[Congressional Record Volume 145, Number 165 (Friday, November 19, 1999)]
[Senate]
[Pages S14975-S14977]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               THE BUDGET

  Mr. DOMENICI. I am going to take a few moments to thank a few people 
and summarize the budget bill that we are going to pass this evening, 
hopefully.
  I want to thank the White House for their cooperation in coming to an 
agreement with reference to the appropriations bill and all of those 
things that are in the so-called omnibus package.
  In particular, I want to thank the director of the Office of 
Management and Budget, Mr. Lew. The last evening

[[Page S14976]]

when we were about to depart and part company and say we will go our 
own ways, they asked me if I would meet with Mr. Lew, and if we could 
see if we could work something out. We are here today with a bipartisan 
bill because we did work something out.
  I thought it was the very best thing we could do. Frankly, I am proud 
of it. I wish it could have been done sooner. I am hoping that next 
year we will get the appropriations bills done perhaps 6 to 7 or 8 
weeks sooner than we did this year. But I want to start by quoting from 
the New York Times, not necessarily a newspaper that thinks what 
Republicans do is necessarily good, as I do, but they said in their 
editorial, on their editorial page, the following thing about this 
budget bill that we are going to have before us:
  There are modest spending increases in some of the President's 
priority areas like education but over all the Republican approach  of 
spending restraint has shaped this budget.''

  I am very proud of that. I think that is true because what we have 
done is we have kept the faith with those who want a balanced budget. 
This budget proposal ensures a balanced budget without using Social 
Security trust fund money.
  I ask parenthetically for those who still doubt that because they do 
not have a Congressional Budget Office letter that says it, if the 
President of the United States would be asking Democrats to vote for 
this measure if he and his OMB Director thought it was using Social 
Security trust fund money? I think the answer is no. They know it does 
not. I know it does not. And I can promise the Senate, come February or 
March, when you reestimate everything, it will not be using the Social 
Security trust fund money.
  I think that is the new discipline that has been imposed on our 
economy and our fiscal policy. It is a brand new event to say we are 
not going to spend Social Security money, and it is the best thing we 
can do for the American economy because, Senator Moynihan, to the 
extent we do not spend it, we reduce the public debt. So for those who 
are wondering about the public debt, the public debt is reduced dollar 
for dollar when you leave Social Security surpluses alone year by year 
as they accumulate and do not spend them.
  Now, let me tell you a dramatic statement about our current fiscal 
policy. Who would think a budget chairman could stand on the floor and 
say to the Senators who are listening, we will pay down the publicly-
held debt by $130 billion? Think of that--$130 billion. If that does 
not mean that as soon as we saw surplus we did not run out and spend 
it, then I do not know what it means.
  Frankly, I think my good friend, Senator Gramm from Texas, is 
correct; in about 30 or 40 years, when they look back on this period in 
time, they are going to say: Incredible. With the kind of surpluses 
that existed, not a single new entitlement program of major proportion 
was started, and not a single new American spending program was started 
because the accumulations went into the Social Security trust fund 
instead of being used to pay for more Government.
  I am proud of that. I think it is the best medicine for growth and 
prosperity in the future.
  It holds Government spending, as we calculate it overall, to about 
3.3 percent this year over last year--that includes entitlements and 
appropriations--a very interesting number.
  In the 1970's, it was 11 percent growth.
  In the 1980's, it was 8 percent growth.
  For those who in editorial comments across this land call this a 
bloated budget, let me suggest, the fiscal policy of the United States 
which has the Government growing less than the economy is growing is 
not bad fiscal policy. That is about where we are now under the 
culmination of this budget process for this year.
  In the meantime, when we passed the budget resolution in April of 
this past year, we said we wanted to do some very important things.
  First, we wanted to increase the flexibility in education programs. 
It does not matter how much the President or others claim that the 
President won the education battle. The truth of the matter is, 
Republicans put more money in education than the President asked for.
  For the first time we have flexibility. Twenty percent of the money 
that was going to go to teachers directly, and targeted and for nothing 
else, can be flexibly used by school districts. And the philosophical 
battle of the future will be flexibility of education funds with 
accountability versus the targeting and direct aid in very numerous and 
numbers of targeted mandates that Government says one size fits all. 
You all use it this way, or you cannot use it at all.
  We suggested in our budget resolution that we should put more money 
into research on the dread diseases that affect our people and mankind. 
We increased NIH $2.3 billion, which is $2 billion more than the 
President asked for, for dreaded diseases like cancer, Alzheimer's, and 
the whole list.

