(i)(I) shall be reinstated in any case where 
     the Commissioner determines that an individual described in 
     subparagraph (B) has filed a request for reinstatement 
     meeting the requirements of paragraph (2)(A) during the 
     period prescribed in subparagraph (C). Reinstatement of such 
     entitlement shall be in accordance with the terms of this 
     subsection.
       ``(B) An individual is described in this subparagraph if--
       ``(i) prior to the month in which the individual files a 
     request for reinstatement--
       ``(I) the individual was entitled to benefits under this 
     section or section 202 on the basis of disability pursuant to 
     an application filed therefor; and
       ``(II) such entitlement terminated due to the performance 
     of substantial gainful activity;
       ``(ii) the individual is under a disability and the 
     physical or mental impairment that is the basis for the 
     finding of disability is the same as (or related to) the 
     physical or mental impairment that was the basis for the 
     finding of disability that gave rise to the entitlement 
     described in clause (i); and
       ``(iii) the individual's disability renders the individual 
     unable to perform substantial gainful activity.
       ``(C)(i) Except as provided in clause (ii), the period 
     prescribed in this subparagraph with respect to an individual 
     is 60 consecutive months beginning with the month following 
     the most recent month for which the individual was entitled 
     to a benefit described in subparagraph (B)(i)(I) prior to the 
     entitlement termination described in subparagraph (B)(i)(II).
       ``(ii) In the case of an individual who fails to file a 
     reinstatement request within the period prescribed in clause 
     (i), the Commissioner may extend the period if the 
     Commissioner determines that the individual had good cause 
     for the failure to so file.
       ``(2)(A)(i) A request for reinstatement shall be filed in 
     such form, and containing such information, as the 
     Commissioner may prescribe.
       ``(ii) A request for reinstatement shall include express 
     declarations by the individual that the individual meets the 
     requirements specified in clauses (ii) and (iii) of paragraph 
     (1)(B).
       ``(B) A request for reinstatement filed in accordance with 
     subparagraph (A) may constitute an application for benefits 
     in the case of any individual who the Commissioner determines 
     is not entitled to reinstated benefits under this subsection.
       ``(3) In determining whether an individual meets the 
     requirements of paragraph (1)(B)(ii), the provisions of 
     subsection (f) shall apply.
       ``(4)(A)(i) Subject to clause (ii), entitlement to benefits 
     reinstated under this subsection shall commence with the 
     benefit payable for the month in which a request for 
     reinstatement is filed.
       ``(ii) An individual whose entitlement to a benefit for any 
     month would have been reinstated under this subsection had 
     the individual filed a request for reinstatement before the 
     end of such month shall be entitled to such benefit for such 
     month if such request for reinstatement is filed before the 
     end of the twelfth month immediately succeeding such month.
       ``(B)(i) Subject to clauses (ii) and (iii), the amount of 
     the benefit payable for any month pursuant to the 
     reinstatement of entitlement under this subsection shall be 
     determined in accordance with the provisions of this title.
       ``(ii) For purposes of computing the primary insurance 
     amount of an individual whose entitlement to benefits under 
     this section is reinstated under this subsection, the date of 
     onset of the individual's disability shall be the date of 
     onset used in determining the individual's most recent period 
     of disability arising in connection with such benefits 
     payable on the basis of an application.
       ``(iii) Benefits under this section or section 202 payable 
     for any month pursuant to a request for reinstatement filed 
     in accordance with paragraph (2) shall be reduced by the 
     amount of any provisional benefit paid to such individual for 
     such month under paragraph (7).
       ``(C) No benefit shall be payable pursuant to an 
     entitlement reinstated under this subsection to an individual 
     for any month in which the individual engages in substantial 
     gainful activity.
       ``(D) The entitlement of any individual that is reinstated 
     under this subsection shall end with the benefits payable for 
     the month preceding whichever of the following months is the 
     earliest:
       ``(i) The month in which the individual dies.
       ``(ii) The month in which the individual attains retirement 
     age.
       ``(iii) The third month following the month in which the 
     individual's disability ceases.
       ``(5) Whenever an individual's entitlement to benefits 
     under this section is reinstated under this subsection, 
     entitlement to benefits payable on the basis of such 
     individual's wages and self-employment income may be 
     reinstated with respect to any person previously entitled to 
     such benefits on the basis of an application if the 
     Commissioner determines that such person satisfies all the 
     requirements for entitlement to such benefits except 
     requirements related to the filing of an application. The 
     provisions of paragraph (4) shall apply to the reinstated 
     entitlement of any such person to the same extent that they 
     apply to the reinstated entitlement of such individual.
       ``(6) An individual to whom benefits are payable under this 
     section or section 202 pursuant to a reinstatement of 
     entitlement under this subsection for 24 months (whether or 
     not consecutive) shall, with respect to benefits so payable 
     after such twenty-fourth

[[Page H10247]]

     month, be deemed for purposes of paragraph (1)(B)(i)(I) and 
     the determination, if appropriate, of the termination month 
     in accordance with subsection (a)(1) of this section, or 
     subsection (d)(1), (e)(1), or (f)(1) of section 202, to be 
     entitled to such benefits on the basis of an application 
     filed therefor.
       ``(7)(A) An individual described in paragraph (1)(B) who 
     files a request for reinstatement in accordance with the 
     provisions of paragraph (2)(A) shall be entitled to 
     provisional benefits payable in accordance with this 
     paragraph, unless the Commissioner determines that the 
     individual does not meet the requirements of paragraph 
     (1)(B)(i) or that the individual's declaration under 
     paragraph (2)(A)(ii) is false. Any such determination by the 
     Commissioner shall be final and not subject to review under 
     subsection (b) or (g) of section 205.
       ``(B) The amount of a provisional benefit for a month shall 
     equal the amount of the last monthly benefit payable to the 
     individual under this title on the basis of an application 
     increased by an amount equal to the amount, if any, by which 
     such last monthly benefit would have been increased as a 
     result of the operation of section 215(i).
       ``(C)(i) Provisional benefits shall begin with the month in 
     which a request for reinstatement is filed in accordance with 
     paragraph (2)(A).
       ``(ii) Provisional benefits shall end with the earliest 
     of--
       ``(I) the month in which the Commissioner makes a 
     determination regarding the individual's entitlement to 
     reinstated benefits;
       ``(II) the fifth month following the month described in 
     clause (i);
       ``(III) the month in which the individual performs 
     substantial gainful activity; or
       ``(IV) the month in which the Commissioner determines that 
     the individual does not meet the requirements of paragraph 
     (1)(B)(i) or that the individual's declaration made in 
     accordance with paragraph (2)(A)(ii) is false.
       ``(D) In any case in which the Commissioner determines that 
     an individual is not entitled to reinstated benefits, any 
     provisional benefits paid to the individual under this 
     paragraph shall not be subject to recovery as an overpayment 
     unless the Commissioner determines that the individual knew 
     or should have known that the individual did not meet the 
     requirements of paragraph (1)(B).''.
       (b) SSI Benefits.--
       (1) In general.--Section 1631 of the Social Security Act 
     (42 U.S.C. 1383) is amended by adding at the end the 
     following:

 ``Reinstatement of Eligibility on the Basis of Blindness or Disability

       ``(p)(1)(A) Eligibility for benefits under this title shall 
     be reinstated in any case where the Commissioner determines 
     that an individual described in subparagraph (B) has filed a 
     request for reinstatement meeting the requirements of 
     paragraph (2)(A) during the period prescribed in subparagraph 
     (C). Reinstatement of eligibility shall be in accordance with 
     the terms of this subsection.
       ``(B) An individual is described in this subparagraph if--
       ``(i) prior to the month in which the individual files a 
     request for reinstatement--
       ``(I) the individual was eligible for benefits under this 
     title on the basis of blindness or disability pursuant to an 
     application filed therefor; and
       ``(II) the individual thereafter was ineligible for such 
     benefits due to earned income (or earned and unearned income) 
     for a period of 12 or more consecutive months;
       ``(ii) the individual is blind or disabled and the physical 
     or mental impairment that is the basis for the finding of 
     blindness or disability is the same as (or related to) the 
     physical or mental impairment that was the basis for the 
     finding of blindness or disability that gave rise to the 
     eligibility described in clause (i);
       ``(iii) the individual's blindness or disability renders 
     the individual unable to perform substantial gainful 
     activity; and
       ``(iv) the individual satisfies the nonmedical requirements 
     for eligibility for benefits under this title.
       ``(C)(i) Except as provided in clause (ii), the period 
     prescribed in this subparagraph with respect to an individual 
     is 60 consecutive months beginning with the month following 
     the most recent month for which the individual was eligible 
     for a benefit under this title (including section 1619) prior 
     to the period of ineligibility described in subparagraph 
     (B)(i)(II).
       ``(ii) In the case of an individual who fails to file a 
     reinstatement request within the period prescribed in clause 
     (i), the Commissioner may extend the period if the 
     Commissioner determines that the individual had good cause 
     for the failure to so file.
       ``(2)(A)(i) A request for reinstatement shall be filed in 
     such form, and containing such information, as the 
     Commissioner may prescribe.
       ``(ii) A request for reinstatement shall include express 
     declarations by the individual that the individual meets the 
     requirements specified in clauses (ii) through (iv) of 
     paragraph (1)(B).
       ``(B) A request for reinstatement filed in accordance with 
     subparagraph (A) may constitute an application for benefits 
     in the case of any individual who the Commissioner determines 
     is not eligible for reinstated benefits under this 
     subsection.
       ``(3) In determining whether an individual meets the 
     requirements of paragraph (1)(B)(ii), the provisions of 
     section 1614(a)(4) shall apply.
       ``(4)(A) Eligibility for benefits reinstated under this 
     subsection shall commence with the benefit payable for the 
     month following the month in which a request for 
     reinstatement is filed.
       ``(B)(i) Subject to clause (ii), the amount of the benefit 
     payable for any month pursuant to the reinstatement of 
     eligibility under this subsection shall be determined in 
     accordance with the provisions of this title.
       ``(ii) The benefit under this title payable for any month 
     pursuant to a request for reinstatement filed in accordance 
     with paragraph (2) shall be reduced by the amount of any 
     provisional benefit paid to such individual for such month 
     under paragraph (7).
       ``(C) Except as otherwise provided in this subsection, 
     eligibility for benefits under this title reinstated pursuant 
     to a request filed under paragraph (2) shall be subject to 
     the same terms and conditions as eligibility established 
     pursuant to an application filed therefor.
       ``(5) Whenever an individual's eligibility for benefits 
     under this title is reinstated under this subsection, 
     eligibility for such benefits shall be reinstated with 
     respect to the individual's spouse if such spouse was 
     previously an eligible spouse of the individual under this 
     title and the Commissioner determines that such spouse 
     satisfies all the requirements for eligibility for such 
     benefits except requirements related to the filing of an 
     application. The provisions of paragraph (4) shall apply to 
     the reinstated eligibility of the spouse to the same extent 
     that they apply to the reinstated eligibility of such 
     individual.
       ``(6) An individual to whom benefits are payable under this 
     title pursuant to a reinstatement of eligibility under this 
     subsection for twenty-four months (whether or not 
     consecutive) shall, with respect to benefits so payable after 
     such twenty-fourth month, be deemed for purposes of paragraph 
     (1)(B)(i)(I) to be eligible for such benefits on the basis of 
     an application filed therefor.
       ``(7)(A) An individual described in paragraph (1)(B) who 
     files a request for reinstatement in accordance with the 
     provisions of paragraph (2)(A) shall be eligible for 
     provisional benefits payable in accordance with this 
     paragraph, unless the Commissioner determines that the 
     individual does not meet the requirements of paragraph 
     (1)(B)(i) or that the individual's declaration under 
     paragraph (2)(A)(ii) is false. Any such determination by the 
     Commissioner shall be final and not subject to review under 
     paragraph (1) or (3) of subsection (c).
       ``(B)(i) Except as otherwise provided in clause (ii), the 
     amount of a provisional benefit for a month shall equal the 
     amount of the monthly benefit that would be payable to an 
     eligible individual under this title with the same kind and 
     amount of income.
       ``(ii) If the individual has a spouse who was previously an 
     eligible spouse of the individual under this title and the 
     Commissioner determines that such spouse satisfies all the 
     requirements of section 1614(b) except requirements related 
     to the filing of an application, the amount of a provisional 
     benefit for a month shall equal the amount of the monthly 
     benefit that would be payable to an eligible individual and 
     eligible spouse under this title with the same kind and 
     amount of income.
       ``(C)(i) Provisional benefits shall begin with the month 
     following the month in which a request for reinstatement is 
     filed in accordance with paragraph (2)(A).
       ``(ii) Provisional benefits shall end with the earliest 
     of--
       ``(I) the month in which the Commissioner makes a 
     determination regarding the individual's eligibility for 
     reinstated benefits;
       ``(II) the fifth month following the month for which 
     provisional benefits are first payable under clause (i); or
       ``(III) the month in which the Commissioner determines that 
     the individual does not meet the requirements of paragraph 
     (1)(B)(i) or that the individual's declaration made in 
     accordance with paragraph (2)(A)(ii) is false.
       ``(D) In any case in which the Commissioner determines that 
     an individual is not eligible for reinstated benefits, any 
     provisional benefits paid to the individual under this 
     paragraph shall not be subject to recovery as an overpayment 
     unless the Commissioner determines that the individual knew 
     or should have known that the individual did not meet the 
     requirements of paragraph (1)(B).
       ``(8) For purposes of this subsection other than paragraph 
     (7), the term `benefits under this title' includes State 
     supplementary payments made pursuant to an agreement under 
     section 1616(a) of this Act or section 212(b) of Public Law 
     93-66.''.
       (2) Conforming amendments.--
       (A) Section 1631(j)(1) of such Act (42 U.S.C. 1383(j)(1)) 
     is amended by striking the period and inserting ``, or has 
     filed a request for reinstatement of eligibility under 
     subsection (p)(2) and been determined to be eligible for 
     reinstatement.''.
       (B) Section 1631(j)(2)(A)(i)(I) of such Act (42 U.S.C. 
     1383(j)(2)(A)(i)(I)) is amended by inserting ``(other than 
     pursuant to a request for reinstatement under subsection 
     (p))'' after ``eligible''.
       (c) Effective Date.--
       (1) In general.--The amendments made by this section shall 
     take effect on the first day of the thirteenth month 
     beginning after the date of enactment of this Act.
       (2) Limitation.--No benefit shall be payable under title II 
     or XVI on the basis of a

[[Page H10248]]

     request for reinstatement filed under section 223(i) or 
     1631(p) of the Social Security Act before the effective date 
     described in paragraph (1).

     Subtitle C--Work Incentives Planning, Assistance, and Outreach

     SEC. 121. WORK INCENTIVES OUTREACH PROGRAM.

       Part A of title XI of the Social Security Act (42 U.S.C. 
     1301 et seq.), as amended by section 101, is amended by 
     adding after section 1148 the following:


                   ``work incentives outreach program

       ``Sec. 1149. (a) Establishment.--
       ``(1) In general.--The Commissioner, in consultation with 
     the Ticket to Work and Work Incentives Advisory Panel 
     established under section 101(f) of the Ticket to Work and 
     Work Incentives Improvement Act of 1999, shall establish a 
     community-based work incentives planning and assistance 
     program for the purpose of disseminating accurate information 
     to disabled beneficiaries on work incentives programs and 
     issues related to such programs.
       ``(2) Grants, cooperative agreements, contracts, and 
     outreach.--Under the program established under this section, 
     the Commissioner shall--
       ``(A) establish a competitive program of grants, 
     cooperative agreements, or contracts to provide benefits 
     planning and assistance, including information on the 
     availability of protection and advocacy services, to disabled 
     beneficiaries, including individuals participating in the 
     Ticket to Work and Self-Sufficiency Program established under 
     section 1148, the program established under section 1619, and 
     other programs that are designed to encourage disabled 
     beneficiaries to work;
       ``(B) conduct directly, or through grants, cooperative 
     agreements, or contracts, ongoing outreach efforts to 
     disabled beneficiaries (and to the families of such 
     beneficiaries) who are potentially eligible to participate in 
     Federal or State work incentive programs that are designed to 
     assist disabled beneficiaries to work, including--
       ``(i) preparing and disseminating information explaining 
     such programs; and
       ``(ii) working in cooperation with other Federal, State, 
     and private agencies and nonprofit organizations that serve 
     disabled beneficiaries, and with agencies and organizations 
     that focus on vocational rehabilitation and work-related 
     training and counseling;
       ``(C) establish a corps of trained, accessible, and 
     responsive work incentives specialists within the Social 
     Security Administration who will specialize in disability 
     work incentives under titles II and XVI for the purpose of 
     disseminating accurate information with respect to inquiries 
     and issues relating to work incentives to--
       ``(i) disabled beneficiaries;
       ``(ii) benefit applicants under titles II and XVI; and
       ``(iii) individuals or entities awarded grants under 
     subparagraphs (A) or (B); and
       ``(D) provide--
       ``(i) training for work incentives specialists and 
     individuals providing planning assistance described in 
     subparagraph (C); and
       ``(ii) technical assistance to organizations and entities 
     that are designed to encourage disabled beneficiaries to 
     return to work.
       ``(3) Coordination with other programs.--The 
     responsibilities of the Commissioner established under this 
     section shall be coordinated with other public and private 
     programs that provide information and assistance regarding 
     rehabilitation services and independent living supports and 
     benefits planning for disabled beneficiaries including the 
     program under section 1619, the plans for achieving self-
     support program (PASS), and any other Federal or State work 
     incentives programs that are designed to assist disabled 
     beneficiaries, including educational agencies that provide 
     information and assistance regarding rehabilitation, school-
     to-work programs, transition services (as defined in, and 
     provided in accordance with, the Individuals with 
     Disabilities Education Act (20 U.S.C. 1400 et seq.)), a one-
     stop delivery system established under subtitle B of title I 
     of the Workforce Investment Act of 1998, and other services.
       ``(b) Conditions.--
       ``(1) Selection of entities.--
       ``(A) Application.--An entity shall submit an application 
     for a grant, cooperative agreement, or contract to provide 
     benefits planning and assistance to the Commissioner at such 
     time, in such manner, and containing such information as the 
     Commissioner may determine is necessary to meet the 
     requirements of this section.
       ``(B) Statewideness.--The Commissioner shall ensure that 
     the planning, assistance, and information described in 
     paragraph (2) shall be available on a statewide basis.
       ``(C) Eligibility of states and private organizations.--
       ``(i) In general.--The Commissioner may award a grant, 
     cooperative agreement, or contract under this section to a 
     State or a private agency or organization (other than Social 
     Security Administration Field Offices and the State agency 
     administering the State medicaid program under title XIX, 
     including any agency or entity described in clause (ii), that 
     the Commissioner determines is qualified to provide the 
     planning, assistance, and information described in paragraph 
     (2)).
       ``(ii) Agencies and entities described.--The agencies and 
     entities described in this clause are the following:

       ``(I) Any public or private agency or organization 
     (including Centers for Independent Living established under 
     title VII of the Rehabilitation Act of 1973, protection and 
     advocacy organizations, client assistance programs 
     established in accordance with section 112 of the 
     Rehabilitation Act of 1973, and State Developmental 
     Disabilities Councils established in accordance with section 
     124 of the Developmental Disabilities Assistance and Bill of 
     Rights Act (42 U.S.C. 6024)) that the Commissioner determines 
     satisfies the requirements of this section.
       ``(II) The State agency administering the State program 
     funded under part A of title IV.

       ``(D) Exclusion for conflict of interest.--The Commissioner 
     may not award a grant, cooperative agreement, or contract 
     under this section to any entity that the Commissioner 
     determines would have a conflict of interest if the entity 
     were to receive a grant, cooperative agreement, or contract 
     under this section.
       ``(2) Services provided.--A recipient of a grant, 
     cooperative agreement, or contract to provide benefits 
     planning and assistance shall select individuals who will act 
     as planners and provide information, guidance, and planning 
     to disabled beneficiaries on the--
       ``(A) availability and interrelation of any Federal or 
     State work incentives programs designed to assist disabled 
     beneficiaries that the individual may be eligible to 
     participate in;
       ``(B) adequacy of any health benefits coverage that may be 
     offered by an employer of the individual and the extent to 
     which other health benefits coverage may be available to the 
     individual; and
       ``(C) availability of protection and advocacy services for 
     disabled beneficiaries and how to access such services.
       ``(3) Amount of grants, cooperative agreements, or 
     contracts.--
       ``(A) Based on population of disabled beneficiaries.--
     Subject to subparagraph (B), the Commissioner shall award a 
     grant, cooperative agreement, or contract under this section 
     to an entity based on the percentage of the population of the 
     State where the entity is located who are disabled 
     beneficiaries.
       ``(B) Limitations.--
       ``(i) Per grant.--No entity shall receive a grant, 
     cooperative agreement, or contract under this section for a 
     fiscal year that is less than $50,000 or more than $300,000.
       ``(ii) Total amount for all grants, cooperative agreements, 
     and contracts.--The total amount of all grants, cooperative 
     agreements, and contracts awarded under this section for a 
     fiscal year may not exceed $23,000,000.
       ``(4) Allocation of costs.--The costs of carrying out this 
     section shall be paid from amounts made available for the 
     administration of title II and amounts made available for the 
     administration of title XVI, and shall be allocated among 
     those amounts as appropriate.
       ``(c) Definitions.--In this section:
       ``(1) Commissioner.--The term `Commissioner' means the 
     Commissioner of Social Security.
       ``(2) Disabled beneficiary.--The term `disabled 
     beneficiary' has the meaning given that term in section 
     1148(k)(2).
       ``(d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $23,000,000 for 
     each of the fiscal years 2000 through 2004.''.

