[Congressional Record Volume 146, Number 25 (Wednesday, March 8, 2000)]
[Senate]
[Pages S1320-S1324]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CAMPBELL (for himself, Mr. Inouye, and Mr. Lott):
  S. 2217. A bill to require the Secretary of the Treasury to mint 
coins in commemoration of the National Museum of the American Indian of 
the Smithsonian Institution, and for other purposes; to the Committee 
on Banking, Housing, and Urban Affairs.


 national museum of the american indian commemorative coin act of 2000

  Mr. CAMPBELL. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2217

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``National Museum of the 
     American Indian Commemorative Coin Act of 2000'', or the 
     ``American Buffalo Coin Commemorative Coin Act of 2000''.

     SEC. 2. FINDINGS.

       Congress finds that--
       (1) the Smithsonian Institution was established in 1846, 
     with funds bequeathed to the United States by James Smithson 
     for the ``increase and diffusion of knowledge'';/
       (2) once established, the Smithsonian Institution became an 
     important part of the process of developing the United 
     States' national identity, an ongoing role which continues 
     today;
       (3) the Smithsonian Institution, which is now the world's 
     largest museum complex, including 16 museums, 4 research 
     centers, and the National Zoo, is visited by millions of 
     Americans and people from all over the world each year;
       (4) the National Museum of the American Indian of the 
     Smithsonian Institution (referred to in this section as the 
     ``NMAI'') was established by an Act of Congress in 1989, in 
     Public Law 101-185;
       (5) the purpose of the NMAI, as established by Congress, is 
     to--
       (A) advance the study of Native Americans, including the 
     study of language, literature, history, art, anthropology, 
     and life;
       (B) collect, preserve, and exhibit Native American objects 
     of artistic, historical, literary, anthropological, and 
     scientific interest; and
       (C) provide for Native American research and study 
     programs;
       (6) the NMAI works in cooperation with Native Americans and 
     oversees a collection that spans more than 10,000 years of 
     American history;
       (7) it is fitting that the NMAI will be located in a place 
     of honor near the United States Capitol, and on the National 
     Mall;
       (8) thousands of Americans, including many American 
     Indians, came from all over the Nation to witness the 
     groundbreaking ceremony for the NMAI on September 28, 1999;
       (9) the NMAI is scheduled to open in the summer of 2002;
       (10) the original 5-cent buffalo nickel, as designed by 
     James Earle Fraser and minted from 1913 through 1938, which 
     portrays a profile representation of a Native American on the 
     obverse side and a representation of an American buffalo on 
     the reverse side, is a distinctive and appropriate model for 
     a coin to commemorate the NMAI; and
       (11) the surcharge proceeds from the sale of a 
     commemorative coin, which would have no net cost to the 
     taxpayers, would raise valuable funding for the opening of 
     the NMAI and help to supplement the endowment and educational 
     outreach funds of the NMAI.

     SEC. 3. COIN SPECIFICATIONS.

       (a) $1 Silver Coins.--In commemoration of the opening of 
     the Museum of the American Indian of the Smithsonian 
     Institution, the Secretary of the Treasury (hereafter in this 
     Act referred to as the ``Secretary'') shall mint and issue 
     not more than 500,000 $1 coins, each of which shall--
       (1) weigh 26.73 grams;
       (2) have a diameter of 1.500 inches; and
       (3) contain 90 percent silver and 10 percent copper.
       (b) Legal Tender.--The coins minted under this Act shall be 
     legal tender, as provided in section 5103 of title 31, United 
     States Code.

     SEC. 4. SOURCES OF BULLION.

       The Secretary may obtain silver for minting coins under 
     this Act from any available source, including stockpiles 
     established under the Strategic and Critical Materials Stock 
     Piling Act.

     SEC. 5. DESIGN OF COINS.