  Mr. MOYNIHAN. Food allergies.
  Mr. DOMENICI. Allergies--all kinds of things.
  We believe the breakthroughs will come in the next the millennium 
from this kind of investment. We are proud of it. We increased national 
defense--if you take out emergencies--by $13.5 billion, and increased 
the pay for the military at a very significant rate, which was long 
overdue and much needed.
  In addition, also in this bill, we have taken care of the 
shortcomings in Medicare that came from the Balanced Budget Act. And 
$16 billion goes into that in the next 5 years, including $2.1 billion 
to replenish skilled nursing home payments. Also, the therapy caps have 
changed. There are slower reductions in payments for teaching 
hospitals, and a long list of changes.
  I ask unanimous consent that the list be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                 MEDICARE AND MEDICAID PROVISIONS SUMMARY
         [Nov. 18, 1999, CBO estimates, in billions of dollars]
------------------------------------------------------------------------
                                             2000   2000-2004  2000-2009
------------------------------------------------------------------------
Increase Skilled Nursing Facilities            0.3       2.1        2.1
 Payments.................................
2 Year Moratorium on Therapy Caps.........     0.2       0.6        0.6
Slow Reductions for Teaching Hospitals....     0.2       0.6        0.6
Hospital Outpatient Department Payments...     0.3       5.3       11.1
Rural Hospital Provisions.................     0.0       0.8        1.7
Delay 15% Home Health Reduction...........     0.0       1.3        1.3
Medicare+Choice Payments..................     0.0       1.9        2.5
Miscellaneous Medicaid and S-CHIP.........     0.1       0.9        1.6
Other.....................................     0.1       2.5        5.5
                                           -----------------------------
    Total.................................     1.2      16.0       27.0
------------------------------------------------------------------------

     1. Nursing homes
       Increases payment rates for medically complex cases by 20% 
     from April 2000 to September 2000.
       Increases all payments by 4% in 2001 and 2002.
       Allows use of higher of federal or current rate at each 
     facility.
     2. Therapy caps
       Provides a 2 year moratorium on further implementation of 
     the $1,500 therapy caps.
     3. Teaching hospitals
       Freezes the indirect medical education (IME) add-on rate at 
     6.5% in 2000 (same as 1999).
       Phases-in further reductions more slowly than the Balanced 
     Budget Act schedule.
     4. Hospital outpatient departments
       Clarifies that the outpatient department prospective 
     payment system should not include an initial 5.7% cut.
       Provides temporary protection to hospitals so that payment 
     rates can fall no more than defined percentages from their 
     1996 levels.
     5. Rural hospitals
       Provides a five year extension of the Medicare dependent 
     hospital program, and several miscellaneous expansions to the 
     critical access hospital program.
     6. Home health
       Delays implementation of the 15% cut until October 1, 2001.
     7. Medicare+Choice
       Phases-in risk adjustment slowly over the period 2000 to 
     2003 and increases the update by 0.2 percentage point in 
     2002.
     8. Medicaid Disproportionate Share Hospitals (DSH)
       Permanently increases the allotment for New Mexico by $4 
     million per year beginning in 2000.
  Many people in the Senate deserve to be thanked for putting this 
entire appropriations package and budget together. To name a few, I 
thank the distinguished senior Senator from Alaska, Mr. Ted Stevens, 
who chairs the overall Appropriations Committee. What a job he had, and 
what a job he did. And Senator Robert Byrd, ranking member, what a 
difficult job he had. We are here with a bipartisan budget agreement 
this afternoon because he and other Democrats worked with Republicans 
to get it done.
  Last but not least, I thank the majority leader, who tried very hard 
to

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understand what we were doing, and worked with us. He now is a budget 
expert. That is good. From time to time, I am very glad we can take 
matters into his office and he understands it thoroughly.
  With that, I yield the floor.

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