[Congressional Record Volume 146, Number 137 (Friday, October 27, 2000)]
[Senate]
[Pages S11206-S11230]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MAKING FURTHER CONTINUING APPROPRIATIONS FOR FISCAL YEAR 2001
Mr. LOTT. Mr. President, I ask unanimous consent that the Senate now
turn to the continuing resolution, H. J. Res. 117, that no motions or
amendments be in order, and the time between now and 3:15 p.m. be
equally divided between the two leaders. I also ask unanimous consent
that the vote occur on adoption of H.J. Res. 117 at 3:15 p.m. and
paragraph 4 of rule XII be waived.
The PRESIDING OFFICER. Is there objection?
Mr. KERRY. Mr. President, no objection.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. LOTT. Therefore, the next vote will occur at 3:15 this afternoon.
Mr. President, for the information of Senators who are interested in
the schedule, it is expected that the vote at 3:15 p.m. will be the
last vote of the day. However, at this time, in view of the need for
continuing resolutions, unless some different agreement can be worked
out, we will be expected to have votes on Saturday and on Sunday with
continuing resolutions.
Of course, there is serious work underway right now on the matters of
disagreement. I note Saturday is the sabbath for a number of our
colleagues and for observant Jews, and Sunday is my sabbath. I prefer
we get a CR that will take us to Monday while we continue to work, but
we have not been able to enter into that agreement yet. If necessary,
we will be here and voting on CRs on Saturday and on Sunday. It is my
expectation that vote will come late in the afternoon or early evening
on Saturday.
Also, again, Senator Stevens from the Appropriations Committee and
the appropriators are meeting right now on the final details of the
Labor-HHS bill. There is also some discussion about how we can move
some of the problem issues out of the CSJ bill that has been reported
out of conference and passed by the House. Corrections or changes, if
agreed to, could be entered into the Labor-HHS bill.
I do want you to know the appropriators are busily working in their
magical way, and I am sure at sometime a cone of honey will be
produced, or maybe that is the wrong terminology to use, but they are
getting closer to agreements. I hope it is something that can be
signed, or I hope it is something I can vote for, too. Both of those
are undetermined at this point. I know Senator Kerry wants to make
further comments about an earlier issue. We now have 3 hours and 15
minutes to talk about the CR or other issues Senators wish.
Mr. STEVENS. Will the Senator yield for a moment?
Mr. LOTT. I will yield since I invoked the name of the distinguished
chairman of the Appropriations Committee.
Mr. STEVENS. My name came up as a magician. I am Aladdin. I rub the
lamp.
Mr. LOTT. Very good. That is right, and I hope you will start rubbing
it very fast.
Mr. STEVENS. I am supposed to bring you out of the lamp.
Mr. LOTT. All right.
Mr. STEVENS. Mr. President, I have to inform the Senate that if we
finish the Health and Human Services bill today--we are in good-faith
negotiations, and we expect to be quite late today--that bill could not
be finished in terms of its reading out and printing and being
available to both sides until Monday afternoon at the earliest.
I hope we can get some consideration from the administration and from
everyone to understand that. We would have two sessions--one on
Saturday and one on Sunday. Some people work on their sabbath and some
people do not. We have a staff who will be working, in spite of that,
around the clock to read the legislation. There are some 40 pieces of
legislation, in addition to the bill itself, that will be in the Health
and Human Services bill; at least that will be our recommendation.
I urge that somehow or another I be allowed to offer an amendment to
this continuing resolution and make it Tuesday night. I have told the
White House and OMB that there is no way, even if we finish tonight,
that we can take it up tomorrow or take it up Sunday. We will not be
able to take it up until Monday night. The White House should know
that, OMB should know that, and I hope the minority agrees with us.
We cannot vote on this bill, the major wrapup piece of legislation,
until, at the earliest in the Senate, Tuesday. The House may be able to
vote on it Monday night. To argue over a CR that takes us to tomorrow
and to argue over one that takes us to Sunday and one that takes us to
Monday, when there is nothing we can do about finishing up this
Congress, is just demonstrating our inability to deal with reality.
I hope the leader will allow me some time today to offer a motion to
amend that CR and make it Tuesday. I have discussed it with the House,
and they are in session. They can adopt it and send it to the
President. Somehow or another, this idea we can only go day to day and
we can produce something tomorrow that we have not finished today, when
we have just one bill left which itself cannot be finished until Monday
night, I think is foolhardy. I am prepared to challenge the President
and all of his people to come to reality.
The discussions are being held with his people. If we do not finish
them tonight, we will finish them tomorrow. If we do not finish them
until tomorrow, it will be Tuesday morning before it is read out.
Maybe people do not understand what we do. Each side has a copy of
the final provisions. Each reads it through, and we call in the people
from the committees involved to be sure the provisions are correct.
Then we get together and our staffs read it together, and each makes
certain the other has not made any changes in it. And that will not be
finished. It will take at least 20 hours of reading to do that. It will
not be finished until Monday night.
Mr. LOTT. Mr. President, I say to the Senator from Alaska, we do not
quite know what the appropriators do. I am not sure we really want to.
We wish you the best because at least all of our schedules are in your
hands, if not our lives. But I think what the Senator is saying is
eminently reasonable. I urge you to get Senator Byrd to discuss that
with the leadership on the other side, and if you talk with Senator
Reid, we will communicate with the administration and hopefully maybe
by 3:15 p.m. we can take that reasonable action. I certainly would
support it. But we have to get an agreement.
I yield the floor.
Mr. KERRY. Mr. President, if I may respond, I am confident the leader
on our side wants to be as reasonable as possible. The issue on our
side has been, as we said earlier, the level of progress, No. 1, and
No. 2, the question of inclusivity.
What the chairman just said suggests there is a lot more inclusivity,
and I presume reasonable minds will prevail at an appropriate time. A
judgment has to be made by the administration and the minority leader
with the level of progress. I am confident that will happen.
If I may continue, Mr. President, for a moment. Would it be
appropriate at this point in time--Senator Wyden has been waiting for a
long time; I know the Senator from Texas has been waiting. I want to
make a few comments yielding myself time off our time for a brief
moment--I will be brief--at which point, may we have a unanimous
consent agreement?
[[Page S11207]]
Mr. WYDEN addressed the Chair.
The PRESIDING OFFICER (Mr. Allard). The Senator from Oregon.
Mr. WYDEN. I would ask----
Mr. KERRY. I will yield only for the purpose of asking a question.
Mr. WYDEN. I thank the Senator.
I ask unanimous consent that I be recognized, Mr. President, to speak
for up to 30 minutes on the continuing resolution when Senator Kerry
has completed his comments.
Mr. KERRY. Mr. President, would the Senator agree that the Senator
from Texas was, in fact, going to precede him?
Mr. DOMENICI. Reserving the right to object, might I ask a question?
Mr. WYDEN addressed the Chair.
The PRESIDING OFFICER. The Senator from Massachusetts has the floor.
Mr. KERRY. I am willing to yield for a question, but I am trying to
proceed here, if we can.
Mr. WYDEN. Would the Senator from Massachusetts yield for me to
clarify this?
Mr. KERRY. I yield for the purpose of clarification only.
Mr. WYDEN. I appreciate the Senator yielding.
I was prepared to allow Senator Gramm to speak because the two of us
were on the floor at the same time, to speak for 15 minutes, on the
proviso that I could go next. I would then talk for up to 30 minutes.
Mr. KERRY. I would modify the unanimous consent request.
Mr. NICKLES. Reserving the right to object.
The PRESIDING OFFICER. The Senator from Oklahoma.
Mr. NICKLES. Knowing the subject matter that my colleague from Oregon
wishes to speak to, I would like to be recognized for 15 minutes,
following the Senator from Oregon, to respond.
Mr. DOMENICI. Reserving the right to object.
The PRESIDING OFFICER. The Senator from New Mexico.
Mr. DOMENICI. I have the right to object. There is a unanimous
consent request pending.
Mr. KERRY. Absolutely.
Mr. DOMENICI. I would like to have 20 minutes reserved for me when
you are finished--whoever is in the chain, whatever that is.
Mr. REID. Reserving the right to object, Mr. President.
The PRESIDING OFFICER. The Senator from Nevada.
Mr. REID. I am happy, until 3:15, to work out time agreements so
people are not standing around. But the way it now appears, it is going
to be a little unbalanced. We should rotate time wise, not necessarily
who is speaking but how much time. We want to work Senator Conrad into
this mix.
Mr. KERRY. Mr. President, could I suggest the following? And I think
it will meet everybody's needs. At the conclusion of my brief remarks,
the Senator from Oregon be recognized, following him, Senator Nickles
to be recognized, with the time to be selected by the managers for how
much time they allocate, and subsequent to that, someone on our side,
to be named, to be recognized, and then the Senator from Texas.
Mr. DOMENICI. What about the Senator----
Mr. KERRY. Afterwards it would come back to this side, and then the
Senator from New Mexico.
Mr. BOND. Reserving the right to object, apparently there is a lot of
discussion that needs to go on. We need to work out the time. Could we
ask--
Mr. KERRY. You control it.
Mr. BOND. I know, but could we ask the initial remarks of the Senator
from Oregon and the Senator from Texas to be 15 minutes each, so then
we can work out a schedule? We know that we will then be able to
develop the schedule so that all of the important things that people on
both sides of the aisle need to say before 3:15 can be said.
Mr. KERRY. Mr. President, the Senator from Oregon has requested 30
minutes. I am prepared to yield him 30 minutes from our time. I think
we should each control our time.
The PRESIDING OFFICER. The Senator has that right.
Mr. NICKLES addressed the Chair.
The PRESIDING OFFICER. The Senator from Oklahoma.
Mr. NICKLES. OK, if our understanding is that the Senator from Oregon
receives up to 30 minutes, if you would allocate me up to 30 minutes in
response, and hopefully neither one of us will take that much time, and
then you can continue the division of time. Certainly it would be
appropriate.
Mr. KERRY. Mr. President, I ask unanimous consent for that request.
The PRESIDING OFFICER. Without----
Mr. DOMENICI. No. Mr. President, I reserve the right to object.
Where are we now with reference to whether the Senator from New
Mexico gets to speak?
Mr. KERRY. Mr. President, the Senator from New Mexico follows on the
Republican side after the Senator from Texas.
Mr. REID. However, I say to Senator Domenici, it would be the
Democratic side's turn prior to you.
Mr. DOMENICI. I understand. The only thing I am concerned about, if
you are going an hour equally divided--3:15 is the vote; isn't it?
Mr. KERRY. Mr. President. I think this is not as complicated as we
are making it. If I could try to simplify it, the unanimous consent
request requires us to alternate to each side. We will go, immediately
following my comments, to the Senator from Oregon, and then back to the
majority side, Senator Nickles, and then back to our side to a person
to be yet named, and then back to the Republican side to the Senator
from New Mexico, and then back to our side, which follows Senator
Gramm. And that is the order with the time to be determined by the
managers on each side.
The PRESIDING OFFICER. Is there objection?
Mr. DOMENICI. Mr. President, reserving the right to object, I wonder
if the manager of the bill, as part of this, would use his efforts with
reference to how much time each one gets so that at least those we have
agreed to would be able to speak before 3:15. You can do that, I
believe.
Mr. BOND. Mr. President, reserving the right to object, I believe the
agreement is that between now and 3:15 the time is equally divided. So
that would roughly be 3 hours and 10 minutes. So that is an hour and 45
minutes for each side. With that understanding, each side has 1 hour 45
minutes.
Mr. KERRY. Mr. President, I ask unanimous consent that the time
consumed to this point not count as equally divided.
The PRESIDING OFFICER. Is the Senator putting off the 3:15 vote?
Mr. KERRY. No. But I was recognized and therefore I do not want this
entire colloquy to come from my time. I am asking that the time
commence for division.
The PRESIDING OFFICER. It has to come from somebody's time.
Mr. KERRY. It comes equally divided from both sides.
The PRESIDING OFFICER. Is there objection?
The Chair hears none, and it is so ordered.
Mr. KERRY. I thank the Chair.
Mr. President, I will be very brief. I simply want to respond very
quickly to the comments made by the distinguished majority leader who
appropriately cited many items within the legislation that we all ought
to support. Indeed, that is precisely what I said in the course of my
comments. We do support a great deal of what is in the legislation.
But what the majority leader never did, in the course of his
comments, was address any of the issues we raised with respect to the
health care system, the fundamental fairness, and the issues of
contention raised by the President of the United States.
He dismissed that rather quickly and cavalierly, suggesting that the
President got a lot of what he wanted. Let me be very precise. Of 119
individual tax provisions in this bill, 35 of them are from the
President's budget; that is 30 percent of the provisions, not the 80
percent that the majority leader talked about. Mr. President, and of
the $240+ billion in tax cuts in this package, only $48 billion, or 20
percent of the total, is from the President's proposals.
No one should be misled by the comments of the majority leader to
believe that this is somehow a fair division, and that the President,
in offering to veto, is not vetoing it on substantive, clear, and
distinct differences of policy.
Secondly, the majority leader suggested that much was included in
this, and this is sort of mostly a bill that is somehow beneficial.
What he neglected to address was the issue that we raised
[[Page S11208]]
about how this bill came together and what is in it as a total.
As a total, it represents, in a sense, a consensus of what the
majority wanted to put in. But it was arrived at without discussion
with the minority, and so there are whole bills in here that raise very
significant issues.
One of them is the issue to which the Senator from Oregon is going to
talk. I just want to take about 2 minutes to say something about it.
There is, in this tax bill, a whole piece of legislation called the
Pain Relief Promotion Act. My colleagues ought to listen to that title
very carefully: Pain Relief Promotion Act. That title is an
extraordinary, almost cynical, play on words. It completely distorts
the notion of what happens in this legislation.
First of all, this Pain Relief Promotion Act completely preempts
State law with respect to the definition of a legitimate medical
purpose with respect to State medical regulations. The implications of
that with respect to this are to require the Drug Enforcement Agency's
agents to determine whether a physician's prescription of a controlled
substance for pain relief medication was intended to relieve pain or to
assist in suicide. I hope my colleagues focus on that.
The Pain Relief Promotion Act is asking DEA agents to make a judgment
of intent about what a doctor intended to do in prescribing a
prescription drug to a patient who is terminally ill in a hospital.
Are we seriously going to go down that road and DEA agents to have
the potential to provide a 20-year prison sentence for a doctor for
making a judgment about pain medication to an ill patient in a
hospital? I find that extraordinary. Yet the majority leader tried to
suggest on the floor that this is just some innocuous conglomeration of
legislation that has no major impact on the lives of Americans, except
80 percent of it is good and what the President wanted. That is a fight
worth fighting on the floor of the Senate today.
I am not going to go into all the details. I just went through a long
hospitalization issue with a parent. I know what that pain medication
meant for cancer. I know how difficult it was in the hospital to get
the proper pain medication, to have people comfortable with what was
being dealt. If we suddenly layer that kind of legal structure over the
delivery of medical care in America, we are taking an extraordinary
step that at least ought to be properly debated on the floor of the
Senate in the context of hearings, the process, and so forth.
A recent New England Journal of Medicine article said the following:
If the Pain Relief Promotion Act becomes law, it will
almost certainly discourage doctors from providing adequate
doses of medicine to relieve the symptoms of dying patients.
That does not belong in a tax bill, conglomerated in a room without
the consent of Democrats. That is why we are here. That is why we are
fighting about this legislation.
My final comment is, with respect to the tax components of this,
major components of fairness were stripped out of this bill. The
majority leader talked about how important it is to provide savings for
Americans. Yes, it is important. There is not one of us on this side of
the aisle who won't vote to encourage Americans to save money. There is
not one of us who does not support a 401(k) program. But when we are
making a choice about how much money we can allocate to people based on
the overall amounts of money available and that choice was made by the
Republicans alone to encourage 401(k)s to the exclusion of middle- and
low-income Americans to be able to save, that is a fight worth
fighting. That is a question of fundamental fairness.
The 401(k)s are terrific for lawyers and doctors and high-income
people, but the kind of Americans we were trying to reach--at the
$30,000, $25,000, $20,000 income level--have a lot harder time gaining
benefit from a 401(k). What the President had in his proposals was a
credit that would have gone directly to those hard-working Americans.
That was stripped out. That is why we are here now raising these issues
regarding this legislation. It is a question of fundamental fairness.
I regret that in all of his comments this morning, the majority
leader did not address the fundamental issue of fairness that we are
raising and over which the President has threatened a veto.
My absolute last comment: The President made clear that he would veto
this. So the majority leader comes to the floor and says, well, we will
come back, and we will work this out down the road.
Why? Why work it out down the road? Why not work it out now? Why not
work it out in the last month before we came to the floor knowing it
would be vetoed? If we can work out these other issues, if we weren't
seeking a political advantage, we could certainly work that out.
People may not like the fact that the President of the United States
is who he is and is of the party that he is, but he has the veto. We
have been through this since 1995, when the Government of the United
States was shut down for the first time in American history over this
very same challenge. And here we are again, in the year 2000, with the
same sort of sense of frustration over the fact that he has the veto
pen that brings us to this point of confrontation. The fact is, he does
have that pen. He has the constitutional right. He made it clear he
would do it. And the reasons he has chosen to do it are substantive and
important to the American people. That is what this debate is about.
I thank my colleague for his courtesy. I yield such time, up to the
30 minutes, as he might consume to the Senator from Oregon.
The PRESIDING OFFICER. The Senator from Oregon.
Mr. WYDEN. Mr. President, before he leaves the floor, I thank the
Senator from Massachusetts, both for his focus on bipartisanship with
respect to the overall package and for his very thoughtful comments
about the assisted suicide issue. I think he has summed it up very
well.
I feel bad that I had to object to consideration of the tax
legislation this morning. I will take just a minute or two to describe
why and then go on to talk about the overall issue as it relates to
pain relief and what is in the tax bill.
I know it is an inconvenience to a number of Senators to have me talk
about this subject at length. This is an important time in the year for
colleagues. I regret the inconvenience. But I believe what is in the
tax bill is going to cause so much pain and suffering to families all
across the country, that the interests of those families who are going
to suffer if this tax bill as written becomes law have to come first.
First and foremost, I want the Senate to understand that before we
are done, I am going to speak at length about exactly what the
consequences will be for families all across this country, who
needlessly are going to suffer great pain that could be averted, if the
bill becomes law as written.
In addition, while the majority leadership in the Congress is
attempting to throw Oregon's vote on assisted suicide into the trash
can, Oregonians are holding on to ballots such as this one. They are
wondering if this ballot, this sacred vote, really counts.
Mr. REID. Will the Senator from Oregon yield for a question?
Mr. WYDEN. In one moment.
I am obligated to speak for those Oregonians, each and every one of
them, over a million Oregon voters, because I want them to understand
that I am going to do everything in my power to make sure the ballot I
have in my hand and the ballots they are holding right now actually
count. The fact is, the senior Senator from Oklahoma has put into the
tax bill legislation that would silence over a million Oregon voices. I
am going to be here to make sure those voices are heard.
I yield to the Senator from Nevada. I thank him for his thoughtful
comments last night on this issue.
Mr. REID. Mr. President, I have a question. This question comes from
the people of the State of Nevada. It is my understanding that if this
provision of this tax bill passes, a vote that was taken in the State
of Oregon, open to everyone in the State of Oregon, would be basically
repealed by the Congress of the United States; is that true?