       (a) Design Requirements.--
       (1) In general.--The design of the $1 coins minted under 
     this Act shall be based on the original 5-cent buffalo nickel 
     designed by James Earle Fraser and minted from 1913 through 
     1938. Each coin shall have on the obverse side a profile 
     representation of a Native American, and on the reverse side, 
     a representation of an American buffalo (also known as a 
     bison).
       (2) Designation and inscriptions.--On each coin minted 
     under this Act there shall be--
       (A) a designation of the value of the coin;
       (B) an inscription of the year ``2001''; and
       (C) inscriptions of the words ``Liberty'', ``In God We 
     Trust'', ``United States of America'', and ``E Pluribus 
     Unum''.
       (b) Selection.--The design for the coins minted under this 
     Act shall be--
       (1) selected by the Secretary, after consultation with the 
     Commission of Fine Arts; and
       (2) reviewed by the Citizens Commemorative Coin Advisory 
     Committee.

     SEC. 6. ISSUANCE OF COINS.

       (a) Quality of Coins.--Coins minted under this Act shall be 
     issued in uncirculated and proof qualities.
       (b) Mint Facility.--
       (1) In general.--Only 1 facility of the United States Mint 
     may be used to strike any particular quality of the coins 
     minted under this Act.
       (2) Sense of congress.--It is the sense of the Congress 
     that the United States Mint facility in Denver, Colorado 
     should strike the coins authorized by this Act, unless the 
     Secretary determines that such action would be technically or 
     cost-prohibitive.
       (c) Commencement of Issuance.--The Secretary may issue 
     coins minted under this Act beginning on January 1, 2001.
       (d) Termination of Minting.--No coins may be minted under 
     this Act after December 31, 2001.

     SEC. 7. SALE OF COINS.

       (a) Sale Price.--The coins issued under this Act shall be 
     sold by the Secretary at a price equal to the sum of--
       (1) the face value of the coins;
       (2) the surcharge required by subsection (d) with respect 
     to such coins; and
       (3) the cost of designing and issuing the coins (including 
     labor, materials, dies, use of machinery, overhead expenses, 
     marketing, and shipping).
       (b) Bulk Sales.--The Secretary shall make bulk sales of the 
     coins issued under this Act at a reasonable discount.
       (c) Prepaid Orders.--
       (1) In general.--The Secretary shall accept prepaid orders 
     for the coins minted under this Act before the issuance of 
     such coins.
       (2) Discount.--Sale prices with respect to prepaid orders 
     under paragraph (1) shall be at a reasonable discount.
       (d) Surcharges.--All sales of coins minted under this Act 
     shall include a surcharge of $10 per coin.

     SEC. 8. DISTRIBUTION OF SURCHARGES.

       (a) In General.--Subject to section 5134(f) of title 31, 
     United States Code, the proceeds from the surcharges received 
     by the Secretary from the sale of coins issued under this Act 
     shall be paid promptly by the Secretary to the National 
     Museum of the American Indian of the Smithsonian Institution 
     for the purposes of--
       (1) commemorating the opening of the National Museum of the 
     American Indian; and
       (2) supplementing the endowment and educational outreach 
     funds of the Museum of the American Indian.
       (b) Audits.--The National Museum of the American Indian 
     shall be subject to the audit requirements of section 
     5134(f)(2) of title 31, United States Code, with regard to 
     the amounts received by the museum under subsection (a).

     SEC. 9. FINANCIAL ASSURANCES.

       (a) No Net Cost to the Government.--The Secretary shall 
     take such actions as may be necessary to ensure that minting 
     and issuing coins under this Act will not result in any net 
     cost to the United States Government.
       (b) Payment for Coins.--A coin shall not be issued under 
     this Act unless the Secretary has received--
       (1) full payment for the coin;
       (2) security satisfactory to the Secretary to indemnify the 
     United States for full payment; or
       (3) a guarantee of full payment satisfactory to the 
     Secretary from a depository institution, the deposits of 
     which are insured

[[Page S1321]]

     by the Federal Deposit Insurance Corporation or the National 
     Credit Union Administration Board.
                                  ____

      By Mr. CLELAND (for himself, Ms. Mikulski, Mr. Grassley, Mr. 
        Akaka, Mr. Warner, Mr. Sarbanes, and Mr. Robb):
  S. 2218. A bill to amend title 5, United States Code, to provide for 
the establishment of a program under which long-term care insurance is 
made available to Federal employees and annuitants and members of the 
uniformed services, and for other purposes; to the Committee on 
Governmental Affairs.