     SEC. 122. STATE GRANTS FOR WORK INCENTIVES ASSISTANCE TO 
                   DISABLED BENEFICIARIES.

       Part A of title XI of the Social Security Act (42 U.S.C. 
     1301 et seq.), as amended by section 121, is amended by 
     adding after section 1149 the following:


``state grants for work incentives assistance to disabled beneficiaries

       ``Sec. 1150. (a) In General.--Subject to subsection (c), 
     the Commissioner may make payments in each State to the 
     protection and advocacy system established pursuant to part C 
     of title I of the Developmental Disabilities Assistance and 
     Bill of Rights Act (42 U.S.C. 6041 et seq.) for the purpose 
     of providing services to disabled beneficiaries.
       ``(b) Services Provided.--Services provided to disabled 
     beneficiaries pursuant to a payment made under this section 
     may include--
       ``(1) information and advice about obtaining vocational 
     rehabilitation and employment services; and
       ``(2) advocacy or other services that a disabled 
     beneficiary may need to secure or regain gainful employment.
       ``(c) Application.--In order to receive payments under this 
     section, a protection and advocacy system shall submit an 
     application to the Commissioner, at such time, in such form 
     and manner, and accompanied by such information and 
     assurances as the Commissioner may require.
       ``(d) Amount of Payments.--
       ``(1) In general.--Subject to the amount appropriated for a 
     fiscal year for making payments under this section, a 
     protection and advocacy system shall not be paid an amount 
     that is less than--
       ``(A) in the case of a protection and advocacy system 
     located in a State (including the District of Columbia and 
     Puerto Rico) other than Guam, American Samoa, the United 
     States Virgin Islands, and the Commonwealth of the Northern 
     Mariana Islands, the greater of--
       ``(i) $100,000; or
       ``(ii) \1/3\ of 1 percent of the amount available for 
     payments under this section; and
       ``(B) in the case of a protection and advocacy system 
     located in Guam, American

[[Page H10249]]

     Samoa, the United States Virgin Islands, and the Commonwealth 
     of the Northern Mariana Islands, $50,000.
       ``(2) Inflation adjustment.--For each fiscal year in which 
     the total amount appropriated to carry out this section 
     exceeds the total amount appropriated to carry out this 
     section in the preceding fiscal year, the Commissioner shall 
     increase each minimum payment under subparagraphs (A) and (B) 
     of paragraph (1) by a percentage equal to the percentage 
     increase in the total amount so appropriated to carry out 
     this section.
       ``(e) Annual Report.--Each protection and advocacy system 
     that receives a payment under this section shall submit an 
     annual report to the Commissioner and the Ticket to Work and 
     Work Incentives Advisory Panel established under section 
     101(f) of the Ticket to Work and Work Incentives Improvement 
     Act of 1999 on the services provided to individuals by the 
     system.
       ``(f) Funding.--
       ``(1) Allocation of payments.--Payments under this section 
     shall be made from amounts made available for the 
     administration of title II and amounts made available for the 
     administration of title XVI, and shall be allocated among 
     those amounts as appropriate.
       ``(2) Carryover.--Any amounts allotted for payment to a 
     protection and advocacy system under this section for a 
     fiscal year shall remain available for payment to or on 
     behalf of the protection and advocacy system until the end of 
     the succeeding fiscal year.
       ``(g) Definitions.--In this section:
       ``(1) Commissioner.--The term `Commissioner' means the 
     Commissioner of Social Security.
       ``(2) Disabled beneficiary.--The term `disabled 
     beneficiary' has the meaning given that term in section 
     1148(k)(2).
       ``(3) Protection and advocacy system.--The term `protection 
     and advocacy system' means a protection and advocacy system 
     established pursuant to part C of title I of the 
     Developmental Disabilities Assistance and Bill of Rights Act 
     (42 U.S.C. 6041 et seq.).
       ``(h) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $7,000,000 for 
     each of the fiscal years 2000 through 2004.''.

        TITLE II--EXPANDED AVAILABILITY OF HEALTH CARE SERVICES

     SEC. 201. EXPANDING STATE OPTIONS UNDER THE MEDICAID PROGRAM 
                   FOR WORKERS WITH DISABILITIES.

       (a) In General.--
       (1) State option to provide opportunity for employed 
     individuals with a medically improved disability to buy into 
     medicaid.--
       (A) Eligibility.--Section 1902(a)(10)(A)(ii) of the Social 
     Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
       (i) in subclause (XIII), by striking ``or'' at the end;
       (ii) in subclause (XIV), by adding ``or'' at the end; and
       (iii) by adding at the end the following:

       ``(XV) who are employed individuals with a medically 
     improved disability described in section 1905(v)(1) and whose 
     assets, resources, and earned or unearned income (or both) do 
     not exceed such limitations (if any) as the State may 
     establish, but only if the State provides medical assistance 
     to individuals described in subclause (XIII);''.

       (B) Definition of employed individuals with a medically 
     improved disability.--Section 1905 of the Social Security Act 
     (42 U.S.C. 1396d) is amended by adding at the end the 
     following:
       ``(v)(1) The term `employed individual with a medically 
     improved disability' means an individual who--
       ``(A) is at least 16, but less than 65, years of age;
       ``(B) is employed (as defined in paragraph (2));
       ``(C) ceases to be eligible for medical assistance under 
     section 1902(a)(10)(A)(ii)(XIII) because the individual, by 
     reason of medical improvement, is determined at the time of a 
     regularly scheduled continuing disability review to no longer 
     be eligible for benefits under section 223(d) or 1614(a)(3); 
     and
       ``(D) continues to have a severe medically determinable 
     impairment, as determined under regulations of the Secretary.
       ``(2) For purposes of paragraph (1), an individual is 
     considered to be `employed' if the individual--
       ``(A) is earning at least the applicable minimum wage 
     requirement under section 6 of the Fair Labor Standards Act 
     (29 U.S.C. 206) and working at least 40 hours per month; or
       ``(B) is engaged in a work effort that meets substantial 
     and reasonable threshold criteria for hours of work, wages, 
     or other measures, as defined by the State and approved by 
     the Secretary.''.
       (C) Conforming amendment.--Section 1905(a) of such Act (42 
     U.S.C. 1396d(a)) is amended in the matter preceding paragraph 
     (1)--
       (i) in clause (x), by striking ``or'' at the end;
       (ii) in clause (xi), by adding ``or'' at the end; and
       (iii) by inserting after clause (xi), the following:
       ``(xii) employed individuals with a medically improved 
     disability (as defined in subsection (v)),''.
       (2) State authority to impose income-related premiums and 
     cost-sharing.--Section 1916 of such Act (42 U.S.C. 1396o) is 
     amended--
       (A) in subsection (a), by striking ``The State plan'' and 
     inserting ``Subject to subsection (g), the State plan''; and
       (B) by adding at the end the following:
       ``(g) With respect to individuals provided medical 
     assistance only under subclause (XV) of section 
     1902(a)(10)(A)(ii), a State may (in a uniform manner for 
     individuals described in either such subclause)--
       ``(1) require such individuals to pay premiums or other 
     cost-sharing charges set on a sliding scale based on income 
     that the State may determine; and
       ``(2) require payment of 100 percent of such premiums in 
     the case of such an individual who has income that exceeds 
     250 percent of the income official poverty line (referred to 
     in subsection (c)(1)) applicable to a family of the size 
     involved.''.
       (3) Prohibition against supplantation of state funds and 
     state failure to maintain effort.--Section 1903(i) of such 
     Act (42 U.S.C. 1396b(i)) is amended--
       (A) by striking the period at the end of paragraph (19) and 
     inserting ``; or''; and
       (B) by inserting after such paragraph the following:
       ``(20) with respect to amounts expended for medical 
     assistance provided to an individual described in subclause 
     (XV) of section 1902(a)(10)(A)(ii) for a fiscal year unless 
     the State demonstrates to the satisfaction of the Secretary 
     that the level of State funds expended for such fiscal year 
     for programs to enable working individuals with disabilities 
     to work (other than for such medical assistance) is not less 
     than the level expended for such programs during the most 
     recent State fiscal year ending before the date of enactment 
     of this paragraph.''.
       (b) Conforming Amendments.--
       (1) Section 1903(f)(4) of the Social Security Act (42 
     U.S.C. 1396b(f)(4)) is amended in the matter preceding 
     subparagraph (A) by inserting ``1902(a)(10)(A)(ii)(XV),'' 
     after ``1902(a)(10)(A)(ii)(X),''.
       (2) Section 1903(f)(4) of such Act, as amended by paragraph 
     (1), is amended by inserting ``1902(a)(10)(A)(ii)(XIII),'' 
     before ``1902(a)(10)(A)(ii)(XV)''.
       (c) Effective Date.--
       (1) In general.--Except as provided in paragraph (2), the 
     amendments made by this section apply to medical assistance 
     for items and services furnished on or after October 1, 1999.
       (2) Retroactivity of conforming amendment.--The amendment 
     made by subsection (b)(2) takes effect as if included in the 
     enactment of the Balanced Budget Act of 1997.

     SEC. 202. EXTENDING MEDICARE COVERAGE FOR OASDI DISABILITY 
                   BENEFIT RECIPIENTS.

       (a) In General.--The next to last sentence of section 
     226(b) of the Social Security Act (42 U.S.C. 426) is amended 
     by striking ``24'' and inserting ``96''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall be effective on and after October 1, 2000.
       (c) GAO Report.--Not later than 5 years after the date of 
     the enactment of this Act, the Comptroller General of the 
     United States shall submit a report to the Congress that--
       (1) examines the effectiveness and cost of the amendment 
     made by subsection (a);
       (2) examines the necessity and effectiveness of providing 
     continuation of medicare coverage under section 226(b) of the 
     Social Security Act to individuals whose annual income 
     exceeds the contribution and benefit base (as determined 
     under section 230 of such Act);
       (3) examines the viability of providing the continuation of 
     medicare coverage under such section 226(b) based on a 
     sliding scale premium for individuals whose annual income 
     exceeds such contribution and benefit base;
       (4) examines the viability of providing the continuation of 
     medicare coverage under such section 226(b) based on a 
     premium buy-in by the beneficiary's employer in lieu of 
     coverage under private health insurance;
       (5) examines the interrelation between the use of the 
     continuation of medicare coverage under such section 226(b) 
     and the use of private health insurance coverage by 
     individuals during the extended period; and
       (6) recommends such legislative or administrative changes 
     relating to the continuation of medicare coverage for 
     recipients of social security disability benefits as the 
     Comptroller General determines are appropriate.

     SEC. 203. GRANTS TO DEVELOP AND ESTABLISH STATE 
                   INFRASTRUCTURES TO SUPPORT WORKING INDIVIDUALS 
                   WITH DISABILITIES.

       (a) Establishment.--
       (1) In general.--The Secretary of Health and Human Services 
     (in this section referred to as the ``Secretary'') shall 
     award grants described in subsection (b) to States to support 
     the design, establishment, and operation of State 
     infrastructures that provide items and services to support 
     working individuals with disabilities.
       (2) Application.--In order to be eligible for an award of a 
     grant under this section, a State shall submit an application 
     to the Secretary at such time, in such manner, and containing 
     such information as the Secretary shall require.
       (3) Definition of state.--In this section, the term 
     ``State'' means each of the 50 States, the District of 
     Columbia, Puerto Rico, Guam, the United States Virgin 
     Islands, American Samoa, and the Commonwealth of the Northern 
     Mariana Islands.
       (b) Grants for Infrastructure and Outreach.--
       (1) In general.--Out of the funds appropriated under 
     subsection (e), the Secretary shall award grants to States 
     to--

[[Page H10250]]

       (A) support the establishment, implementation, and 
     operation of the State infrastructures described in 
     subsection (a); and
       (B) conduct outreach campaigns regarding the existence of 
     such infrastructures.
       (2) Eligibility for grants.--
       (A) In general.--No State may receive a grant under this 
     subsection unless the State--
       (i) has an approved amendment to the State plan under title 
     XIX of the Social Security Act (42 U.S.C. 1396 et seq.) that 
     provides medical assistance under such plan to individuals 
     described in section 1902(a)(10)(A)(ii)(XIII) of the Social 
     Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XIII)); and
       (ii) demonstrates to the satisfaction of the Secretary that 
     the State makes personal assistance services available under 
     the State plan under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.) to the extent necessary to enable 
     individuals described in clause (i) to remain employed (as 
     determined under section 1905(v)(2) of the Social Security 
     Act (42 U.S.C. 1396d(v)(2))).
       (B) Definition of personal assistance services.--In this 
     paragraph, the term ``personal assistance services'' means a 
     range of services, provided by 1 or more persons, designed to 
     assist an individual with a disability to perform daily 
     activities on and off the job that the individual would 
     typically perform if the individual did not have a 
     disability. Such services shall be designed to increase the 
     individual's control in life and ability to perform everyday 
     activities on or off the job.
       (3) Determination of awards.--
       (A) In general.--Subject to subparagraph (B), the Secretary 
     shall determine a formula for awarding grants to States under 
     this section that provides special consideration to States 
     that provide medical assistance under title XIX of the Social 
     Security Act to individuals described in section 
     1902(a)(10)(A)(ii)(XV) of that Act (42 U.S.C. 
     1396a(a)(10)(A)(ii)(XV)).
       (B) Award limits.--
       (i) Minimum awards.--

       (I) In general.--Subject to subclause (II), no State with 
     an approved application under this section shall receive a 
     grant for a fiscal year that is less than $500,000.
       (II) Pro rata reductions.--If the funds appropriated under 
     subsection (e) for a fiscal year are not sufficient to pay 
     each State with an application approved under this section 
     the minimum amount described in subclause (I), the Secretary 
     shall pay each such State an amount equal to the pro rata 
     share of the amount made available.

       (ii) Maximum awards.--No State with an application that has 
     been approved under this section shall receive a grant for a 
     fiscal year that exceeds 15 percent of the total expenditures 
     by the State (including the reimbursed Federal share of such 
     expenditures) for medical assistance for individuals eligible 
     under subclause (XIII) or (XV) of section 1902(a)(10)(A)(ii) 
     of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)), 
     as estimated by the State and approved by the Secretary.
       (c) Availability of Funds.--
       (1) Funds awarded to states.--Funds awarded to a State 
     under a grant made under this section for a fiscal year shall 
     remain available until expended.
       (2) Funds not awarded to states.--Funds not awarded to 
     States in the fiscal year for which they are appropriated 
     shall remain available in succeeding fiscal years for 
     awarding by the Secretary.
       (d) Annual Report.--A State that is awarded a grant under 
     this section shall submit an annual report to the Secretary 
     on the use of funds provided under the grant. Each report 
     shall include the percentage increase in the number of title 
     II disability beneficiaries, as defined in section 1148(k)(3) 
     of the Social Security Act (as amended by section 101(a)) in 
     the State, and title XVI disability beneficiaries, as defined 
     in section 1148(k)(4) of the Social Security Act (as so 
     amended) in the State who return to work.
       (e) Appropriation.--
       (1) In general.--Out of any funds in the Treasury not 
     otherwise appropriated, there is appropriated to make grants 
     under this section--
       (A) for fiscal year 2000, $20,000,000;
       (B) for fiscal year 2001, $25,000,000;
       (C) for fiscal year 2002, $30,000,000;
       (D) for fiscal year 2003, $35,000,000;
       (E) for fiscal year 2004, $40,000,000; and
       (F) for each of fiscal years 2005 through 2010, the amount 
     appropriated for the preceding fiscal year increased by the 
     percentage increase (if any) in the Consumer Price Index for 
     All Urban Consumers (United States city average) for the 
     preceding fiscal year.
       (2) Budget authority.--This subsection constitutes budget 
     authority in advance of appropriations Acts and represents 
     the obligation of the Federal Government to provide for the 
     payment of the amounts appropriated under paragraph (1).
       (f) Recommendation.--Not later than October 1, 2009, the 
     Secretary, in consultation with the Work Incentives Advisory 
     Panel established under section 201(f), shall submit a 
     recommendation to the Committee on Commerce of the House of 
     Representatives and the Committee on Finance of the Senate 
     regarding whether the grant program established under this 
     section should be continued after fiscal year 2010.

     SEC. 204. DEMONSTRATION OF COVERAGE UNDER THE MEDICAID 
                   PROGRAM OF WORKERS WITH POTENTIALLY SEVERE 
                   DISABILITIES.

       (a) State Application.--A State may apply to the Secretary 
     of Health and Human Services (in this section referred to as 
     the ``Secretary'') for approval of a demonstration project 
     (in this section referred to as a ``demonstration project'') 
     under which up to a specified maximum number of individuals 
     who are workers with a potentially severe disability (as 
     defined in subsection (b)(1)) are provided medical assistance 
     equal to that provided under section 1905(a) of the Social 
     Security Act (42 U.S.C. 1396d(a)) to individuals described in 
     section 1902(a)(10)(A)(ii)(XIII) of that Act (42 U.S.C. 
     1396a(a)(10)(A)(ii)(XIII)).
       (b) Worker With a Potentially Severe Disability Defined.--
     For purposes of this section--
       (1) In general.--The term ``worker with a potentially 
     severe disability'' means, with respect to a demonstration 
     project, an individual who--
       (A) is at least 16, but less than 65, years of age;
       (B) has a specific physical or mental impairment that, as 
     defined by the State under the demonstration project, is 
     reasonably expected, but for the receipt of items and 
     services described in section 1905(a) of the Social Security 
     Act (42 U.S.C. 1396d(a)), to become blind or disabled (as 
     defined under section 1614(a) of the Social Security Act (42 
     U.S.C. 1382c(a))); and
       (C) is employed (as defined in paragraph (2)).
       (2) Definition of employed.--An individual is considered to 
     be ``employed'' if the individual--
       (A) is earning at least the applicable minimum wage 
     requirement under section 6 of the Fair Labor Standards Act 
     (29 U.S.C. 206) and working at least 40 hours per month; or
       (B) is engaged in a work effort that meets substantial and 
     reasonable threshold criteria for hours of work, wages, or 
     other measures, as defined under the demonstration project 
     and approved by the Secretary.
       (c) Approval of Demonstration Projects.--
       (1) In general.--Subject to paragraph (3), the Secretary 
     shall approve applications under subsection (a) that meet the 
     requirements of paragraph (2) and such additional terms and 
     conditions as the Secretary may require. The Secretary may 
     waive the requirement of section 1902(a)(1) of the Social 
     Security Act (42 U.S.C. 1396a(a)(1)) to allow for sub-State 
     demonstrations.
       (2) Terms and conditions of demonstration projects.--The 
     Secretary may not approve a demonstration project under this 
     section unless the State provides assurances satisfactory to 
     the Secretary that the following conditions are or will be 
     met:
       (A) Election of optional category.--The State has elected 
     to provide coverage under its plan under title XIX of the 
     Social Security Act of individuals described in section 
     1902(a)(10)(A)(ii)(XIII) of the Social Security Act (42 
     U.S.C. 1396a(a)(10)(A)(ii)(XIII)).
       (B) Maintenance of state effort.--Federal funds paid to a 
     State pursuant to this section must be used to supplement, 
     but not supplant, the level of State funds expended for 
     workers with potentially severe disabilities under programs 
     in effect for such individuals at the time the demonstration 
     project is approved under this section.
       (C) Independent evaluation.--The State provides for an 
     independent evaluation of the project.
       (3) Limitations on federal funding.--
       (A) Appropriation.--
       (i) In general.--Out of any funds in the Treasury not 
     otherwise appropriated, there is appropriated to carry out 
     this section for the 5-fiscal-year period beginning with 
     fiscal year 2000, $56,000,000.
       (ii) Budget authority.--Clause (i) constitutes budget 
     authority in advance of appropriations Acts and represents 
     the obligation of the Federal Government to provide for the 
     payment of the amounts appropriated under clause (i).
       (B) Limitation on payments.--In no case may--
       (i) the aggregate amount of payments made by the Secretary 
     to States under this section exceed $56,000,000; or
       (ii) payments be provided by the Secretary for a fiscal 
     year after fiscal year 2005.
       (C) Funds allocated to states.--The Secretary shall 
     allocate funds to States based on their applications and the 
     availability of funds. Funds allocated to a State under a 
     grant made under this section for a fiscal year shall remain 
     available until expended.
       (D) Funds not allocated to states.--Funds not allocated to 
     States in the fiscal year for which they are appropriated 
     shall remain available in succeeding fiscal years for 
     allocation by the Secretary using the allocation formula 
     established under this section.
       (E) Payments to states.--The Secretary shall pay to each 
     State with a demonstration project approved under this 
     section, from its allocation under subparagraph (C), an 
     amount for each quarter equal to the Federal medical 
     assistance percentage (as defined in section 1905(b) of the 
     Social Security Act (42 U.S.C. 1395d(b)) of expenditures in 
     the quarter for medical assistance provided to workers with a 
     potentially severe disability.
       (d) Recommendation.--Not later than October 1, 2002, the 
     Secretary shall submit a recommendation to the Committee on 
     Commerce of the House of Representatives and the Committee on 
     Finance of the Senate regarding whether the demonstration 
     project established under this section should be continued 
     after fiscal year 2003.