Mr. WYDEN. The Senator is correct. In effect, it would be impossible
to carry out the will of Oregon voters on a matter that has
historically been left to the States.
[[Page S11209]]
What is so striking--and I appreciate the Senator's question--is that
we constantly have colleagues come to the floor and talk about the
importance of States rights and the beauty of the 10th amendment. Then
when they don't happen to agree with what a State is doing, I guess the
10th amendment isn't so important anymore.
I appreciate the Senator's question.
Mr. REID. One more question I will ask the Senator from Oregon: Then
the people of Nevada, no matter how they feel about the substance of
the legislation that passed in the State of Oregon, should be warned by
me and others that if this piece of legislation passes, if we pass a
ballot proposition or a law in the State of Nevada, it would be subject
to repeal by the Congress. We in Nevada believe in States rights. We
are part of the great western heritage.
Is it true that if this particular legislation passes, the people of
the State of Nevada should be aware of the fact that we could repeal
something that they pass in the legislature or by ballot proposition?
Mr. WYDEN. The Senator is absolutely right. People in Nevada should
understand that what this legislation does is take away from all States
what has historically been their prerogative, which is to determine
appropriate medical practice. There is a great body of case law and a
variety of legal precedents that establish that right, and folks in
Nevada should understand that. I think it is also on point to note that
people in Maine are voting right now on this issue. I think it is open
to some question as to what will be the effect of that Maine ballot
measure right now if the tax legislation were to pass as written and,
in effect, throw Oregon folk to the trash can, and it might do the same
thing for people in Maine. I thank my colleague for his questions.
Mr. President, if the Senate was here today to vote on a stand-alone
bill which would lead to unspeakable, avoidable suffering for hundreds
of thousands of terminally ill citizens, there is no question in my
mind that the Senate would not pass it. So what we have to ask is why
has the Senate leadership stuck into this tax bill, legislation that
the American Cancer Society and over 50 nationally recognized health
organizations believe will cause unnecessary suffering for thousands of
terminally ill citizens in each State in our country.
What is particularly ironic is that this legislation has not moved
forward with any of the traditional procedures of the Senate. It has
never been reported out by a committee of jurisdiction. It has never
been subject to amendment by the full Senate. There has never been a
chance to debate it on the floor of the Senate. The fact is that this
legislation, which is one of the central bioethical questions in our
society, was stuffed into the tax bill close to midnight the other
night, without overcoming even one of the traditional procedures the
Senate follows.
Now, Senator Kerry noted the name of this bill. It is the so-called
``Pain Relief Promotion Act.'' The fact of the matter is, this
legislation is really the ``Pain Promotion Act'' because it is going to
have a chilling effect on health care providers all across this country
who simply want to practice good pain management.
I know my friend from Colorado, who is in the Chair today, also
represents a rural State. Let me tell you about the kind of concern I
have if the Nickles bill, as written, becomes law. Let us say you have
a physician in Colorado or in Iowa or another rural State who is
opposed to assisted suicide--and I am opposed to assisted suicide; I
have joined colleagues here in voting to ban Federal funding of
assisted suicide. But let's say a physician in Colorado, who is opposed
to assisted suicide, wants to treat pain aggressively with a suffering
patient. If they do, their intent, their mental calculus can later be
dissected by law enforcement officials who, if they believe that anti-
assisted suicide physician really had a different intent, can prosecute
that physician. And the medical providers involved would be subject to
a mandatory minimum sentence of 20 years, a fine that is upwards of a
million dollars and they would lose their DEA registration.
The fact is that the undertreatment of pain today is a documented
public health crisis. There was just another survey published very
recently demonstrating that physicians and health care providers are
reluctant to treat pain aggressively because they are very fearful of
having their decisions second-guessed by law enforcement. There are a
number of us--the American Cancer Society is one--who are opposed to
assisted suicide. Yet the American Cancer Society has said that because
of the chilling ramifications of pain management, it believes the
Nickles legislation included in the tax bill is going to hurt cancer
patients nationwide.
The American Academy of Family Physicians is another major medical
group opposed to assisted suicide and they oppose the Nickles
legislation; so is the American Nurses Association, the Oncology
Nursing Society, the Indiana State Hospice and Palliative Care
Association, and the Texas Medical Association. In sum, there are more
than 50 respected health organizations that are opposed to physician-
assisted suicide and also oppose the Nickles legislation included in
this tax bill.
If we do care about humane medical treatment--and I know that every
Senator cares about the suffering of those who are vulnerable--I
believe when you actually read what is in this tax bill and what
Senator Nickles has been able to include, if you wish to join us in
alleviating suffering and protecting the poor, elderly, and vulnerable,
you have to oppose the Nickles legislation because it hurts the very
people that our colleagues care about.
I want to raise a troublesome flag now with respect to this bill. To
my knowledge, not a single nursing organization in America supports the
bill purporting to relieve pain for the dying--not one. But seven
nursing organizations, including the American Nurses Association,
National Association of Hospice and Palliative Nurses, Pediatric
Oncology Nurses, and the American Society of Pain Management Nurses,
oppose the alleged pain relief bill included in this tax legislation.
Now, you know when a loved one is in a hospital, the physician may
have ultimate responsibility for the care, but the nurses are the ones
on the front lines coping with pain. Seven major nursing organizations,
representing those on the front lines, have come out against the
Nickles bill. So the question is, how could all of this happen? I think
the Senate may want to reflect on the procedures involved because I
think other Senators may find the same sort of absurd process applied
in matters that are important to their States.
When Senator Nickles introduced the Pain Relief Promotion Act last
year, the bill was referred to the Committee on Health, Education,
Labor, and Pensions. That is because, for obvious reasons, the bill has
enormous ramifications for pain and health care. The bill received a
hearing in 1999. It wasn't acted on by the committee. Members on both
sides of the aisle expressed concerns about the legislation's impact on
end-of-life and pain care. Unfortunately, a House bill identical to
that legislation was passed by the House and was suddenly referred to
the Senate Judiciary Committee, which didn't have jurisdiction on this
critical health issue. The Parliamentarian did something that I believe
showed great courage, and I commend him for it. He simply told the news
media that a mistake had been made, that the Nickles legislation had
been referred to the wrong committee.
I thought it was a very courageous, gutsy thing for the
Parliamentarian to do. It was the kind of unfortunate accident that can
happen.
The Judiciary Committee, as one might guess, had a chairman who was
sympathetic to the Nickles legislation who pushed and pushed to mark it
up before the American Cancer Society made it clear that the Nickles
legislation would hurt cancer patients. They got the bill out of the
Judiciary Committee on a 10-8 vote.
Now you know that the bill is very controversial. That is why it is
coming to the floor of the Senate in the form it is. They could not get
the Senate to approve this legislation if the traditional procedure of
the Senate were followed.
In fact, since the Nickles legislation had been introduced with a
handful of Democrats who were supportive, several have now indicated
their opposition largely for the reasons I have cited--that the Nickles
legislation would have a chilling effect on pain management.
[[Page S11210]]
The reason this bill has been stuffed into the tax legislation is
that it cannot go forward on its own. There is too much controversy
attached to it, too much uncertainty about its ramifications on pain
care for the dying for the leadership to bring it to the floor in the
normal way.
The fact is that the Senator from Oklahoma doesn't have the votes. At
one point, the supporters had 80 votes. It got out of the Judiciary
Committee 10-8.
I said last summer, let's follow the traditional rules of the Senate.
After we had agreed to that, the distinguished Senator from New York,
who is very opposed to assisted suicide, saw how much damage this
legislation would do for the suffering and said he couldn't support the
bill.
Senator Nickles saw that support was quickly moving away from him and
that he didn't have the votes to pass his legislation following the
traditional procedure of the Senate. To compensate for the lack of
votes and the inability to follow traditional procedures in the Senate,
the senior Senator from Oklahoma has chosen the least democratic method
at his disposal to circumvent an honest debate and avoid even a couple
of modest amendments.
What is striking is the senior Senator from Oklahoma has on various
occasions apparently said we shouldn't have extraneous matters brought
in that had not been considered separately in a conference report. But
he is allowing exactly this to be done with his bill.
The senior Senator from Oklahoma is betting that by stuffing his
legislation into this conference report, everybody is going to be so
resigned to the outcome and so anxious to bring down the gavel and get
home that this body is just going to ignore its obligation to the
scores and scores of families and suffering patients who are going to
be hurt by this legislation.
The senior Senator from Oklahoma may be right. I suppose that is the
way it often works in the Senate. However, I am going to be asking my
colleagues--and will talk more about this subject when we get back on
the tax legislation--to step up to the suffering with so much on the
line. I want them to know what is at stake.
If this legislation is approved, the friends of every Senator, loved
ones, and constituents are going to find it impossible to obtain
aggressive pain care in their communities. Patients unable to obtain
pain care are a fact of life right now, but at least we have some
solace in knowing that thousands of brave health professionals are
willing to risk their reputations and their careers to prescribe
controlled substances to relieve suffering.
If the tax legislation goes forward without removing the Nickles
bill, the undertreatment of pain, which is already a documented public
health crisis, is going to get worse. Our loved ones--yours, mine--and
individuals in every community across this country are going to suffer
the consequences with this flawed legislation.
I hope that before we have a final vote on this issue, each and every
one of our colleagues will read the statement of the American Cancer
Society on this legislation. They are an organization that opposes
assisted suicide, as I do. Yet here is what they say about the Nickles
legislation. This is the direct statement of the American Cancer
Society about the Nickles legislation. The American Cancer Society
states, and I quote:
Under the act, all physicians, and particularly physicians
who care for those with terminal illnesses, will be made
especially vulnerable to having their pain and symptom
management treatment decisions questioned by law enforcement
officials not qualified to judge medical decision-making.
This can result in unnecessary investigation and further
disincentive to aggressively treat pain.
That is the American Cancer Society describing how the Nickles
legislation will have a chilling effect on pain care.
I would like to offer a bit of a historical perspective. The
nonprescription abuse of opioids and cocaine around the turn of the
century and the growing sentiment that doctors at that time were one
component of the growing drug problem in America helped contribute to
the stigma associated with the use of opioids for pain.
According to a seminar on oncology and in an article by Dr. David
Wiseman, ``Doctors, Opioids, and the Law: The Effect of Controlled
Substances Regulation on Cancer Pain Management,'' when regulations
were enacted in 1914 to keep from treating drug addicts with opioids,
the stigma attached to those drugs continued to grow, and physicians
across the country became more reticent to prescribe those drugs
because of their fear of criminal or licensing sanctions against their
practice.
The undertreatment of pain is due to a variety of complex causes.
There certainly are a number of studies that show that the threat of
legal sanctions is one of the main roadblocks to humane pain control.
And that is before the Nickles legislation in the Senate would direct
to Drug Enforcement Administration to have law enforcement agents
second-guessing the judgment of doctors.
One 1994 California survey showed that 69 percent of physicians cited
the potential for disciplinary action as a reason for prescribing
opioids conservatively. One-third of the doctors went on to acknowledge
that their own patients may be suffering from untreated pain.
What we saw last week in Oregon was a brand new study that showed
again that physicians are fearful about aggressively treating pain for
fear of legal prosecution. It confirmed the 1994 California survey.
For that reason, I am happy to yield to my friend and colleague.
Mrs. BOXER. Mr. President, I thank my friend for bringing these
issues to the floor of the Senate. I think this issue of pain abatement
is a key issue.
I go even further than that in this debate because the issue of
physician-assisted suicide, which I do not support, is really not what
I am afraid of in Senator Nickles' approach. But I just want to say to
my friend, thank you for bringing this issue forward. I watched a loved
one, who was as close to me as anyone could be, cry out in pain hour
after hour, saying: I don't want to live.
I wanted this person to live more than I can say. But I went to that
physician of this loving relative and I said: Please, please, do
everything in your power to anesthetize this pain, to sop this pain.
This physician looked at me and he said: I will do everything that I
can.
I am so fearful that someone else, if this bill becomes law, will
look at me and say: Barbara, I know how much you love this individual,
but I can't do more than I am doing because I'm afraid I'm going to be
hauled off to prison.
I don't want any family looking in the eyes of a physician, begging
to put a loved one out of this type of misery and pain, being told that
their hands are tied; they would love to help and they can't.
That is why what the Senator from Oregon is doing is so important and
why I am so saddened that this bill, in the dead of night, that could
lead to people writhing in pain, not being able to get the help they
need, was done in such a fashion where we really can't even give it the
attention it deserves.
As my final point, would my friend tell me again, for the record, so
that everyone watching this debate can know, which organizations are
opposing this Nickles provision for the reason that the Senator has
stated--that it will lead to people suffering needlessly, and doctors
being afraid to help them because they will be hauled off to jail.
Mr. WYDEN. I appreciate my colleague's questions. There are more than
50 major health organizations. The American Cancer Society has stated
why they feel this legislation would have a chilling effect on pain
management.
I want my colleague to know, because time is short, that Senator
Nickles, in offering this bill, says doctors don't have anything to
worry about with respect to prosecution under the bill--that his
legislation says doctors can prescribe drugs which will hasten death if
their intent is to treat the pain. So he is talking about ``intent.''
Our colleagues are right to be so concerned about who is going to
determine the intent of the physician, who is just trying to help
somebody suffering and gives a suffering person critical relief and
dignity as they face difficult hours at the end-of-life. The person who
is going to decide ``intent'' is not another doctor, not a nurse, not a
health professional, not anybody with medical
[[Page S11211]]
training, but law enforcement officials. A law enforcement official is
going to determine that medical provider's' intent. Somebody with no
medical training is going to, in effect, have the authority to put
medical providers on trial; a trial that could cause a provider to lose
their license, serve 20 years in prison, and face upwards of a $1
million fine.
It doesn't have to be this way. There are many who oppose assisted
suicide, who want to work in a bipartisan way to promote better pain
management and reduce the demand for assisted suicide.
Mrs. BOXER. I thank my friend.
Mr. WYDEN. The Senator from Oklahoma is not allowing Members to do
that.
The Senator from California has made the key point. At the end of the
day, I want it understood when the people of Oregon cast a ballot like
the one I have in my hand on a matter that has historically been left
to the people of my State and to every State, I will do everything I
can on the floor of the Senate to protect that vote.
I yield the floor, and I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. WYDEN. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. WYDEN. Mr. President, I ask unanimous consent that the time be
equally divided between both sides.
Mr. BOND. I object.
The PRESIDING OFFICER. The objection is heard.
Mr. WYDEN. Mr. President, I will keep talking if the Senator from
Missouri objects. I am sure some of our colleagues have other concerns.
I will continue on this question of dissecting medical providers'
intent, as the Nickles legislation does, a dissecting exercise that
will be done by law enforcement professionals rather than medical
providers.
Here is what the American Cancer Society had to say about determining
``intent'' under the Nickles legislation. The American Cancer Society
says: Unfortunately, intent cannot be easily determined, particularly
in the area of medicine, where effective dosage levels for patients may
deviate significantly from the norm. The question of deciding intent
should remain in the hands of those properly trained to make such
decisions--the medical community and State medical boards.
What the American Cancer Society is saying, as with these other 50
organizations, they are especially troubled that the Nickles
legislation is second-guessing the pain management practices of
physicians and providers all across the country. It is especially
troublesome because law enforcement officials, rather than health care
professionals, are going to be the ones to assess the intent of a
medical provider. A medical providers' intentions under any calculus,
as the American Cancer Society has noted, cannot be easily determined.
To allow law enforcement officials to have this enormous discretion,
after the fact, to challenge our medical providers, in my view, is
going to significantly compound the undertreatment of pain in America.
Mr. NICKLES. Mr. President, I was told that the time of the Senator
expired and I was coming to claim my time to respond.
The PRESIDING OFFICER. The time of the Senator has expired under the
previous order, and the Senator from Oklahoma is to be recognized.
Mr. NICKLES. I will be happy to let my colleague conclude his
thought.
Mr. WYDEN. Mr. President, I hoped we could have worked it out. My
time has expired. As the Senator from Oklahoma knows, I have wanted a
real debate on this legislation for some time, so I am happy to have
the Senator hold forth.
The PRESIDING OFFICER. The Senator from Oklahoma.
Mr. NICKLES. Mr. President, one, I wish to respond to my colleague
and my friend from Oregon. He is my friend. We happen to have a
disagreement on this issue. We have a difference of opinion, a rather
pronounced difference of opinion. I heard several things in his
statement that I want to correct. I almost don't know where to start.
First, let me touch on a couple of things on procedure. This is so
wrong procedurally and should not be in this bill.
Again, he is my good friend, but he has known all along I would try
to get this bill on the floor. Yes, it was put in the tax bill. I tried
to put it in the appropriations bill. We ended up putting it in a tax
bill. Is that the best way to legislate? No.
I might tell my colleagues and my friend from Oregon I tried about
half a dozen different ways to pull the bill up, to have it be an
amendable state, to offer my colleague from Oregon or others a chance
to have relevant amendments, and those offers were always rejected. So
now we have the bill before the Senate.
I might also mention, if one is complaining about this procedure,
then we shouldn't have any problem with the Commerce-State-Justice
because the administration is trying to put an amnesty provision that
doesn't belong on the Commerce-State-Justice bill. It did not pass
either the House or the Senate, and is totally extraneous to the
conference.
Senator Byrd had one dealing with trade that was on an appropriations
bill. It should not have been. It was inserted.
At least this bill did pass the House by over 100 votes. It did pass
the Judiciary Committee. It has had hearings. It has been marked up. It
has had 42 cosponsors--maybe my friend and colleague from Oregon has
been able to convince one or two to get off. Senator Lieberman is still
a principal cosponsor, to my knowledge. He testified in favor of this
legislation, as have I. So this legislation is not new. It is not a
surprise.
My colleague from Oregon has sent several letters to all colleagues
saying what is wrong with the legislation. I have sent several letters
to all of our colleagues saying he was incorrect. So everyone knows
about this bill and everyone knows at some point we are going to have a
debate on it. I hope it will be passed.
Let me touch on a couple of issues that were brought up. My colleague
from Oregon said if this bill is passed it is going to tell a million
people in Oregon who voted for this on a ballot initiative, a
referendum, that their vote does not mean anything. I disagree with
that. This bill does not overturn Oregon's law. I want to be very clear
about this. This bill does not say anything about making Oregon's law
null and void. What this bill does is it deals with pain and pain
management. The bill does say: Oregon, you cannot overturn Federal law.
It doesn't say quite that. Federal law, the controlling law, is the
Controlled Substances Act. That is a Federal law. It passed in 1970. It
controls very strong drugs, I tell my friend from New York. These are
deadly drugs. They are strong drugs. They are under Federal control.
They are not under State control; they are under Federal control. It is
a Federal Controlled Substances Act. The State of Oregon cannot pass a
law that changes a Federal statute.
I make the analogy, Oklahoma might say let's legalize heroin.
Oklahomans might pass that in a referendum, but it doesn't make heroin
legal. It is still against the Federal law to use heroin. These are
federally controlled drugs. They are deadly if they are used in very
large quantities, but they are also very helpful. They can help
alleviate pain. Unfortunately, we have a real problem in pain. I heard
my colleague from California mention she knew a friend who was in
enormous pain. We all have friends or families or have known people who
are suffering and suffering greatly. I want to alleviate their pain.