FEDERAL EMPLOYEES AND UNIFORMED SERVICES GROUP LONG-TERM CARE INSURANCE 
                              ACT OF 2000

  Mr. CLELAND. Mr. President, and Members of the Senate, I am very 
pleased to join with my distinguished colleagues, Senators Barbara 
Mikulski and Charles Grassley, to introduce our proposal for the 
largest employer-based long-term care insurance program in American 
history. Today, we are introducing the Federal Employees and Uniformed 
Services Group Long-Term Care Insurance Act of 2000.
  At age 25, I returned from Vietnam facing the potential need for 
long-term care. I did not have the opportunity to plan for those needs 
and I was fortunate to avoid that outcome through the support of my 
family and the wonderful military health care system and VA system I 
encountered. Our legislation will provide federal employees, members of 
the Uniformed Services, including Reservists and the National Guard, 
retirees, spouses, parents and parents-in-law with the opportunity to 
plan for assistive care needs that become a necessity for all of us at 
some time in our lives.
  Currently there are several measures pending in the Senate which 
offer different approaches to providing long-term care insurance to 
federal and military employees and their families. Our bill represents 
a carefully considered compromise between these competing approaches.
  The Cleland-Mikulski-Grassley bill combines the features of our 
original proposals, S. 894, S. 57 and S. 36, as well as additional 
provisions to produce the most comprehensive proposal for an employer-
based long-term care insurance program. Our legislation will:
  One, allow federal employees, members of the Uniformed Services and 
Foreign Service, Reservists and retirees, spouses, parents, and parent-
in-laws to purchase long-term care insurance at group rates.
  Second, have premiums based on age (premiums are expected to be 10%-
20% less than on the open market).
  Third, provide individuals with options, including cash 
reimbursements for family caregivers, tax exemptions under the Health 
Insurance Portability and Accountability Act (HIPAA), and portability 
of benefits.
  The current forecast for the cost of meeting long-term care needs of 
our aging population is staggering in terms of personal and national 
resources. Average nursing home costs are projected to increase from 
$40,000 per person per year today to $97,000 by 2030. Medicare and 
regular health insurance programs do not cover most long-term care 
needs. Medicaid can offer some long-term care support, but generally 
requires ``spend-down'' of income and assets to qualify. Additionally, 
very few employers offer a long-term care insurance benefit to their 
employees. We hope that our legislation will be a model that other 
employers will use in providing long-term care insurance for their 
employees and will lessen the financial burden on the Medicare and 
Medicaid programs.
  Working families are too often being forced to choose between sending 
a child to college and paying for a nursing home for a parent. Families 
desperately need the tools to help themselves and to meet their family 
responsibilities.
  Consider these astounding statistics:
  Almost 6 million Americans aged 65 or older currently need long-term 
care.
  As many as six out of 10 Americans have experienced a long-term care 
need either for themselves or a family member.
  41% of women in caregiver roles quit their jobs or take family 
medical leave to care for a frail older parent or parent-in-law.
  80% of all long-term care services are provided by family and 
friends.
  The need for this legislation is clear. By working together in a 
bipartisan cooperative spirit my fellow sponsors and I have bridged 
some significant differences in approach to craft a proposal which 
should have widespread support in the Senate. I hope and expect that we 
will take up and pass this bill this year. Those who have served, and 
are now serving, our nation deserve nothing less.
  I ask unanimous consent that the Section-by-Section Analysis of this 
bill be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

Federal Employees and Uniformed Services Group Long-Term Care Insurance 
                    Act--Section-by-Section Analysis

(To amend title 5, United States Code, to provide for the establishment 
of a program under which long-term care insurance is made available to 
Federal employees and annuitants and members of the uniformed services, 
                        and for other purposes)