[[Page H10251]]

       (e) State Defined.--In this section, the term ``State'' has 
     the meaning given such term for purposes of title XIX of the 
     Social Security Act (42 U.S.C. 1396 et seq.).

     SEC. 205. ELECTION BY DISABLED BENEFICIARIES TO SUSPEND 
                   MEDIGAP INSURANCE WHEN COVERED UNDER A GROUP 
                   HEALTH PLAN.

       (a) In General.--Section 1882(q) of the Social Security Act 
     (42 U.S.C. 1395ss(q)) is amended--
       (1) in paragraph (5)(C), by inserting ``or paragraph (6)'' 
     after ``this paragraph''; and
       (2) by adding at the end the following new paragraph:
       ``(6) Each medicare supplemental policy shall provide that 
     benefits and premiums under the policy shall be suspended at 
     the request of the policyholder if the policyholder is 
     entitled to benefits under section 226(b) and is covered 
     under a group health plan (as defined in section 
     1862(b)(1)(A)(v)). If such suspension occurs and if the 
     policyholder or certificate holder loses coverage under the 
     group health plan, such policy shall be automatically 
     reinstituted (effective as of the date of such loss of 
     coverage) under terms described in subsection (n)(6)(A)(ii) 
     as of the loss of such coverage if the policyholder provides 
     notice of loss of such coverage within 90 days after the date 
     of such loss.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     apply with respect to requests made after the date of the 
     enactment of this Act.

             TITLE III--DEMONSTRATION PROJECTS AND STUDIES

     SEC. 301. EXTENSION OF DISABILITY INSURANCE PROGRAM 
                   DEMONSTRATION PROJECT AUTHORITY.

       (a) Extension of Authority.--Title II of the Social 
     Security Act (42 U.S.C. 401 et seq.) is amended by adding at 
     the end the following:


                   ``DEMONSTRATION PROJECT AUTHORITY

       ``Sec. 234. (a) Authority.--
       ``(1) In general.--The Commissioner of Social Security (in 
     this section referred to as the `Commissioner') shall develop 
     and carry out experiments and demonstration projects designed 
     to determine the relative advantages and disadvantages of--
       ``(A) various alternative methods of treating the work 
     activity of individuals entitled to disability insurance 
     benefits under section 223 or to monthly insurance benefits 
     under section 202 based on such individual's disability (as 
     defined in section 223(d)), including such methods as a 
     reduction in benefits based on earnings, designed to 
     encourage the return to work of such individuals;
       ``(B) altering other limitations and conditions applicable 
     to such individuals (including lengthening the trial work 
     period (as defined in section 222(c)), altering the 24-month 
     waiting period for hospital insurance benefits under section 
     226, altering the manner in which the program under this 
     title is administered, earlier referral of such individuals 
     for rehabilitation, and greater use of employers and others 
     to develop, perform, and otherwise stimulate new forms of 
     rehabilitation); and
       ``(C) implementing sliding scale benefit offsets using 
     variations in--
       ``(i) the amount of the offset as a proportion of earned 
     income;
       ``(ii) the duration of the offset period; and
       ``(iii) the method of determining the amount of income 
     earned by such individuals,

     to the end that savings will accrue to the Trust Funds, or to 
     otherwise promote the objectives or facilitate the 
     administration of this title.
       ``(2) Authority for expansion of scope.--The Commissioner 
     may expand the scope of any such experiment or demonstration 
     project to include any group of applicants for benefits under 
     the program established under this title with impairments 
     that reasonably may be presumed to be disabling for purposes 
     of such demonstration project, and may limit any such 
     demonstration project to any such group of applicants, 
     subject to the terms of such demonstration project which 
     shall define the extent of any such presumption.
       ``(b) Requirements.--The experiments and demonstration 
     projects developed under subsection (a) shall be of 
     sufficient scope and shall be carried out on a wide enough 
     scale to permit a thorough evaluation of the alternative 
     methods under consideration while giving assurance that the 
     results derived from the experiments and projects will obtain 
     generally in the operation of the disability insurance 
     program under this title without committing such program to 
     the adoption of any particular system either locally or 
     nationally.
       ``(c) Authority To Waive Compliance With Benefits 
     Requirements.--In the case of any experiment or demonstration 
     project conducted under subsection (a), the Commissioner may 
     waive compliance with the benefit requirements of this title 
     and the requirements of section 1148 as they relate to the 
     program established under this title, and the Secretary may 
     (upon the request of the Commissioner) waive compliance with 
     the benefits requirements of title XVIII, insofar as is 
     necessary for a thorough evaluation of the alternative 
     methods under consideration. No such experiment or project 
     shall be actually placed in operation unless at least 90 days 
     prior thereto a written report, prepared for purposes of 
     notification and information only and containing a full and 
     complete description thereof, has been transmitted by the 
     Commissioner to the Committee on Ways and Means of the House 
     of Representatives and to the Committee on Finance of the 
     Senate. Periodic reports on the progress of such experiments 
     and demonstration projects shall be submitted by the 
     Commissioner to such committees. When appropriate, such 
     reports shall include detailed recommendations for changes in 
     administration or law, or both, to carry out the objectives 
     stated in subsection (a).
       ``(d) Reports.--
       ``(1) Interim reports.--On or before June 9 of each year, 
     the Commissioner shall submit to the Committee on Ways and 
     Means of the House of Representatives and to the Committee on 
     Finance of the Senate an annual interim report on the 
     progress of the experiments and demonstration projects 
     carried out under this subsection together with any related 
     data and materials that the Commissioner may consider 
     appropriate.
       ``(2) Termination and final report.--The authority under 
     the preceding provisions of this section (including any 
     waiver granted pursuant to subsection (c)) shall terminate 5 
     years after the date of the enactment of this Act. Not later 
     than 90 days after the termination of any experiment or 
     demonstration project carried out under this section, the 
     Commissioner shall submit to the Committee on Ways and Means 
     of the House of Representatives and to the Committee on 
     Finance of the Senate a final report with respect to that 
     experiment or demonstration project.''.
       (b) Conforming Amendments; Transfer of Prior Authority.--
       (1) Conforming amendments.--
       (A) Repeal of prior authority.--Paragraphs (1) through (4) 
     of subsection (a) and subsection (c) of section 505 of the 
     Social Security Disability Amendments of 1980 (42 U.S.C. 1310 
     note) are repealed.
       (B) Conforming amendment regarding funding.--Section 201(k) 
     of the Social Security Act (42 U.S.C. 401(k)) is amended by 
     striking ``section 505(a) of the Social Security Disability 
     Amendments of 1980'' and inserting ``section 234''.
       (2) Transfer of prior authority.--With respect to any 
     experiment or demonstration project being conducted under 
     section 505(a) of the Social Security Disability Amendments 
     of 1980 (42 U.S.C. 1310 note) as of the date of enactment of 
     this Act, the authority to conduct such experiment or 
     demonstration project (including the terms and conditions 
     applicable to the experiment or demonstration project) shall 
     be treated as if that authority (and such terms and 
     conditions) had been established under section 234 of the 
     Social Security Act, as added by subsection (a).

     SEC. 302. DEMONSTRATION PROJECTS PROVIDING FOR REDUCTIONS IN 
                   DISABILITY INSURANCE BENEFITS BASED ON 
                   EARNINGS.

       (a) Authority.--The Commissioner of Social Security shall 
     conduct demonstration projects for the purpose of evaluating, 
     through the collection of data, a program for title II 
     disability beneficiaries (as defined in section 1148(k)(3) of 
     the Social Security Act) under which benefits payable under 
     section 223 of such Act, or under section 202 of such Act 
     based on the beneficiary's disability, are reduced by $1 for 
     each $2 of the beneficiary's earnings that is above a level 
     to be determined by the Commissioner. Such projects shall be 
     conducted at a number of localities which the Commissioner 
     shall determine is sufficient to adequately evaluate the 
     appropriateness of national implementation of such a program. 
     Such projects shall identify reductions in Federal 
     expenditures that may result from the permanent 
     implementation of such a program.
       (b) Scope and Scale and Matters To Be Determined.--
       (1) In general.--The demonstration projects developed under 
     subsection (a) shall be of sufficient duration, shall be of 
     sufficient scope, and shall be carried out on a wide enough 
     scale to permit a thorough evaluation of the project to 
     determine--
       (A) the effects, if any, of induced entry into the project 
     and reduced exit from the project;
       (B) the extent, if any, to which the project being tested 
     is affected by whether it is in operation in a locality 
     within an area under the administration of the Ticket to Work 
     and Self-Sufficiency Program established under section 1148 
     of the Social Security Act; and
       (C) the savings that accrue to the Federal Old-Age and 
     Survivors Insurance Trust Fund, the Federal Disability 
     Insurance Trust Fund, and other Federal programs under the 
     project being tested.

     The Commissioner shall take into account advice provided by 
     the Ticket to Work and Work Incentives Advisory Panel 
     pursuant to section 101(f)(2)(B)(ii) of this Act.
       (2) Additional matters.--The Commissioner shall also 
     determine with respect to each project--
       (A) the annual cost (including net cost) of the project and 
     the annual cost (including net cost) that would have been 
     incurred in the absence of the project;
       (B) the determinants of return to work, including the 
     characteristics of the beneficiaries who participate in the 
     project; and
       (C) the employment outcomes, including wages, occupations, 
     benefits, and hours worked, of beneficiaries who return to 
     work as a result of participation in the project.

     The Commissioner may include within the matters evaluated 
     under the project the merits of trial work periods and 
     periods of extended eligibility.

[[Page H10252]]

       (c) Waivers.--The Commissioner may waive compliance with 
     the benefit provisions of title II of the Social Security 
     Act, and the Secretary of Health and Human Services may waive 
     compliance with the benefit requirements of title XVIII of 
     such Act, insofar as is necessary for a thorough evaluation 
     of the alternative methods under consideration. No such 
     project shall be actually placed in operation unless at least 
     90 days prior thereto a written report, prepared for purposes 
     of notification and information only and containing a full 
     and complete description thereof, has been transmitted by the 
     Commissioner to the Committee on Ways and Means of the House 
     of Representatives and to the Committee on Finance of the 
     Senate. Periodic reports on the progress of such projects 
     shall be submitted by the Commissioner to such committees. 
     When appropriate, such reports shall include detailed 
     recommendations for changes in administration or law, or 
     both, to carry out the objectives stated in subsection (a).
       (d) Interim Reports.--Not later than 2 years after the date 
     of enactment of this Act, and annually thereafter, the 
     Commissioner of Social Security shall submit to Congress an 
     interim report on the progress of the demonstration projects 
     carried out under this subsection together with any related 
     data and materials that the Commissioner of Social Security 
     may consider appropriate.
       (e) Final Report.--The Commissioner of Social Security 
     shall submit to Congress a final report with respect to all 
     demonstration projects carried out under this section not 
     later than 1 year after their completion.
       (f) Expenditures.--Expenditures made for demonstration 
     projects under this section shall be made from the Federal 
     Disability Insurance Trust Fund and the Federal Old-Age and 
     Survivors Insurance Trust Fund, as determined appropriate by 
     the Commissioner of Social Security, and from the Federal 
     Hospital Insurance Trust Fund and the Federal Supplementary 
     Medical Insurance Trust Fund, as determined appropriate by 
     the Secretary of Health and Human Services, to the extent 
     provided in advance in appropriation Acts.

     SEC. 303. STUDIES AND REPORTS.

       (a) Study by General Accounting Office of Existing 
     Disability-Related Employment Incentives.--
       (1) Study.--As soon as practicable after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall undertake a study to assess existing tax credits 
     and other disability-related employment incentives under the 
     Americans with Disabilities Act of 1990 and other Federal 
     laws. In such study, the Comptroller General shall 
     specifically address the extent to which such credits and 
     other incentives would encourage employers to hire and retain 
     individuals with disabilities.
       (2) Report.--Not later than 3 years after the date of 
     enactment of this Act, the Comptroller General shall transmit 
     to the Committee on Ways and Means of the House of 
     Representatives and the Committee on Finance of the Senate a 
     written report presenting the results of the Comptroller 
     General's study conducted pursuant to this subsection, 
     together with such recommendations for legislative or 
     administrative changes as the Comptroller General determines 
     are appropriate.
       (b) Study by General Accounting Office of Existing 
     Coordination of the DI and SSI Programs as They Relate to 
     Individuals Entering or Leaving Concurrent Entitlement.--
       (1) Study.--As soon as practicable after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall undertake a study to evaluate the coordination 
     under current law of the disability insurance program under 
     title II of the Social Security Act and the supplemental 
     security income program under title XVI of such Act, as such 
     programs relate to individuals entering or leaving concurrent 
     entitlement under such programs. In such study, the 
     Comptroller General shall specifically address the 
     effectiveness of work incentives under such programs with 
     respect to such individuals and the effectiveness of coverage 
     of such individuals under titles XVIII and XIX of such Act.
       (2) Report.--Not later than 3 years after the date of 
     enactment of this Act, the Comptroller General shall transmit 
     to the Committee on Ways and Means of the House of 
     Representatives and the Committee on Finance of the Senate a 
     written report presenting the results of the Comptroller 
     General's study conducted pursuant to this subsection, 
     together with such recommendations for legislative or 
     administrative changes as the Comptroller General determines 
     are appropriate.
       (c) Study by General Accounting Office of the Impact of the 
     Substantial Gainful Activity Limit on Return to Work.--
       (1) Study.--As soon as practicable after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall undertake a study of the substantial gainful 
     activity level applicable as of that date to recipients of 
     benefits under section 223 of the Social Security Act (42 
     U.S.C. 423) and under section 202 of such Act (42 U.S.C. 402) 
     on the basis of a recipient having a disability, and the 
     effect of such level as a disincentive for those recipients 
     to return to work. In the study, the Comptroller General also 
     shall address the merits of increasing the substantial 
     gainful activity level applicable to such recipients of 
     benefits and the rationale for not yearly indexing that level 
     to inflation.
       (2) Report.--Not later than 2 years after the date of 
     enactment of this Act, the Comptroller General shall transmit 
     to the Committee on Ways and Means of the House of 
     Representatives and the Committee on Finance of the Senate a 
     written report presenting the results of the Comptroller 
     General's study conducted pursuant to this subsection, 
     together with such recommendations for legislative or 
     administrative changes as the Comptroller General determines 
     are appropriate.
       (d) Report on Disregards Under the DI and SSI Programs.--
     Not later than 90 days after the date of enactment of this 
     Act, the Commissioner of Social Security shall submit to the 
     Committee on Ways and Means of the House of Representatives 
     and the Committee on Finance of the Senate a report that--
       (1) identifies all income, assets, and resource disregards 
     (imposed under statutory or regulatory authority) that are 
     applicable to individuals receiving benefits under title II 
     or XVI of the Social Security Act (42 U.S.C. 401 et seq., 
     1381 et seq.);
       (2) with respect to each such disregard--
       (A) specifies the most recent statutory or regulatory 
     modification of the disregard; and
       (B) recommends whether further statutory or regulatory 
     modification of the disregard would be appropriate; and
       (3) with respect to the disregard described in section 
     1612(b)(7) of such Act (42 U.S.C. 1382a(b)(7)) (relating to 
     grants, scholarships, or fellowships received for use in 
     paying the cost of tuition and fees at any educational 
     (including technical or vocational education) institution)--
       (A) identifies the number of individuals receiving benefits 
     under title XVI of such Act (42 U.S.C. 1381 et seq.) who have 
     attained age 22 and have not had any portion of any grant, 
     scholarship, or fellowship received for use in paying the 
     cost of tuition and fees at any educational (including 
     technical or vocational education) institution excluded from 
     their income in accordance with that section;
       (B) recommends whether the age at which such grants, 
     scholarships, or fellowships are excluded from income for 
     purposes of determining eligibility under title XVI of such 
     Act should be increased to age 25; and
       (C) recommends whether such disregard should be expanded to 
     include any such grant, scholarship, or fellowship received 
     for use in paying the cost of room and board at any such 
     institution.
       (e) Study by the General Accounting Office of Social 
     Security Administration's Disability Insurance Program 
     Demonstration Authority.--
       (1) Study.--As soon as practicable after the date of the 
     enactment of this Act, the Comptroller General of the United 
     States shall undertake a study to assess the results of the 
     Social Security Administration's efforts to conduct 
     disability demonstrations authorized under prior law as well 
     as under section 301 of this Act.
       (2) Report.--Not later than 5 years after the date of the 
     enactment of this Act, the Comptroller General shall transmit 
     to the Committee on Ways and Means of the House of 
     Representatives and the Committee on Finance of the Senate a 
     written report presenting the results of the Comptroller 
     General's study conducted pursuant to this section, together 
     with a recommendation as to whether the demonstration 
     authority authorized under section 301 of this Act should be 
     made permanent.

            TITLE IV--MISCELLANEOUS AND TECHNICAL AMENDMENTS

     SEC. 401. TECHNICAL AMENDMENTS RELATING TO DRUG ADDICTS AND 
                   ALCOHOLICS.

       (a) Clarification Relating to the Effective Date of the 
     Denial of Social Security Disability Benefits to Drug Addicts 
     and Alcoholics.--Section 105(a)(5) of the Contract with 
     America Advancement Act of 1996 (42 U.S.C. 405 note) is 
     amended--
       (1) in subparagraph (A), by striking ``by the Commissioner 
     of Social Security'' and ``by the Commissioner''; and
       (2) by adding at the end the following:
       ``(D) For purposes of this paragraph, an individual's 
     claim, with respect to benefits under title II based on 
     disability, which has been denied in whole before the date of 
     the enactment of this Act, may not be considered to be 
     finally adjudicated before such date if, on or after such 
     date--
       ``(i) there is pending a request for either administrative 
     or judicial review with respect to such claim; or
       ``(ii) there is pending, with respect to such claim, a 
     readjudication by the Commissioner of Social Security 
     pursuant to relief in a class action or implementation by the 
     Commissioner of a court remand order.
       ``(E) Notwithstanding the provisions of this paragraph, 
     with respect to any individual for whom the Commissioner of 
     Social Security does not perform the entitlement 
     redetermination before the date prescribed in subparagraph 
     (C), the Commissioner shall perform such entitlement 
     redetermination in lieu of a continuing disability review 
     whenever the Commissioner determines that the individual's 
     entitlement is subject to redetermination based on the 
     preceding provisions of this paragraph, and the provisions of 
     section 223(f) shall not apply to such redetermination.''.
       (b) Correction to Effective Date of Provisions Concerning 
     Representative Payees and Treatment Referrals of Social 
     Security Beneficiaries Who Are Drug Addicts

[[Page H10253]]

     and Alcoholics.--Section 105(a)(5)(B) of the Contract with 
     America Advancement Act of 1996 (42 U.S.C. 405 note) is 
     amended to read as follows:
       ``(B) The amendments made by paragraphs (2) and (3) shall 
     take effect on July 1, 1996, with respect to any individual--
       ``(i) whose claim for benefits is finally adjudicated on or 
     after the date of the enactment of this Act; or
       ``(ii) whose entitlement to benefits is based upon an 
     entitlement redetermination made pursuant to subparagraph 
     (C).''.
       (c) Effective Dates.--The amendments made by this section 
     shall take effect as if included in the enactment of section 
     105 of the Contract with America Advancement Act of 1996 
     (Public Law 104-121; 110 Stat. 852 et seq.).

     SEC. 402. TREATMENT OF PRISONERS.