That is one reason why this bill was created.
There were two reasons. We want to alleviate pain. That is why all
the pain management groups endorse this bill. I will go through a list.
My colleague from Oregon listed a few groups that endorsed his. We have
10 times as many people, groups, physicians, you name it--hospice care,
palliative care, the American Medical Association, that endorse this
bill; pain management societies--you name it. I will have all that
printed in the Record. These groups, the hospice groups and others,
their members worked their entire lives because they want to alleviate
pain. This bill will alleviate pain.
[[Page S11212]]
This bill does two things. It says we can use these drugs. My
amending the Controlled Substances Act says we can use these very
strong drugs to alleviate pain. We put a safe harbor in to protect
physicians, making sure when they use these drugs to alleviate pain, if
it causes someone's death there will be no problem. The bill also says
these drugs cannot be used for the purpose of assisted suicide.
Guess what. That has been the law of the land for 30 years. These
drugs were never allowed to be used for assisted suicide. The Drug
Enforcement Administration--I will put a letter from Mr. Constantine
who says he reviewed it--the Controlled Substances Act says these drugs
can be used for legitimate medical purposes. In our bill, we state that
includes pain management, the alleviation of pain. We put that in
specifically so everyone will know: Use these drugs to alleviate pain.
It is now in the law. Mr. Constantine also said it is not construed to
be used for assisted suicide.
You say: Why do you need this bill?
You need this bill for two reason. One, we want to make sure
everybody knows these drugs can be used to alleviate pain.
What about the Oregon law? My colleague from Oregon said this is
going to outlaw the Oregon law and nullify a million voters who voted
for it. This is going to gut the bill.
Granted, they have had dozens of suicides that have been committed
using federally controlled drugs. Guess what. The law was always
interpreted before that these drugs cannot be used for assisted
suicide. They cannot be used to cause someone's death. They can be used
to alleviate someone's pain, and we clarify that in our legislation. We
go further. We put in funds to educate people on pain management.
My colleague from Oregon and I happen to agree with this. There is a
real problem in pain management. There are a lot of people who are not
doing enough in pain management, for whatever reason. Maybe they have
not been educated. Maybe they are afraid of liability. Maybe they are
afraid of doing too much and that might enhance someone's death. We
said you can be very aggressive in pain management. What you cannot do
is take federally controlled drugs and use them to kill somebody. These
drugs are controlled by the Federal Government. They can be used to
alleviate pain. They cannot be used to kill somebody.
About the Oregon law, Oregon passes a law and says they are going to
say one can have assisted suicide. Fine. You cannot use Federal
controlled drugs. These are federally controlled drugs. Oregon cannot
amend the Controlled Substances Act. They think they can. Now with the
Attorney General's letter, maybe they think they can. It is really
awkward. In 49 States, you cannot use federally controlled substances
for assisted suicide, but in Oregon you can.
So how did Oregon amend the Federal law, the Federal statute? Maybe
Oklahoma is going to amend the Federal law. They might not like the .08
we just passed.
I heard my colleague say: What about States rights? I am a very
strong supporter of States rights but States cannot change Federal law.
I am all for giving States the right to opt out. If we want to say the
Controlled Substances Act applies unless the States want to opt out,
let's pass it. We have not done that. If we want to have a different
law to allow States to opt out, maybe it should be used against the
Federal law against heroin or cocaine, and we want to have the State
opt out on that? I don't think so. Oregon is saying let's have the
State opt out on the Controlled Substances Act so we can use these
substances for assisted suicide. Oregon cannot change the Federal law.
So it is not us, it is not the Federal Government now trying to
overturn the Oregon law. Oregon, by referendum, thought they could
overturn the Federal law. They cannot do it. They cannot do it.
Let's do what we can to alleviate pain. Let's take these very strong
drugs--morphine and others that if used in excess can be deadly--let's
make sure they are used to alleviate pain. Let's do it aggressively and
educate people all across the country in pain management. So we do that
as well.
Let me also knock down a couple of the arguments that my colleagues
used. He said if we do this, it is going to have a chilling impact.
Far from it. I will tell my colleagues, the AMA and some other
groups, the hospice groups, said that a couple of years ago. We stated
very clearly in the Controlled Substances Act that these drugs can be
used to alleviate pain. They said: We are afraid it will have a
chilling impact so we put in language to guarantee, to give physicians
safe harbors, to do all kinds of things in the legislation to encourage
using the drugs for pain management but not assisted suicide. So the
chilling effect argument is not accurate.
In fact, if you look at the several States that have passed laws
against assisted suicide but for pain management--and there are
several, and I have charts of several: Kansas, Rhode Island, several
States--in every one of those States, when they passed legislation
banning assisted suicide but encouraging pain management, the use of
morphine has gone up dramatically. So instead of having a chilling
impact on pain management, it encouraged pain management, it encouraged
the use of these drugs, these very strong drugs to alleviate pain. That
is the history in every single State. It is interesting to note since
Oregon passed their law on allowing or legalizing assisted suicide, it
is just the opposite. The use of pain management drugs has actually
gone down.
I look at Indiana, the use of morphine has gone up substantially.
They have banned assisted suicide. Iowa, the same thing, a dramatic
increase in pain control drugs when they banned assisted suicide.
Kansas, again, more than double. Louisiana doubled the use of these
very strong drugs to alleviate pain. In Rhode Island, it more than
doubled. South Dakota had a big increase. Again, almost all of these
have doubled. Tennessee--it has more than tripled the use of pain
control drugs.
When the States banned the use of assisted suicide, they used the
strong drugs to alleviate pain. This is what we want to do. We want to
alleviate pain. We want to be effective. We want to get the very strong
drugs that a lot of physicians have been reluctant to utilize and we
want to get them into physicians' hands. We want to let them know they
have the power, the authority, the education to use these drugs to
alleviate pain. Even if they increase the use and it causes someone's
death, there is no penalty, and I have to touch on the penalty
sanctions. My colleague was so wrong.
We want them to alleviate pain. My colleague says: If they do not
comply, we will have a new group of Federal officers running around,
and this is going to have a chilling impact. He is exactly wrong. The
Drug Enforcement Administration is in control of these drugs right now.
There are 990,000 registrants who use these federally controlled drugs
nationwide.
My colleague from Oregon implied that if we pass this bill, we are
going to have a new set of Federal police; they are going to be
arresting people and they will do years in jails and pay thousands of
dollars in fines. We have given zero, none, no additional law
enforcement authority.
Guess how many drug enforcements there were in fiscal year 1999?
There are 990,000 registrants, and they investigated 921 cases, almost
all of which were referred by the States. They revoked their
registration, which is DEA's enforcement. They revoked the
registrations of 29.
In 1998--again, there are almost 1 million people who are licensed to
dispense these federally controlled drugs--they revoked the
registrations of 17; in the year 1997, 18. So DEA already has this
authority. They have it nationwide. They have always had it. We do not
take it away. We do not enhance their authority.
This is a bogus red herring. Somebody is trying to scare the people:
We are going to increase the Government power. Hogwash, we are
increasing the power of the physicians. We are giving them a safe
harbor, giving them greater standing. Before somebody can take action,
they have to prove intent before there would be any claim against that
physician. We give the physicians greater power and greater reliability
that they will not be going to court, that they will not be in trouble
with law enforcement if they are aggressively using these drugs for
pain management.
[[Page S11213]]
Under this bill, they can use these drugs aggressively in pain
management. They just cannot use them for Dr. Kevorkian assisted
suicide, plain and simple. In Oregon, in at least 43 cases, they have
used federally controlled drugs to kill someone. We are saying these
are federally controlled drugs and you can use them to alleviate pain,
but you cannot use them to kill someone.
I want to touch on a couple of other issues. I mentioned safe harbor.
I have a letter from the American Medical Association, which says:
This bill would explicitly include this as a safe harbor,
creating a legal environment in which physicians may
administer appropriate pain care for patients without fear of
prosecution.
This is the AMA.
They continue:
The Pain Relief Promotion Act does not create a new Federal
authority to regulate physicians. The bill contains specific
rules of construction preserving the roles of States and the
Federal Government in regulating the practice of medicine.
I could go on and on.
Mr. President, I ask unanimous consent to print in the Record a
volume of information because this is an important issue. I have
editorials, a couple of which came from Oregon, one of which is dated
July 1, 1999. This is the Oregonian. It says: ``Kill the pain, not the
patients.'' That is what we try to do with our bill. We try to kill the
pain and not the patients.
Also, I have an Oregonian editorial which says: ``A state's rights, a
state's wrongs.'' This is dated October 19, 1999.
And a more recent editorial from the Oregonian, September 10, 2000,
says:
Approve pain relief promotion bill. The Senate should put a
quick end to Wyden's filibuster and pass a bill that favors
pain killing over patient killing.
I have a volume of things. I mentioned these three editorials which
are very well written, and also I have a legal analysis of the bill; I
have a list of organizations supporting the Pain Relief Promotion Act.
This list is very long. It starts with Aging With Dignity, the American
Academy of Pain Management, the American College of Osteopathic Family
Physicians, American Medical Association, American Society of
Anesthesiologists, American Society of Interventional Pain Physicians,
Americans for Integrity in Palliative Care, Americans United for Life,
California Disability Alliance, Catholic Health Association, Catholic
Medical Association. I could go on and on. There are medical
associations--the Florida Medical Association.
There being no objection, the material was ordered to be printed in
the Record, as follows:
The Pain Relief Promotion Act and the Substitute Amendment--Supporting
Organizations
Aging With Dignity.
American Academy of Pain Management.
American College of Osteopathic Family Physicians.
American Medical Association.
American Society of Anesthesiologists.
American Society of Interventional Pain Physicians.
Americans for Integrity in Palliative Care.
Americans United for Life.
California Disability Alliance.
Catholic Health Association.
Catholic Hospice (Florida).
Catholic Medical Association.
Christian Legal Society.
Christian Medical & Dental Society.
Coalition of Concerned Medical Professionals.
Carondelet Health System.
Eagle Forum.
Family Research Council.
Florida Hospices and Palliative Care, Inc.
Florida Medical Association.
Focus on the Family Physicians Resource Council.
Friends of Seasonal and Service Workers (Oregon).
Hope Service and Palliative Care (Florida).
Hospice Association of America.
Iowa Medical Society.
Louisiana State Medical Society.
Lutheran Church--Missouri Synod.
Medical Association of the State of Alabama.
Medical Society of Delaware.
Medical Society of New Jersey.
Medical Society of the State of New York.
Michigan State Medical Society.
National Association of Pro-life Nurses.
National Conference of Catholic Bishops.
National Hospice Organization.
National Legal Center for the Medically Dependent and
Disabled.
National Right to Life.
Nebraska Coalition for Compassionate Care.
Nebraska Medical Association.
Not Dead Yet.
Ohio State Medical Association.
Oklahoma State Medical Association.
OSF Healthcare System.
Pain Care Coalition--American Academy of Pain Medicine,
American Headache Society; American Pain Society.
Pennsylvania Medical Society.
Physicians for Compassionate Care.
Puerto Rico, Office of the Governor.
Supportive Care of the Dying: A Coalition for Compassionate
Care.
South Carolina Medical Association.
South Dakota Medical Association.
Union of Orthodox Jewish Congregations of America.
Utah Medical Association.
Virginia Association For Hospices.
VistaCare Hospice.
Vitas Healthcare Corporation (CA, FL, IL, OH, PA, TX, WI).
Wisconsin Council on Developmental Disabilities.
State Medical Society of Wisconsin.
____
[From the Oregonian, July 1, 1999]
Kill the Pain, Not The Patients
It's no secret to any reader of this space that we oppose
Oregon's venture into physician-assisted suicide.
But last year, when the American Medical Association and
the National Hospice Organization came out against a bill in
Congress giving medical review boards the power to deny or
yank the federal drug-prescribing license to physicians who
prescribed these drugs to assist in suicides, we took their
concerns seriously.
The groups argued that the proposed law could reverse
recent advances in end-of-life care. Doctors might become
afraid to prescribe drugs to manage pain and depression--
things that, when uncontrolled, can lead the terminally ill
to consider killing themselves in the first place. We thought
then that the problem could be worked out and that it was
possible to keep doctors from using federally controlled
substances to kill their patients without also preventing
them from relieving their terminally-ill patients' agonies.
This Congress's Pain Relief Promotion Act proves it, and
the proposed legislation comes not a moment too soon. A new
report by the Center for Ethics in Health Care at Oregon
Health Sciences University shows that end-of-life care in
Oregon--which fancies itself a leader in this area--is far
from all it should be. Too many Oregonians spend the last
days of their life in pain.
There's no real need for that--and the Pain Relief
Promotion Act of 1999 would go a long way toward addressing
these systemic and professional failures here and elsewhere.
The proposal would authorize federal health-care agencies to
promote an increased understanding of palliative care and to
support training programs for health professionals in the
best pain management practices. It would also require the
Agency for Health Care Policy and Research to develop and
share scientific information on proper palliative care.
Further, the Pain Relief Promotion Act would clarify the
Controlled Substances Act in two essentials ways.
One, it makes clear that alleviating pain and discomfort is
an authorized and legitimate medical purpose for the use of
controlled substances.
Two, the bill states that nothing in the Controlled
Substances Act authorizes the use of these drugs for assisted
suicide or euthanasia and that state laws allowing assisted
suicide or euthanasia are irrelevant in determining whether a
practitioner has violated the Controlled Substances Act.
Technically, of course, the bill does not overturn Oregon's
so-called Death with Dignity Act. But it would thwart it, for
all practical purposes, because it makes it illegal for
Oregon doctors to engage in assisted suicide using their
federal drug-prescribing license. Suicide's advocates may
think of some other method, but none seems obvious.
Is this a federal intrusion on a state's right to allow
physician-assisted suicide or euthanasia?
To hear some recent converts to state's rights talk, you
might think so. But you could just as easily argue that
Oregon's assisted suicide law intrudes on the federal domain.
The feds have long had jurisdiction over controlled
substances, even as states kept the power to regulate the way
physicians prescribe them. At best, it's a gray area.
You'll recall that the Department of Justice declined to
assert a federal interest in all of this when it plausibly
could have, shortly after Oregon voters approved assisted
suicide. It's probably better--and high time--that Congress
asserts that interest explicitly.
This act would establish a uniform national standard
preventing the use of federally controlled drugs for assisted
suicide. That, in itself, should advance the national debate
on this subject in a more seemly way than, say, the recent
efforts of Dr. Jack Kervorkian.
Beyond that, it's high time that the Congress made clear
that improved pain relief is a key objective of our nation's
health-care institutions and our Controlled Substances Act.
The Pain Relief Promotion Act will do all this. No wonder the
American Medical Association and the National Hospice
Organization are now on board.
[[Page S11214]]
____
[From the Oregonian, Oct. 19, 1999]
A State's Rights, a State's Wrongs
not even oregon has a right to intrude on federal government's
traditional regulatory arena
Nobody can say Oregon didn't have a full debate on assisted
suicide before reaffirming in November 1997 what voters first
passed a year earlier. Both sides expended much blood and
treasure in the fight and it's natural to think the matter
should end there. Oregon voters passed assisted suicide;
Oregon should have assisted suicide.
Normally, we'd agree.
But Oregon's ``Death with Dignity Act'' barges into an area
of long-standing federal jurisdiction--the Controlled
Substances Act--and Measure 16 proponents' new infatuation
with ``states' rights'' betrays a misunderstanding of the
concept.
We mention this as Congress prepares to debate the Pain
Relief Promotion Act of 1999. The bill would authorize
federal health-care agencies to promote an improved
palliative care, and not even our new states' rights
enthusiasts are grousing about that proposed federal
initiative. The Pain Relief Promotion Act also makes clear
that alleviating pain and discomfort is an authorized and
legitimate medical purpose for the use of controlled
substances under the Controlled Substances Act. Nobody minds
this either, which is understandable, since it would ensure
that federal drug laws don't get in the way of proper
palliative care.
But the fur starts flying when the bill states that nothing
in the Controlled Substances Act authorizes the use of these
drugs for assisted suicide or euthanasia and that state laws
allowing assisted suicide or euthanasia are irrelevant in
determining if a physician has violated this federal law.
Although the act wouldn't technically nullify Oregon's
suicide law, doctors here would have to help patients die
without the aid of federally controlled substances.
Initially, U.S. Drug Enforcement Administration
Administrator Thomas Constantine ruled that using controlled
drugs such as barbiturates to terminate patients violated the
Controlled Substance Act, because assisted suicide was not a
``legitimate medical practice.'' We couldn't agree more that
helping patients kill themselves is not a ``legitimate
medical practice.'' But in a later decision, Constantine's
boss, Attorney General Janet Reno, took a different view.
She stated there was no evidence that Congress, in the
Controlled Substance Act, wanted to override the states'
right to determine what was a ``legitimate medical
practice.'' Nor is there evidence, Reno continued, that
Congress intended to hand the DEA power to decide the
assisted suicide question.
A fair historical point. Congress probably couldn't imagine
in 1969 that a state would countenance assisted-suicide using
controlled substances--but what about now? Reno said the DEA
shouldn't decide if physician-assisted suicide is a
``legitimate medical practice,'' and that's a fair point,
too. These issues, Reno stated, are fundamental questions of
morality and public policy.'' But does Congress have a right
to answer such questions in the context of the Controlled
Substances Act?
Absolutely.
These are drugs the federal government already controls.
The federal government wouldn't allow a state's doctors to
dispense heroin simply because a state legalized it. The
federal government didn't allow doctors to dispense marijuana
even to terminally-ill patients--just because a few states'
voters deemed this a nifty idea. Congress didn't even have to
weigh in on medical marijuana; the administration made that
decision on its own, because of its worries about drug
addiction.
Clearly, Congress has every right to update or clarify U.S.
law on the use of federally controlled substances for
assisted suicide. If Congress can concern itself with drug
addiction, surely it can--and should--concern itself with the
quality of health care across the country.
It can--and should--concern itself with the effects of
assisted suicide on that health care.
And it can--and should--approve the Pain Relief Promotion
Act of 1999.
____
[From the Sunday Oregonian, Sept. 10, 2000]
Approve Pain Relief Promotion Bill
senate should put a quick end to wyden's filibuster and pass bill that
favors pain-killing over patient-killing
Life-and-death issues aren't always open to consensus
solutions, but a reasonable consensus on end-of-life care
seems to have emerged.
It's embodied in the Pain Relief Promotion Act that the
U.S. Senate should vote on soon--if it has the wisdom to shut
off a threatened filibuster led by Oregon's Ron Wyden.
How broad is this consensus? Well, the American Medical
Association, the American Academy of Pain Management, the
Hospice Association of America, and other medical groups all
back the Pain Relief Promotion Act.
It passed the House, 271-156, last fall and has 42 co-
sponsors in the Senate. Democrat Joe Lieberman, Al Gore's
running mate, is the chief Senate sponsors along with
Oklahoma Republican Don Nickles.
The Connecticut Democrat has company on the campaign trail,
too, Republican presidential nominee George W. Bush backs the
bill. So does the Green Party's Ralph Nader, who worries that
HMOs and corporate medical interests will see assisted
suicide as a cheap alternative to expensive medical care.