       Section 1 of the bill titles the bill as the ``Federal 
     Employees and Uniformed Services Group Long-Term Care 
     Insurance Act of 2000.''
       Section 2 of the bill amends title 5, United States Code, 
     to provide for the establishment and operation of the Program 
     by adding a new chapter 90.
       New section 9001 provides the definitions used in the 
     administration of the Program. Included are the following:
       ``Activities of daily living'' includes eating, toileting, 
     transferring, bathing, dressing, and continence.
       ``Annuitant'' has the meaning such term would have under 
     section 8901(3), if for purposes of such paragraph, the term 
     ``employee'' were considered to have the meaning of 
     ``employee'' in (5) of this section.
       ``Appropriate Secretary'' means, except as otherwise 
     provided, the Secretary of Defense; with respect to the 
     United States Coast Guard when it is not operating as a 
     service of the Navy, the Secretary of Transportation; with 
     respect to the commissioned corps of the National Oceanic and 
     Atmospheric Administration, the Secretary of Commerce; and 
     with respect to the commissioned corps of the Public Health 
     Service, the Secretary of Health and Human Services.
       ``Eligible individual'' means (A) an annuitant, employee, 
     member of the uniformed services, or retired member of the 
     uniformed services, or (B) a qualified relative of an 
     individual described in (A).
       ``Employee'' means an employee as defined under section 
     8901(1)(A) through (D) and (F) through (I), but does not 
     include an employee excluded by regulation of the Office 
     under section 9010, and an individual described under section 
     2105(e).
       ``Member of the uniformed services'' means a person who (A) 
     is a member of the uniformed services on active duty for a 
     period of more than 30 days; or is a member of the Selected 
     Reserve as defined under section 10143 of title 10, including 
     members on (1) full-time National Guard duty as defined under 
     section 101(d)(5) of title 10; or (2) active Guard and 
     Reserve duty as defined under section 101(d)(6) of title 10; 
     and (B) satisfies such eligibility requirements as the Office 
     prescribes under section 9010.
       ``Office'' means the Office of Personnel Management.
       ``Qualified carrier'' means a company or consortium 
     licensed and approved to issue group long-term care insurance 
     in all States and to do business in each of the States.
       ``Qualified relative'' as used with respect to an eligible 
     individual in this section means the spouse of such 
     individual; a parent or parent-in-law of such individual; and 
     any other person bearing a relationship to such individual 
     specified by the Office in regulations.
       ``Retired member of the uniformed services'' means a member 
     of the uniformed services entitled to retired or retainer pay 
     (other than chapter 1223 of title 10) who satisfies such 
     eligibility requirements as the Office prescribes under 
     section 9010.
       ``State'' means a State of the United States, and includes 
     the District of Columbia.
       New section 9002 provides that any eligible individual may 
     obtain coverage under this chapter; that a qualified relative 
     must provide documentation to demonstrate the relationship as 
     prescribed by the Office, and; an individual is not eligible 
     for coverage if the individual would be immediately eligible 
     to receive benefits upon obtaining coverage.
       New section 9003 provides the contracting authority for the 
     Office to use in establishing and operating the Program.
       Paragraph 1 of subsection (a) of this section provides that 
     the Office is authorized to contract with carriers for a 
     policy or policies of group long-term care insurance for 
     benefits specified in this chapter, without regard to section 
     3709 of the Revised Statutes (41 U.S.C. 5) or any other 
     statute requiring competitive bidding.
       Paragraph (2) of this subsection states that the Office 
     shall contract with a primary carrier for the assumption of 
     risk; no less than 2 qualified carriers to act as reinsurers; 
     and; as many qualified carriers as necessary to administer 
     this chapter, which shall also act as reinsurers. The Office 
     will ensure that each contract is awarded on the basis of 
     contractor qualifications, price, and reasonable competition 
     to the extent practicable. This

[[Page S1322]]