       (a) Implementation of Prohibition Against Payment of Title 
     II Benefits to Prisoners.--
       (1) In general.--Section 202(x)(3) of the Social Security 
     Act (42 U.S.C. 402(x)(3)) is amended--
       (A) by inserting ``(A)'' after ``(3)''; and
       (B) by adding at the end the following:
       ``(B)(i) The Commissioner shall enter into an agreement 
     under this subparagraph with any interested State or local 
     institution comprising a jail, prison, penal institution, or 
     correctional facility, or comprising any other institution a 
     purpose of which is to confine individuals as described in 
     paragraph (1)(A)(ii). Under such agreement--
       ``(I) the institution shall provide to the Commissioner, on 
     a monthly basis and in a manner specified by the 
     Commissioner, the names, Social Security account numbers, 
     dates of birth, confinement commencement dates, and, to the 
     extent available to the institution, such other identifying 
     information concerning the individuals confined in the 
     institution as the Commissioner may require for the purpose 
     of carrying out paragraph (1) and other provisions of this 
     title; and
       ``(II) the Commissioner shall pay to the institution, with 
     respect to information described in subclause (I) concerning 
     each individual who is confined therein as described in 
     paragraph (1)(A), who receives a benefit under this title for 
     the month preceding the first month of such confinement, and 
     whose benefit under this title is determined by the 
     Commissioner to be not payable by reason of confinement based 
     on the information provided by the institution, $400 (subject 
     to reduction under clause (ii)) if the institution furnishes 
     the information to the Commissioner within 30 days after the 
     date such individual's confinement in such institution 
     begins, or $200 (subject to reduction under clause (ii)) if 
     the institution furnishes the information after 30 days after 
     such date but within 90 days after such date.
       ``(ii) The dollar amounts specified in clause (i)(II) shall 
     be reduced by 50 percent if the Commissioner is also required 
     to make a payment to the institution with respect to the same 
     individual under an agreement entered into under section 
     1611(e)(1)(I).
       ``(iii) There are authorized to be transferred from the 
     Federal Old-Age and Survivors Insurance Trust Fund and the 
     Federal Disability Insurance Trust Fund, as appropriate, such 
     sums as may be necessary to enable the Commissioner to make 
     payments to institutions required by clause (i)(II).
       ``(iv) The Commissioner shall maintain, and shall provide 
     on a reimbursable basis, information obtained pursuant to 
     agreements entered into under this paragraph to any agency 
     administering a Federal or federally-assisted cash, food, or 
     medical assistance program for eligibility and other 
     administrative purposes under such program.''.
       (2) Conforming amendments to the privacy act.--Section 
     552a(a)(8)(B) of title 5, United States Code, is amended--
       (A) in clause (vi), by striking ``or'' at the end;
       (B) in clause (vii), by adding ``or'' at the end; and
       (C) by adding at the end the following:
       ``(viii) matches performed pursuant to section 202(x)(3) or 
     1611(e)(1) of the Social Security Act (42 U.S.C. 402(x)(3), 
     1382(e)(1));''.
       (3) Conforming amendments to title xvi.--
       (A) Section 1611(e)(1)(I)(i)(I) of the Social Security Act 
     (42 U.S.C. 1382(e)(1)(I)(i)(I)) is amended by striking ``; 
     and'' and inserting ``and the other provisions of this title; 
     and''.
       (B) Section 1611(e)(1)(I)(ii)(II) of such Act (42 U.S.C. 
     1382(e)(1)(I)(ii)(II)) is amended by striking ``is authorized 
     to provide, on a reimbursable basis,'' and inserting ``shall 
     maintain, and shall provide on a reimbursable basis,''.
       (4) Effective date.--The amendments made by this subsection 
     shall apply to individuals whose period of confinement in an 
     institution commences on or after the first day of the fourth 
     month beginning after the month in which this Act is enacted.
       (b) Elimination of Title II Requirement That Confinement 
     Stem From Crime Punishable by Imprisonment for More Than 1 
     Year.--
       (1) In general.--Section 202(x)(1)(A) of the Social 
     Security Act (42 U.S.C. 402(x)(1)(A)) is amended--
       (A) in the matter preceding clause (i), by striking 
     ``during which'' and inserting ``ending with or during or 
     beginning with or during a period of more than 30 days 
     throughout all of which'';
       (B) in clause (i), by striking ``an offense punishable by 
     imprisonment for more than 1 year (regardless of the actual 
     sentence imposed)'' and inserting ``a criminal offense''; and
       (C) in clause (ii)(I), by striking ``an offense punishable 
     by imprisonment for more than 1 year'' and inserting ``a 
     criminal offense''.
       (2) Effective date.--The amendments made by this subsection 
     shall apply to individuals whose period of confinement in an 
     institution commences on or after the first day of the fourth 
     month beginning after the month in which this Act is enacted.
       (c) Conforming Title XVI Amendments.--
       (1) 50 percent reduction in title xvi payment in case 
     involving comparable title ii payment.--Section 1611(e)(1)(I) 
     of the Social Security Act (42 U.S.C. 1382(e)(1)(I)) is 
     amended--
       (A) in clause (i)(II), by inserting ``(subject to reduction 
     under clause (ii))'' after ``$400'' and after ``$200'';
       (B) by redesignating clauses (ii) and (iii) as clauses 
     (iii) and (iv) respectively; and
       (C) by inserting after clause (i) the following:
       ``(ii) The dollar amounts specified in clause (i)(II) shall 
     be reduced by 50 percent if the Commissioner is also required 
     to make a payment to the institution with respect to the same 
     individual under an agreement entered into under section 
     202(x)(3)(B).''.
       (2) Expansion of categories of institutions eligible to 
     enter into agreements with the commissioner.--Section 
     1611(e)(1)(I)(i) of such Act (42 U.S.C. 1382(e)(1)(I)(i)) is 
     amended in the matter preceding subclause (I) by striking 
     ``institution'' and all that follows through ``section 
     202(x)(1)(A),'' and inserting ``institution comprising a 
     jail, prison, penal institution, or correctional facility, or 
     with any other interested State or local institution a 
     purpose of which is to confine individuals as described in 
     section 202(x)(1)(A)(ii),''.
       (3) Elimination of overly broad exemption.--Section 
     1611(e)(1)(I)(iii) of such Act (as redesignated by paragraph 
     (1)(B)) is amended further--
       (A) by striking ``(I) The provisions'' and all that follows 
     through ``(II)''; and
       (B) by striking ``eligibility purposes'' and inserting 
     ``eligibility and other administrative purposes under such 
     program''.
       (4) Effective date.--The amendments made by this subsection 
     shall take effect as if included in the enactment of section 
     203(a) of the Personal Responsibility and Work Opportunity 
     Reconciliation Act of 1996 (Public Law 104-193; 110 Stat. 
     2186). The reference to section 202(x)(1)(A)(ii) in section 
     1611(e)(1)(I)(i) of the Social Security Act as amended by 
     paragraph (2) shall be deemed a reference to such section 
     202(x)(1)(A)(ii) of such Act as amended by subsection 
     (b)(1)(C).
       (d) Continued Denial of Benefits to Sex Offenders Remaining 
     Confined to Public Institutions Upon Completion of Prison 
     Term.--
       (1) In general.--Section 202(x)(1)(A) of the Social 
     Security Act (42 U.S.C. 402(x)(1)(A)) is amended--
       (A) in clause (i), by striking ``or'' at the end;
       (B) in clause (ii)(IV), by striking the period and 
     inserting ``, or''; and
       (C) by adding at the end the following new clause:
       ``(iii) immediately upon completion of confinement as 
     described in clause (i) pursuant to conviction of a criminal 
     offense an element of which is sexual activity, is confined 
     by court order in an institution at public expense pursuant 
     to a finding that the individual is a sexually dangerous 
     person or a sexual predator or a similar finding.''.
       (2) Conforming amendment.--Section 202(x)(1)(B)(ii) of such 
     Act (42 U.S.C. 402(x)(1)(B)(ii)) is amended by striking 
     ``clause (ii)'' and inserting ``clauses (ii) and (iii)''.
       (3) Effective date.--The amendments made by this subsection 
     shall apply with respect to benefits for months ending after 
     the date of the enactment of this Act.

     SEC. 403. REVOCATION BY MEMBERS OF THE CLERGY OF EXEMPTION 
                   FROM SOCIAL SECURITY COVERAGE.

       (a) In General.--Notwithstanding section 1402(e)(4) of the 
     Internal Revenue Code of 1986, any exemption which has been 
     received under section 1402(e)(1) of such Code by a duly 
     ordained, commissioned, or licensed minister of a church, a 
     member of a religious order, or a Christian Science 
     practitioner, and which is effective for the taxable year in 
     which this Act is enacted, may be revoked by filing an 
     application therefor (in such form and manner, and with such 
     official, as may be prescribed by the Commissioner of 
     Internal Revenue), if such application is filed no later than 
     the due date of the Federal income tax return (including any 
     extension thereof) for the applicant's second taxable year 
     beginning after December 31, 1999. Any such revocation shall 
     be effective (for purposes of chapter 2 of the Internal 
     Revenue Code of 1986 and title II of the Social Security 
     Act), as specified in the application, either with respect to 
     the applicant's first taxable year beginning after December 
     31, 1999, or with respect to the applicant's second taxable 
     year beginning after such date, and for all succeeding 
     taxable years; and the applicant for any such revocation may 
     not thereafter again file application for an exemption under 
     such section 1402(e)(1). If the application is filed after 
     the due date of the applicant's Federal income tax return for 
     a taxable year and is effective with respect to that taxable 
     year, it shall include or be accompanied by payment in full 
     of an amount equal to the total of the taxes that would

[[Page H10254]]

     have been imposed by section 1401 of the Internal Revenue 
     Code of 1986 with respect to all of the applicant's income 
     derived in that taxable year which would have constituted net 
     earnings from self-employment for purposes of chapter 2 of 
     such Code (notwithstanding paragraphs (4) and (5) of section 
     1402(c)) except for the exemption under section 1402(e)(1) of 
     such Code.
       (b) Effective Date.--Subsection (a) shall apply with 
     respect to service performed (to the extent specified in such 
     subsection) in taxable years beginning after December 31, 
     1999, and with respect to monthly insurance benefits payable 
     under title II on the basis of the wages and self-employment 
     income of any individual for months in or after the calendar 
     year in which such individual's application for revocation 
     (as described in such subsection) is effective (and lump-sum 
     death payments payable under such title on the basis of such 
     wages and self-employment income in the case of deaths 
     occurring in or after such calendar year).

     SEC. 404. ADDITIONAL TECHNICAL AMENDMENT RELATING TO 
                   COOPERATIVE RESEARCH OR DEMONSTRATION PROJECTS 
                   UNDER TITLES II AND XVI.

       (a) In General.--Section 1110(a)(3) of the Social Security 
     Act (42 U.S.C. 1310(a)(3)) is amended by striking ``title 
     XVI'' and inserting ``title II or XVI''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect as if included in the enactment of the 
     Social Security Independence and Program Improvements Act of 
     1994 (Public Law 103-296; 108 Stat. 1464).

     SEC. 405. AUTHORIZATION FOR STATE TO PERMIT ANNUAL WAGE 
                   REPORTS.

       (a) In General.--Section 1137(a)(3) of the Social Security 
     Act (42 U.S.C. 1320b-7(a)(3)) is amended by inserting before 
     the semicolon the following: ``, and except that in the case 
     of wage reports with respect to domestic service employment, 
     a State may permit employers (as so defined) that make 
     returns with respect to such employment on a calendar year 
     basis pursuant to section 3510 of the Internal Revenue Code 
     of 1986 to make such reports on an annual basis''.
       (b) Technical Amendments.--Section 1137(a)(3) of the Social 
     Security Act (42 U.S.C. 1320b-7(a)(3)) is amended--
       (1) by striking ``(as defined in section 
     453A(a)(2)(B)(iii))''; and
       (2) by inserting ``(as defined in section 453A(a)(2)(B))'' 
     after ``employers'' .
       (c) Effective Date.--The amendments made by this section 
     shall apply to wage reports required to be submitted on and 
     after the date of enactment of this Act.

     SEC. 406. ASSESSMENT ON ATTORNEYS WHO RECEIVE THEIR FEES VIA 
                   THE SOCIAL SECURITY ADMINISTRATION.

       (a) In General.--Section 206 of the Social Security Act (42 
     U.S.C. 606) is amended by adding at the end the following:
       ``(d) Assessment on Attorneys.--
       ``(1) In general.--Whenever a fee for services is required 
     to be certified for payment to an attorney from a claimant's 
     past-due benefits pursuant to subsection (a)(4)(A) or 
     (b)(1)(A), the Commissioner shall impose on the attorney an 
     assessment calculated in accordance with paragraph (2).
       ``(2) Amount.--
       ``(A) The amount of an assessment under paragraph (1) shall 
     be equal to the product obtained by multiplying the amount of 
     the representative's fee that would be required to be so 
     certified by subsection (a)(4)(A) or (b)(1)(A) before the 
     application of this subsection, by the percentage specified 
     in subparagraph (B).
       ``(B) The percentage specified in this subparagraph is--
       ``(i) for calendar years before 2001, 6.3 percent, and
       ``(ii) for calendar years after 2000, 6.3 percent or such 
     different percentage rate as the Commissioner determines is 
     necessary in order to achieve full recovery of the costs of 
     certifying fees to attorneys from the past-due benefits of 
     claimants.
       ``(3) Collection.--The Commissioner may collect the 
     assessment imposed on an attorney under paragraph (1) by 
     offset from the amount of the fee otherwise required by 
     subsection (a)(4)(A) or (b)(1)(A) to be certified for payment 
     to the attorney from a claimant's past-due benefits.
       ``(4) Prohibition on claimant reimbursement.--An attorney 
     subject to an assessment under paragraph (1) may not, 
     directly or indirectly, request or otherwise obtain 
     reimbursement for such assessment from the claimant whose 
     claim gave rise to the assessment.
       ``(5) Disposition of assessments.--Assessments on attorneys 
     collected under this subsection shall be credited to the 
     Federal Old-Age and Survivors Insurance Trust Fund and the 
     Federal Disability Insurance Trust Fund, as appropriate.
       ``(6) Authorization of appropriations.--The assessments 
     authorized under this section shall be collected and 
     available for obligation only to the extent and in the amount 
     provided in advance in appropriations Acts. Amounts so 
     appropriated are authorized to remain available until 
     expended, for administrative expenses in carrying out title 
     II of the Social Security Act and related laws.
       (b) Conforming Amendments.--
       (1) Section 206(a)(4)(A) of such Act (42 U.S.C. 
     606(a)(4)(A)) is amended by inserting ``and subsection (d)'' 
     after ``subparagraph (B)''.
       (2) Section 206(b)(1)(A) of such Act (42 U.S.C. 
     606(b)(1)(A)) is amended by inserting ``, but subject to 
     subsection (d) of this section'' after ``section 205(i)''.
       (c) Effective Date.--The amendments made by this section 
     shall apply in the case of any attorney with respect to whom 
     a fee for services is required to be certified for payment 
     from a claimant's past-due benefits pursuant to subsection 
     (a)(4)(A) or (b)(4)(A) of section 206 of the Social Security 
     Act after--
       (1) December 31, 1999, or
       (2) the last day of the first month beginning after the 
     month in which this Act is enacted.

     SEC. 407. PREVENTION OF FRAUD AND ABUSE ASSOCIATED WITH 
                   CERTAIN PAYMENTS UNDER THE MEDICAID PROGRAM.

       (a) Requirements for Payments.--Section 1903(i) of the 
     Social Security Act (42 U.S.C. 1396b(i)) (as amended by 
     section 201(a)(3)(B)) is amended further--
       (1) in paragraph (20), by striking the period at the end 
     and inserting ``; or''; and
       (2) by inserting immediately after paragraph (20) the 
     following:
       ``(21) with respect to any amount expended for an item or 
     service provided under the plan, or for any administrative 
     expense incurred to carry out the plan, which is provided or 
     incurred by, or on behalf of, a State or local educational 
     agency or school district, unless payment for the item, 
     service, or administrative expense is made in accordance with 
     a methodology approved in advance by the Secretary under 
     which--
       ``(A) in the case of payment for--
       ``(i) a group of individual items, services, and 
     administrative expenses, the methodology--

       ``(I) provides for an itemization to the Secretary that 
     assures accountability of the cost of the grouped items, 
     services, and administrative expenses and includes payment 
     rates and the methodologies underlying the establishment of 
     such rates;
       ``(II) has an actuarially sound basis for determining the 
     payment rates and the methodologies; and
       ``(III) reconciles payments for the grouped items, 
     services, and administrative expenses with items and services 
     provided and administrative expenses incurred under this 
     title; or

       ``(ii) an individual item, service, or administrative 
     expense, the amount of payment for the item, service, or 
     administrative expense does not exceed the amount that would 
     be paid for the item, service, or administrative expense if 
     the item, service, or administrative expense were incurred by 
     an entity other than a State or local educational agency or 
     school district, unless the State can demonstrate to the 
     satisfaction of the Secretary a higher amount for such item, 
     service, or administrative expense; and
       ``(B) in the case of a transportation service for an 
     individual under age 21 who is eligible for medical 
     assistance under this title (whether or not the child has an 
     individualized education program established pursuant to part 
     B of the Individuals with Disabilities Education Act)--
       ``(i) a medical need for transportation is noted in such an 
     individualized education program (if any) for the individual, 
     including such an individual residing in a geographic area 
     within which school bus transportation is otherwise not 
     provided;
       ``(ii) in the case of a child with special medical needs, 
     the vehicle used to furnish such transportation service is 
     specially equipped or staffed to accommodate individuals with 
     special medical needs; and
       ``(iii) payment for such service only--

       ``(I) is made with respect to costs directly attributable 
     to the costs associated with transporting such individuals 
     whose medical needs require transport in such a vehicle; and
       ``(II) reflects the proportion of transportation costs 
     equal to the proportion of the school day spent by such 
     individuals in activities relating to the receipt of covered 
     services under this title or such other proportion based on 
     an allocation method that the Secretary finds reasonable in 
     light of the benefit to the program under this title and 
     consistent with the cost principles contained in OMB Circular 
     A-87; or

       ``(22) with respect to any amount expended for an item or 
     service under the plan or for any administrative expense to 
     carry out the plan provided by or on behalf of a State or 
     local agency (including a State or local educational agency 
     or school district) that enters into a contract or other 
     arrangement with a person or entity for, or in connection 
     with, the collection or submission of claims for such 
     expenditures, unless, notwithstanding section 1902(a)(32), 
     the agency--
       ``(A) uses a competitive bidding process or otherwise to 
     contract with such person or entity at a reasonable rate 
     commensurate with the services performed by the person or 
     entity; and
       ``(B) requires that any fees (including any administrative 
     fees) to be paid to the person or entity for the collection 
     or submission of such claims are identified as a non-
     contingent, specified dollar amount in the contract.''; and
       (3) in the third sentence, by striking ``(17), and (18)'' 
     and inserting ``(17), (18), (19), and (21)''.
       (b) Provision of Items and Services Through Medicaid 
     Managed Care Organizations.--
       (1) Contractual requirement.--Section 1903(m)(2)(A) of the 
     Social Security Act (42 U.S.C. 1396b(m)(2)(A)) is amended by 
     redesignating clause (xi) (as added by section

[[Page H10255]]

     4701(c)(3) of the Balanced Budget Act of 1997) as clause 
     (xiii), by striking ``and'' at the end of clause (xi), and by 
     inserting after clause (xi) the following:
       ``(xii) such contract provides that with respect to payment 
     for, and coverage of, such services, the contract requires 
     coordination between the State or local educational agency or 
     school district and the medicaid managed care organization to 
     prevent duplication of services and duplication of payments 
     under this title for such services.''
       (2) Prohibition on duplicative payments.--
       (A) In general.--Section 1903(i) of the Social Security Act 
     (42 U.S.C 1396b(i)), as amended by subsection (a), is 
     amended--
       (i) in paragraph (22), by striking the period and inserting 
     ``; or''; and
       (ii) by adding at the end the following:
       ``(23) with respect to any amount expended under the plan 
     for an item, service, or administrative expense for which 
     payment is or may be made directly to a person or entity 
     (including a State or local educational agency or school 
     district) under the State plan if payment for such item, 
     service, or administrative expense was included in the 
     determination of a prepaid capitation or other risk-based 
     rate of payment to an entity under a contract pursuant to 
     section 1903(m).''.
       (B) Conforming amendment.--The third sentence of section 
     1903(i) of such Act (42 U.S.C. 1396b(i)), as amended by 
     subsection (a)(3), is amended by striking ``and (21)'' and 
     inserting ``(21), and (23)''.
       (c) Allowable Share of FFP With Respect to Payment for 
     Services Furnished in School Setting.--Section 1903(w)(6) of 
     the Social Security Act (42 U.S.C. 1396b(w)(6)) is amended--
       (1) in subparagraph (A), by inserting ``subject to 
     subparagraph (C),'' after ``subsection,''; and
       (2) by adding at the end the following:
       ``(C) In the case of any Federal financial participation 
     amount determined under subsection (a) with respect to any 
     expenditure for an item or service under the plan, or for any 
     administrative expense to carry out the plan, that is 
     furnished by a State or local educational agency or school 
     district, the State shall provide that there is paid to the 
     agency or district a percent of such amount that is not less 
     than the percentage of such expenditure or expense that is 
     paid by such agency or district.''.
       (d) Uniform Methodology for School-Based Administrative 
     Claims.--Not later than 90 days after the date of enactment 
     of this Act, the Administrator of the Health Care Financing 
     Administration, in consultation with State medicaid and State 
     educational agencies and local school systems, shall develop 
     and implement a uniform methodology for claims for payment of 
     administrative expenses furnished under title XIX of the 
     Social Security Act by State or local educational agencies or 
     school districts. Such methodology shall be based on 
     standards related to time studies and population estimates 
     and a national standard for determining payment for such 
     administrative expenses.
       (e) Effective Date.--
       (1) In general.--The amendments made by this section (other 
     than by subsection (b)) shall apply to items and services 
     provided on and after the date of enactment of this Act, 
     without regard to whether implementing regulations are in 
     effect.
       (2) Managed care amendments.--The amendments made by 
     subsection (b) shall apply to contracts entered into or 
     renewed on or after the date of the enactment of this Act.
       (3) Regulations.--The Secretary of Health and Human 
     Services shall promulgate such final regulations as are 
     necessary to carry out the amendments made by this section 
     not later than 1 year after the date of the enactment of this 
     Act.

     SEC. 408. EXTENSION OF AUTHORITY OF STATE MEDICAID FRAUD 
                   CONTROL UNITS.