It's easy to see why left and right, Republicans and
Democrats, support the bill. It calls on federal health
agencies to disseminate information on palliative care to
health-care providers and the public.
It authorizes $5 million a year for grants to teach medical
people the latest pain-management techniques. In addition, it
makes explicit a ``safe harbor'' provision in the federal
Controlled Substances Act. Doctors could use controlled
substances to ease pain even when this may unintentionally
hasten death. The bill provides for continuing education on
this ``safe harbor'' for Drug Enforcement Administration and
other law-enforcement officials.
Foes claim that the Nickles-Lieberman bill would have a
``chilling effect'' on doctors' ability or inclination to
relieve patients' suffering. Please. Every section of the
bill advances the cause of pain relief. States that have
passed similar laws--Iowa and Rhode Island, for example--have
seen per-capita use of federally controlled morphine for pain
relief go up dramatically.
The only thing Nickles-Lieberman will have a chilling
effect on is doctors who want to use federally controlled
drugs in their patients' suicides. The bill clarifies the
Controlled Substances Act so this 31-year-old federal law
cannot be read to countenance the use of federally controlled
drugs in assisted suicides and euthanasia. It makes plain
that assisted suicide and euthanasia are not ``legitimate
medical purposes'' under the Controlled Substances Act. (By
contrast, alleviating pain and suffering are, states the
bill, ``legitimate medical purposes'' for a controlled
substance--``even if the use of such a substance may increase
the risk of death.'')
As such, the Pain Relief Promotion Act would have a
chilling effect on Oregon's assisted suicide law. It wouldn't
exactly nullify it, but doctors here couldn't prescribe
federally controlled drugs for physician-assisted suicides.
This explains Wyden's opposition to the bill, through
things get tricky here. He says he actually opposes the
assisted suicide law. He just thinks Oregonians have a right
to pass this law, good or bad. That's the senator's right,
but the Senate shouldn't play along with the effort to dress
up this exercise in constituent service as some great stand
for states' rights or better pain relief.
As we've seen, Nickles-Lieberman's entire thrust is geared
to improving pain relief and palliative care under the
Controlled Substances Act. As is also clear, Wyden has picked
a strange place to make his stand for states' rights. Nickles
and Lieberman are, after all, clarifying the federal
Controlled Substances Act of 1970. In truth, it's Oregon that
has barged into an accepted area of federal regulation, 30
years after the fact, with its assisted-suicide experiment.
Debate on the Nickles-Lieberman should lead to an informed
decision not put off such a decision and protect one state's
warped views of its powers. The Senate should vote a quick
end to any Wyden filibuster on its way to passing the Pain
Relief Promotion Act.
____
[From the Washington Post, Nov. 10, 1999]
Health, Not Suicide
With regard to Oregon Gov. John Kitzhaber's op-ed column of
Nov. 2, ``Congress's Medical Meddlers,'' let's get the facts
straight.
Federally controlled substances are exactly that--federally
controlled. Under present law, they can be used only for a
legitimate medical purpose to promote health and safety. This
has been true since 1970, when Congress passed the Controlled
Substances Act, giving primary jurisdiction over these
narcotics and dangerous drugs to the Drug Enforcement
Administration. A lethal overdose, otherwise known as
assisted suicide, has never been considered a legitimate
medical purpose and certainly does not promote public health
and safety.
Oregon voters passed a state law to allow physician-
assisted suicide, and they had the right to do so. But they
do not have the right to change federal law. If Oregon were
to legalize the use of heroin for medicinal purposes, that
wouldn't change the federal law forbidding its use.
Last year, Attorney General Janet Reno issued a letter
carving out an exception for Oregon to use federally
controlled substances for assisted suicide, a decision in
conflict with an earlier determination by her own DEA and
with the Controlled Substances Act. The Pain Relief Promotion
Act makes clear, for the first time, that aggressive
treatment of pain is a legitimate medical purpose, and it
provides new legal protections for physicians to use these
medications to alleviate pain and discomfort. It also
restates that the use of these federally controlled drugs to
cause, or assist in causing, death is not a legitimate
medical purpose.
Don Nickles
U.S. Senator.
____
C. Everett Koop, M.D.,
Washington, DC, June 17, 1999.
Statement of C. Everett Koop, M.D. on the Pain Relief Promotion Act of
1999
I am pleased to lend my strong support to the Pain Relief
Promotion Act of 1999.
Clearly, controlled substances such as narcotics have very
legitimate and important
[[Page S11215]]
uses in modern medicine, not least in alleviating the
suffering of dying patients. Just as clearly, government has
a legitimate interest in ensuring that these substances are
never intentionally used to take a human life. Physicians
entrusted by the federal government with the privilege of
using these potentially dangerous drugs in their practice
should be the first to understand the need for laws ensuring
their proper use. Their own ethical code instructs them
always to use medications only to care, never to kill.
We should recall what the late Margaret Mead once said
about efforts to legalize euthanasia: In such a society,
patients will not know whether their physician is visiting
them in his role of healer or killer. Acceptance of assisted
suicide as a ``solution'' to the problems of dying patients
would undermine the trust that all patients must be able to
place in their physicians. It would also undermine efforts to
improve compassionate care for dying patients, as the ``quick
fix'' of assisted suicide replaces the more difficult but
vitally important tasks of controlling pain and other
symptoms and keeping company with the dying. We cannot let
this happen.
This Act strikes the right balance, by promoting the much-
needed role of federally regulated drugs for pain relief
while reaffirming that they should not be abused to assist
patients' suicides. A better understanding of the difference
between trying to kill pain and trying to kill patients will
be of great help to law enforcement authorities, to
physicians, and especially to patients themselves.
I especially applaud the sponsors for including in this
legislation a new grant program to promote improved knowledge
and practice in the field of palliative care. When medical
professionals truly learn how to ease their patients'
suffering and address their real problems during the dying
process, assisted suicide and euthanasia become irrelevant
issues. All our patients deserve skilled care of this kind,
especially when they are weakest and most vulnerable. I hope
Congress will approve this bill without delay.
____
American Medical Association,
Washington, DC, September 7, 2000.
Statement of the American Medical Association in Support of the Pain
Relief Promotion Act (PRPA)
The American Medical Association (AMA) supports H.R. 2260,
the ``Pain Relief Promotion Act'' (PRPA), as reported from
the Senate Judiciary Committee, offered by Chairman Orrin
Hatch. The new bill represents significant improvements in
addressing the continuing concerns of the physician community
regarding the proper roles of the state and federal
governments in regulating the practice of medicine.
The AMA is squarely opposed to physician-assisted suicide
and believes it is antithetical to the role of physician as
healer. The AMA strongly advocated against the Oregon public
initiative that has legalized physician-assisted suicide in
that State. In crafting an appropriate legislative response,
physicians have been deeply concerned that legislation must
recognize that aggressive treatment of pain carries with it
the potential for increased risk of death, the so-called
``double effect.'' The threat of criminal investigation and
prosecution for fully legitimate medical decisions is
unacceptable to the AMA.
As reported from the Senate Judiciary Committee, the
legislation would recognize the ``double effect'' as a
potential consequence of the legitimate and necessary use of
controlled substances in pain management, and explicitly
include this as a ``safe harbor'' provision for physicians in
the Controlled Substance Act. This is a vital element in
creating a legal environment in which physicians may
administer appropriate pain care for patients without fear of
prosecution.
The provisions of the Chairman's Substitute to H.R. 2260,
reported by the Senate Judiciary Committee on April 27, 2000,
represents substantial success in achieving the AMA's policy
goals. The AMA is pleased to endorse H.R. 2260, which now
contains significant improvements explained below.
preserves state's role in regulating physician practice
The PRPA preserves deference to state licensing boards and
professional disciplinary authority as currently exists under
the Controlled Substances Act (CSA). This bill would also
maintain the current balance of authority between state and
federal government, in which the DEA and state medical
licensing boards have overlapping authority when it comes to
physicians prescribing controlled substances.
the prpa does not create new federal authority to regulate physicians
The bill contains specific rules of construction preserving
the roles of the states and federal government in regulating
the practice of medicine. Furthermore the Attorney General is
explicitly prohibited from creating new federal standards for
pain management or palliative care; existing and developing
standards in the private sector and research community will
continue to be the gold standard.
prohibits federal guidelines or standards of care
The PRPA does not give the DEA new powers to regulate
physicians or to evaluate whether a prescribing decision is
``legitimate.'' The DEA is already authorized to evaluate
whether a physician's prescribing decision is for a
``legitimate medical purpose.'' This amendment also negates
the possibility that law enforcement might create its own
standards on pain care and clarifies that the training and
education programs would not interfere with the traditional
role of the state in regulating the practice of medicine.
the prpa will continue to foster professionally developed standards
This bill will improve pain management and palliative care
for patients by encouraging and supporting the vital research
necessary for advancing the science and art of pain
management and palliative care. While it authorizes grants
and educational activity, the Agency for Health Research and
Quality is also prohibited from creating its own standards
for pain management or palliative care.
expands scope of bill to cover pain management, as well as palliative
care
H.R. 2260 expands the scope of the bill to include all pain
management, rather than an exclusive focus on end-of-life
pain.
Again, the AMA supports the language contained in the bill
reported from the Judiciary Committee which includes
essential clarifications of the original bill, specifically
expressing the sponsors' intention to honor the existing
authority of the states to regulate legitimate medical
practice, while exercising the concurrent federal authority
to regulate the prescribing and administration of controlled
substances. The language of H.R. 2260 has been carefully
crafted to reflect this proper balance. We urge the full
Senate to pass the ``Pain Relief Promotion Act,'' as soon as
possible.
Mr. NICKLES. Mr. President, my colleague was reading a few letters.
Incidentally, he kept talking about the American Cancer Association. I
do not think they ever wrote a letter saying they were opposed to the
bill. He made it sound like they did. I do not know if they did. He has
one that is maybe questionable on the bill.
We have dozens which spent a lot of time supporting us. The National
Hospice Association, the group that takes in individuals in their later
years, particularly in the years where they are close to death,
supports this bill. So the allegations that this might have a chilling
impact is hogwash. To make an allegation that this might be offensive
to States rights is absolute hogwash. That is not correct.
We are not overturning Oregon's law. Oregon cannot overturn Federal
statute. Do we want to repeal the Federal Controlled Substances Act?
The Federal Government has been controlling these strong drugs before
that act. There was another act that passed years before, but the
Federal Controlled Substances Act is what I am amending and clarifying
that legitimate medical purposes includes pain management.
What is wrong with that? It also says assisted suicide is not a
legitimate medical purpose. Think of that. We have had a Federal
statute on the books since 1970 to control very strong drugs because we
know they are deadly, we know they are hazardous. So the Federal
Government passed a law regulating these drugs.
The State of Oregon said: Let's legalize assisted suicide, and we
will pretend that is a legitimate medical purpose. The Drug Enforcement
Administration said: No, it is not. The Attorney General wrote a letter
that it is in 49 States, but it is not in Oregon because we did not
prohibit assisted suicide.
The Controlled Substances Act says these drugs can be used for
legitimate medical purposes. It did not say anything about assisted
suicide. So the Attorney General comes up with this weird analysis:
Maybe it's not prohibited. The Drug Enforcement Administration before
her said: No, assisted suicide is not a legitimate medical purpose. The
Drug Enforcement Administration is right, and they have been the ones
enforcing this law for the last 30 years.
Oregon should live under the law just like every other State in the
Nation. In 49 States, you cannot use these drugs right now--you cannot
use them in Arkansas or in any other State in the Nation because they
are Federal controlled substances and they can only be used for
legitimate medical purposes. You cannot use the drugs in assisted
suicide except in Oregon because the Attorney General says maybe it is
OK.
The law says you can use them to alleviate pain but not assisted
suicide. We put that in the bill. I mention that to my friend from
Nevada and my friend from Oregon. It is awfully important that people
understand the substance of this legislation, and this
[[Page S11216]]
legislation would not have a chilling impact. We would not have all
these organizations from the American Medical Association to the
American Hospice Association supporting this bill.
I urge my colleagues to review the letters Senator Wyden and I have
provided to further complement their knowledge on this issue. I urge
them to review the materials we are printing in the Record, and I urge
them to support this bill.
I am proud of the fact that 40-some colleagues, maybe 38 now--maybe a
couple names were removed--support this bill; Democrats and Republicans
support this bill, including Senator Lieberman, who testified with me
on a couple of occasions on this bill. I look forward to its adoption
and enactment this year.
Mr. President, I reserve the remainder of my time.
Mr. REID addressed the Chair.
The PRESIDING OFFICER. The Senator from Nevada.
Mr. REID. Mr. President, if I could say to my Democratic colleagues,
we have a number of people who have indicated a desire to speak on this
issue prior to 3:15. And we appreciate the effort made by the Senator
from Oregon. We have Senator Lincoln, to whom we are going to yield 5
minutes; Senator Bayh, to whom we are going to yield 5 minutes; Senator
Torricelli, 10 minutes; and Senator Dorgan, 10 minutes; Senator Baucus,
10 minutes; Senator Conrad, 12 minutes.
Each minute they are not here means their portion of the share of
time will be lessened because we are next in line to speak, and there
is no one on the Republican side to speak. The time I have allocated
here will use up basically all of our time. There will, of course, be
time after the 3:15 vote where people can come and speak on any issue
they desire. But I have announced to the Senate those who have
requested time. Unless there is some other arrangement made, those who
desire to speak prior to 3:15 will not be able to do so until after
3:15.
Mr. President, I suggest the absence of a quorum and request that
time be allocated between both sides evenly.
The PRESIDING OFFICER. Without objection, it is so ordered. The clerk
will call the roll.
The legislative clerk proceeded to call the roll.
Mr. DASCHLE. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. DASCHLE. Mr. President, I hope my colleagues will come to the
floor and express themselves about this legislation. I know a number of
our colleagues have indicated an interest in being heard.
I note that it is my hope we can still get votes on both the tax bill
as well as the Commerce-State-Justice bill today. We need to move this
process along. We are now less than 2 weeks away from the election.
There is a lot of work that remains prior to the time we leave. It
seems to me we ought to be maximizing each day. That is why the
President has insisted on 24-hour continuing resolutions.
I have just had a conversation with the majority leader and noted my
interest in our effort to try to resolve these matters today so we can
move on to other outstanding issues. We talked earlier about the
importance of trying to bring some resolution to both bills.
The Commerce-State-Justice bill could be resolved, certainly, by
Monday. If we can vote on it, and move it along, I think that behooves
us and certainly accords us more of an opportunity to ensure that we
can resolve these matters at a time that would allow us to bring
closure to this whole session of Congress.
Mr. NICKLES. Will the Senator yield?
Mr. DASCHLE. I am happy to yield.
Mr. NICKLES. One, I thank my colleague from South Dakota, the
minority leader, for his statement. I think that would be a great idea.
We need to pass these conference reports, and send them to the
President. Somebody said, there is a veto threat on one or two of them,
and on Commerce-State-Justice. I think there is some work going on
right now, and some things could happen that would make it possible for
that bill to be signed.
I do not know if the President has threatened to veto the tax bill.
Regardless, we need to get these completed. It would be great if we
could get them completed today or on Monday or Tuesday, but if we could
do it today, I think it would be in the interest of all of our
colleagues. Certainly, I know Senator Stevens doesn't think it would be
humanly possible to get the Labor-HHS bill out before Tuesday, but if
we could clear everything else but for the Labor-HHS bill, that would
simplify all of our work. I think it would be a real positive thing for
our colleagues. So I would be happy to work with my friend and
colleague to try to make that happen.
Senator Stevens suggested, knowing that Labor-HHS could not be
completed until Tuesday for a vote, extending the time for the
continuing resolution until Tuesday so we do not require everyone to be
here. A lot of us will be here Saturday and Sunday and Monday. But to
be, one, respectful of religious holidays on Saturday and Sunday, and
to accommodate people's schedules, is there support on both sides to
amending the continuing resolution--and saving taxpayers some money so
we do not have to go through performance sessions--to amend the CR to
make it go through Tuesday?
Mr. DASCHLE. I will respond, if I could reclaim my time, and say that
I know the President has expressed concern on several occasions about
the tendency for those of us who serve in the Congress to leave and
then not to come back until close to the end of whatever CR timeframe
we have been allotted. I think that is the President's concern, that if
we were to go to Monday or Tuesday, most likely we probably would not
revisit these questions until Monday or Tuesday. But we can certainly
discuss the matter at greater length and attempt to see what
opportunities for real progress we are going to be making.
We are now 28 days into the new fiscal year, and we still have a lot
of work, especially on appropriations bills, that remains to be done.
So it would be my hope that we could maximize every day.
And he is right; it is very rare that we have met on Saturdays--or
Sundays, for that matter. It would not be our intention to make a
regular practice of it, but these are extraordinary circumstances,
without a doubt. I think each day should be used, with the maximum
opportunity that each day affords us, to try to resolve these issues
and get our work done. I don't like staying. I had plans this weekend
myself. I was going to go home to South Dakota. It does not appear that
is going to be possible. But I would say, certainly, if we are here we
ought to be maximizing the use of our time. I think that is what the
President intends. Certainly, we ought to attempt to do as well with
each day that remains.
I would also say that we ought to go into this with an attitude that
we are going to complete our work successfully. There is no reason why
we cannot finish C-J-S. There isn't any reason we cannot finish Labor-
HHS. There isn't any reason we can't come to an agreement on the
remaining outstanding issues.
There is very little disagreement about the need to address each of
these issues. We know we have to address education in the
appropriations bill. We know we have to address the Balanced Budget
Reform Act and the extraordinary problems that our health facilities
are facing. We know we have to face and address the issues having to do
with Commerce-State-Justice and especially immigration.
So there are a lot of issues that demand we stay and resolve them. I
think we ought to use the weekend to keep negotiating, to try to find a
way to resolve these matters, before we get well into next week.
Basically, I think the bottom line for many of us is, if we can make
these bills more fair, if we can address fairness with regard to
immigration, if we can address fairness with regard to the BBA bill and
the tax bill, if we can address fairness with regard to education and
school construction--if we can do all that in a fair and meaningful
way, we can resolve these matters and be done by the middle of next
week.
There is no reason why we should not. It seems to me we waste
opportunities by allowing Senators to leave town and expect somehow
they will come back. But I am certainly more than willing to talk about
it and see if
[[Page S11217]]
we can make the most of what days remain.
Mr. REID. Will the leader yield?
Mr. DASCHLE. I am happy to yield to the Senator from Nevada.
Mr. REID. I say to my friend, no one in the Congress has worked
harder than you have. So I know you, as much as anyone, would like to
have this session end. But I do say, in response to my friend from
Oklahoma about working the weekend--now, I am not an expert in
religion; we have a Chaplain and others to take care of our
professional aspects of religion--but I do know that even in biblical
times, when the ox was in the mire on the Sabbath, you had to help get
that animal out of the mud. I think that is what we are in now.
It may be necessary that we work on Sunday; We have so many things
left to do. I agree with the minority leader. These breaks don't have
us doing the work that we need to do. We need our attention focused on
completing Commerce-State-Justice, doing this tax bill, and doing
whatever needs to be done on bankruptcy, if, in fact, anything is going
to be done. There are a number of items we have to do. The minute we
say we are not going to do anything until Tuesday, Washington is
vacated and nothing is done.