     provision ensures that at least 3 companies or consortia will 
     participate in the Program.
       Subsection (b) gives the Office the authority to design a 
     benefits package or packages and negotiate final offerings 
     with qualified carriers.
       Subsection (c) provides that each contract shall contain a 
     detailed statement of the benefits offered, including any 
     limitations or exclusions, the rates charged, and other terms 
     and conditions as may be agreed upon by the Office and the 
     carrier involved can be consistent with the provisions of 
     this chapter.
       Subsection (d) provides that premium rates shall reasonably 
     reflect the cost of the benefits provided under a contract, 
     as determined by the Office.
       Subsection (e) provides that the coverage and benefits 
     under this section shall be guaranteed renewable and may not 
     be canceled except for nonpayment of premium.
       Subsection (f) gives the Office the authority to withdraw 
     an offering based on open season participation rates, the 
     composition of the risk pool, or both.
       Subsection (g) requires each contract to provide insurance, 
     payment, or benefits to an  individual if the Office, or a 
     designated party, determines the individual is entitled to 
     such under the contract. The subsection also requires 
     reinsurers under (a)(2)(A)(ii) to participate in 
     administrative procedures to effect an expeditious 
     resolution of disputes arising under such contract, and 
     where appropriate, one or more means of dispute 
     resolution.
       Subsection (h) provides in paragraph (1) that each contract 
     shall be for a term of five years, unless terminated earlier 
     by the Office. The rights and responsibilities of the 
     enrolled individual, the insurer, and the Office (or a duly 
     designated third party) under any contract shall continue 
     until the termination of coverage of the individual.
       Paragraph (2) of subsection (h) specifies that the 
     termination of coverage shall occur upon the occurrence of 
     death, the exhaustion of benefits, or nonpayment of premium 
     as specified in subsection (e).
       Paragraph (3) of subsection (h) provides that each contract 
     under this section shall be consistent with regulations of 
     the Office under section 9010 to (1) preserve all parties' 
     rights and responsibilities under such contracts, 
     notwithstanding the termination of such contract and (2) 
     ensure that once an individual is enrolled, the coverage will 
     not terminate due to any change in status, such as separation 
     from Government service or the uniformed services, or ceasing 
     to be a qualified relative.
       Subsection (i) specifies that nothing in this chapter shall 
     be construed to grant authority to the Office or a third 
     party to change the rules under which the contract operates 
     for disputed claims purposes.
       New Section 9004 specifies the long-term care benefits to 
     be provided under this chapter.
       Subsection (a) states that benefits under this chapter will 
     be long-term care insurance under qualified long-term care 
     insurance contracts within the meaning of section 7702B of 
     the Internal Revenue Code. Additionally, as determined 
     appropriate by the Office, the benefits under such contracts 
     will be consistent with the more stringent of the most recent 
     standards of the National Association of Insurance 
     Commissioners or such standards as recommended in 1993.
       Subsection (b) of this requires each contract under this 
     chapter to provide for: (1) adequate consumer protections; 
     (2) adequate protections in the event of carrier bankruptcy; 
     (3) the availability of benefits upon certification as to the 
     individual's inability to perform at least 2 activities of 
     daily living for a period of at least 90 days or substantial 
     supervision of the individual to protect such individual from 
     threats to health and safety due to severe cognitive 
     impairment; (4) choice of service benefits; (5) availability 
     of inflation protection; (6) portability of benefits; (7) 
     length-of-benefit options; (8) options relating to flexible 
     long-term care benefit options regarding care modalities, 
     such as nursing home care, assisted living care, home care, 
     and care by family members; (9) options relating to 
     elimination periods; and (10) options relating 
     to nonforfeiture benefits.
       New section 9005 addresses the financing of the Program and 
     makes clear that each individual enrolled for coverage must 
     pay 100 percent of the charges for such coverage. Subsections 
     (b) through (d) of this section provide for the withholding 
     of premium from the pay of an employee or member of the 
     uniformed services or the annuity of an annuitant or retired 
     member of the uniformed services. Withholdings for a 
     qualified relative, may at the discretion of the individual 
     related to the relative, be withheld from pay as if the 
     enrollment were for the qualified relative. An enrollee whose 
     pay, annuity, or retired or retainer pay is insufficient to 
     cover the withholding is required to remit the full amount of 
     premiums directly to the carrier.