       (a) Extension of Authority To Investigate and Prosecute 
     Fraud in Other Federal Health Care Programs.--Section 
     1903(q)(3) of the Social Security Act (42 U.S.C. 1396b(q)(3)) 
     is amended--
       (1) by inserting ``(A)'' after ``in connection with''; and
       (2) by striking ``title.'' and inserting ``title; and (B) 
     upon the approval of the Inspector General of the relevant 
     Federal agency, any aspect of the provision of health care 
     services and activities of providers of such services under 
     any Federal health care program (as defined in section 
     1128B(f)(1)), if the suspected fraud or violation of law in 
     such case or investigation is primarily related to the State 
     plan under this title.''.
       (b) Recoupment of Funds.--Section 1903(q)(5) of such Act 
     (42 U.S.C. 1396b(q)(5)) is amended--
       (1) by inserting ``or under any Federal health care program 
     (as so defined)'' after ``plan''; and
       (2) by adding at the end the following: ``All funds 
     collected in accordance with this paragraph shall be credited 
     exclusively to, and available for expenditure under, the 
     Federal health care program (including the State plan under 
     this title) that was subject to the activity that was the 
     basis for the collection.''.
       (c) Extension of Authority To Investigate and Prosecute 
     Resident Abuse in Non-Medicaid Board and Care Facilities.--
     Section 1903(q)(4) of such Act (42 U.S.C. 1396b(q)(4)) is 
     amended to read as follows:
       ``(4)(A) The entity has--
       ``(i) procedures for reviewing complaints of abuse or 
     neglect of patients in health care facilities which receive 
     payments under the State plan under this title;
       ``(ii) at the option of the entity, procedures for 
     reviewing complaints of abuse or neglect of patients residing 
     in board and care facilities; and
       ``(iii) procedures for acting upon such complaints under 
     the criminal laws of the State or for referring such 
     complaints to other State agencies for action.
       ``(B) For purposes of this paragraph, the term `board and 
     care facility' means a residential setting which receives 
     payment (regardless of whether such payment is made under the 
     State plan under this title) from or on behalf of two or more 
     unrelated adults who reside in such facility, and for whom 
     one or both of the following is provided:
       ``(i) Nursing care services provided by, or under the 
     supervision of, a registered nurse, licensed practical nurse, 
     or licensed nursing assistant.
       ``(ii) A substantial amount of personal care services that 
     assist residents with the activities of daily living, 
     including personal hygiene, dressing, bathing, eating, 
     toileting, ambulation, transfer, positioning, self-
     medication, body care, travel to medical services, essential 
     shopping, meal preparation, laundry, and housework.''.
       (d) Effective Date.--The amendments made by this section 
     take effect on the date of enactment of this Act.

     SEC. 409. SPECIAL ALLOWANCE ADJUSTMENT FOR STUDENT LOANS.

       (a) Amendment.--Section 438(b)(2) of the Higher Education 
     Act of 1965 (20 U.S.C. 1087-1(b)(2)) is amended--
       (1) in subparagraph (A), by striking ``(G), and (H)'' and 
     inserting ``(G), (H), and (I)'';
       (2) in subparagraph (B)(iv), by striking ``(G), or (H)'' 
     and inserting ``(G), (H), or (I)'';
       (3) in subparagraph (C)(ii), by striking ``(G) and (H)'' 
     and inserting ``(G), (H), and (I)'';
       (4) in the heading of subparagraph (H), by striking ``july 
     1, 2003'' and inserting ``january 1, 2000'';
       (5) in subparagraph (H), by striking ``July 1, 2003,'' each 
     place it appears and inserting ``January 1, 2000,''; and
       (6) by inserting after subparagraph (H) the following new 
     subparagraph:
       ``(I) Loans disbursed on or after january 1, 2000, and 
     before july 1, 2003.--
       ``(i) In general.--Notwithstanding subparagraphs (G) and 
     (H), but subject to paragraph (4) and clauses (ii), (iii), 
     and (iv) of this subparagraph, and except as provided in 
     subparagraph (B), the special allowance paid pursuant to this 
     subsection on loans for which the first disbursement is made 
     on or after January 1, 2000, and before July 1, 2003, shall 
     be computed--

       ``(I) by determining the average of the bond equivalent 
     rates of the quotes of the 3-month commercial paper 
     (financial) rates in effect for each of the days in such 
     quarter as reported by the Federal Reserve in Publication H-
     15 (or its successor) for such 3-month period;
       ``(II) by subtracting the applicable interest rates on such 
     loans from such average bond equivalent rate;
       ``(III) by adding 2.34 percent to the resultant percent; 
     and
       ``(IV) by dividing the resultant percent by 4.

       ``(ii) In school and grace period.--In the case of any loan 
     for which the first disbursement is made on or after January 
     1, 2000, and before July 1, 2003, and for which the 
     applicable rate of interest is described in section 
     427A(k)(2), clause (i)(III) of this subparagraph shall be 
     applied by substituting `1.74 percent' for `2.34 percent'.
       ``(iii) PLUS loans.--In the case of any loan for which the 
     first disbursement is made on or after January 1, 2000, and 
     before July 1, 2003, and for which the applicable rate of 
     interest is described in section 427A(k)(3), clause (i)(III) 
     of this subparagraph shall be applied by substituting `2.64 
     percent' for `2.34 percent', subject to clause (v) of this 
     subparagraph.
       ``(iv) Consolidation loans.--In the case of any 
     consolidation loan for which the application is received by 
     an eligible lender on or after January 1, 2000, and before 
     July 1, 2003, and for which the applicable interest rate is 
     determined under section 427A(k)(4), clause (i)(III) of this 
     subparagraph shall be applied by substituting `2.64 percent' 
     for `2.34 percent', subject to clause (vi) of this 
     subparagraph.
       ``(v) Limitation on special allowances for plus loans.--In 
     the case of PLUS loans made under section 428B and first 
     disbursed on or after January 1, 2000, and before July 1, 
     2003, for which the interest rate is determined under section 
     427A(k)(3), a special allowance shall not be paid for such 
     loan during any 12-month period beginning on July 1 and 
     ending on June 30 unless, on the June 1 preceding such July 
     1--

       ``(I) the bond equivalent rate of 91-day Treasury bills 
     auctioned at the final auction held prior to such June 1 (as 
     determined by the Secretary for purposes of such section); 
     plus
       ``(II) 3.1 percent,

     exceeds 9.0 percent.
       ``(vi) Limitation on special allowances for consolidation 
     loans.--In the case of consolidation loans made under section 
     428C and for which the application is received on or after 
     January 1, 2000, and before July 1, 2003, for which the 
     interest rate is determined under section 427A(k)(4), a 
     special allowance shall not be paid for such loan during any 
     3-month period ending March 31,

[[Page H10256]]

     June 30, September 30, or December 31 unless--

       ``(I) the average of the bond equivalent rates of the 
     quotes of the 3-month commercial paper (financial) rates in 
     effect for each of the days in such quarter as reported by 
     the Federal Reserve in Publication H-15 (or its successor) 
     for such 3-month period; plus
       ``(II) 2.64 percent,

     exceeds the rate determined under section 427A(k)(4).''.
       (b) Effective Date.--Subparagraph (I) of section 438(b)(2) 
     of the Higher Education Act of 1965 (20 U.S.C. 1087-1(b)(2)) 
     as added by subsection (a) of this section shall apply with 
     respect to any payment pursuant to such section with respect 
     to any 3-month period beginning on or after January 1, 2000, 
     for loans for which the first disbursement is made after such 
     date.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Archer) and the gentleman from New York (Mr. Rangel) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Texas (Mr. Archer).


                             General Leave

  Mr. ARCHER. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days within which to revise and extend their remarks 
and include extraneous material on H.R. 1180.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. ARCHER. Mr. Speaker, I yield myself 2 minutes.
  Mr. Speaker, the Social Security disability program provides 
essential income to those who are unable to work due to severe illness 
or injury. Last year, benefits were paid to over 6 million workers, 
their wives and their children. Since arriving on Capitol Hill some 27 
years ago, I have worked to find ways to make this complex and often 
unfriendly program work better.
  Most of those receiving disability benefits, due to the severity of 
their impairments, cannot attempt to work. Today, however, because of 
the Americans with Disabilities Act, along with advancements in 
assistive technology, medical treatment and rehabilitation, doors are 
opening for opportunities never thought possible to individuals with 
disabilities. Now one can telecommute to work, there are voice-
activated computers, and as technology provides new ways to clear 
hurdles presented by a disability, government must also keep pace by 
providing opportunity and not just dependency.
  Yet, current law still tends to chain individuals with disabilities 
to the system through complex so-called ``work incentives.'' In 
essence, individuals who work lose cash benefits along with access to 
essential medical coverage. This bill assists beneficiaries to pass 
through those doors of opportunity and return to self-sufficiency. I 
cannot think of anything more important than providing support to allow 
individuals the freedom to reach their utmost potential and that is 
what this bill is all about.

                              {time}  1545

  During the last Congress, former Social Security Chairman Jim Bunning 
and ranking member Barbara Kennelly initiated similar bipartisan 
legislation. This bill passed the Committee on Ways and Means by 33 to 
1. The bill last year passed the House of Representatives by 410 to 1. 
Unfortunately, in the last Congress it was never considered by the 
other body. I compliment the gentleman from Missouri (Mr. Hulshof) for 
taking up the cause in the 106th Congress and introducing this bill. It 
is an outstanding piece of legislation, and I strongly recommend it to 
my colleagues.
  Mr. RANGEL. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, let me congratulate the gentleman from Texas for this 
bipartisan effort to make certain that those people who are disabled 
can make that transition into the labor market.
  This is a bill that was cosponsored by all of the Democrats on the 
Committee on Ways and Means. It was a bill that has been worked out by 
Republicans and Democrats not working in a partisan way, but trying to 
make life easier without losing benefits for those people that suffer 
disabilities. This, I think, really shows what can happen when people 
put partisanship behind them and try to work together.
  This was not a case where the majority was asking for the President 
to send them a plan, no. It was as legislators they got together and 
drafted the plan. As we have been able to work out differences on this 
bill, why can we not do this with Medicare? Why can we not do it with 
prescription drugs? Why can we not do it with Social Security?
  Oh, I know we will hear screams that the President really ought to 
send us something to guide us. Mr. Speaker, my colleagues did not ask 
the President for any guidance when they decided to enact the $792 
billion tax cut, and we did not ask for a whole lot of guidance to come 
up with this decent piece of legislation.
  So, Mr. Speaker, I say congratulations to Democrats and Republicans 
for doing the right thing, and I hope this might be just one giant step 
forward in moving toward resolving the Social Security problem that we 
have.
  Mr. Speaker, I yield the balance of my time to the gentleman from 
California (Mr. Matsui), and I ask unanimous consent that he be allowed 
to control that time.
  The SPEAKER pro tempore (Mr. Burr of North Carolina). Is there 
objection to the request of the gentleman from New York?
  There was no objection.
  The SPEAKER pro tempore. Without objection, the gentleman from 
Missouri (Mr. Hulshof) will control the remaining time for the 
gentleman from Texas (Mr. Archer).
  There was no objection.
  Mr. HULSHOF. Mr. Speaker, I yield 2\1/2\ minutes to the gentleman 
from Florida (Mr. Shaw), the Chairman of the Subcommittee on Social 
Security who has been championing this issue through our subcommittee.
  (Mr. SHAW asked and was given permission to revise and extend his 
remarks.)
  Mr. SHAW. Mr. Speaker, I thank the gentleman for yielding this time 
to me and congratulate the gentleman for his good work in seeing that 
this was reintroduced and brought to the House floor, an extremely 
important piece of legislation.
  Mr. Speaker, today I welcome the chance to speak in support of this 
excellent bill. Simply put, this bill is about work. Its aim is to help 
individuals with disability achieve their goals of working and 
supporting themselves and their family.
  Through Subcommittee on Social Security hearings over the past 4 
years, we have been told over and over again that people with 
disabilities do want to work. That has always been the case. What has 
changed is the fact that advances in medicine, technology, and the 
field of rehabilitation have given many individuals with disabilities a 
real chance to work. The next step is to redesign our programs to 
encourage, rather than discourage, their efforts.
  With H.R. 1180 we are helping disabled individuals take advantage of 
these advances in science and medicine both by allowing them to obtain 
needed rehabilitation and support services and by removing barriers 
that have prevented them from becoming self-sufficient. Topping the 
list of barriers is fear of losing health coverage, the cash benefits.
  Another disincentive is that beneficiaries currently have limited 
choices in selecting rehabilitation services and the providers of these 
services. To address these concerns we would allow the Social Security 
Administration to begin offering new tickets that disabled Social 
Security supplemental security income beneficiaries could use to 
purchase services to help them enter the work force. Disabled 
individuals in every State will be able to meet with service providers 
of their choice to develop a personalized employment plan. The 
Government will pay for services needed to help them work, rewarding 
the results by paying the service provider part of the benefit savings 
when disabled individuals leave the rolls.
  I would just like to take this one-half minute to ask really the 
other side and the White House to really bring the spirit of 
cooperation together. We have reached out to the Democrat side on many 
occasions in order to try to bring the spirit of the ticket of work to 
Social Security.
  Social Security should not be a partisan issue. There are Democrats 
and Republicans, millions across this country, who are dependent upon 
and will be dependent upon the Social Security Administration to keep 
them out of poverty, and it is time that this Congress and the White 
House stops the politicking and the wall of silence that

[[Page H10257]]

we are receiving from the other side end and that we work together to 
do great things like we are doing today.
  Mr. MATSUI. Mr. Speaker, I yield myself 3 minutes.
  I do not know if I will take the entire 3 minutes, in which case I 
will reserve my time; but let me just say that this bill passed in the 
last Congress with over 400 votes. Only one Member voted against it, 
and obviously it has strong bipartisan support at this time. It is a 
kind of bill that all of us obviously realize is extremely important 
for the disabled. Basically what it will do that is so important to the 
disabled is continue Medicare benefits once the disabled person is in 
the work force.
  The real issue here is that we give, instead of 4 years, we give them 
a total of 10 years; and in my opinion this will go a long ways in 
keeping people that have disabilities in the work force.
  In addition to this, one of the major components of it is that it 
sets up a program that allows the disabled to go into private or public 
type agencies for support services such as job training, job searches 
and things of that nature.
  I want to commend both the majority and the minority staff for their 
leadership in making this work out. We did have some problems obviously 
before the committee markup and after the committee markup and during 
the committee markup. On the other hand, I think the results that we 
have today on the floor of the House are excellent.
  I want to also commend both the Committee on Commerce and the 
Committee on Ways and Means for working together and ironing out our 
differences.
  Hopefully, this bill will get to conference soon so that we can get 
it to the President, and there is no politics in this issue. I think 
people had a good-faith belief in their differences, but we were able 
to resolve them and come to some conclusion.
  Mr. Speaker, I reserve the balance of my time.
  Mr. HULSHOF. Mr. Speaker, I ask unanimous consent that each side will 
have an additional 5 minutes for a total of 10 minutes to be added to 
the entirety of the debate.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Missouri?
  There was no objection.
  Mr. HULSHOF. Mr. Speaker, I yield 1 minute to the gentleman from 
Minnesota (Mr. Ramstad), cochair of the Disability Caucus.
  (Mr. RAMSTAD asked and was given permission to revise and extend his 
remarks.)
  Mr. RAMSTAD. Mr. Speaker, I thank the gentleman for yielding this 
time to me.
  Mr. Speaker, this day has been a long time coming. I first heard 
about this problem in 1981 when I was attending a meeting as a young 
State senator at the Courage Center in Golden Valley, Minnesota. Jeff 
Bangsberg, a person with quadriplegia, told me how it was not 
economically sensible for him to work because he would lose his health 
benefits, and then Tom Haben told me the same thing, and one after 
another people with disabilities at that meeting in 1981 when I was a 
young State senator explained why it did not make sense for them from 
an economic standpoint to work, and that is why I am so grateful for 
this day when we are getting near to passing this important legislation 
because eliminating work disincentives for people with disabilities is 
not just humane public policy, it is sound fiscal policy.
  It is not only the right thing to do, but it is clearly the cost-
effective thing to do. People with disabilities have to make decisions 
on financial reality, and they should not be penalized for going to 
work, they should have incentives to go to work, and I appreciate the 
bipartisan cooperation on this important legislation.
  Mr. Speaker, I want to thank the people back in Minnesota who have 
advised me on this bill, people with disabilities who will be outlined 
for the Record, and I have said many times before passing this bill, 
passing this bill today is one of the most important things we could do 
as a Congress and as a people.
  Mr. Speaker, this day has been a long time coming. Since my election 
to this body in 1990, and as a Minnesota State Senator ten years prior, 
I have worked hard to help people with disabilities live up to their 
full potential. That's why, in 1993, Representative Pete Stark and I 
introduced legislation to achieve the same goal we seek today. Glad 
we're finally here, Pete.
  Nine years ago, President Bush signed the ADA into law and reminded 
us that ``many of our fellow citizens with disabilities are unemployed. 
They want to work and they can work . . . this is a tremendous pool of 
people who will bring to jobs diversity, loyalty, low turnover rate, 
and only one request: the chance to prove themselves.''
  Mr. Speaker, despite the remarkably low unemployment rate in this 
country today, many of those with disabilities are still asking for 
this chance to prove themselves in the workplace.
  Despite all the good that the ADA has done to date, there is still 
room for improvement. The ADA did not remove all the barriers within 
current federal programs that prohibit people with disabilities from 
working. It's time to eliminate work disincentives for people with 
disabilities!
  Eliminating work disincentives for people with disabilities is not 
just humane public policy, it is sound fiscal policy. It's not only the 
right thing to do; it's the cost-effective thing to do!
  Discouraging people with disabilities from working, earning a regular 
paycheck, paying taxes and moving off public assistance actually 
results in reduced federal revenues.
  Like everyone else, people with disabilities have to make decisions 
based on financial reality. Should they consider returning to work or 
even making it through vocational rehabilitation, the risk of losing 
vital federal health benefits often becomes too threatening to future 
financial stability. As a result, they are compelled not to work. Given 
the sorry state of present law, that's generally a reasonable and 
rational decision.
  Transforming these federal programs to spring-boards into the 
workforce for people with disabilities is the goal of legislation that 
I have cosponsored this important legislation before us today.
  I want to publicly thank the people who have worked so tirelessly on 
this legislation, especially Kim Hildred and Beverly Crawford of the 
Ways and Means Committee.
  But most importantly, I want to thank my friends with disabilities 
back in Minnesota who have counseled me on these issues for two 
decades.
  Mary O'Hara Anderson, Mary Jean Babock, Jeff and Anita Bangsberg, 
Bill Blom, Gary Boetcherk, Wendy Brower, Mary Helen Gunkler, Tom Haben, 
Mark Hughes, Carol and Jonathan Hughes, Mary Kay Kennedy, Mary Jo 
Nichols, Joyce Scanlan, Rand Stenhjem, Colleen Wieck, Leah Welch--this 
day is for you!
  As I have said many times, preventing people from working runs 
counter to the American spirit, one that thrives on individual 
achievements and the larger contributions to society that result. We 
must stay true to our Nation's spirit and pass H.R. 1180 today!
  Mr. MATSUI. Mr. Speaker, I yield 5 minutes to the gentleman from Ohio 
(Mr. Brown).
  Mr. BROWN of Ohio. Mr. Speaker, I thank my friend from California 
(Mr. Matsui) for yielding this time to me.
  Mr. Speaker, if we can help disabled individuals reenter and stay in 
the work force, we should do that. It clearly makes sense from a fiscal 
perspective, and it exemplifies our values as a Nation. I plan to vote 
for H.R. 1180 for one reason and one reason only. The programs it 
establishes are in the best interests of disabled individuals and the 
Nation.
  However, it is important for us to recognize that this bill is not 
the same as the one 279 Members of this body cosponsored. It started 
out stronger, but that was before Members less dedicated to the policy 
and more dedicated to the politics of this bill got hold of it. 
Republican members of the Committee on Ways and Means got a hold of the 
original bill.
  As a result, we are being asked to consider without amendment a weak 
alternative to a strong bill. For political reasons rather than policy 
reasons we are only partially funding H.R. 1180. The Ways and Means 
majority ignored committee jurisdiction to include Medicaid offsets in 
H.R. 1180, then refused to cooperate on a noncontroversial offset for 
which the Committee on Commerce has primary jurisdiction.
  Apparently some Committee on Ways and Means members' feathers were 
ruffled that the Committee on Commerce would even suggest the Medicare 
part B offset. Somehow they felt justified in claiming the Committee on 
Commerce had overstepped our jurisdiction. In fact, of the two 
committees, the Committee on Commerce is the one that did not attempt 
to overstep its jurisdiction.
  Republican Ways and Means leadership claims the administration 
refused

[[Page H10258]]

to lift a finger to help find offsets for this bill. I was there. I can 
assure my colleagues that this assertion is patently false. As a matter 
of fact, the administration helped us identify the very offset that the 
Committee on Ways and Means refused to accept. Basically, the Committee 
on Ways and Means majority leadership broke the rules to fund the 
pieces of the bill they liked and co-opted the rules in attempt to kill 
the sections of the bill they did not like, and none of their actions 
reflects what is best for the disabled community or for American 
taxpayers.
  The original Work Incentive Act that passed out of the Committee on 
Commerce has well over a majority of Members of this body sponsoring 
it. H.R. 1180 funds Medicare and Medicaid options for disabled 
individuals who want to return to work. It funds a demonstration 
program, the goal of which is to prevent disabled individuals from 
being forced to leave a job because of a degenerative illness. Ignoring 
for a moment what our values as a Nation say about supporting the 
effort to contribute to society, let us talk dollars and cents. The 
work incentives bill enables disabled individuals to work instead of 
being dependent on cash assistance.