Mr. NICKLES. Will the minority leader yield?
Mr. DASCHLE. I am happy to yield to the Senator from Oklahoma.
Mr. NICKLES. Mr. President, I compliment both my colleagues and say
that everybody who has an ox in the mire, who is working on the
appropriations bills, on BBA adjustments, or on the tax bill, ought to
stay here until we have those bills totally complete--that includes
Saturday, Sunday, and Monday--and have our colleagues come in and vote
on Monday or on Tuesday. I just don't think it behooves us to have the
entire Senate in on Saturday and Sunday. I will be here. I might be
watching the football game on Saturday. But for those people who are
directly involved in the negotiations, they need to be here, period. We
need to get these wrapped up.
I also heard my friend from South Dakota address several issues that
remain and if we give him everything he wants, we can go home. That is
not going to happen. But we might as well find out that is not going to
happen on Friday or Monday or Tuesday as have it continue. I look
forward to working with both my friends from Nevada and South Dakota on
the remaining bills. We have about four bills left--five, if you count
bankruptcy and split the appropriations. We need to finish them one way
or the other. We need to vote on them and dispose of them. I will work
with my colleagues.
I would appreciate serious consideration to assist our colleagues to
extend the CR. You mentioned the President stated he always wanted a 1-
day CR. All that is going to do is cost the taxpayers money to have the
entire Senate come back in and vote on Saturday and Sunday. We need to
have the negotiators stay here Saturday and Sunday and complete the
work.
Mr. DASCHLE. Mr. President, if I could just respond, I will probably
have to agree to disagree. I suppose you could argue that we have spent
a lot more money over the last 27 days than most of us realized in
keeping the Senate in session as long as we have. We have been in, in
large measure, because we haven't been able to complete our work. One
could argue if we would have used the days we had available to us more
effectively, we wouldn't be here today.
As to the President's insistence on trying to find compromise, I
guess this isn't a matter of whether the President gets all he wants.
This is a President who has said on numerous occasions we are making
progress in coming together. Let us keep at it. Let us try to find a
way to resolve these issues. I am not asking for everything I want, but
I don't expect the Republican leadership to get everything they want.
The essence of good compromise is give on both sides. We haven't seen
that. That is the essence of the concern we have on this side, the lack
of fairness, not only with regard to any real void in bipartisanship in
putting the tax and BBA bill together, but the consequences of having
done so without constructive engagement, consequences that led somebody
inadvertently, I assume, to leave out the minimum wage entirely, to
nullify the minimum wage for 6 months. That is what happens if this
bill passes. It is going to be nullified for 6 months. I know that that
was not intended, but that is what happens.
To reference bills as are referenced in this two-page conference
report with no real ability to read it thoughtfully, to carefully look
through it, ought to give everybody pause.
I know one of the points raised by our colleague from Alaska
regarding the appropriations bill is that he needs up to 20 hours to
read, whenever it is agreed to, the Labor-HHS bill, the last
appropriations bill to be addressed. That Labor and Education bill, if
it is read by the Senator from Alaska, will at least assure that one
Senator in this body has had a chance to read it from front to back.
Nobody had that opportunity with this bill. There was no 20-hour read
of this bill, in part because there was no bill. This is a reference to
five bills. There was no careful consideration of what went into this
legislation. Nobody knows. We are shooting entirely in the dark. We
have no appreciation of what is in this bill. What we do know is that
some things were inadvertently left out. What we do know is that when
it comes to school construction, we fall $10 billion short of what
ought to be a minimum in the commitment we make to school construction
this year.
This country has a deficit in infrastructure of $127 billion, a $127
billion backlog in school construction alone. What we have said is,
let's require the States and the school districts to come up with at
least $100 billion of that responsibility, but why not do for schools
what we do for courthouses and airports and highways. Let us help
school districts. Let us help States provide the funding mechanism that
will allow them to refurbish and rebuild and construct new schools.
That is part of the debate. That is part of this fairness question
that is at the heart of the debate regarding the tax bill. Is it fair?
That is the question. Is it fair to provide three times more in
business lunch deductions than it is school construction? That is what
this bill does. Three times more goes to business lunch deductions than
we are prepared to commit to school construction. I don't think that is
fair.
We can argue a lot about whether it is fair to give more to the top 5
percent of all taxpayers than we do the bottom 80. One can argue that
is a legitimate thing to do in public policy. But is it fair? I don't
think anybody could argue it is fair to give the top 5 percent more in
tax benefits in this bill than the bottom 80, but we are doing that.
Again, it is a question of fairness.
The question is, too, Is it fair to have two pots of money--one for
hospitals, one for clinics, one for hospice, one for all the medical
and health facilities all over this country--and say: We have a limited
amount of money to spend, and we are going to split that amount into
two pots. We are going to give a third of all the money to HMOs at the
expense of all these health facilities.
The HMOs are leaving States by the dozens. We are going to pay ransom
to those HMOs to try to keep them in the States when they have already
publicly announced they are leaving. The question is, Is it fair to
say, no, hospital administrator, no, clinic administrator, no, hospice
director, you can't have the money we are going to give to HMOs, even
though you may go bankrupt, even though you may close your doors?
That is not fair. And it is a question of fairness. It is a question
of priorities. It is a question of how we do business around here and
the fairness of excluding half the Senate as these decisions are being
made.
It is really a question of good management as well, when you leave
out the minimum wage law, when you nullify that law for 6 months
inadvertently. I think the speaker had it right. I won't use the phrase
he used. He said ``half,'' I will say ``baked.'' He said, when you
don't use the committee process, you have a half-baked process. Well,
he was right because it is half baked. This work product doesn't
deserve support. Because it doesn't deserve support, it will be vetoed.
And when it is vetoed, I hope we can come back and do it right.
I hope we can say that in the name of fairness we are going to
provide more help to health facilities, in the name of fairness we are
going to provide better
[[Page S11218]]
balance in the Tax Code, in the name of fairness we are going to do
better on school construction, in the name of fairness we are going to
allow everybody in the room as we make these very critical decisions.
Fairness dictates at least that. That is the essence of this argument.
That is why it is important. It is what we should do. It also goes to
the whole question of other things we should do. We talked about it
earlier today.
There is so much in unfinished business that we could have
addressed--unfinished business relating to the Patients' Bill of
Rights, prescription drugs, gun safety. None of those issues was
addressed. That leads, of course, to the question of how long, if we
don't address these and all the issues relating to fiscal
responsibility, can we assure that this prosperity continues?
There are two very fundamental differences in philosophy and approach
enunciated in large measure by our two Presidential candidates.
Governor Bush has articulated a particular position that, as it bears
scrutiny, begs the question: How soon will we be right back to where we
were 10 or 15 years ago?
The American Society of Actuaries answered that question yesterday.
They said--not a Democrat or anybody here in the Congress, but they
said--having scrutinized the Bush proposal, we would be back into
deficits similar to what we experienced in the 1980s by the year 2015
and that we would end the fiscal progress we have made for the last 3
years. It would be gone. If you pass the Bush tax plan, pass the Bush
Social Security plan, you are right back smack in the middle of
deficits as we were before. That is one approach. Again, as I say, that
is not our analysis; that is not our report. That report is by the
American Society of Actuaries.
Mr. President, I see that other colleagues are on the floor. I want
to respect their right to be heard as well.
I yield the floor.
The PRESIDING OFFICER. The Senator from Missouri is recognized.
Mr. BOND. Mr. President, I will yield 20 minutes to the Senator from
New Mexico, Mr. Domenici.
The PRESIDING OFFICER. The Senator from New Mexico is recognized for
20 minutes.
Mr. DOMENICI. Mr. President, this bill, H. R. 2614 contains three
important titles: A Medicare and health package to improve the
infrastructure of our health care delivery system; a tax relief package
and the small business bill.
The tax package is $295 billion over ten years. It includes:
$35 billion in small business tax relief;
$88 billion in health and long term care tax relief;
$46 billion in Pension and IRA tax relief;
$7 billion in school construction tax provisions and
$25 billion in Community Revitalization provisions.
The package also includes a repeal of the telephone tax which will
save consumers $55 billion over ten years.
I am very pleased that this bill includes an IRA Pension Security
package. At a time of unprecedented prosperity, it is a startling to
realize that most Americans have only saved about 40 percent of what
they will need for retirement.
Another frightening fact: Americans, in the aggregate, borrow more
than they save.
The pathetic truth about our tax code: Our federal income tax code is
down right hostile to savings and investment. Therapeutically, the bill
before us today is a step toward eliminating some of that hostility.
Fact: The baby boom generation is aging. Americans are living longer,
and yet, there has been no growth in pension coverage for the past 2
decades.
Half of the American work force today--70 million Americans--do not
have a 401 (k) or any kind of pension plan. The problem is much worse
for people who are small business persons. Only 19 percent of small
businesses with 25 or fewer employees have any kind of pension.
To address this dire situation Chairman Roth and the joint leadership
have developed a package of IRA and pension simplification provisions
that are excellent tax and pension policy.
The bill includes $46 billion in tax benefits for IRAs to make more
people eligible and so that they can save more in their IRAs.
The bill increases the IRA contribution limit from $2,000 to $5,000.
Contribution levels were set 20 years ago and they need to be updated.
This bill will increase the current law IRA contribution limitations
to $5,000 over three years in $1,000 increments;
Increases the income limits for contributions to Roth IRAs for joint
filers to twice the limit for single filers.
It increases the income limits for those eligible to make a rollover
from a traditional IRA to a Roth IRA to $200,000.
This bill strengthens our pension system. And its expands
opportunities for Americans to get pension coverage especially women.
As we know, women live longer than men but only 32 percent of women
have pensions as compared to 55 percent of men. This bill includes
pension catch-up provisions for workers over the age of 50. This is
accomplished through an accelerated contribution mechanism. Older
workers, especially women who return to the work force would have the
opportunity to build up their retirement nest egg more quickly. Under
this bill women who have left the work force, perhaps to be stay at
home mothers, and then reenter the workforce later in life, can
increase their pension contributions to make up for the time when they
were not in the workforce.
This legislation modernizes our pension laws to meet the work
patterns of today's more mobile workers. Defined contribution plan are
made portable so workers can move their retirement nest egg from one
type of pension plan to another as they move from job to job.
This bill allows workers to become vested in their pension plans more
quickly. The vesting period is the amount of time a worker must stay at
a job in order to take his employee and employer contributions with him
when he changes jobs. Instead of the current law vesting period of 5
years, this bill would shorten the period to 3 years. This means that
if a worker changes jobs after three years he can take his entire
pension benefit contributions with him and roll it into the pension
plan at his new job.
Small business tax relief is also provided in this bill and it is
coupled with an increase in the minimum wage. This package is similar
to an amendment I offered to the bankruptcy bill last year. It is a
sound and balanced package.
Nationwide, 1.6 million workers are paid the minimum wage. In my own
state of New Mexico, roughly 5 percent of all workers (or 40,000
citizens) are paid at or below the minimum wage. I think we should give
these workers a raise. However, it is important that we do so in a way
that generates the least amount of hardship on small business. That is
why I'm pleased that this bill will increase the minimum wage by $1.00
per hour over the next two years, bringing it to $6.15 by 2002 and
includes a package of small business tax cuts that will help small
businesses create more and better paying jobs.
I would submit that a key reason for modestly raising the minimum
wage is to ensure the continued success of the historic welfare reform
legislation passed by Congress in 1996. I would note that nationally
since the March of 1994 record high welfare caseload of almost 5.1
million families the 1996 welfare reform legislation has reduced the
number of families receiving assistance by 48 percent to about 2.7
million.
However, as we ask more and more people to get off welfare rolls and
onto employment rolls, we must have a minimum wage that reflects the
reality of the marketplace. My point is simple, if these individuals
are to continue as productive members of the workforce, we must ensure
the minimum wage at least keeps pace with inflation. For instance, in
the New Mexico the average hourly earnings of an individual working in
retail has increased by one penny over the past year.
I would also like to take a minute and briefly discuss the impact of
a minimum wage increase on New Mexico. From 1990 to 1996 the median
household income actually fell almost $5,000 to about $25,000. Let me
repeat that, the median household income in New Mexico has actually
fallen and not surprisingly the percentage of New Mexican's
[[Page S11219]]
living below the poverty level has increased fro 20.9 percent to 25.5
percent.
Sadly, New Mexico ranks near bottom nationally in terms of personal
income per capita and median household income and conversely near the
top in terms of people living below the poverty level. I do not believe
for one minute the minimum wage increase will solve all the ills facing
New Mexico, but I do believe it is a good first start.
Let me briefly describe the small business provisions included in the
bill.
Above the line deduction for health insurance expenses for families
without employer-provided coverage: Under current law corporations are
allowed to write off 100 percent of their health insurance costs, but
workers without an employer-subsidized plan get no deduction unless
they itemize and have total medical costs exceeding 7.5 percent of
their adjusted gross income.
Most middle class American's don't itemize, and of those who do, few
can meet the 7.5 percent AGI test to get any tax relief for health
insurance costs. This bill provides an above-the-line deduction
(available whether you itemized or not) for health insurance costs for
individuals whose employers do not pay for more than 50 percent of the
costs of coverage.
Under the bill, workers may deduct 25 percent of costs in 2001-2003;
35 percent in 2004 ; 65 percent in 2005 and 100 percent thereafter.
One hundred percent Self-Employed Health Insurance Deduction will
help 11 million people who are self employed.
If a person is doing business as a corporation, health insurance is
100 percent deductible. This means that the corporation can provide
health care insurance with pre-tax dollars and that makes it much less
expensive to provide benefit to employees.
This is the way it has been for a long, long time. However, in 1995,
if someone were self-employed he or she would not be allowed to deduct
health insurance costs because the law lapsed. For several years now,
Congress has been trying to increase the deduction for the self
employed.
Under the tax law currently in effect 60 percent of their health
insurance costs is deductible for the self-employed. There is no tax
policy justification for treating corporations one way and the self-
employed another.
The majority of all businesses in this country are self-employed.
These are often firms with very little cash, a good idea and talent
struggling to make a success. Once they do succeed, they are the ones
that create nearly two out of every three net new jobs. These small
firms have sustained this job creating record for more than twenty
years. Clearly, the tax code should not treat them so shabbily.
The need for the deduction is indisputable. Unincorporated business
owners experience the worst of all possible worlds in the health
insurance marketplace. Usually they can only buy an insufficient health
insurance policy for a very high price and they are denied the same
incentives and tax treatment enjoyed by incorporated, bigger
businesses. If this legislation becomes law, the self-employed will be
able to take 100 percent deduction for their health insurance costs on
their 2001 taxes. I am pleased that Congress is taking this step to
address the health insurance deductibility gap and to make it
permanent.
Total deductibility has been a top priority of the various state
small business throughout the country. In addition to tax policy
fairness and job creation, restoring the deduction for the self-
employed is important because the self-employed are one of the largest
groups of uninsured citizens in America.
In New Mexico, there are 75,000 self-employed individuals about one-
third of them take advantage of the deduction. This number does not
include farmers and ranchers who are an other group that will benefit
from the tax law change we are making today.
The self-employed do not have high level incomes. Over 75 percent of
the self-employed have incomes of less than $25,000 and an additional
13 percent have incomes between $25,000 and $50,000. Twenty-three
percent of self-employed do not have health insurance.
We have as good an economy as we're ever going to have . . . but the
number of uninsured has increased,'' said Chip Kahn, president of the
Health Insurance Association of America. ``The problem has gotten worse
in good times, which means people are very nervous about what would
happen in an economic downturn.''
This conference report increases the amount that can be expensed from
$20,000 to $35,000. Under currrent law, the amount that may be deducted
is $20,000 to 2000; $24,000 in 2001 and 2002; and $25,000 in 2003 and
thereafter. This change means an additional $15,000 tax savings for
small businesses investing in new equipment next year. Small business
people will be able create more jobs because they will be able to
expense up to $35,000 of investment in any one year. This will lower
the cost of capital, and help with cash flow. I expect that the most
likely expenditure to be expensed is computer systems. Computers are
contributing significantly to the productivity of the American work
force.
The work opportunity credit, WOTC, provides a tax credit for wages
paid to employees hired from one or more of eight targeted groups, i.e.
individuals receiving federal assistance. The credit is designed to
encourage the hiring of hard-to-place workers. The work opportunity tax
credit replaced the targeted jobs tax credit which I helped author in
the 1970's. The bill extends the WOTC through June 30, 2004.
The bill also includes a provision that allows banks to pay interest
on business checking accounts. It's about time.
Business meals are one of the few ordinary and necessary business
expenses that are not 100 percent deductible. In 1993, the Democrats
lowered the business and meal deduction from 80 percent deductible to
50 percent deductible. This bill would reverse that trend. Restoring
the deduction to 70 percent will help waiters, waitresses, busboys,
bartenders, bell hops, reservation clerks.
When the Democrats went after the deduction they said they were
targeting the three-martini lunch. But experience has shown us that
there have been many unintended consequences--consequences that we
predicted. They meant to stop the three martini lunch, but it was the
business traveler who eats his own meals, whether eaten in a hotel,
coffee shop, or restaurant, or grabbed from a food cart that got the
ax. Most of the people purchasing business meals are self-employed and
in total, 70 percent of those who purchase business meals have incomes
below $50,000 and 39 percent had incomes below $35,000.
The last major section of this tax package that I would like to talk
about is the community renewal provisions. The bill would designate 40
renewal communities, 12 of which are in rural areas. They would receive
the a 15 percent wage credit on the first $10,000 of wages paid per
worker, an additional $35,000 of expensing; deduction
for revitalization expenditures capped at $12 million per community and
a zero percent capital gains rate on qualifying assets held for more
than five years.
The bill increases the low income housing tax credit and increases
the volume cap for private activity bonds that are very useful in
attracting business.
Mr. President, I am extremely pleased this package also contains a
helping hand for our seniors. Today we are providing renewed assurances
to our seniors that Congress is committed to not only the continued
health of the Medicare program but, to improving the program.
The ``Medicare, Medicaid and SCHIP Benefits Improvements and
Protection Act of 2000'' is a victory for our seniors and I commend my
colleagues and especially Leader Lott and Chairman Roth for all of
their work on this measure. The package before us addresses the
critical needs of the Medicare+Choice program, skilled nursing
facilities, home health care, hospitals, rural health care providers,
and the Medicaid program.
I am especially pleased the package contains the ``Medicare
Geographic Fair Payment Act of 2000'' that will create a far more
equitable reimbursement system for the Medicare+Choice program. The
provision will place states on more equal footing and begin to end the
blatant discrimination against states, like New Mexico that deliver
health care in an efficient manner. It means New Mexico seniors will
[[Page S11220]]
continue to have the option of sticking with their Medicare-HMO plans
that often offer more options, like prescription drugs, than the basic
Medicare program.
Specifically, the package will increase the Medicare+Choice minimum
payment floor to $525 a month per beneficiary in 2001 for all
Metropolitan Statistical Areas, MSA's, with populations exceeding
250,000. In New Mexico, the stakes are particularly high because
without this provision 15,000 seniors will lose their Medicare+Choice
coverage on January 1, 2001.