       Subsection (e) of this section requires each carrier to 
     account for all funds under this chapter separate and apart 
     from funds unrelated to this chapter.
       Subsection (f) of this section specifies that a contract 
     under this chapter must include provisions under which the 
     carrier must reimburse the Office or other administering 
     agency for administrative costs incurred by the Office or 
     other agency, including implementation costs. These costs are 
     considered allocable to the carrier. Reimbursements under 
     this section, except for the initial costs of implementation, 
     must be deposited in the Employees Health Benefits Fund and 
     held in a separate Long-Term Care Insurance Account. This 
     account is available without limitation to the Office for 
     purposes of this chapter.
       New section 9006 provides that this chapter shall supersede 
     and preempt any State or local law, or law of a territory or 
     possession, which is inconsistent with the provisions of this 
     chapter or, after consultation with the National Association 
     of Insurance Commissioners, the efficient provision of a 
     nationwide long-term care insurance Program for Federal 
     employees. An exception applies to any financial requirement 
     by a State or District of Columbia that is more stringent 
     than the requirements of 9004(b)(1).
       New section 9007 provides that each qualified carrier 
     entering into a contract with this Office shall provide such 
     reasonable reports as the Office determines necessary to 
     carry out its functions and permit the Office and the General 
     Accounting Office to examine the records of the carrier. It 
     also requires Federal agencies to keep records and 
     certifications, and furnish the Office, the carrier, or both 
     with information the Office may require.
       New section 9008 addresses claims for benefits under this 
     chapter.
       Subsection (a) of this section requires that claims be 
     filed within 4 years after the date on which the reimbursable 
     cost was incurred or the service was provided.
       Subsection (b)(1) provides that benefits payable under this 
     chapter are secondary to any other benefit payable for such 
     cost or service, e.g., workers' compensation, no-fault 
     insurance. It also provides that no benefit is payable where 
     no legal obligation exists to pay.
       Paragraph (2) of subsection (b) specifies the exceptions to 
     the policy in paragraph (1) such that benefits payable under 
     the medical assistance program of title XIX of the Social 
     Security Act and any other Federal or State program that the 
     Office may specify in regulations that provide health 
     coverage designated to be secondary to other insurance 
     coverage are secondary to benefits paid under this chapter.
       New section 9009 specifies that a claimant may file suit 
     against a carrier of the long-term insurance policy covering 
     such claimant in the district courts of the United States, 
     after exhausting all available administrative remedies.
       New section 9010 requires the Office, in subsection (a), to 
     prescribe regulations to carry out the requirements of this 
     chapter.
       Subsection (b) of this section that the Office shall 
     prescribe the time at which and manner and conditions under 
     which an individual can obtain or continue long-term care 
     insurance, including the length of time for the first 
     opportunity to enroll, the minimum period of coverage 
     required for portability, and provisions for periodic 
     coordinated enrollment.
       Subsection (c) provides that the Office cannot exclude an 
     employee or group of employees solely on the basis of the 
     hazardous nature of employment or part-time employment.
       Subsection (d) specifies that any regulations necessary to 
     effect the application and operation of this chapter with 
     respect to an eligible individual or qualified relative shall 
     be prescribed by the Office in consultation with the 
     appropriate Secretary.
       The Technical and Conforming Amendment amends the table of 
     chapters for part III of title 5, United States Code, by 
     inserting, after the item relating to chapter 89, the new 
     reference to chapter 90, Long-Term Care Insurance.
       Section 3 of the bill authorizes the appropriations of such 
     sums as may be necessary to pay for costs incurred by the 
     Office in the implementation of chapter 90, title 5, United 
     States Code, from enactment of this Act to the date on which 
     long-term care insurance coverage first becomes effective. 
     Any reimbursements of such costs by carriers under 9005(f) of 
     title 5, United States Code, are to be deposited in the 
     General Fund.
       Section 4 provides that the amendments made by this Act 
     will be effective on the date of enactment. However, this 
     section also provides that coverage will be effective under 
     this Act not later than the first day of the first fiscal 
     year beginning more than 2 years after the date of enactment. 
     This time frame is necessary to negotiate contracts, 
     preparation of materials, and the large task of educating the 
     millions of potential enrollees about this Program.