                              {time}  1600

  The effect of the bill is to reduce the cost of cash assistance 
programs. Knowing they will have health insurance should they return to 
work, disabled people would not need to remain dependent on cash 
assistance. We should be considering full funding for H.R. 1180, which 
means we should be considering the Commerce bill.
  Finally, Mr. Speaker, I want to address the issue of offsets. The 
majority cited the fact that offsets have not been agreed upon as a 
justification for weakening this bill. I have to say that concerns 
raised by the majority are more than a little ironic given their 
arbitrary application of pay-as-you-go rules. The $792 billion tax cut 
bill had no offsets nor did the $48 billion tax cut for buying health 
insurance. Both bills are touted as helping one population, but in 
reality, help another.
  The tax bill ostensibly would provide the bulk of the tax cut to 
those Americans who make up the majority of the population and happen 
to need the money; that is, to low- and middle-income families. Simply 
not so. The access bill ostensibly would expand access to those most 
likely to be uninsured and least able to afford coverage. Again, not 
so. These bills generally skip over those in need of help and help 
those with influence.
  In contrast, the Work Incentives Act which we know would actually 
help the intended beneficiaries, people with disabilities, apparently 
has been slashed by the Committee on Ways and Means for the lack of 
considerably fewer dollars in offsets. Apparently, there is one set of 
rules for bills that aid Americans with money and power and another set 
of rules for those bills that help the less fortunate.
  Mr. Speaker, I am going to vote for this bill. I expect and hope a 
majority of our colleagues will vote for this bill, but I hope those 
who underfunded this version of H.R. 1180 will reconsider and work with 
us in conference to achieve the strongest bill possible.
  Mr. HULSHOF. Mr. Speaker, I yield myself 30 seconds.
  I am disappointed, Mr. Speaker, that the gentleman from Ohio who just 
spoke would take such a negative tone. This really was an effort to 
reach bipartisan consensus. In fact, I would point out to the gentleman 
that in the last Congress, by a vote of 410-to-1, we passed a Ticket to 
Work piece of legislation and made vast improvements to that bill, and 
that is the bill that is in front of the House today. I would 
regrettably urge the gentleman to support the bill.
  Mr. Speaker, I yield 1 minute to the gentleman from California (Mr. 
Cunningham).
  Mr. CUNNINGHAM. Mr. Speaker, I rise today in support of H.R. 1180 in 
memory of a fine San Diegan who died last May, who died too soon, whose 
life work lives on.
  Holly Caudill of San Diego, California was a vigorous and tireless 
advocate for persons with disabilities. She was a young lawyer, a 
native of the State of Washington, an assistant U.S. Attorney, and she 
was a quadriplegic. She died last year.
  I would like to quote from San Diego Union Columnist Peter Rowe who 
was a preeminent teller of Holly's life and her advocacy. ``There are 
thousands of people, there may be tens of thousands of people, just 
like her,'' said Cyndi Jones, Director of the Accessible Society Action 
Project, ASAP, a San Diego-based organization that lobbies on behalf of 
the disabled.
  ``If you are disabled and Washington, via Social Security or 
Medicare, pays some of your health bills, you cannot work. Without a 
job, there is a good chance you will end up on welfare.''
  Holly fought until the very last second not to be on welfare, to 
fight because she wanted to work, she wanted to be an active member of 
this society, but our government stopped it.
  I laud the authors of this bill.
  Mr. Speaker, I met Ms. Caudill some years ago in a meeting where she 
gave me the benefit of her experience. Notwithstanding the fact that 
she was eager and qualified to work, the existing system of medical 
benefits, disability coverage, and other government programs made 
productive work almost impossible.
  A job with greater pay meant a severe reduction in benefits payments, 
providing a powerful disincentive against paid work for her and for 
other Americans with severe disabilities.
  Her knowledge of the system, and her determination to succeed, 
together with support from others that she inspired, helped Ms. Caudill 
to continue to work and be a tax-paying citizen. When it cam to this 
basic principle--that people who work for pay should not have the 
government arrayed against them--Holly Caudill was second to none as a 
vigorous, determined, effective and inspirational advocate.
  I recall most vividly that in the 105th Congress, at her request, I 
helped her to meet with House Speaker Newt Gingrich. He was the sponsor 
of H.R. 2020, the Medicaid Community Attendant Services Act, which 
would have made a greater amount of attendant services benefits payable 
under the Medicaid program. She had a long and wide-ranging discussion 
with the Speaker and his staff--about her life, about the Speaker's 
bill, and, most importantly, about how important it was to stop 
government programs from being such a barrier to work and dignity for 
persons with disabilities.
  The Speaker himself remarked to me on several occasions about Ms. 
Caudill's vigor and determination, and what an inspiration she was.
  With her advice, I was privileged to add my name as a cosponsor to 
H.R. 2020, which had 76 cosponsors at the close of the 105th Congress.
  And in this Congress, I am honored to be one of 249 cosponsors of a 
similar measure introduced by the gentleman from New York, Mr. LAZIO, 
which is H.R. 1180, the Work Incentives Improvement Act.
  The fact that this legislation is before us today is testimony to the 
power of Holly Caudill's message: that, in America, the system ought to 
work for people with disabilities, not against them, so that we all 
have a fighting chance to achieve the American Dream.
  Mr. Speaker, Holly Caudill had the ability. She had the desire. She 
found the whole system aligned against her iron will to work. Yet she 
did work. She helped to make our system of justice work as an Assistant 
U.S. Attorney, while she so vigorously advocated for justice and 
dignity in work for persons with disabilities.
  Before she reached her goal, of an America where people with 
disabilities could work and enjoy the fruits of their labors, our 
Heavenly Father brought her home. There are no wheelchairs there, Mr. 
Speaker.
  Let the permanent Record of the Congress of the United States today 
note that Ms. Holly Caudill, Assistant U.S. Attorney in San Diego, 
California, was an inspiration to me and to many others, and a friend 
of America. May God rest her soul, and give peace to her family, 
friends, co-workers, and to so many others that she touched.
  Today, by adopting this bill, we help to remember well her life's 
purpose.
  Mr. MATSUI. Mr. Speaker, I yield 3 minutes to the distinguished 
gentleman from the State of Maryland (Mr. Cardin), the ranking member 
of the Committee on Ways and Means and the Subcommittee on Human 
Resources.
  Mr. CARDIN. Mr. Speaker, I want to thank the gentleman for yielding 
me this time and thank him for the work that he has done on this very 
important legislation. I want to compliment the leadership of both the 
Committee on Ways and Means and the Committee on Commerce on both sides 
of the aisle.
  I think the gentleman from Ohio (Mr. Brown) has pointed out that we 
have not completed our work yet, but this is a good bill. This is a 
bill that we need

[[Page H10259]]

to move forward, and I do hope that it will be even strengthened as it 
moves through the Senate, the other body, and through conference.
  Mr. Speaker, we are talking about 4.7 million Americans who are 
currently on SSDI, Social Security Disability, and 4.3 that are on SSI. 
Of this number, only about 10,000 move off the rolls every year to 
work. That is not acceptable for this Nation.
  Let me just talk economics for a moment, if I might. For every 1 
percent of the disabled that we can move off of SSDI and SSI into work, 
we save during their beneficiary's lifetime $3 billion in benefits. So 
it is in our financial interests to work to get people who are on 
disability to work.
  The problem is that the current system puts too many barriers in the 
way for people to leave the disability rolls to work. People want to 
work, but our system prevents them from working. What the Ticket to 
Work legislation does is provide more providers, a choice of providers, 
to help people with disabilities to become gainfully employed. It 
offers incentive payments so that the provider has incentives to work 
with the beneficiary to get the individual a job, to get the individual 
employed.
  It removes the disincentives. Perhaps the greatest disincentive is 
health benefits. Currently, only 35 percent of the people who leave 
disability to get gainful employment find health insurance, and yet if 
one is disabled, it is virtually impossible for one to leave the 
disability rolls where one has guaranteed health benefits unless one 
has health insurance.
  So what this legislation does is provide a way that we can continue 
health benefits for people who work off of the disability rolls. That 
makes sense for the individual, it makes sense for us.
  We also make it easier for an individual to be able to get back on 
cash assistance if the work experience does not work. We want people to 
take the risk to go to work. If it does not work, we should be able to 
come back and help that individual. We have taken care of that 
particular problem.
  Mr. Speaker, we brag, both parties, about how low the unemployment 
rates are in this Nation. We are very proud of what we have been able 
to do with our economy, and yet, for the disabled population, the 
unemployment rate is 75 percent. That is unacceptable. We need to do 
something about it. The Ticket to Work legislation is aimed at reducing 
that unemployment number to help people become employed. This is a good 
step forward; I hope that we can improve it as it goes through the 
process, but I would urge all of my colleagues to support the 
legislation.
  Mr. HULSHOF. Mr. Speaker, I yield 1 minute to the gentleman from 
Pennsylvania (Mr. English).
  Mr. ENGLISH. Mr. Speaker, it seems axiomatic that every American 
should have the right to aspire to the American dream. In America, 
every citizen should have the opportunity to participate in our economy 
to the extent of their talent or abilities in order to claim their 
stake in the American dream. Unfortunately, many individuals with 
disabilities have had the American dream recede beyond their reach, not 
because of physical limitations, but because of roadblocks created 
within our system of social services. These artificial barriers 
unfairly and arbitrarily reduce work force participation and economic 
opportunity for many of these Americans who want to work.
  Mr. Speaker, the time has come to empower these Americans to 
participate fully in the cornucopia of our national economy.
  I rise in strong support of this legislation, a bill that would 
empower citizens with disabilities by improving their access to the job 
market, extending their health care coverage when they participate in 
the work force, and by selectively liberalizing the Social Security 
earnings limit. These changes are long overdue and need to be regarded 
as an initial modest step in the direction of giving those among us 
with disabilities greater control over their own destiny and ultimately 
freedom.
  Mr. MATSUI. Mr. Speaker, may I inquire as to how much time each side 
has remaining?
  The SPEAKER pro tempore (Mr. Burr of North Carolina). The gentleman 
from California (Mr. Matsui) has 14 minutes remaining; the gentleman 
from Missouri (Mr. Hulshof) has 17 minutes remaining.
  Mr. MATSUI. Mr. Speaker, I yield 3 minutes to the gentleman from 
California (Mr. Waxman).
  Mr. WAXMAN. Mr. Speaker, no group is more deserving of our support 
than persons with severe disabilities who want to work and be 
contributing members of society but who need help, particularly medical 
help, to be able to work. And, no public policy makes more sense than 
providing that support at a stage that will prevent a potentially 
severe disability from getting worse.
  Both of these things are what this bill is about. That is why I 
recommend that members vote for it and move this process forward into 
conference with the Senate.
  Of course, I regret that the House does not have the opportunity 
today to pass H.R. 1180 as it was reported out by the Committee on 
Commerce with unanimous bipartisan support.
  That legislation, which had some 247 bipartisan cosponsors in the 
House, provided, in my view, the most complete and necessary assurance 
of coverage for severely disabled individuals who need medical help to 
work, and provided assured support for State efforts to also help 
potentially severely disabled individuals from deteriorating to the 
point of complete disability before they can get help. It provided 
assurance of permanent Medicare coverage, and it provided incentives to 
States to extend Medicaid services and establish the infrastructure to 
help assure help to these individuals.
  This legislation falls short in several ways. It does, though, give 
us the opportunity to join in a conference with the Senate. It is good 
enough to take the steps to move this process forward, and I hope and 
expect that we will bring back to this House from the conference with 
the Senate a stronger bill, much closer in its provisions to H.R. 1180 
as it was introduced. Clearly, there is much work still to be done.
  I commend those who have worked so hard in support of this 
legislation. Groups representing the disability community have worked 
tirelessly to bring legislation to fruition. The President, who urged 
action in his State of the Union message, the members on both sides of 
the aisle in the Senate, Senators Roth and Moynihan, Jeffords and 
Kennedy, in particular. In the House, the gentleman from New York (Mr. 
Lazio), who introduced the original bill; the gentleman from California 
(Mr. Matsui), who has been working in this area for a great deal of 
time and has produced a good bill out of the Committee on Ways and 
Means; and so many of our colleagues in the House all deserve credit 
that this legislation is moving today.
  I urge support for the bill, but even more, I urge that we all work 
to better meet the promise we have made to those Americans facing or 
dealing with severe disabilities who want to work. They deserve the 
best bill we can give them. I hope when we send this legislation on to 
the President, it will be just that.
  Mr. HULSHOF. Mr. Speaker, if the gentleman from California will 
indulge me, we have a handful of 1-minute speakers, and at this time I 
yield 1 minute to the gentleman from Arizona (Mr. Hayworth), my good 
friend.
  Mr. HAYWORTH. Mr. Speaker, I thank my colleague from Missouri for his 
hard work on the Committee on Ways and Means. I rise in strong support 
of this legislation.
  Mr. Speaker, I find it unfortunate that in the midst of this triumph 
for all of the American people, and especially the disabled, there are 
those on this floor who would come to deal with jurisdictional issues 
and inside baseball issues that at this point seem, quite frankly, 
rather petty.
  I have heard from many of my constituents. A dear lady in Apache 
Junction, Arizona at our town hall meeting who came to point out to me 
that she wants to work, but that there have been disincentives that 
eventually barred her from the opportunity to work. This legislation 
deals with that problem. It allows her to get back to work.
  Mr. Speaker, 75 percent of working-age adults with disabilities are 
out of work. That is the unemployment rate. That is what we are dealing 
with here, Mr. Speaker, not jurisdictional issues,

[[Page H10260]]

but a chance to give those people an opportunity to work, for the 
limits they have confronted are not physical, they are financial.
  I rise in strong support of the legislation and I am pleased to urge 
its passage.
  Mr. HULSHOF. Mr. Speaker, I yield 1 minute to the gentleman from 
Florida (Mr. Foley), another champion on the Committee on Ways and 
Means.
  Mr. FOLEY. Mr. Speaker, I commend this legislation. I am pleased to 
join my colleagues in supporting the Work Incentive Improvement Act on 
the House floor here today.
  It has been almost 10 years since the Americans with Disabilities Act 
was signed into law. This law was intended to remove barriers that 
prevent disabled individuals from enjoying a full life. It is ironic 
that many of the doors that were supposed to be opened by the ADA are 
still firmly closed because people who choose to work risk losing the 
health care benefits they desperately need. It is like giving someone a 
driver's license and telling them they are capable of driving a car, 
but charging them $50,000 a year for insurance. They would not be able 
to drive unless they were rich.
  For too long, many individuals with disabilities have not had the 
freedom that the rest of us have to pursue their goals and dreams.

                              {time}  1615

  They live in fear of losing the health care that is essential to 
their functioning independently. They have lived with the frustration 
of trying to enter a job market that is becoming increasingly technical 
and competitive. They cannot earn enough to buy a home on their own or 
to build up a savings account.
  I hope that this Ticket to Work Act will ease some of this fear and 
frustration and restore a sense of freedom.
  We all know the barriers in discrimination still exist with the 
disabled as with other groups in society; but if we could pass this 
bill, it will have another significant step toward removing these 
barriers. A disability should not be a hindrance to achieving the 
American dream.
  Mr. HULSHOF. Mr. Speaker, I yield 1 minute to the gentleman from 
California (Mr. Herger), another member of the Committee on Ways and 
Means.
  Mr. HERGER. Mr. Speaker, I rise today in strong support of the Ticket 
to Work and the Work Incentive Improvement Act. I am particularly 
pleased that this legislation includes a provision that I offered, the 
Criminal Welfare Prevention Act Part Two, which will save taxpayers 
millions of dollars by bolstering efforts to deny fraudulent Social 
Security benefits to prisoners.
  My original Criminal Welfare Prevention Act has enabled the Social 
Security Administration to establish a system for cutting off these 
fraudulent government benefits. This new provision included in the 
legislation before us today will improve this system; thus, saving 
taxpayers an estimated $123 million over the next 5 years.
  I want to thank the gentleman from Texas (Chairman Archer), the 
gentleman from Florida (Chairman Shaw) and the gentleman from Missouri 
(Mr. Hulshof) for their continued support. I look forward to seeing 
this worthy legislation enacted into law.
  Mr. HULSHOF. Mr. Speaker, I yield 1 minute to the gentleman from 
Kansas (Mr. Moran), my good friend and classmate.
  (Mr. MORAN of Kansas asked and was given permission to revise and 
extend his remarks.)
  Mr. MORAN of Kansas. Mr. Speaker, in this chorus of accolades, and I 
wholeheartedly support the original intent of this bill, in fact I am a 
cosponsor of H.R. 1180, improving the current system to provide real 
choices for people with disabilities is essential; but unfortunately, 
this bill we are considering today is not H.R. 1180. This bill includes 
troubling language from the substitute bill which will cost Kansans and 
other State school districts millions of dollars.
  Section 408 of this bill would impact medicaid funding for school 
districts and their education of disabled children. 408 precludes or 
significantly restricts the use of bundled rates. The bundling system 
allows schools to minimize paperwork for billing, rather than 
individual services provided to each child.
  Kansas is one of seven States that has a HCFA-approved bundling 
system. This administrative change will impose burdens, economic costs 
upon our schools to the tune of $17 million.
  Mr. Speaker, small schools are struggling today to survive and in the 
time and cost it takes to package this reimbursement opportunity we 
will not be able to afford the reimbursement.
  Mr. Speaker, I ask that the conferees take a look at this provision.
  Mr. MATSUI. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from Texas (Mr. Doggett).
  Mr. DOGGETT. Mr. Speaker, as an original cosponsor of this measure 
back in March, I was particularly pleased when it received the 
unanimous approval of the United States Senate. However, I dissented 
from this particular version of the bill when it was before the 
Committee on Ways and Means because some last minute changes in the 
bill changed its form and substantially weakened it.
  I am pleased that today a number of further amendments have restored 
much of the harm that was done prior to the Committee on Ways and Means 
meeting. My concern has been that without the guarantee of health 
insurance this will not be for individuals with disabilities a ticket 
to work. It will be a ticket to nowhere.
  It is essential that these provisions be fully funded and guaranteed 
to individuals with disabilities so that we have more than a title to 
the bill; we have something that is meaningful for the many Americans 
who have disabilities and want to work in the labor force.
  A second concern was the effect on individuals who are HIV positive, 
who have Parkinson's Disease, multiple sclerosis, or some other type of 
disease which allows them to work now and who do not want to have to 
leave their job in order to get insurance benefits. It is my 
understanding that these last-minute amendments that have been made 
today address those concerns, and so I applaud them.
  I think to the extent that we are returning to the bill that a total 
of 247 Members of the House cosponsored we are moving in the right 
direction. Certainly, I agree that this bill must be fully paid for, as 
with any other measure, and that we not dip into Social Security funds. 
However, I can say that in the Committee on Ways and Means, there was 
no visible effort to pay for the abandoned provisions, and the one pay-
for that was included in this bill is a new tax that is simply going to 
make it more difficult for people with disabilities to secure the 
representation they need in combatting a Social Security Administration 
which is often not sympathetic to their concerns.
  It is still flawed, but in order to move the process along my vote 
today is for a flawed bill, with the hope that the Senate will hang as 
tough as it did in the last session and give us truly meaningful 
legislation.
  Mr. HULSHOF. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman 
from Maryland (Mrs. Morella).
  (Mrs. MORELLA asked and was given permission to revise and extend her 
remarks.)
  Mrs. MORELLA. Mr. Speaker, I want to thank the gentleman from 
Missouri (Mr. Hulshof) for yielding to me, and for his work on the 
bill; the ranking member, the gentleman (Mr. Matsui); the gentleman 
from New York (Mr. Lazio), who has been so involved with H.R. 1180. 
This is a great bill.
  Mr. Speaker, today's demographics show that there are about 54 
million Americans living with a disability, almost 20 percent of our 
constituents. They are our largest minority. Further studies show that 
individuals with disabilities are the most underemployed, among the 
poorest also of our citizens.
  H.R. 1180, the Work Incentives Improvement Act, will assist Americans 
with disabilities to become gainfully employed and self-reliant.
  I am pleased to rise in strong support of this critically needed 
legislation.
  The bill takes an essential step toward reforming Federal disability 
programs and removing the barriers to work. By passing this 
legislation, it is going to help people with disabilities to go to work 
and become productive members of our society and to become taxpayers 
instead of tax users.
  People with disabilities should not have to choose between working 
and