Under the provision health care providers in the Albuquerque MSA are
currently reimbursed at $430 per beneficiary and they will now see an
increase of $95 to create partial equity with other areas of the
country. The result will be at least an additional $34 million for New
Mexico in FY2001, and at least $170 million over the next five years.
Also, the package will increase the payment floor for Rural Areas from
the current $415 to $475 in 2001.
However, the victory for seniors in New Mexico and across the country
may be very short lived because the President believes the legislation
spends too much money on the Medicare+Choice program. I am utterly
shocked and dismayed over the President's threat to veto this package.
I would simply ask the President not to treat this hard-won compromise
agreement as a political football. Too many lives will be affected on
whether this increased funding is made available to ensure continued
access to Medicare-HMO benefits, nursing home care or health insurance
for children.
The Clinton-Gore Administration is actually threatening to veto a
bill that would increase spending on Medicare and help millions of
seniors across this country. I find it very hard to believe that the
President would want to veto a bill which: increases payment for
hospitals, including teaching hospitals and rural hospitals; increases
payments for home health agencies; and increases payments for hospices
and other health care providers.
I would submit that spending money to end discriminatory practices
should never result in veto threats. There is simply no rationale for a
discrepancy of an $814 reimbursement for Staten Island and $430 for
Albuquerque. It is especially unfair given the fact that seniors pay
the same Medicare premium no matter where they live.
I am also sure Benny Maestas of Santa Fe would disagree with the
President's belief the package spends too much on the Medicare+Choice
package. I say this because the Santa Fe New Mexican newspaper ran a
story about one of these seniors--Benny Maestas. Unfortunately, Benny
will lose his prescription drug coverage next year and be forced to pay
several hundred dollars a month for his medications, instead of the $50
per month he currently pays for his prescription coverage through
Medicare+Choice.
And it is not only seniors in New Mexico that will benefit, but
seniors from all over the country. Let me name just a few of the places
that will get sizeable increases in their payment rates: Portland,
Oregon; Seattle, Washington; Fresno, California; Albany, New York;
York, Pennsylvania; Grand Rapids, Michigan; Fayetteville, Arkansas;
Buffalo, New York, and many more.
I would simply ask the Clinton-Gore Administration, which of these
cities do they not want to help?
I also want to state how pleased I am that we are once again
addressing the need of Skilled Nursing Facilities, SNFs. Our action
today will assure our senior citizens maintain continued access to
quality nursing home care through the Medicare program. I believe the
provisions supporting SNFs are particularly important because
nationally, almost eleven percent of nursing facilities in the United
States are in bankruptcy and in New Mexico the number is nothing short
of alarming, nearly fifty percent of the nursing facilities are in
bankruptcy.
I believe these provisions are especially important for rural states
like New Mexico, because many of our communities are served by a single
facility that is the only provider for many miles. If such a facility
were to close, patients in that home would be forced to move to
facilities much farther away from their families. Moreover, nursing
homes in smaller, rural communities often operate on a razor thin
bottom line and for them, the reductions in Medicare reimbursements
have been especially devastating.
Additionally, not only does the package stabilize the Medicare
program but, our seniors will be provided with new and improved
benefits. In addition to lowering out-of-pocket outpatient hospital
costs, the plan also offers new coverage for biannual pap smear
screenings and pelvic exams, medical nutrition therapy for patients
with diabetes and renal disease, and screenings for colon cancer and
glaucoma.
I am also pleased the package addresses a critical funding problem
with the State Children's Health Insurance Program, SCHIP, faced by
forty states, including New Mexico. The Medicare-Medicaid package will
allow New Mexico and other states to retain a majority of their unspent
FY 1998 and 1999 SCHIP allotments until 2002 and use a percentage of
those funds to continue outreach and enrollment activities.
New Mexico's situation arose because the Heath Care Financing
Administration strictly implemented the SCHIP program and refused
repeated requests by the state to implement additional benefits. As a
result, New Mexico has only been able to use about $3 million of its
SCHIP allocation. However, the provision in this package will allow the
state to keep about 60 percent of the $58 million it stood to lose this
year under the SCHIP program.
Mr. President, I was here for part of the discussion by the majority
leader and minority leader with reference to this bill. I think he made
a few allusions to what soon-to-be-President Bush would do. First, I
want to say about this tax bill, for those who think we don't know what
is in this bill, let me suggest that almost all of it has passed either
body, either the Senate or the House--every provision.
All of the small business provisions, which are wonderful for many
people who work for small businesses, passed the Senate. How do I know
that? It was my amendment. It was a minimum wage amendment that had on
it all the small business tax measures, one of which is earth-shaking
but so simple that I don't know how anybody could be against it. Those
who vote against this bill are saying to those people who are employees
and do not get their health insurance paid by their employer, if they
have the wherewithal to buy their own insurance, they can deduct the
cost of that insurance. Now most people listening would say they
thought that was the law all along; why would you deny that?
Businesses deduct the costs of health insurance, but individuals who
buy their own, who are employees and are not covered--which, I believe,
is millions of Americans--will begin deducting the cost of their health
insurance, just as businesses do, on their own individual returns.
Right now, they are precluded, unless they take it as the big
deduction, and then 7 percent of the money they earn has to be for
health expenses.
Let me suggest that the minimum wage is raised in two pieces. It goes
up one full dollar. That is what the President wanted. It is in this
bill. To suggest that we would vote against this bill because there is
an error in the bill regarding the effectiveness of the minimum wage is
a phony argument. That will be fixed probably before we leave. That
will probably be fixed in one of the appropriations bills. I could go
on.
Let me ask one question: What does the tax law of this land need more
than anything else? It needs provisions that tell Americans: You can
save more money for your retirement than you do today. This is probably
the most significant package ever passed to enhance the savings of
American people because the IRAs go up, and many other things they will
be using and are using will be enhanced dramatically.
The Democrats were up here arguing about retirement reform, in terms
of having the ability to accumulate more savings for retirement time.
They talk about it. This bill does it. It does it in a very good way.
Frankly, there are some things in this bill I would not favor. It is a
very large bill. This Senator remembers when we voted on a tax bill
that was brought to the Senate in a big cardboard box. That is not a
good way to do it. It happened to be a pretty good bill. But it was
brought over here by the Clerk of the House in a big cardboard box; it
was so big. It passed the Senate overwhelmingly because pieces and
parts of it had passed
[[Page S11221]]
both Houses and, more or less, everybody knew what was in it and
thought it was a good bill.
One last observation. For those on the other side who are talking
about how late we are, I want to remind those who pay attention to us
that in the last 25 years, most of which have been controlled by that
side of the aisle, we have completed our appropriations bills on time
only three times. That means every single Congress, in 22 out of 25
years, was unable to get its work done by the October 1 deadline. I
don't know why. I seek to change that. I seek to make appropriations 2
years and budgets 2 years. That might mean this won't happen in the
future. But even that is hard to get passed.
So to those who think it is management and it is our Republican
leader, let me say I think he has done an outstanding job. There has
never been a more political time in the closure of a Congress in my 28
years here. The White House is playing politics to the hilt, the
Democrats are playing politics to the hilt, and then they blame
Republicans for not getting it done.
I believe the agenda to finish is an agenda that the Republican
leader has in mind, and if we just get a little cooperation out of the
President, we will get our job done. If he sits down there like a
dictator instead of understanding that under the Constitution of the
United States we have a very powerful right, and that is the purse
strings and the bills under the purse strings of America--he comes at
the end of the session and he wants all kinds of things, such as a
major new immigration law. I might support it, but it obviously needs
hearings and it ought to be worked on.
Now we are being told if you don't do that, you can't get the
appropriations bill to keep the Justice Department open and the FBI
salaries. Maybe we ought to test the President on that one. Maybe he
ought to be permitted to veto the bill that pays the FBI, and other law
enforcement, and the judges because he doesn't get one thing--just one
item--on the bill he wants. That item may be one he is looking at out
there and saying, let me be political and see if I can help Vice
President Gore in his campaign.
I want to also suggest that the President of the United States is
going to be vetoing this bill when it goes down to him, in spite of the
fact that there are some real Medicare changes that help seniors across
this land. I believe we have made the case that HMO Plus is a good
program in States such as New Mexico, Oregon, Washington, Minnesota,
and literally scores of cities across America. Why? Because the senior
citizen is getting more than he gets when he goes to the Federal
Government for Medicare. In many cases, they are getting prescription
drugs, which we are arguing about giving them, too. They already get it
under HMOs in some parts of America.
I want to talk about New Mexico.
New Mexico is one of those States that has been discriminated against
in the Medicare+Choice reimbursement. We were receiving such a small
amount that the HMOs are saying they cannot exist. And they have
already told thousands of senior citizens in New Mexico that by January
1 they cancel out. That is because we have never had an adequate
reimbursement. Why? Because when we passed the law, it gave the States
essentially what is was costing them. In New Mexico, Minnesota, Oregon,
Washington, and scores of other places the cost of health care was very
cheap. So they gave us a very low rate of reimbursement while other
parts of America got very large ones.
To put it into perspective, in New Mexico the HMOs were getting
reimbursed at $430 per senior, while in parts of New York they were
getting $814.
We are asking that this discrimination stop, and the thousands of
people in New Mexico who have HMOs that perhaps give them prescription
drugs ask that you sign this bill so they can continue to have that
kind of care and that kind of protection.
If it is vetoed, Mr. President, come January 1, in my State, everyone
who is going to be denied their current coverage, which they think is
very good coverage, can look to this White House and this President for
saying: I will not sign that bill--even though it has many provisions
the President likes. But he says the HMOs cost too much. He says the
HMOs are big businesses.
Let me tell you, in my State, the three that deliver coverage are
known as Presbyterian hospitals--two are the St. Joseph's Hospital Plan
and the Lovelace Plan. None of them are profit making, as I understand
it. Two are charitable, and one is a foundation of sorts.
So, Mr. President, veto the bill. Say to the seniors in New Mexico
who are currently covered that we don't know what is going to happen to
them on January 1.
There are many other provisions in this bill, contrary to what the
minority leader said, on the Medicaid side that are very good for
hospitals and very good for rural hospitals. I am not an expert on it.
But this bill provides $31 billion in the first 5 years for Medicare
reimbursement adjustments.
My friend is sitting here. Is it 31 over 10 or over 5?
Mr. GRAMM. It is over 5.
Mr. DOMENICI. How can the President of the United States say he is
going to veto the bill because of the Medicare provisions?
Actually, everyone knows that nursing homes need additional
reimbursement. That is in this bill.
I could go on with each one of them.
I believe what is happening is that politics is walking up from
Pennsylvania Avenue into the Chambers of the House and Senate, and
politics from the White House is saying: You give me everything I want
or you do not get the bills completed. And then the White House can
say: You didn't do your work. You didn't get your work done.
Let me say we will get our work done.
Mr. President, you just consider the compromise with us on some of
these. This is a good bill for the American people. I might like to do
it differently. In fact, if this bill is vetoed next year, we will do
it a lot differently. But for now, Mr. President, you cannot get
everything you want in this kind of bill.
This one is not our President in the Senate. This is the President at
the other end of Pennsylvania Avenue. That President, not our President
here. You can't get everything you want, and when you don't get it,
blame the Republicans for ``not completing their work.''
I want to repeat one more time that the Republicans have tried to
lead this Senate and get its work done. For those on the other side of
the aisle who complain about not getting our work done, if you look
back at the record, it has been the Democrats on that side of the aisle
who have been insisting on their agenda all year long. They get a vote
on guns; they want another one on an appropriations bill, or the next
bill that comes through. They even held up the education bill because
of guns.
That is the record.
The education bill that everyone touted was held up by the other side
of the aisle who wanted their agenda of amendments on that bill.
I think our leader did the right thing. He wouldn't let them, after
they had their vote once.
So what happened? We don't get the bill. Who is to blame?
It appears to me that what we ought to do right now is sit down
together and get this work done. And Democrats ought to tell the
President of the United States, instead of concurring with him every
time and saying they are with him and to go ahead and veto the bill,
they ought to say to him: Mr. President, we have done a very good job
in the closing moments to try to get our work done, and you ought to
help us, President Bill Clinton, get our work done instead of
threatening us.
In fact, I am wondering about this business over the weekend with 1-
day extensions of the appropriations process that has not been
completed--1 day at a time. It is as if the President doesn't care
anything about our leadership and what we think we ought to do. We have
to come back every day to vote on a continuing resolution.
I have been here a long time--28 years. I have never seen a President
do that. As a matter of fact, I have never seen a President use
continuing resolutions to get their way as this President has. They
just didn't do it in the past.
It was kind of a sacred thing to sign appropriations bills and get
them done.
This President is on the way out. He is very desirous of electing
Vice President Gore. And we all understand that. But everybody knows
that the Justice
[[Page S11222]]
Department of the United States ought to get its money, the FBI ought
to get paid, and all of those entities that are part of our criminal
justice ought to get paid. They ought not be held up for one provision
that is really extraneous to that bill because this is an
appropriations bill. There is an authorizing bill the President wants
on immigration. So the whole bill will die.
If they want to talk about who is to blame, then I submit to
Pennsylvania Avenue that it ought to be a two-way street. It ought not
get down to the end where it is a one-way street or one or two or three
provisions that the President insists upon. We are close to completing
the people's business, one or two or three provisions that the
President of the United States insists upon that we have offered
compromises on, and he says that or nothing.
The PRESIDING OFFICER. The Senator from Nevada.
Mr. REID. Mr. President, on behalf of the minority, I yield 5 minutes
to the Senator from North Dakota. The Senator from New Mexico used 20
minutes. We will just use 15 minutes now.
Mr. BOND. Mr. President, if you are asking, we are happy to yield 5
minutes. But the minority leader consumed a great amount of time. We
had people waiting. We would prefer to continue to go back and forth,
if the Senator does not mind.
Mr. REID. I think the time the minority leader used is almost
identical to what the chairman of the Budget Committee used.
Mr. BOND. Mr. President, what is the time remaining on both sides?
The PRESIDING OFFICER. The majority has 54 minutes. The minority has
33 minutes.
Mr. REID. I hate to admit this, but you are right. We will do that.
How long is the next speaker going to take?
Mr. GRAMM. Mr. President, I would be very happy to listen to Senator
Dorgan. I will learn something.
Mr. REID. I don't think that is possible. But would you think you
would mind listening to Senator Torricelli also for a total of 10
minutes?
Mr. GRAMM. Why don't we do Senator Dorgan, and I will speak. I think
I have 20 minutes reserved.
Mr. BOND. Seriously, Mr. President, we are very tight on time and
would like to be able to continue to go back and forth. Many of our
Members are waiting.
Mr. REID. It will balance out the time. I understand. As I said, I
hated to acknowledge that, but you were right.
Mr. BOND. That is a rare occasion. That should be noted with bugles.
Mr. REID. The minority yields 5 minutes to the Senator from Arkansas,
Mrs. Lincoln.
The PRESIDING OFFICER. The Senator from Arkansas is recognized for 5
minutes.
Mrs. LINCOLN. Thank you, Mr. President. I thank my colleagues for
yielding.
In listening to the chairman of the Budget Committee, he has been
willing to work with me and I truly appreciate that. I thank him for
his graciousness in working with me. But in his comments, I would like
to say, for me and for others, that this is really more of a missed
opportunity. So much has been talked about in the Presidential debates
about bipartisanship.
I think all that many are asking for in this process is an
opportunity to do exactly what the people of Arkansas elected me to do.
That is to come into this debate with the ideas and the issues and
concerns of the people of Arkansas. It is a missed opportunity for
Members to be able to express how we feel about these issues in this
bill.
The people of Arkansas sent me to this Senate to represent them and
their issues. When the President comes from the White House to debate
on these issues, I am not in that room nor are any of my Democratic
colleagues. We have missed the opportunity to very passionately
represent the people who have sent us to this body to speak up on their
very behalf.
There are some good pieces in this bill. I am not here to say the
other side doesn't know anything or that they haven't done anything
right. All I am here to say is that the people who elected me to come
to this body have been shortchanged because I have not been allowed a
part of that process.
Mind you, I know I am on the bottom of the totem pole. I am not one
of the higher muckety-mucks. The fact is, so many of the issues we hear
are good for certain States; perhaps they are not good for our State.
When we talk about Medicare+Choice in a State such as Arkansas that is
predominantly rural, where Medicare Choice has pulled out in some
instances and left seniors without coverage, we are going to give one-
third of the funds in this bill directly to HMOs without any assurances
from those groups that they will even stay in the Medicare program. Nor
are there assurances that the HMOs will return to counties where they
have already pulled out or will maintain the benefits they promised to
seniors. We cannot in good conscience give this large sum to HMOs
without providing accountability. If the other side believes that is
the way to go, provide me the assurances that those HMOs are going to
be willing to come back into those areas where they have already pulled
out.
Meanwhile, in most of the other provisions that are so necessary to
other providers in our States, the bill receives only 1-year fixes for
the funding shortfalls.
This is a missed opportunity. No, it is not perfect. But it could be
so much better for so many people across this Nation. It is our duty to
stay here until we make it the best it can possibly be.
I support many of the provisions in the tax bill brought to the
floor. However, there are problems with the bill, and being able to
provide something that is the best that we can possibly provide for all
individuals out there is our responsibility. I am willing to stay here,
Mr. President, as long as it takes, to do what is right for the
American people.
We deserve to discuss the merits of the school construction
provisions in this bill. I want to do more for school construction in
our country. Our schools, especially in the South, are crumbling around
our students. The school construction provisions in this bill don't go
far enough. If Democrats were allowed in that debate on this issue,
perhaps we could bring these provisions closer to what we really need
to do.
What we really do need is something similar to what Senator Chuck
Robb has proposed in his school construction bill. But the fact is we
haven't been at the table. We feel as passionately about representing
the people in our States as our Republican counterparts do. All we have
simply been asking is to be at the table.
And I also heard the majority leader say that he was willing to work
on Senator Landrieu's adoption language. Well, was she invited to the
table? Did he ask her what would be acceptable to her? There is no one
more dedicated to this issue than Senator Landrieu, and she should be
involved in this discussion. When exactly will she be consulted? When
they call her name during the roll call vote?
I have been particularly frustrated that the Medicare BBA relief
provisions in this bill ignore the real bipartisan solutions that have
been worked out between me and many of my colleagues throughout the
year. I joined my Republican colleagues in a press conference the other
day on a crucial bill, the Hospital Preservation Act of 2000, a bill in
the Senate that has the support of 59 bipartisan cosponsors but it is
left out of this package. This bill would restore full inflationary
updates in Medicare hospital payments and is supported by hospitals
across the country.
Another bipartisan bill is also left out of this package. The Home
Health Payment Fairness Act of 2000, which has the support of 54
bipartisan cosponsors, would eliminate the 15 percent reduction in
payment rates for home health services. This provision is very
important to home health agencies in Arkansas and across the nation.
But the bill we are considering here merely delays this devastating
cut for one year. This is not a long-term solution. Why spend time on
short-term fixes when we could correct this problem right now? We
delayed this cut last year for one year, and here we are again, in the
same boat. Let's fix this now. It makes no sense to keep postponing
these real solutions year after year and leave our health care
providers without the ability to plan their budgets for the long-term.