 Ms. MIKULSKI. Mr. President, I rise today as a proud cosponsor 
of the ``Federal Employees and Uniformed Services Group Long-Term Care 
Insurance Act of 2000.'' This important piece of legislation represents 
a carefully considered compromise between several bills currently 
pending in the Senate.
  I would like to thank Senator Cleland and Senator Grassley for all of 
their hard work in coming to a consensus on how best to provide federal 
and military employees, retirees, and their families with the 
opportunity to purchase long-term care insurance.
  Since my first days in Congress, I have been fighting to help people 
afford the burdens of long-term care. Ten years ago, I introduced 
legislation to change the cruel rules that forced elderly couples to go 
bankrupt before

[[Page S1323]]

they could get any help in paying for nursing home care. Because of my 
legislation, AARP tells me that we've kept over six hundred thousand 
people out of poverty and stopped liens on family farms.
  I also fought for higher quality standards for nursing homes. Through 
the Older Americans Act, seniors have easier access to information and 
referrals they need to make good choices about long-term care. I am 
also working hard to create a National Family Caregivers Program, so 
that families can access comprehensive information when faced with the 
dizzying array of choices in addressing the long-term care needs of a 
family member.
  These are important steps. But unfortunately, we haven't made much 
progress in the last few years. We've been stymied by partisan 
bickering, shutdowns, and inaction. The long-term care crisis needs a 
long-term care solution. I am pleased to say that this new bipartisan 
legislation puts an important down payment on this solution.
  Despite past disagreements on approaches to financing long-term care, 
everyone agrees that the crisis is growing. Nursing home costs are 
projected to increase from $40,000 today to $97,000 by 2030. This will 
only get worse since the number of senior citizens will double over the 
next thirty years. Families are being forced to choose between sending 
a child to college or paying for a nursing home for a parent, or a 
parent-in-law. I think that is wrong.
  Consider these sobering statistics:

       At least 5.8 million Americans aged 65 or older currently 
     need long-term care
       As many as six out of 10 Americans have experienced a long-
     term care need
       41 percent of women in caregiver roles quit their jobs or 
     take family medical leave to care for a frail older parent or 
     parent-in-law
       80 percent of all long-term care services are provided by 
     family and friends

  Families desperately need the tools to help themselves and meet their 
family responsibilities. This bill is the first step in helping all 
Americans do just that. Let me tell you what our new legislation will 
do:

       It will enable federal and military workers, retirees and 
     their families to purchase long-term care insurance
       It will provide help to those who practice self-help by 
     offering employees the option to better prepare for their 
     retirement and the potential need for long-term care
       It will enable federal employees to buy long-term care 
     insurance at group rates--they are projected to be 10%-20% 
     below open market rates.
       Participants will pay the entire premium but because of the 
     lower premium this is a good deal for federal workers--and 
     for taxpayers