[[Page H10261]]

maintaining access to necessary health benefits. Current law puts 
people with disabilities in a Catch-22 situation. The risk of losing 
health care benefits under the Medicare and Medicaid program is a 
terrible disincentive for millions of beneficiaries of both SSI and 
SSDI. This bill would remove these fears and risks by allowing disabled 
individuals to keep their Medicaid benefits such as personal assistance 
and prescription drugs while they take their job.
  We are going into the Information Age. We are having trouble keeping 
up with employment, the demand for technology personnel. If we are 
going to stay on top, we have to make sure that we utilize all of our 
talent. This is a good bill.
  Mr. Speaker, today's demographics show that there are about 54 
million Americans living with a disability, almost 20% of our 
constituents. They are our largest minority. Further studies show that 
individuals with disabilities are the most underemployed, and among the 
poorest of our citizens. H.R. 1180, the Work Incentives Improvement 
Act, will assist Americans with disabilities to become gainfully 
employed and self-reliant, and I am pleased to rise in strong support 
of this critically important legislation.
  H.R. 1180 takes an essential step toward reforming federal disability 
programs and removing the barriers to work. Passing this legislation 
will help people with disabilities to go to work and become productive 
members of society, to become taxpayers instead of tax users.
  People with disabilities should not have to choose between working 
and maintaining access to necessary health benefits. Current law puts 
people with disabilities in a Catch-22 situation. The risk of losing 
health care benefits under the Medicare and Medicaid program is a 
terrible disincentive for millions of beneficiaries of both the SSI and 
SSDI programs. H.R. 1180 would remove those fears and risks by allowing 
disabled individuals to keep their Medicaid benefits, such as personal 
assistance and prescription drugs, when they take a job.
  This is an ideal time for us to remove barriers and help disabled 
Americans return to work. Our economy is one of the most dynamic and 
diverse in history, and the unemployment rate is low. We have achieved 
a level of technological advancement unequaled around the world.
  However, while we are leading the world into the Information Age, we 
are having trouble keeping up with the demand for new technology 
personnel. If we are to stay on top, we must promote legislation, such 
as H.R. 1180, that will ensure economic vitality and enhanced 
opportunities for all Americans. If we are to stay on top, we must make 
sure that we are utilizing 100% of our talent.
  We must give people with disabilities a chance to unleash their 
creativity, to become productive members of society, and to fulfill 
their dreams. Disabled individuals are part of the American family. 
They are here to participate and teach us as well as to learn with us. 
We must give them the opportunity to be accepted by everyone in their 
community, and to live and work in regular environments. We can do this 
by passing the Work Incentives Improvement Act.
  I urge a ``yes'' vote on H.R. 1180.
  Mr. MATSUI. Mr. Speaker, I yield 1 minute to the distinguished 
gentlewoman from California (Ms. Lee).
  Ms. LEE. Mr. Speaker, I first want to thank my colleague, the 
gentleman from California (Mr. Matsui), for yielding and for his strong 
commitment to justice for all.
  Some of us here in this House have members of our families who are 
disabled, and so I just want to thank all of the cosponsors and all of 
the supporters of H.R. 1180 for that, on a very personal level.
  We know that the current system is extremely frustrating for disabled 
people eligible for medicaid. This bill will help disabled workers by 
extending the period of medicaid coverage as needed. It also creates 
options for States by removing senseless limitations for workers with 
disabilities.
  Now, many of these individuals who can work want desperately to 
contribute to society and to become self-sufficient. However, the 
current system of cumbersome Federal regulations and conflicting rules 
discourage and block many qualified, competent, and energetic 
individuals with disabilities from the world of work.
  They can provide our Nation with tremendous resources, experience, 
and knowledge by directly investing their abilities in the workforce. 
We are currently denying our Nation the talent of these individuals and 
limiting their ability to exhibit their untapped resources. So let us 
stop limiting the rights of so many competent people. Let us pass 1180 
on a bipartisan vote and send the right signal so that so many eager 
and valuable Americans may be included.
  Mr. HULSHOF. Mr. Speaker, I yield 1 minute to the gentleman from New 
Hampshire (Mr. Bass).
  Mr. BASS. Mr. Speaker, I rise in strong support of the legislation 
before us today. I believe that Government certainly has a legitimate 
role to provide assistance for those who are truly in need, but the 
fact is when Government traps people in poverty, out of work year after 
year, that is not a program that works.
  What this piece of legislation will do, in a common sense fashion, is 
allow disabled Americans to go back into the workforce without losing 
their health care. It will help them in a time of high technology. It 
will help them be empowered to get back into the workforce.
  True compassion in government empowers people, Mr. Speaker. It does 
not hold them down.
  With the unemployment rate amongst disabled individuals in excess of 
75 percent, it is time we passed a piece of legislation in an 
environment where unemployment is at historic lows. It will bring these 
people into the workforce and do it in such a fashion so they will be 
able to maintain their health care. So I strongly support this piece of 
legislation and urge that the Congress adopt it.
  Mr. MATSUI. Mr. Speaker, I yield 2 minutes to the distinguished 
gentlewoman from Wisconsin (Ms. Baldwin).
  Ms. BALDWIN. Mr. Speaker, I rise in strong support of the Work 
Incentives Improvement Act, this important legislation that removes the 
disincentives that people with disabilities face when entering or 
reentering the workforce. I also rise in strong tribute to my friend 
Charlie.
  I want to say a little bit about my friend Charlie. I met him one day 
on the campaign trail as I was running for Congress. I walked into my 
headquarters, and there he was working incredibly hard early in the 
morning. I left for a variety of appointments and came back in the 
afternoon and Charlie was still there working very diligently. I left 
for further appointments and I came back, and into the evening hours 
Charlie was still working.
  At the end of this long day, I walked up to Charlie, and I said, 
``Thank you so much for all you are doing to help me.''
  Charlie corrected me very quickly. He said, ``I am not doing this to 
help you. I am doing this to help myself.''
  Charlie has a very significant disability. He also has a simple 
dream. His dream is to finish up school and to get a job, but he can't 
afford to risk losing the benefits for health care and other things 
that make a difference in his life.
  Charlie and the many that he symbolizes have so much talent and 
energy to give our economy and our country. This legislation is also 
going to help Wisconsin's newly developed Pathways to Independence 
program. Pathways has already demonstrated that people with 
disabilities can work with the right support and assistance and 
encouragement.
  It is time to pass this legislation and, I might add, provide the 
appropriate funding to remove the barriers that keep people with 
disabilities from becoming fully contributing members to our 
communities.
  Mr. HULSHOF. Mr. Speaker, I yield 1 minute to the gentleman from 
Illinois (Mr. Weller), another member of the Committee on Ways and 
Means, and my seat mate.
  (Mr. WELLER asked and was given permission to revise and extend his 
remarks.)
  Mr. WELLER. Mr. Speaker, let me first begin by commending my seat 
mate, the gentleman from Missouri (Mr. Hulshof), for his leadership on 
shepherding this important legislation, which is in response to a 
question that I have heard often back home. I remember when 
representatives of the Will County Center for Independent Living came 
into my office shortly after I was elected and they said, We understand 
that under current laws and under current rules that it is really 
difficult, if you are disabled, to work; that there are limitations 
that make it hard for us to participate in the workforce, and they 
asked for help.

[[Page H10262]]

  I am pleased that this Congress, this House, is moving forward with 
this ticket to work legislation, legislation designed to give those 
with disabilities the full opportunity to participate in today's 
workforce.
  Unfortunately, our current system makes it difficult, in fact, to the 
point of difficulty where many of those who are disabled are 
discouraged and, in fact, almost afraid to seek work. They are most 
concerned that they will lose their benefits they currently have and 
wondering if they have further health conditions, what it means for 
them.
  This legislation addresses that, giving those with disabilities a 
full ticket, punching their ticket so they have the opportunity to 
work. It deserves bipartisan support. I commend the gentleman from 
Missouri (Mr. Hulshof) for his leadership and I urge a bipartisan yes 
vote.

                              {time}  1630

  Mr. MATSUI. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from Texas Mr. Bentsen).
  (Mr. BENTSEN asked and was given permission to revise and extend his 
remarks.)
  Mr. BENTSEN. Mr. Speaker, I rise today to express some concerns 
regarding consideration of H.R. 1180, the Work Incentives Improvement 
Act. As a cosponsor of the original legislation, I am pleased that the 
House is taking this up. But I do have some concerns.
  The gentleman from Arizona Mr. Hayworth) earlier said that it was 
petty to be concerned about the fact that we did not follow the regular 
order in this bill. But while we are concerned and supportive of the 
underlying scope of this bill, some of us are also concerned about what 
the impact of the offsets of this bill will do on school districts.
  In my State of Texas and in my home district, I have the La Porte 
School District, which is the lead school for a consortium of 200 small 
and rural Texas school districts. They do not think it is petty at all 
that this bill might squeeze them on their reimbursement under the 
Medicaid administrative claiming program.
  In fact, Members, particularly Members from the other side might be 
coming over and saying this is some sort of an unfunded mandate that we 
are putting on the local school districts. So I do not think it is 
petty at all.
  We have 4\1/2\ million children in this country who have no health 
insurance but are eligible for Medicaid, and we are asking the school 
districts to help us in screening these children to get them into the 
Medicaid Program. My home State of Texas leads the Nation in uninsured 
children. In this bill, we are going to make that problem worse. So I 
do not think that is petty at all.
  The underlying bill is good, but there are some real problems. I know 
the staff has been working overnight to try to work this out, but the 
staff are the only ones who know what is in this bill.
  It is not like we are in a big rush. We have not finished our budget. 
We are going to be here next week and the week after. I think following 
the regular order and making sure we do not stick it to the school 
districts back in our home districts in our home States maybe was not 
such a bad idea because all of us, or certainly the vast majority of 
us, including this Member, agree with what the intent of the bill is. 
But the process is not very good, and I do not think the majority 
really wants to stick it to the school districts either.
  So, hopefully, in the conference, the staff can get together and work 
this out, and we can get a bill that everyone can approve of.
  Mr. Speaker, I rise today to express my concerns regarding 
consideration of H.R. 1180, the Work Incentives Improvement Act. As a 
consponsor of the original legislation, I am pleased that the House of 
Representatives will be voting upon this legislation on an expedited 
basis. However, I am concerned that this legislation will be considered 
under the suspension calendar and is not subject to amendments. And I 
am concerned about the offsets included in this bill.
  Last Thursday, during consideration by the House Ways and Means 
Committee of this bill, the House Republican Leadership added several 
provisions to help pay for the Medicaid benefits included in this bill. 
Unfortunately, these offsets could be detrimental to local school 
districts which are helping to screen children for Medicaid 
eligibility. According to the U.S. Census Bureau there are 4.4 million 
children who are eligible for, but not enrolled in, Medicaid. I believe 
it is wrong to include provisions included in this measure that 
threaten the Medicaid Administrative Claiming (MAC) expenses paid to 
local schools and increase the number of uninsured children. In my 
district, for example, the La Porte School District is the lead school 
district for a consortium of 200 small and rural Texas school districts 
participating in this program. These offset provisions would require 
the Health Care Financing Administration (HCFA) to issue new 
regulations related to this program that would make it more difficult 
to administer and may lower reimbursements to schools. I am pleased 
that these regulations would require consultation with public schools, 
but I am concerned about their impact on smaller school districts.
  This ``one-size-fits-all'' regulation would restrict payments for 
contracts related to this program. This offset section includes a 
provision requiring a competitive bidding process for such contracts as 
well as a restriction on contingency fees. As a result, many of the 200 
school districts in the Texas consortia would likely drop this program. 
Since there is only one private company currently providing such 
services, I am concerned that competitive bidding may not be possible 
in the short term. Also, the restriction on contingency fees could 
reduce incentives for private companies to develop the software 
necessary for these outreach screenings. As a result, only the largest 
school districts would continue to participate in these programs. It 
would not be economically feasible for our nation's smallest school 
districts to develop and maintain software for their individual system. 
The consortia provide a mechanism whereby these smaller, but less urban 
school districts can help with Medicaid screenings. Although fraud and 
abuse in Medicaid must not be tolerated, this provision is not the 
right answer. In Texas, schools receive a total of $14 per child who is 
deemed eligible for Medicaid.
  I am also concerned that these provisions were added to this bill 
without consultation with the House Commerce Committee, which has 
exclusive jurisdiction over Medicaid programs.
  Regardless of my concerns, I will support final passage of this bill 
because it would ensure that disabled persons can keep their health 
insurance when they return to work. I will work with conferees on this 
legislation to make appropriate changes to protect local school 
districts. Under current law, disabled persons who are eligible for 
social security disability benefits are precluded from earning 
significant income without losing their Medicare or Medicaid health 
insurance. This bill would permit disabled persons to work while 
maintaining their health insurance coverage. For many disabled persons, 
this health insurance is critically important since they can neither 
afford nor purchase health insurance in the open market. This bill 
would provide SSDI beneficiaries with Medicare coverage for 10 years, 
instead of the current 4-year term. This legislation also provides 
vocational rehabilitative services to disabled persons to ensure that 
they can receive the training they need to become more self-sufficient. 
I support all of these provisions.
  I urge my colleagues to support this legislation with the caveat that 
these offset provisions should be revised in order to protect local 
school districts.
  Mr. HULSHOF. Mr. Speaker, I am happy to yield 1 minute to the 
gentlewoman from New Mexico (Mrs. Wilson), another classmate of mine.
  Mrs. WILSON. Mr. Speaker, about a year ago, Zig and Charlene Piscotti 
came to visit me in Albuquerque. Their daughter is disabled, and she 
works at Kirkland Air Force Base, and she works as an hourly employee. 
But they told me they had to be careful to make sure that their 
daughter could not get more hours than she could afford because she 
could potentially lose her eligibility for Social Security.
  They knew that they were not going to be around forever. Their 
daughter is in independent living. She is doing very well. But the last 
thing they wanted was their daughter to lose Social Security benefits 
because they knew, if she lost those benefits and then had a reduction 
in her hours, it would be very hard and time consuming for her to get 
back on those benefits.
  This bill is for Michelle. It allows her easy-on provisions so she 
can go back to work as much as she wants to at Kirkland Air Force Base 
and do as well as she possibly can in the work force without that fear 
of not being able to get back on Social Security if her hours are cut 
back. I commend the gentleman for bringing forward his bill.
  The SPEAKER pro tempore (Mr. Burr of North Carolina). The Chair would 
inform Members that the gentleman from California (Mr. Matsui)

[[Page H10263]]

has 4 minutes remaining, and the gentleman from Missouri (Mr. Hulshof) 
has 8\1/2\ minutes remaining.
  Mr. HULSHOF. Mr. Speaker, I am happy to yield 1 minute to the 
gentlewoman from Connecticut (Mrs. Johnson), another tireless advocate 
for this bill, and a trusted Committee on Ways and Means member.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I rise in strong support of 
this legislation and commend my House colleagues on funding it. It was 
frustrating to have the Senate vote 98 to 2 for it. But without any 
money and without the means, where is the promise?
  I want to just say that work may be the one thing that matters most 
in our lives. It is the means by which we achieve our dreams. It is the 
means by which we come to know ourselves. Stretching ourselves, 
challenging ourselves at work, develops our minds, develops our skills.
  We have passed in this Congress legislation to prevent discrimination 
against people with disabilities in the workplace. We have passed 
legislation to provide training and education for people with 
disabilities so they can participate in the workplace. Today we knock 
down what is probably the last and one of the biggest barriers to that 
freedom to work, the barrier of health insurance.
  With this bill, they will not have to fear losing their health 
insurance. If they want to work more hours, if they want to develop 
themselves further, they will know that, with a relapse, they will be 
able to come back to the program.
  This is for the people at Prime Time and throughout my district, the 
disabled who want to work and see us as standing in their way. We are 
getting out of the way with this bill.
  Mr. HULSHOF. Mr. Speaker, I am happy to yield 1 minute to the 
gentleman from Connecticut (Mr. Shays).
  Mr. SHAYS. Mr. Speaker, I appreciate the gentleman from Missouri 
yielding me this time. I just want to say that I think I came in part 
because I wanted to debate something where we could be bipartisan, 
something where we could talk about the real needs of our communities.
  I have people with disabilities who want to work. Yet, if they work, 
they make less and have less benefits than if they stay home. So I just 
applaud my colleagues for bringing this legislation forward. It makes 
tremendous sense, I say to the gentleman from New York (Mr. Lazio) in 
particular and the gentlewoman from Connecticut (Mrs. Johnson) who just 
spoke.
  The bottom line is, under our current system, the government pays for 
health benefits for people with disabilities who do not work, but is 
unwilling to pay for those same benefits when people with disabilities 
get a job. We are going to change that, and it is about time.
  Mr. MATSUI. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from California (Mr. Becerra).
  (Mr. BECERRA asked and was given permission to revise and extend his 
remarks.)
  Mr. BECERRA. Mr. Speaker, I thank the gentleman for yielding the 
time, and I also thank him for his efforts over the past several years 
to try to move us to the point where we now have legislation that we 
can move to the President for signature.
  As I said, I rise in support of H.R. 1180, the Work Incentives 
Improvement Act, more because we are finally going to be able to remove 
a barrier that laws have imposed on people who have had the desire for 
quite some time to do simply what most of us take for granted; that is, 
to work. But simply because of the disability, many of these 
individuals have not been able to go forward with those desires to 
work. Simply because public policy has not caught up to their desire, 
they have found that they are either discouraged from taking a job or 
they are discouraged from keeping a job.
  We must remove those barriers and make it possible for those who many 
of us would sometimes look at them and say, well, there is no way that 
they can work. We should applaud their efforts. Many of these folks, 
and I know all of us knows someone who has some form of disability, are 
out there in the work force doing tremendous work out there. We applaud 
those efforts.
  But to think that, because laws that Congress passed some time ago 
made it very difficult for these individuals to continue to work full 
time or for a full year oftentimes decided it was better not to even 
start. So this is a good step forward.
  I would also underscore the admonition by the gentleman from Texas 
(Mr. Bentsen) regarding the pay fors. We have to make sure that, in the 
process of doing good, we do not do harm to some other program where we 
must seek money to pay for this program.
  But, certainly, at the end of the day, I would hope that we realize 
that someone who has shown the desire to work and has shown the ability 
to work is given that opportunity.
  All we have to do is make sure that someone who says I want that 
opportunity has that chance to, not only work, but also keep Medicaid 
if that is essential for the person to continue to just exist, to live, 
not just let alone work.
  We could talk about a lot of examples, but I can mention one real 
quickly, and that is my father. He has got a bum knee. He has had an 
operation on his knee. His tendons have been shot in both hands for 
several years where he has had to have them split open, the tendons 
split so that he could have movement in his fingers. Of course, he has 
had cataract surgery for his eyes. Yet he still works at the age of 70; 
day in, day out. He does not stop. I suspect there are millions of 
Americans who would do the same. Let us pass this bill.
  Mr. HULSHOF. May I inquire, Mr. Speaker, of the time remaining.
  The SPEAKER pro tempore. The gentleman from Missouri (Mr. Hulshof) 
has 6\1/2\ minutes remaining. The gentleman from California (Mr. 
Matsui) has 2 minutes remaining.
  Mr. HULSHOF. Mr. Speaker, I yield myself 1\1/2\ minutes.
  Mr. Speaker, 50 years ago, the only President of the United States 
from the show-me State, Harry S. Truman, set a goal for our Nation to 
give every American with a disability the chance to play a full part in 
strengthening our Nation and sharing in the greatest satisfaction of 
American life, that being independence and the right to self-supporting 
and self-reliance.
  But, yet, even as we continue to enjoy low unemployment, as the 
gentleman from Maryland mentioned at the very beginning of this debate, 
three out of four individuals with disabilities remain unemployed. The 
vast majority want to go back to work. How often do we have a segment 
of the population that comes to Washington to say we want to be 
taxpayers?
  Yet, as many Members have taken to the floor to talk about 
constituents, a constituent of mine, Rich Blakely from Columbia, 
Missouri, the former executive director of the Services for Independent 
Living, came to our committee at his own expense to talk about the 
barriers that are in place.
  For instance, going to vocational rehabilitation, the question is, 
``Can you go back to work?'' The answer to that one government agency 
is, ``Yes, I can.'' Yet, in order to qualify for SSDI or SSI benefits, 
when that agency asks, ``Can you work?,'' the answer has to be ``no.'' 
So there is inconsistency even among these agencies as we try to help 
these individuals regain their independence.
  Now, I think this bill is a major step forward, especially 
considering the ticket to work bill that we had on the floor last year. 
We made some strong concessions.
  It happens that October is National Disability Employment Awareness 
Month, and I can think of no better way to celebrate that event than to 
pass this ticket to work bill. I urge its adoption.
  Mr. MATSUI. Mr. Speaker, I yield 1 minute to the very distinguished 
gentleman from Maryland (Mr. Hoyer).
  Mr. HOYER. Mr. Speaker, I thank the gentleman from California for 
yielding me this time.
  The gentleman from Missouri (Mr. Hulshof) mentioned Harry Truman's 
remarks about the disabled community. I had the privilege of 
cosponsoring the Americans with Disabilities Act that President Bush 
signed in July of 1990. That bill said that we were going to give 
opportunity to 43 million Americans who were disabled.
  What this bill does, as the gentleman from Missouri (Mr. Hulshof) has 
pointed out and as the gentleman from California (Mr. Matsui) has 
pointed out so well, is to facilitate the entry into the workplace for 
those who, but for this

[[Page H10264]]

bill, may not be able to risk it or afford it.
  The good news is that the bill for a portion of time made optional 
the payment of some of these expenses. I want to thank the committee 
and those who worked on this bill to reinstall the mandatory nature 
under Medicaid of the payments that have been provided for. That is 
essential not to discriminate against those who might be disabled and 
who do, as the gentleman has said, want to enter the workplace, want to 
be taxpayers, and want to enjoy the full opportunities that America has 
to offer.
  Mr. MATSUI. Mr. Speaker, I yield myself such time as I may consume to 
close now.
  Mr. Speaker, I am just going to close by saying that everybody has 
really acted in good faith on this legislation. It has been a very, 
very difficult piece of legislation. It has had a number of committees 
involved in it. Obviously, feelings were very high, and there were a 
number of components to this legislation. But I think it is well taken 
on both sides of the aisle, both Republicans and Democrats have 
problems with some of the offsets.
  When we get into conference, it is my hope that we will have time to 
vent some of these issues, find out what the implications of them are, 
which I am sure everybody will want to do, and then come up with a very 
good piece of legislation.
  We should try to finish this before we leave, otherwise, undoubtedly, 
if we go into the year 2000, it could get stale, and advocacy groups 
will, maybe, lose some kind of involvement in it. So we need to finish 
this quickly. But we really need to know the implications of these 
offsets, because they have come up at the last minute.
  I urge strong support of this legislation. Everybody works hard in 
good faith, and we need to do this for the disabled of America.
  Mr. HULSHOF. Mr. Speaker, I yield the balance of our time to the 
gentleman from New York (Mr. Lazio).
  Mr. LAZIO. Mr. Speaker, I do not think in my four terms in the House 
that I have ever felt better or stronger about a piece of legislation 
than I do about this one.