The bottom line is, this is a missed opportunity. The bottom line is
that we have been spending well over our surpluses while we haven't
provided for the essentials, predominantly the downpayment on our debt.
[[Page S11223]]
The PRESIDING OFFICER. The Senator from Texas.
Mr. GRAMM. Mr. President, there are two issues I wish to talk about
and they are related to the two bills that are before the Senate. Let
me begin with the Commerce-Justice-State appropriations bill.
As my colleagues are aware, we currently have a situation--Senator
Domenici has been here longer than I have--that I don't ever remember.
A President is threatening to veto a bill based on an issue other than
what is in the bill. Obviously, there have been many vetoes as part of
our constitutional process. But normally when we are dealing with an
appropriations bill, it has to do with funding or not funding various
priorities.
What we have before the Senate is an extraordinary circumstance where
the President of the United States is literally threatening to veto
this bill, saying if we don't add a totally extraneous matter that has
nothing whatever to do with funding the law enforcement effort in
America, then he is going to veto the bill appropriating funds for the
criminal justice system and law enforcement in America.
What is even a greater paradox, in my opinion--I have to say, in my
period of public life I have never seen anything like it--the President
is saying, if we don't grant amnesty to people who violated the law, he
will veto a bill that funds DEA, the FBI, the Justice Department, the
prison system. He is literally threatening if we don't pass a law
forgiving people who violated the law by coming into this country
illegally, if we don't grant them amnesty and therefore forgiveness for
having violated the law, his threat to us is that he is going to risk
shutting down the FBI, the DEA, the criminal justice system, the
courts, and the prisons.
That is an extraordinary threat. It is a threat that, I am happy to
say, is opposed on a bipartisan basis by at least one Democrat who
happens to be the ranking Democrat on the Appropriations Committee. It
is opposed very strongly by many Republicans.
I want to say on this bill to our President, I want him to sign the
bill funding our drug enforcement effort, the FBI, the prison system,
our criminal justice system, our courts. I want to urge the President
to do that, but I want to make it clear to him there is at least one
Member of the Senate who is never going to grant amnesty for illegal
aliens to pay a political bribe to the President. That is what this
issue is about. This is about electioneering, where the President is
putting politics in front of people. He is willing to play politics
with law enforcement and the criminal justice system, to try to
pressure us to grant amnesty for law breakers.
I despair of trying to reason with the President in the waning hours
of his administration, but I say again to the extent that any one
Member can influence this decision, we will not grant amnesty to
illegal aliens in this Congress or, hopefully, ever again. We did that
once. Everybody said it was a one-time deal. We were never going to do
it again. The problem with doing it was we reward people who violated
the law. We reward people who came into the country illegally. Granting
amnesty to people who broke the law penalizes the millions of people
who are waiting to come to America legally. What we have proposed, and
what is in the bill before us, is a provision which I believe is
strongly supported by the vast majority of Americans. That provision
basically says if you came to America legally, if you played by the
rules, if you have been self-supporting while you are here, we will
expedite the process to allow you to bring your spouse and your
dependent children. We are for family unification.
The President, by vetoing this bill, will be denying family
unification.
We also say, where there is a legal dispute, a legitimate dispute as
to whether people have gotten justice through the courts based on
recent court rulings, we give them their day in court because we
believe in due process.
I do not need to say any more about this issue other than to simply
say I hope the President will sign this bill. I know he probably
believes he is going to force us to grant amnesty to illegal aliens in
return for funding the DEA and the FBI, but I want to tell him I am not
going to support it, I am going to oppose it vigorously. There are many
Members of the Senate, I believe, who share my views. The President may
win it, but he is not going to win it without one big terrific fight.
In the end, I think nobody benefits from that kind of politics as
usual.
I want to now say something about the tax bill that is before us. I
would have to say it is pretty extraordinary that the President picked
out and attacked as a rich person's provision the one provision in this
bill that I would have thought was absolutely unassailable. In fact,
our President can say things with a straight face that Shakespeare's
Richard III would blush in saying.
That is a strong statement, but let me give an example. As I am sure
everybody in this chamber knows, the general pattern in America is, if
you have a good job, if you are making good wages, part of your
employment package is health insurance. I have the standard Blue Cross/
Blue Shield policy. People who work for the Government are blessed with
good health insurance. People who make high wages in America get their
health insurance through their job.
One of the good things in this tax bill is that we think it is wrong
that, if the Federal Government helps buy me health insurance, it is
tax deductible; if General Motors buys health insurance for its
employees, it is tax deductible; but if somebody makes a low wage and
their company does not provide health insurance, they have to buy their
health insurance with after-tax dollars, they get no deduction.
In what I think is excellent public policy in this bill, we make
health insurance tax deductible for everybody: For the self-employed,
for the small business person, and for the person who is working at $7
an hour and who is not provided health insurance where they work.
You would think that would be pretty unassailable, but it is not
unassailable by Bill Clinton, because this morning on the radio, Bill
Clinton, through his spokesman, was saying that we are giving health
benefits to rich people by providing deductibility for health
insurance. I ask my colleagues, do you know any rich people who do not
get health insurance through their jobs? Do you know any rich people
who do not get health insurance by being members of corporate boards?
The point is, this is a bill, at least in this provision, that is
targeted precisely at moderate-income people who get cheated in the
system because their employer cannot afford to buy them health
insurance and they have to buy it with after-tax dollars. That would
seem to me to be an unassailable position. But to Bill Clinton, it is
helping rich people and he is not for it.
The plain truth is, any tax cut in Bill Clinton's mind helps rich
people, so he is not for it.
Mr. DOMENICI. Will the Senator yield for a question?
Mr. GRAMM. I will be happy to yield.
Mr. DOMENICI. Would you explain ``after-tax dollars''? Since you are
talking about millions of Americans who might buy their own insurance
and get nothing today by way of tax relief, how will that work?
Mr. GRAMM. Let me tell you how it works. Let me take two individuals.
Let's say one works for General Motors and one works at the Exxon
station in College Station. The one who works for General Motors gets
health insurance as part of his employment contract. General Motors
provides health insurance and it is a nontaxable benefit to the
employee. So, in essence, the employee who works for General Motors
gets health insurance and the company can deduct from its taxable
income the cost of buying the insurance.
Joe Brown, who works at the Exxon station changing tires, may work
for a small, independent filling station operator who cannot afford to
buy health insurance for the employees at the station. So for Joe Brown
to get health insurance, he has to earn income, he has to take what is
left after the Government takes its share and then, with after-tax
dollars, he has to buy health insurance for him and his family and he
gets no deduction for the cost of his insurance.
What does it mean? It means if you are a high-income worker and you
work for a company that provides health insurance, the company gets a
[[Page S11224]]
tax break but if you are a low-income wage earner who has to buy his
health insurance himself, you don't get the tax break. We think that is
wrong. What this bill does, in its best provision, is it treats
everybody the same and says Joe Brown can buy health insurance with
pretax dollars, just as General Motors can. It is expensive because we
have a lot of Americans, moderate-income people, who are now buying
health insurance with after-tax dollars. We think it is a question of
fairness. So we fix it in the bill.
What does President Clinton say? ``This is a provision that is
helping rich people.'' I just simply pose the question: Do you know any
rich person who does not get health insurance through his or her job? I
do not know any. I have never met a poor person--excuse me--a rich
person like that; I have met plenty of poor people who do not get
health insurance through their jobs--but I have never met any high-
income person who did not have health insurance through his or her job.
How the President can stand up with a straight face and say this
provision is for rich people, I do not understand. I also do not
understand why the Washington Post and other people in the media write
it in the paper, as if it were believable, that somehow people who buy
their own health insurance because they do not get it through their
job--principally low-income or moderate-income people--are suddenly
rich merely because we are trying to treat them like everybody else.
Let me make one final comment about the tax bill before I run out of
time. Our dear colleague from Nebraska, Senator Kerrey--Democrat, for
anyone who was not here listening--remarked that this did not look like
a Republican tax bill. In fact, he wondered what we were doing with a
tax bill that looks like a grab bag of 300 different parts. Let me say,
to be bipartisan today, he is absolutely right. But why do we have a
tax bill that looks like a 300-part grab bag with one little provision
here and one little provision there? It doesn't sound very Republican.
Repeal the marriage penalty, repeal the death tax, cut rates across the
board is what we want to do.
We have the bill we have because we have the President we have. This
was the only bill we had any chance of getting him to sign. He's vetoed
the others.
The President is threatening, and apparently being supported by
Members of his party in Congress, that he is going to veto this bill.
Let me say to my colleagues, and say to the President, have at it.
The bad news is that Bill Clinton is going to veto this bill. The
good news is he is not going to be President next year. The good news
is we are going to have a President, I believe, who will sign a repeal
of the marriage penalty, a repeal of the death tax, and cut rates
across-the-board. And that is what we are really for.
So, Mr. President--and I am talking to the President downtown--we
wrote this bill because we thought this was what we had to do to get
you to sign it. But if you do not want to sign it, veto it. I will vote
to sustain your veto. I am going to be here next year. And next year we
will write a much better bill than this bill. This is like the threat--
the President reminds me of the guy who is holding a gun to his head
and saying: Do what I say, or I will shoot.
``If you do not legalize criminal activity, I am going to shut down
the FBI,'' he says. If we don't take this tax cut bill and write it his
way, adding more and more of his provisions and fewer things that we
are for, he says he is going to veto it.
I say: Look, free country. Bill Clinton is President. We tried to
write a bill we thought would help America that he might sign, but this
is not our bill. This is not our agenda. This does not represent our
philosophy. If the President wants to sign it, great. If he wants to
veto it, veto it. But remember this. There is not going to be another
tax bill. If the President wants to veto this tax bill, this is going
to be the last tax bill this year because we are going to be back here
next year, we will have a new President next year, and we will produce
a better product.
Mr. DOMENICI. Will the Senator yield?
Mr. GRAMM. I will be happy to yield.
Mr. DOMENICI. Mr. President, before Senator Gramm leaves the floor, I
thank him for this aspect of the bill that helps every senior in New
Mexico and across this Nation, 1.6 million, who have HMO Choice Plus.
In this bill, we have provided new reimbursement, increased
reimbursement to those areas of the United States that were not getting
enough money to stay in business. Can the Senator comment on whether he
thinks that is good policy based upon choice and other things?
Mr. GRAMM. I will comment on it in two ways. First, it amazes me that
HMOs are the President's favorite whipping boy today. In 1993, you
remember he wanted to put every American in a giant Government-run HMO.
The President is not complaining about how much we reimburse HMOs in
New York when they are reimbursed twice as much as what they are
reimbursed in New Mexico. I wonder why he is not doing that. He says
there is something wrong with us trying to help competitive medicine
stay in business in rural areas and in States such as New Mexico and in
the nonurban areas of States such as Texas.
Again, if you listen to the President, it sounds as if he is unhappy
that HMOs are getting all this money, but he is not unhappy that the
HMOs in New York are being reimbursed at two times the rate of the same
HMOs providing the same services in New Mexico. I think what he is
saying would have credibility if he were talking about the ones that
have high reimbursements.
If we were raising reimbursement in New York, he might have a
legitimate criticism, but what he is basically saying is we did not
spend the money the way he wanted it spent.
Our President still does not understand that we have a system of
government where we do not serve under the President. We serve with the
President. We are a coequal branch of Government, and that means give
and take and compromise. It does not mean he can dictate to us. It does
not mean that the President is King and he can tell us what to do.
This threat that he is going to shut down the FBI and the DEA and the
court system if we do not grant amnesty to lawbreakers I think, quite
frankly, is an outrageous threat, and I am ready to call his hand on
it. It needs to be stopped. I do not think we should encourage any
President, Democrat or Republican, to think they can just simply say if
you do not take totally extraneous legislation--it does not even have
to do with spending money--and put it in this bill, I am going to veto
the bill if you do not do that.
Mr. BYRD. Will the Senator yield?
Mr. GRAMM. I will be happy to yield.
Mr. BYRD. Mr. President, I have been involved in some discussions
concerning one of the appropriations bills that remains to be acted on.
I was listening to the debate here. I find that we are discussing, are
we, the amnesty provision?
Mr. GRAMM. Yes.
Mr. BYRD. I would like to have a few minutes to talk on that.
Mr. GRAMM. I ask unanimous consent that the Senator have as long as
he would like.
Mr. CRAIG. Reserving the right to object.
Mr. BOND. Reserving the right to object.
Mr. GRAMM. I give him the remainder of my time, if I can.
Mr. CRAIG. Reserving the right to object, I certainly will not object
as long as we conform to the 3:15 p.m. vote time. Rearranging the time
that remains between now and then is certainly the prerogative of the
manager. I just want to secure that time for the vote under the
original UC.
Mr. REID. As I understand the request of my friend from West
Virginia, he is going to use the remaining time of the Senator
from Texas, which is how much?
The PRESIDING OFFICER. One minute 10 seconds.
Mr. REID. I don't think that will do the trick for Senator Byrd.
Mr. GRAMM. Why don't you give him 5 minutes and then he will have 6?
Mr. REID. I have already explained to the ranking member of the
Appropriations Committee, our former leader, that I have allocated all
of our time. We do not have time left. I have explained it to him. He
is not just asking now. It is not as if we are denying something to
which he is not entitled.
[[Page S11225]]
He certainly is. He is going to speak on a provision most of us over
here like.
Mr. GRAMM. Do not run my time. Let me give the time I do have to
Senator Byrd.
Mr. BYRD. Mr. President, if the Senator only has that much time, I do
not want to take his time.
Mr. GRAMM. I would like him to take that time.
Mr. BYRD. No, that will not be enough. Let me say, it is nobody's
fault but mine. I could not help being in the appropriations meeting. I
have been over to the House side twice, and both times the House
Members were not ready, not ready to sit down and discuss it. We are
talking about the Labor-HHS appropriations bill. I am not complaining,
not blaming anybody.
The PRESIDING OFFICER. The time of the Senator from Texas has
expired. Who yields time?
Mr. REID. I yield 5 minutes to the Senator from New Jersey, Mr.
Torricelli.
Mr. BYRD. Will the Senator yield to me without his losing any of his
time?
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. TORRICELLI. I will be happy to yield.
Mr. BOND. Mr. President, we have all the time committed on our side.
I have some time. I can give Senator Byrd 1 minute of my time, but we
have people who are waiting to speak on our side as well.
Mr. BYRD. Mr. President, I need 15 minutes. I do not know why we have
to be out at 3:15.
Mr. REID. I say to my friend from West Virginia, based upon the
compromise we originally had to vote at 3:30, a number of people have
airplanes to catch. One of them, for example, has to introduce the
former Prime Minister of Great Britain. They have planes to catch.
Mr. BYRD. OK. As I say, I blame nobody. I am not complaining, except
I think this is cramping us a little bit. I am going to vote against
this amnesty provision. I would like to speak a little on it. Maybe I
will not be able to. At some point today, I will be able to speak, I am
sure of that.
The PRESIDING OFFICER. The Senator from New Jersey.
Mr. TORRICELLI. Mr. President, I hope my friend from West Virginia
knows that had I had the time, I would have been happy to yield to him.
I did not have it.
I rise in opposition to the conference report and, unlike some of my
colleagues, I am not citing broad policy reasons or enormous
constituencies, but for a fight I have waged for almost 3 years, and
that is for 17,000 Americans who are going to die, are certain to die,
will be dead within a matter of 2 years. They are ALS patients. They
have Lou Gehrig's disease, and they are the victims of an unintended
consequence.
Under Medicare rules, there is a 24-month waiting period from the
time of diagnosis. Uniquely, with Lou Gehrig's disease, diagnosis is
difficult. Sometimes there is only a simple muscle pain for up to a
year, and then at the time of diagnosis, life expectancy is only 2 to 3
years. So people facing the certainty of death and medical bills of
$200,000 a year are unable to get a dollar, a dime, a penny of Medicare
assistance while they are losing their lives.
This was no one's intention. It is a mistake. It is an error, and it
should be changed.
Earlier in the year, this Senate unanimously adopted my legislation
to exempt ALS patients from Medicare's regulations.
Twenty-eight Senators have cosponsored the bill.
Yet in this conference report, despite strong support from the White
House and this Senate on a bipartisan basis, the conference report
eliminates the provision and asks for a study--a study.
The Congressional Research Office has already done a study. I will
tell you the study. When I introduced this bill, I stood with ALS
patients outside the Capitol. Almost every one of them is now dead.
They lost their lives waiting for Medicare, and they never got it.
I will tell you the results of the study. There are now 17,000 people
in the country who need this same 24-month exemption. If we return here
next year to argue this again, half of them will be dead, and they
never will have received any Medicare assistance.
My request is very simple. And I ask the support of the Republican
leadership, as I have received the support of my leadership and of the
White House: Give us a 24-month exemption so that these desperate
people can get this assistance and their families, in addition to
losing someone they love--a parent, a husband, a spouse--also do not
have to deal with this enormous financial responsibility.
It is a small and unique class of citizens. There is virtually no
other disease in the Nation with quite the same circumstances--for
which there is no cure, little treatment, and a certainty of death
within the 24-month period.
There are desperate people across this country who thought when the
Senate acted earlier in the year, they would at least have this relief.
I believe they had reason to believe, given the bipartisan support, and
White House support, when the conference report was written, this would
happen. Tragically, the conference report does not contain this relief.
I cannot imagine anything more cruel to these families.
This has to happen. This simply must be done. I ask, again, that if
this conference report does not become law, and it is changed again,
that these victims of ALS have this numerically and financially
insignificant but personally overwhelmingly important relief from the
Medicare rules.
Mr. President, I thank the distinguished minority whip for the time
and I yield the floor.
The PRESIDING OFFICER (Mr. Voinovich). The Senator from Missouri.
Mr. BOND. Mr. President, I yield 5 minutes to the distinguished
Senator from New Hampshire.
The PRESIDING OFFICER. The Senator from New Hampshire.
Mr. GREGG. Mr. President, I thank the Senator from Missouri for his
courtesy, and also the Senator from Idaho for his courtesy.
I want to speak today, just quickly, in response to the press
conference which the President held in the Rose Garden approximately an
hour and a half ago. The tenor of the press conference was that the
Commerce-State-Justice bill will be vetoed because the White House had
not been allowed to participate in the negotiations on how the bill was
put together.
I chair the Subcommittee on Commerce-State-Justice appropriations. I
have to say that I believe the President's statement is an inaccuracy
of the most egregious level. The fact is, the White House, myself,
Congressman Rogers, along with Senator Hollings and Congressman
Serrano, representing the ranking membership on the committee,
negotiated with the White House for many hours relative to the
Commerce-State-Justice bill.
The bill that was produced was agreed to in almost all aspects except
on issues of extraneous language that had never been in either bill,
that language was authorizing language dealing with immigration--the
NACARA language, as it has come to be known. This was language that had
nothing to do with the appropriations bill. It was authorizing on an
appropriations bill. It has not been acted on in either committee. It
was, therefore, not relevant, appropriate, and would not be germane to
the bill under our rules. However, the White House wanted action on
that language.