  I'm starting with federal employees for two reasons. First, as our 
nation's largest employer, the federal government can be a model for 
employers around the country. By offering long-term care insurance to 
its employees, the federal government can set the example for other 
employers whose workforce will be facing the same long-term care needs. 
Starting with the nation's largest employer also raises awareness and 
education about long-term care options.
  I have a second reason for starting with our federal employees. I am 
a strong supporter of our federal employees. I am proud that so many of 
them live, work, and retire in Maryland. They work hard in the service 
of our country. And I work hard for them. Whether it's fighting for 
fair COLAs, lower health care premiums, or to prevent unwise schemes to 
privatize important services our federal workforce provide, they can 
count on me.
  One of my principles is ``promises made should be promises kept.'' 
Federal retirees made a commitment to devote their careers to public 
service. In return, our government made certain promises to them. One 
important promise made was the promise of health insurance. The lack of 
long-term care for federal workers has been a big gap in this important 
promise to our federal workers. This legislation will close that gap 
and provide our federal workers and retirees with comprehensive health 
insurance.
  Mr. President, I reiterate my commitment to finding long-term 
solutions to the long-term care problem. I am proud that this 
bipartisan bill takes an important step forward in helping all 
Americans to prepare for the challenges facing our aging 
population.
  Mr. AKAKA. Mr. President, it is with great pleasure that I cosponsor 
the Federal Employees and Uniformed Services Long-Term Care Group 
Insurance Act of 2000, introduced by the Senator from Georgia [Mr. 
Cleland], the ranking minority member of the HELP Aging Subcommittee 
[Ms. Mikulski], and the chairman of the Special Committee on Aging [Mr. 
Grassley]. This bipartisan legislation is testament to what can be 
accomplished when members from both sides of the aisle have a common 
goal. I salute the months-long effort undertaken by my colleagues and 
their staffs to bring this compromise bill to fruition.
  As the ranking minority member of the Subcommittee on International 
Security, Proliferation, and Federal Services, with direct jurisdiction 
over this measure, I am mindful that there are several long-term care 
bills pending before the Subcommittee. However, I would like to point 
out that the three pending bills, S. 894, S. 57, and S. 36, are 
original proposals introduced by the Senators from Georgia, Maryland, 
and Iowa, who have combined features from each of their bills to craft 
a measure that will address the long-term care insurance needs of 
federal and military personnel and their families.
  Many Americans mistakenly believe that Medicare and their regular 
health insurance programs will pay for long-term care. They do not. 
Although Medicaid provides some long-term care support, an individual 
generally must ``spend-down,'' his or her income and assets to qualify 
for coverage.
  More and more Americans are requiring long-term care. About 5.8 
million Americans aged 65 or older require long-term, care due to 
illness or disability. An approximately equal number of children and 
adults under the age of 65 also require long-term care because of 
health conditions from birth or a chronic illness developed later in 
life.
  The need for long-term care is great. By the year 2030, the number of 
Americans age 65 years or older will double, from 34.3 to 69.4 million. 
The cost of nursing home care now exceeds $40,000 per year in many 
parts of the country, and home care visits for nursing or physical 
therapy runs about $100 per visit. In 1996, over $107 billion was spent 
on nursing homes and home health care. However, this figure does not 
take into account that fully 80 percent of all long-term care services 
are provided by family and friends.
  In my own state of Hawaii, 13.2 percent of the population is persons 
65 and older. Although Hawaii enjoys one of the highest life 
expectancies--79 years, compared to a national average of 75 years--the 
state's rapidly aging population will greatly impact available 
resources for long-term care, both institutional and from non-
institutional sources. Hawaii's long-term care facilities are operating 
at full capacity. According to the Hawaii State Department of Health, 
the average occupancy rate peaked at 97.8 percent in 1994. But 
occupancy remains high. By 1997, the average occupancy dropped to 90 
percent.
  These statistics point to the overriding need to help American 
families provide dignified and appropriate care to their parents and 
relatives. We know that the demand for long-term care will increase 
with each passing year, and that federal, state, and local resources 
cannot cover the expected costs. Nursing home costs are expected to 
reach $97,000 by the year 2030.
  What Congress can do, however, is make long-term care insurance 
available to a broad segment of the population and offer a model for 
the private sector. The bill introduced today will provide quality 
group long-term care insurance to the nation's federal employees, 
including postal workers, members of the Foreign Service, and Uniformed 
Services. Retirees of these agencies and their spouses, parents, and 
parents-in-law will be eligible to participate, and employees in a 
``deferred annuitant status'' can enroll when retirement benefits are 
activated. The bill has broad-based support, including endorsement by 
the National Treasury Employees Union and the National Association of 
Retired Federal Employees, two federal employee unions, as well as the 
Military Consortium, an organization of the major military groups.
  The proposal parallels portions of the President's four-part 
initiative designed to address long-term health, including having the 
federal government

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serve as a model employer by offering quality private long-term care 
insurance to federal employees. The bill introduced today allows the 
Office of Personnel Management to use its market leverage to offer 
enrollee-paid quality private long-term care insurance to federal 
employees, military personnel, retirees, and their families at group 
rates. Participants would pay the full premium, whose costs are 
expected to be 10-20 percent lower than open market rates. There would 
be options, including cash reimbursement for family care givers, tax 
exemptions under the Health Insurance Portability and Accountability 
Act (HIPAA), and portability benefits--features that will provide 
enrollees the ability to tailor policies to individual needs.
  Mr. President, I am pleased to be an original cosponsor of this bill, 
which will offer federal employees, uniformed service personnel, 
retirees, and their families an opportunity to plan for future long-
term care needs in a responsible manner. I foresee this proposal as 
serving as a model for the private sector and state and local 
governments, and I again thank my colleagues for their diligence in 
crafting this compromise measure.
                                 ______