                              {time}  1645

  Nearly 7 months to the day I introduced H.R. 1180, and 5 days after 
that we had the first hearing on it. It was introduced with bipartisan 
spirit. And I want to thank the gentleman from California (Mr. Matsui), 
the gentleman from California (Mr. Waxman), the gentleman from Virginia 
(Mr. Bliley), and the gentleman from Texas (Mr. Archer) for their 
continued and sustained support throughout all the difficulties in 
bringing this bill forward.
  In my mind's eye, Mr. Speaker, this is the most dramatic breakthrough 
for Americans with disabilities since the Americans with Disabilities 
Act. It is a major stride forward, and I think it is one of the most 
important pieces of legislation that this House will consider not just 
this year but this entire session. Why? Because it opens up 
opportunities. Because it empowers Americans with disabilities. Because 
it says to people who would otherwise stay home that they can have the 
courage to go to work because we are going to extend their health care 
benefits and give them the peace of mind to know that when they go to 
work and become a taxpayer they will not leave their family or 
themselves destitute. That is a false choice, Mr. Speaker, and we 
reject it today.
  I am proud of the 247 cosponsors on both sides of the aisle who have 
stepped up and cosponsored H.R. 1180. I am proud of their work. I am 
proud of their patience. I am proud of their perseverance. This bill is 
supported by over 100 health care organizations and disabilities 
groups. I could name many, but I want to name at least a few: The 
United Cerebral Palsy Association, the National Alliance for the 
Mentally Ill, and the National Association of Development Disability 
Councils. It is also supported by major business groups, including the 
U.S. Chamber of Commerce, which speaks to the fact that our economy 
needs Americans with disabilities in the work force.
  Over the last 3 decades, Mr. Speaker, America has made tremendous 
progress when it comes to empowering people. We have helped them with 
housing. We have tried to empower them through the Tax Code. We have 
tried to empower that for people with disabilities, and now we move 
forward. We have provided disabled Americans with social services that 
dramatically improve the quality of their lives. We have passed 
legislation to make it illegal to discriminate against them. We have 
made sure our businesses and public spaces are accessible to everybody. 
But disabled Americans still face barriers to their full integration in 
society. Today we tear those barriers down.
  Mr. Speaker, most disabled Americans are heavily reliant on Federal 
health care and social services, assistance that makes it possible for 
them to lead independent, productive lives. But we have conditioned 
that assistance on them not working. People with disabilities must get 
poor and stay poor if they are going to retain their health care 
benefits, and that is just plain wrong. It is a perverse system and we 
need to change it today.
  That is why we introduced this Work Incentives Improvement Act. This 
bill will help provide hope and opportunity for millions of Americans 
who have disabilities. It will improve Federal job training by giving 
disabled people new freedom to choose from various public and private 
sector employment services. It will help people continue their health 
care benefits.
  Mr. Speaker, a 1998 Harris Poll surveyed disabled Americans, and in 
that poll 72 percent of disabled Americans said they want to go to 
work. How many who are disabled are actually able to go to work and get 
off public assistance? One-half of 1 percent. We can do better and we 
will do better.
  In the meantime, in this age of technological explosion, all the 
recent innovations in the field of assistive technology have made it 
far easier for disabled people to hold on to good jobs. There are 
hands-free mouses, word prediction programs, on-screen keyboards, and 
increasingly sophisticated voice recognition software. This is all 
aimed at helping people achieve a higher quality of life.
  But in the end, this bill is simply about empowering people to change 
their lives. This bill is for people like Tom Deeley, a developmentally 
challenged young man who holds a part-time job performing custodial 
services in Virginia. He testified before our Committee on Commerce. He 
is limited to working only 2 days a week because working more would 
jeopardize his health care benefits. He is a star in our community. He 
is a hard worker. He is eager to work full time. And his employer would 
love to have him work full time.
  As a matter of fact, Tom has been named employee of the year in his 
firm. He has been awarded a $200 bonus. And guess what our system says 
to Tom Deeley, who is developmentally disabled and loves to work? It 
says that he has to give that $200 bonus back, that he cannot accept 
it. What kind of a perverse system holds that as a rule?
  We are going to change that today and bring that curtain down. We are 
going to let Tom Deeley and others like him accept their bonuses for 
their hard work. We are going to rip down bureaucratic walls.
  Mr. Speaker, we have come a long way. It is time to remove the 
barriers to integration for disabled Americans into society. Millions 
of Americans, Mr. Speaker, are waiting for us to give them a chance to 
pursue the American Dream. Today, let us tell them that their wait is 
over. Let us pass the Work Incentives Improvement Act with a unanimous 
vote.
  Ms. SCHAKOWSKY. Mr. Speaker, I am a cosponsor and strong supporter of 
H.R. 1180, the Work Incentives Improvement Act of 1999. Access to 
health care is important to all of us. To persons with disabilities, it 
is critical. Unfortunately, current policies penalize those persons 
with disabilities who are able to work but, by doing so, lose access to 
Medicare and Medical coverage.
  The loss of health care is the major reason why persons with 
disabilities are locked out of the workplace. According to the report 
issued last fall by the President's Task Force on the Employment of 
Persons with Disabilities, ``(a)ccess to health care is accepted as the 
primary barrier to keeping people with disabilities outside the world 
of work.'' While 72 percent of persons with disabilities want to work 
and could be productive members of the community, the loss of health 
care coverage keeps them from doing so. H.R. 1180, as originally 
introduced, corrects this situation. It would

[[Page H10265]]

allow persons with disabilities to return to work and retain access to 
a broad array of services.
  The bill before us today, however, is significantly different from 
H.R. 1180 as introduced. While I will support this version, I strongly 
urge the conferees to improve the Work Incentives Improvement in order 
to bring it closer to the provisions of the original bill. I am 
concerned that, despite last minute negotiations, the bill does not 
provide full funding to ensure that services will be available to 
Medicaid beneficiaries who return to work. Because this bill has been 
rushed to the floor with little chance for review and no chance for 
amendments, it has been difficult to analyze fully the impacts of those 
funding sources that have been identified. There are numerous ways to 
fully fund the Work Incentives Improvement Act without taking funding 
from other essential programs. I hope that the original provisions of 
H.R. 1180 will be restored in conference, and that we find funding 
sources that do not jeopardize critical health care programs such as 
school-based health care.
  I am also concerned that just as we are working to help persons with 
disabilities move into the workforce, the new 6.3 percent attorney tax 
will harm other persons with disabilities receive their Social Security 
benefits. Legal representation is critical in Social Security 
disability cases--it often makes the difference between whether a 
person receives or does not receive disability benefits. Taxing the 
attorneys who help persons with disabilities receive the benefits to 
which they are entitled may mean that those persons never receive their 
benefits. I believe that this is an unwise and dangerous provision, and 
I hope that the conferees will eliminate it from the final bill.
  We can act now to give persons with disabilities the opportunity to 
be productive members of their community. We can provide sufficient 
funding so that those who move into the workforce receive 
comprehensive, quality health care. And we can find this major 
initiative in a manner that is fair. I urge my colleagues to work for 
improvements in H.R. 1180 so that its full promise will be realized.
  Ms. ESHOO. Mr. Speaker, I'm proud to count myself among the 
cosponsors of H.R. 1180 as it will truly improve the lives of people 
with disabilities by helping them to achieve self-sufficiency through 
employment. People with disabilities want to work yet our current 
system discourages them from doing so by taking away their health care 
coverage. This bill will undo this practice and provide job 
opportunities for the estimated 72 percent of Americans with 
disabilities who want to work yet remain unemployed.
  Under existing law, when a person with a disability takes a job, they 
lose health care coverage through the Medicare or Medicaid programs. 
Yet private sector health coverage is often unavailable or unaffordable 
for people with disabilities specifically because of their disability. 
H.R. 1180 would allow states to extend Medicaid health care coverage to 
working people with disabilities who would otherwise be eligible but 
for their income.
  We should not be forcing Americans with disabilities to choose 
between work and losing their health benefits or forgoing work in order 
to maintain them. Now, more than ever, thanks to innovations in 
medicine and technology, people with disabilities can and should be 
able to work. People with disabilities deserve to be able to contribute 
their talents and skills to society and to have broad options for 
obtaining the care and services they need to be productive workers.
  H.R. 1180 provides these services--services like Medicaid coverage 
and Tickets to Work. The bill also provides grants to states to develop 
infrastructures for working people with disabilities and for outreach 
efforts aimed at getting more people with disabilities to work.
  We took the first step toward significantly improving the lives of 
people with disabilities when we enacted the Americans with 
Disabilities Act (ADA) in 1990. Thanks to that law, people with 
disabilities can no longer be discriminated against in hiring. With 
passage of H.R. 1180, we will take the next important step to ensuring 
that the thousands of Americans with disabilities who are offered jobs 
this year will be able to take them.
  Mr. SWEENEY. Mr. Speaker, I thank the gentleman for the opportunity 
to address this important issue for people with disabilities.
  I rise in strong support of the Work Incentives Improvement Act.
  This legislation gives Americans with disabilities the freedom to 
achieve self-sufficiency through employment.
  As Labor commissioner in New York State I worked to ensure that 
individuals with disabilities were given ample opportunity to return to 
work thus freeing themselves from the despair of dependency.
  In doing this they are able to experience the dignity of self 
sufficiency.
  Currently, people with disabilities are actually given incentives to 
stay unemployed because they often can not obtain adequate health care 
if they receive outside income.
  In 1998, the National Organization on Disability found that 72 
percent of unemployed Americans with disabilities want to go to work.
  However, only 1 in 500 people receiving Social Security Disability 
Insurance ever returns to work.
  Mr. John T. Svingala from Hudson, New York is one of the 72 percent 
of unemployed Americans with disabilities who, in his words, ``can't 
wait to become a tax payer instead of a recipient.''
  Mr. Svingala is a 42-year-old diabetic, kidney transplant recipient.
  Mr. Svingala is an educated man who was a dedicated physical 
education teacher in Hudson and Catskill, New York until he was not 
longer able to work because of his illness.
  Unfortunately, if Ms. Svingala were to return to work, he would lose 
all of his unearned income and half his wages in order to access 
personal assistance coverage under Medicaid.
  To remedy such circumstances, H.R. 1180 provides states with 
incentive grants to set up their own affordable Medicaid buy-in 
programs when Mr. Svingala and thousands like him go to work.
  Individuals with disabilities represent a major untapped resource in 
the workplace of the 21st century.
  Now is the time to remove barriers and enable people like Mr. 
Svingala to work. Congress has an obligation to help people with 
disabilities achieve their American Dream.
  I strongly urge my colleague to vote in favor of the Work Incentives 
Improvement Act.
  Mr. DOOLITTLE. Mr. Speaker, the bill currently before the House, H.R. 
1180, the Work Incentives Improvements Act of 1999, allows the disabled 
to retain healthcare coverage that they would lose if they went back to 
work. Under current law, after a nine-month trial work period, a 
disabled worker who receives Social Security disability benefits but 
earns more than $700 per month will lose his or her Medicare health 
coverage. In addition, workers who receive Supplemental Security Income 
(SSI) disability benefits will lose their Medicaid coverage once their 
earnings reach the basis SSI benefit level. As a result, current law 
tends to trap individuals with disabilities to the system. In essence, 
individuals who try to work lose cash benefits, along with access to 
medical coverage they so desperately need.
  H.R. 1180 would revamp present law so that individuals receiving 
Social Security Disability and Supplemental Security Income could 
return to work without losing Medicare or Medicaid insurance. It would 
also create a system of vouchers that could be used to purchase job 
training and rehabilitation services from government or private 
sources.
  I support providing legislative relief and feel that it would help 
remove some of the most significant barriers to the employment of 
people with disabilities. However, I am voting against this bill 
because of a provision that would require the Social Security 
Administration to impose fees upon attorneys who represent disability 
claimants during the appeals process.
  At present, when an attorney successfully represents a disability 
claimant and that claimant is entitled to past-due benefits, SSA 
withholds a portion of those past-due benefits in order to pay the 
attorney for the services he or she provided. The Work Incentives 
Improvement Act seeks to impose an ``assessment'' of 6.3 percent on all 
such payments to attorneys. I believe that this ``assessment'' is 
unnecessary in the context of this bill, and would likely deter some 
attorneys from representing disability claimants. The reliance on a 
user fee assessed on attorneys' fees in Social Security case to fund 
the important work incentives bill is poor policy. It would hurt many 
of the very people that work incentives legislation is designed to 
help.
  I strongly hope that these differences can be resolved when the House 
and Senate come together to work on a final version of this bill. We 
need to enact legislation that fulfills the promise of the Work 
Incentives Improvement Act and does not harm those people with 
disabilities whom the bill is designed to assist.
  Mr. RODRIGUEZ. Mr. Speaker, I rise in support of HR 1180, the Work 
Incentives Improvement Act of 1999. More than 100 organizations 
dedicated to helping people with disabilities support this bill and I 
welcome the concept behind allowing those who face obstacles help 
themselves.
  However, I have grave concerns with the funding mechanism for this 
bill. The 6.3 percent user fee on SSI claimant representatives 
represents a blow to those who need able counsel in filing and guiding 
their SSI claim. The extensive time, preparation and expense in filing 
a claim for SSI disability creates barriers for many, and we are taking 
a step in the wrong direction by imposing a fee on those who provide 
this assistance.
  As this bill progresses, I look forward to working with my colleagues 
in eliminating this user fee which would have a disproportionate impact 
on those who need representation in order to pursue their claim.
  Mr. STARK. Mr. Speaker, this bill is a vitally important for disabled 
people in our country. It

[[Page H10266]]

will finally make changes to the disability system that will assist 
beneficiaries' desires to return to or enter the workforce. This should 
have been done years ago--and we should be doing more now. That being 
said, there is no question that this bill is a tremendous improvement 
from the status quo.
  The most significant component of this legislation is that it will 
provide disabled people with the ability to maintain their Medicare 
coverage for ten years after returning to work.
  Under current law, a disabled beneficiary who returns to work loses 
Medicare coverage after 4 years. That reality keeps people from even 
thinking about entering the workforce because losing disability status 
is not an easy thing to reverse. Maintaining health insurance is a 
priority for anyone, but for someone who is disabled, health insurance 
coverage is a lifeline they cannot afford to mess around with.
  Stretching that Medicare eligibility time period to 10 years is a 
giant step forward. Of course, the real solution is making Medicare 
coverage permanent for a disabled person regardless of work status. I 
wish we were voting on that full provision today and I will certainly 
continue working toward that goal.
  It is also worth noting that the process for this bill reaching the 
House floor has been horrendous. The Republicans have continued to play 
political games with this legislation every step of the way.
  Until just before this debate began, we weren't even sure if this 
bill would contain important Medicaid components that were in both the 
Senate-passed version of the legislation and the House Commerce 
Committee bill. Those two provisions directly appropriate funds for 
grants to states to establish support services for working individuals 
with disabilities and funds for demonstration projects to the states to 
extend Medicaid coverage to a wider group of workers with potentially 
severe disabilities.
  Those two Medicaid improvements are very important--they expand the 
number of people helped by this legislation and they are both strongly 
supported by the disability community.
  I am pleased that the bill before us today does now include those key 
provisions, but it has been a struggle to make sure that was the case.
  The Senate passed their version of this legislation unanimously more 
than 4 months ago. I don't understand why it's taken 4 months for the 
House to act, but I am glad this day is finally here. Let's pass this 
bill, get to conference, and enact this law which will finally correct 
a serious problem in our disability system by empowering disabled 
people to enter the workforce without fear of losing their health 
coverage.
  Mr. DINGELL. Mr. Speaker, I am pleased that the Work Incentives 
Improvement Act has finally made it to the floor. This bill had its 
origins in the 105th Congress and has been accumulating an impressive 
array of support ever since. H.R. 1180, the Work Incentives Act as 
introduced by my colleagues Mr. Lazio and Mr. Waxman, has 247 
cosponsors. The Senate passed a similar bill by a vote of 99 to 0. 
Finally, the people whom his bill would benefit--the disability 
groups--have shown us how important this legislation is by campaigning 
tirelessly for its passage.
  During the past months, the House has seen many controversial pieces 
of legislation. However, no one disputes the value of the Work 
Incentives Improvement Act. This bill helps people with disabilities 
who want to get off cash assistance and start working. The bill allows 
people to keep their Medicaid or Medicare health benefits when they 
return to work, so that they can stay healthy enough to keep working. 
It provides grants to states to help set up the kinds of personal 
services that working people with disabilities require. The bill 
creates a demonstration project that would give Medicaid coverage to 
working people with serious medical conditions--such as multiple 
sclerosis or Parkinson's disease--before their diseases become so 
disabling that they have to apply for cash assistance. This bill makes 
sense.
  The only argument against the Work Incentives Act as it was 
originally introduced was its cost. The Commerce Committee has acted in 
a fiscally prudent manner by providing offsets for the provisions in 
its jurisdiction. However, these offsets are about 100 million dollars 
shy of fully funding the Work Incentives Improvement Act as reported by 
the Commerce Committee. Consequently, the bill before us today omits 
the Committee's improved Medicaid buy-in option and leaves the 
demonstration program partially funded.
  But I do note that, just a few weeks ago, the House passed a measure 
to provide tax deductions for individuals to purchase health coverage. 
This bill would cost about $43 billion, provided benefits mainly to the 
healthy and wealthy, and none of it was funded. This double standard 
for the disabled prevented us from passing the entire bill here today. 
I hope we can do better in conference.
  Mr. DAVIS of Virginia. Mr. Speaker, I rise today to offer my strong 
support for H.R. 1180, and particularly the provisions within the bill 
that will help financially modernize the private student loan industry. 
Not only will we assure the future of the private student loan industry 
and protect student's interest rates, we will also be providing at 
least a $20 million off-set to help pay for other provisions in this 
very important bill.
  The Federal Family Education Loan Program (FFELP), the largest source 
of federal student loans to college students and parents, has undergone 
a revolution in recent years. FFELP service providers are employing a 
range of new technologies, such as the Internet, to vastly improve the 
delivery of student loans. Intense competition among FFELP providers 
has generated efficiencies that have driven down cost to both education 
loan borrowers and to U.S. taxpayers. Regrettably, the gains in 
efficiency and cost-reduction are being hampered by an archaic federal 
financing system that does not promote the most modern, efficient 
practices for student loan providers.
  Private student loan lenders and student loan secondary markets tap 
global capital markets to raise the $25 billion needed annually to 
support new student loans. The job of raising this private capital is 
more difficult, because federal law ties student loan interest rates to 
the 91-day Treasury bill, which does not necessarily reflect supply and 
demand issues in private capital markets. The student loam program, and 
the students, families and colleges that rely on it, will benefit from 
a more reliable supply of funding if Congress adopts a true market-
based index for determining lender yields on student loans.
  Importantly, the fundamental improvement to the private sector 
student loan program can be achieved with a savings to the U.S. 
taxpayer, Mr. Speaker, that bears repeating. We can vastly improve the 
ability of private student loan providers to more efficiently and 
cheaply deliver their products to student and family borrowers, while 
saving the America people more than $20 million over the next four 
years alone. In addition, this proposal would not change the index or 
formula used for determining interest rates paid by student loan 
borrowers.
  Ironically, Mr. Speaker, the necessity of this provision was not 
highlighted until our economy began booming and the Federal Government 
began operating with a non-Social Security surplus. The Treasury bill 
is not a market-based index. By definition, only the U.S. government 
borrows at the T-bill rate. Other than the federal government and 
Government-Sponsored Enterprises (GSEs), virtually no organizations 
issue market securities that are tied to the T-bill.
  Unfortunately, private student loan lenders are statutorily required 
to raise the capital they need from private capital markets at the T-
bill rate. The capital raised privately to fund student loans is 
typically pegged to market indices that do not necessarily move in 
tandem with the T-bill rate. This means that lenders and student loan 
secondary markets have to account for the risk that the T-bill rate and 
these market rates will be different. To do so, lenders partly protect 
themselves against this risk through hedging agreements, whereby others 
bear the risk. These hedging agreements inject uncertainly and add to 
the lenders' cost of funds.
  When the difference between T-bill rates and market-based rates 
widen, lenders incur significant additional cost to finance student 
loans. This scenario was realized in the last half of 1998 when the 
wide spreads between T-bill rates and market-based rates effectively 
``dried up'' the market for student loan asset-backed securities, which 
represent a major source of student loan funding. In essence, the 
Treasury Department stopped issuing T-bills and the supply disappeared.
  Mr. Speaker, it is situations like these, that if allowed to 
continue, could drive private lenders out of the student loan business. 
That is why I am very grateful that this bill could include the 
provisions that will shift the index for determining lender yields on 
Federal Education Loans from the 91-day T-bill rate to the 90-day 
Commercial Paper rate. This is an important amendment. It will protect 
private student loans lenders, increase efficiency and reduce the cost 
of delivering the funds, save the taxpayer a minimum of $20 million, 
while guaranteeing the interest rate student and family borrowers pay 
does not increase.
  The SPEAKER pro tempore (Mr. Burr of North Carolina). The question is 
on the motion offered by the gentleman from Texas (Mr. Archer) that the 
House suspend the rules and pass the bill, H.R. 1180, as amended.
  The question was taken.
  Mr. HULSHOF. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.




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