As to the appropriations bill, his representation that the
appropriations bill was in some way done in a back room without White
House participation is totally fallacious. The fact is, the White House
was there at the table, negotiating. And because of the White House's
insistence on certain changes, this bill was changed. The White House
asked for an additional $700 million. We agreed to it. We agreed to
fully fund peacekeeping. We agreed to fully fund the COPS Program. We
agreed to a number of funding increases which the White House demanded,
as a matter of good faith, to move along this piece of legislation
which is so critical to the operation of our Government.
Specifically, this bill, as has been mentioned before on this floor,
represents the funding for almost all law enforcement activities at the
Federal level. The FBI, the Drug Enforcement Administration, the Border
Patrol, the Federal marshals, the U.S. attorneys, the U.S. court
system--all of these agencies require funding. All of these agencies
need the funding in this bill to
[[Page S11226]]
operate effectively in our law enforcement community.
This bill also funds the State Department, the other Commerce
Department agencies, and agencies such as the SBA, the FTC, the FCC,
and the SEC, fairly significant agencies in our Government which need
to operate.
For the President to claim that he has not been a participant in
developing this bill is absolutely inaccurate. It is an inaccuracy of
the worst sort because it is totally inconsistent with the facts as
they occurred.
They participated. We changed the bill to meet their desires, except
in one area, the area of NACARA, which, by the way, has nothing to do
with an appropriations bill. This type of legislation should be taken
up on some other bill, and by the Judiciary Committee where the
jurisdiction actually lies.
This bill, I am sure, will be vetoed because the President has
promised to do so. The Administration will throw up a lot of other
issues, but those issues were essentially settled--questions such as
Amy Boyer's law. We accepted the two major items they wanted; on issues
such as tobacco. We essentially said: We will no longer try to take
congressional control over how money is distributed to the Justice
Department. You have $350 million to do with whatever you want, within
the Justice Department, and in the area of litigation. You certainly do
not need another $7 or $12 million earmarked to tobacco litigation.
They have plenty of money for tobacco.
Those issues are red herrings and would not be in play at all except
for this extraneous issue of NACARA. The President has once again used
his bully pulpit to mislead the American public on this specific issue,
which is the question of whether or not the White House played a role
in developing the Commerce-State-Justice appropriations bill. The White
House not only played a role, they had a significant impact.
I appreciate the courtesy of the Senator from Missouri.
I yield the floor.
Mr. REID addressed the Chair.
The PRESIDING OFFICER. The Senator from Nevada.
Mr. REID. Mr. President, I yield 5 minutes to the Senator from North
Dakota.
The PRESIDING OFFICER. The Senator from North Dakota.
Mr. DORGAN. Mr. President, I thank my colleague from Nevada.
It is always interesting to me to watch how a legislative session
ends. None has ended, in my judgment, with less elegance and grace than
this one. It is now 26 days past October 1st. That is the date on which
we were to have passed appropriations bills and sent them to the
President.
On the desk in front of all of us is the Calendar of Business, which
says that it is Friday, October 27. The legislative day is September
22.
I just want to remind everyone why it says that, what we have on the
floor of the Senate, and why some people are chafing about where we
find ourselves.
What does September 22 mean? That is the day that a motion was filed,
a motion to proceed on an energy bill that the leadership never
intended to proceed to--a motion to proceed on an energy bill.
Since that day, we have never adjourned. We have always recessed.
Why? Because that motion was designed to prevent any other activity on
the floor of the Senate, to prevent any single Member from offering a
motion, for example, or an amendment to deal with a Patients' Bill of
Rights. Yes, we have had a vote on that before, but there has been a
change in the Senate, as we know, and if we took that vote now, we
would win that vote. So how do you prevent that from happening? You
prevent anybody from offering an amendment and having a vote--or on the
education issues that we have talked about. So that is what is going on
here.
This Senate has been blocked since September 22, so that the people
on the Democratic side of the aisle could not offer an amendment. And
we have not even adjourned. We are in the legislative day of September
22. So 26, 27 days now have passed since October 1st, and we find
ourselves not having passed the appropriations bills. People stand on
the floor with great surprise, wondering, what on Earth is all the fuss
here? I cannot understand why things are not working very well, why
things are coming apart on us.
I will tell you why things are coming apart. Because this Congress
didn't get its work done. It was blocking the floor, afraid of
amendments, and then we reached the time when appropriations bills were
supposed to have been done. They are not done. Then the tax bill is
cobbled together and stuck in this vessel called a small business
authorization bill. It is cobbled together behind locked doors with no
Democratic participation and brought to the floor of the Senate. And
people say: Gee, this is reasonable. Why would anyone object to that?
Does anybody remember watching the old western movies, the old
spaghetti westerns where someone inevitably would ride into a box
canyon and then wonder: What on earth has happened to me? I am in a box
canyon. I am attacked from every side.
What happened is, you rode into a box canyon. That is exactly what
this Congress has done. It hasn't done its work. What it has done, it
hasn't done well. And now it can't understand for all the world why
anyone would object to cobbling together a tax bill on a small business
authorization conference and shipping it through here and not receiving
objections from us or from the White House.
Let's add up the numbers. Together these proposals for tax cuts
represent the single priority of this Congress. It is around $1.4
trillion. I may err on either side a bit, but it is somewhere around
$1.4 trillion. We have an appetite by those who have no end of desire
to cut taxes, most of which will inure to the upper income folks, who
say: Our fiscal policy is to move us right back into that same old risk
of toppling this economy into the deficit ditch once again.
Our first priority ought not be large tax cuts for upper income folks
and $1.4 trillion in tax cuts before we even have the surpluses which,
incidentally, I don't think we will have for 10 years. We are not going
to have 10 years of surplus. That suggests we no longer have a business
cycle of contraction and expansion. But the first priority from the
majority party is to say: Let's have big tax cuts, and let's put them
in law permanently right now.
Our priority is to say: That doesn't make any sense. Let's do a
couple of things. Let's pay down the Federal debt. If during tough
times you run it up--and we did--then during good times, you ought to
be able to pay down the Federal debt.
There is no money around to pay down the Federal debt when you have
the majority party saying they demand $1.4 trillion in tax cuts.
Second, it seems to me reasonable that in addition to paying down the
Federal debt, you want to make some investments that will bear some
rewards for this country in the years ahead: invest in children,
education, invest in health care. That is not the priority; we don't
want to do that.
Third, yes, some tax cuts, but tax cuts that go to working families
as well.
My friend from Texas a few moments ago said he would be happy to
listen to me. I know better than that.
The PRESIDING OFFICER. The Senator's 5 minutes is up.
Mr. DORGAN. I will talk about tax cuts later. The point is, if we are
going to have tax cuts, they ought to be targeted to middle-income
families.
We should not be surprised to find ourselves in this position on
October 27, 27 days after we should have completed our work.
The PRESIDING OFFICER. The Senator from Missouri.
Mr. BOND. Mr. President, I yield 10 minutes to the Senator from
Idaho, Mr. Craig.
Mr. CRAIG. Mr. President, I thank Senator Bond for yielding.
I have been listening to the Senator from North Dakota. I have to
remind him by quoting his own leader. Here is what his leader said in
USA Today on September 8: We will stall the spending bills until we get
our way.
I suggest to the Senator from North Dakota that he ought to listen to
his leader because his leader said it and that is exactly what is going
on at this moment.
Let me also say to the Senator from North Dakota, after all these
spending bills and after this tax cut we are debating, we will pay down
the national debt by $700 billion. That is one whale
[[Page S11227]]
of an accomplishment. No, it doesn't go to bigger Government. No, it
doesn't go to create a new program. It goes to pay down the debt.
So between what his own leader has said and the facts of what we are
doing, let me remind the Senator from North Dakota, stalling your way
through this session has complicated matters. The box canyon that he
referred to is a box canyon that his own leader created.
From USA Today: Senate Minority Leader Daschle, Democrat of South
Dakota, has a simple strategy for winning the final negotiations over
spending bills: stall, until the Republicans have caved in because they
can't wait any longer to recess.
That is the reality of where we are. They have stalled their way into
a big problem. Now we will work the weekend, if we have to. We have to
resolve these issues for the sake of the American people.
For just a few moments, let me talk about the tax bill that is before
us. I so vividly remember the first Clinton-Gore campaign in 1992,
running for election and saying: We will give America a middle-class
tax cut. It was the mantra of their campaign.
Remember, they said in that banner during the campaign: It is the
economy, stupid; we have to make this economy work. And we are going to
make it work by giving a middle-class tax cut.
Well, let's remember what happened once they were elected. They
pushed through the largest tax increase in the history of this country.
The new bigger bite on the middle class included a fuel tax, a new tax
on Social Security benefits, a hefty variety of small business taxes.
And when the new administration nearly pulled off the greatest scheme
of all, and that was to nationalize one-sixth of our Nation's economy--
that was that great, new health care bureaucracy that became
affectionately known across the country as ``Hillary Care'' that was to
give every American the opportunity to live inside the greatest HMO of
all, a federalized Government health care program--when Americans heard
the detail of that, thanks to a few Senators and a few Congressmen on
this side of the aisle who stood up hour after hour and went through
page after page of what Bill and Hillary Clinton were talking about,
Americans rejected that resoundingly.
We know what happened. America said things had to change. And they
did change in 1995; A Republican Congress was elected. Slowly but
surely, we have tried to roll back those massive tax increases. What we
have in front of us today is an installment in that effort. At a time
of unprecedented surpluses, at a time when we are paying down $700
billion on the debt and that side of the aisle does not want to give a
dime back to the American taxpayer, shame on them. But then again,
their Presidential candidate says: I need it all because I want to
spend it all for all kinds of new Federal programs. That is the reality
of what they are dealing with.
Mr. BOND. Mr. President, may I interrupt to propound a unanimous
consent request?
Mr. CRAIG. I yield to the Senator.
The PRESIDING OFFICER. The Senator from Missouri.
Order of Procedure
Mr. BOND. Mr. President, I ask unanimous consent that the vote
scheduled for 3:15 p.m. be changed to now occur at 3 p.m. and the time
be reduced equally for both sides of the aisle.
I further ask unanimous consent that immediately following passage of
the joint resolution, the Senate proceed to the conference report to
accompany the D.C. appropriations bill, including the Commerce-Justice-
State appropriations bill, the conference report be considered as
having been read, and the Senate proceed to immediately vote on
adoption of that conference report without any intervening action,
motion, or debate.
I further ask unanimous consent that statements throughout the day
relative to the appropriations conference report be placed in the
record immediately prior to the adoption vote.
I further ask unanimous consent that the votes at 3 p.m. be reversed
so that the first vote occur on adoption of the D.C. conference report,
to be followed by passage of H. J. Res. 117.
Mr. REID. Reserving the right to object, Mr. President, I would say
to my friend, principally, Senator Bayh and Senator Conrad, that means
there will be no time for them to speak today. What remaining time we
have, which is about 7 minutes, would be for the Senator from Montana.
I am sure his people will also have to cut back on their time because
we have equal allocation of time until 3.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. BOND. Mr. President, therefore, for the information of all
colleagues, the next votes will occur now at 3 p.m. There will be two
back-to-back votes at that time. The time has been reduced on both
sides.
I appreciate being able to interrupt the Senator from Idaho.
What is the time remaining under this reduced amount?
The PRESIDING OFFICER. The Democrats will have 6 minutes, and
Republicans will have 13 minutes.
Mr. REID. Mr. President, if I could, before we finish this procedural
matter, the minority would be willing to have a voice vote on the tax
bill.
I ask unanimous consent that during this process we have a voice vote
on the tax bill.
Mr. BOND. I object.
Mr. CRAIG. Reserving the right to object.
The PRESIDING OFFICER. It is not appropriate to seek a voice vote at
this time by unanimous consent.
Mr. CRAIG. Mr. President, let me reclaim my time briefly.
The PRESIDING OFFICER. The Senator from Idaho.
Mr. CRAIG. Mr. President, because we have collapsed this time--and I
think appropriately so--and several colleagues need to be elsewhere
later today, let me close my comments.
Now some of our bills have been vetoed. We have yet to return to the
American people all the tax increases they suffered as the result of
the 1993 hike. But the last five-plus years also have produced a solid
record of tax relief and IRS reform, thanks to Republican principles
and bipartisan partnerships. Perhaps most important, that record
highlights the Democrat and Republican contrasting views of people
priorities.
Decades of liberal government meant more and more Americans were
over-taxed on the one hand, and more and more dependent on ``government
programs'' on the other. But a determined Republican Congress has been
turning the tide, slowly but surely--even in the face of frequent
vetoes and partisan obstruction--because it has believed in its mission
of returning power to the people.
People are empowered when they can keep most of the fruits of their
own labor, and use those resources to provide for families and their
future the way they feel is best. People are empowered when the tax
laws are a help, not a hindrance, to them choosing and being able to
afford a good education, medical care that meets their specific needs,
the right balance between work and family, and secure retirement
planning. People are empowered when the government--especially the tax
collector--respects the dignity and rights of the individual taxpayer.
The Republican-majority Congress has been making strong, steady,
incremental progress in areas like these. While several major bills
have been vetoed, several have become law. Among them: In 1996,
Congress enacted the Health Insurance Portability and Accountability
Act. This law increased health insurance deductions for the self-
employed, created new Medical Savings Accounts so folks can set aside
money for future needs, made it easier for workers to transfer from one
job to another without losing benefits, allowed penalty-free IRA
withdrawals for medical expenses, and reduced the cost of long-term
health care.
The Taxpayer Relief Act of 1997 included, among other things, the
$500 per-child tax credit, credits and deductions for higher education,
expanded IRA limits and the new Roth IRA and the first significant
steps in death Tax relief for family-owned farms and small business.
The IRS Restructuring and Reform Act of 1998 finally began shifting
the burden of proof from the taxpayer to the IRS, required the IRS to
pay court costs more often, provided protection for innocent spouses
from IRS collection efforts, and created a new, taxpayer-oriented
oversight board. The
[[Page S11228]]
Senior Citizens Freedom to Work Act of 2000 repealed the ``earnings
limit'' on the amount of outside income seniors of retirement age can
earn without having their Social Security benefits cut.
That's a good record but--we can and should do more. The tax
collector should not be the uninvited guest at every wedding and the
rude intruder at every funeral. But the Clinton-Gore Administration
vetoed bills to repeal the Death Tax and the Marriage Penalty. I
promise you, however, those issues will not go away. And now, in the
waning hours of the 106th Congress, we are hard at work on wrapping up
one more bill to provide tax relief to make health insurance affordable
to millions of uninsured Americans, help more with retirement planning,
help family farmers and small businesses, and encourage investment in
economically depressed areas. In a matter of days it will be up to the
President to decide the fate of that bill, with his signature pen or
his veto pen. I hope, this time, he chooses power to the people over
power to the tax collector.
I will conclude by saying this: This very meager tax package in front
of us, which has been objected to so strenuously by the other side, is
a small step in trying to put money back into the pockets of taxpayers
during a time of unprecedented surplus. It is also an opportunity to
facilitate; that is, to allow small businesspeople and others who want
to provide health care and to provide farmers and ranchers and other
people in agriculture the flexibility to do all kinds of positive
things.
But most importantly, the reason the gnashing of teeth and the
wringing of hands has been heard so loudly on the other side of the
aisle is they don't want to give any tax cut. They don't want to
provide any of that opportunity. They want to spend it all and they
want to spend it all in a way that will grow Government and grow it in
a way that will reduce our freedoms and, most importantly, deny the
American taxpayer what should justifiably be theirs. Once you have
balanced the budget and you have a surplus, you ought to give just a
little bit of it back--that is, the surplus--to those from which it
came.
With that, I yield the floor for other allocations of time.
The PRESIDING OFFICER. The Senator from Missouri is recognized.
Mr. BOND. Mr. President, let me begin by noting a point made by the
Senator from Texas. I urge all colleagues to change their plans to be
here for the vote at 3 p.m. I believe there are colleagues on both
sides of the aisle with planes to catch. The sooner we can complete the
vote at 3 o'clock, the sooner we will be able to go on to the second
vote, and there are many colleagues on both sides who hear the engines
warming up and smell the jet fuel.
Mr. President, before I talk about this bill in particular, we have
had a lot of politics on the floor and that is where I think it is
appropriate for us to have our political discussions. I think, as
chairman of the Small Business Committee, we have been able to work on
a bipartisan basis on small business issues. But something is very
disturbing to me, and I want to call that to the attention of my
colleagues and to a much broader constituency. It is something that
appears to be an attempt by this administration to politicize the Small
Business Administration just days before the national election this
November.
I call on the SBA Administrator to stop this effort. Yesterday, an
anonymous employee of the Small Business Administration faxed to my
office a draft of the ``SBA Day Plan.'' It was faxed to the Small
Business Committee staff.
According to the plan, in the week before the election, the SBA will
use personnel from its district offices to conduct a nationwide blitz
of making small business loans, releasing media statements on the
Clinton-Gore administration accomplishments, and coordinating
advertising with 5,000 lending partners across the country. The
whistleblower who contacted us had one short message: ``This must be
stopped.'' I agree. This must be stopped.
According to this SBA document, SBA allegedly plans a major public
relations campaign in the first days of November, right before the
election. SBA central office will make mention of the hundreds of
events going on all over the country. SBA regional and district offices
will publicize their local SBA Day events throughout their regions.
What wonderful timing. Does anybody want to guess what those days
will feature? Do you think they will mention the name of the Vice
President?
Well, more disturbingly, SBA district offices will enlist and co-opt
volunteers from the Small Business Development Centers, Women Business
Centers, SCORE Chapters, and U.S. Export Assistance Centers, to place
at least one person in lender offices in branches throughout the
country in the week before the election. I say co-opt because these
SBDC, SCORE, USEAC, and WBC centers receive a substantial amount of
funding from SBA. It appears that the SBA may be using their private
sector partners' dependence on SBA funding as leverage, pushing them to
carry out this SBA campaign plan.
SBA partners are expected to encourage local lenders to make joint
media announcements with SBA. SBA private sector partners are also
expected to coordinate advertising regarding the SBA Plan Day at their
local offices.
In particular, SBA district offices [are to] make every
effort to target lender offices in key communities (i.e.,
Hispanic, African American, Asian, Native American, Export,
Women).
The most abusive part of this plan would be SBA's efforts to ``close
or get commitments for as many new SBA-guaranteed loans as possible
during the week of October 30 through November 3, 2000.'' A followup
news release, of course, will publicize the success of this effort.
Is this a great country or what? When I read this plan, I was shocked
at what I saw. This thinly veiled attempt by the administration to
promote itself in the days before the election is an abomination. Too
many of us worked too long to allow the political manipulation and
abuse of SBA resources, SBA personnel, and SBA partners with the goal
of influencing the election.
As chairman of the Small Business Committee, I, along with the
committee, have worked tirelessly on a bipartisan basis to promote
small business development and success. This entire Senate has worked
on fostering small business growth as a top priority on a bipartisan
basis.
Focusing the resources of the SBA and its programs and loans towards
historically disadvantaged and underutilized communities has also been
a chief goal. This Senate passed the HUBZone Program overwhelmingly. It
is now part of the SBA's programs to bring opportunity to areas of high
unemployment and poverty. We cannot and should not allow SBA, in the
waning days of this administration, to be politically hijacked for an
election. Staging the events in the days before the election would
spread a political taint throughout the SBA. This campaign plan will
undermine the credibility of every SBA employee and partner. I don't
want to see that political destruction.
If SBA is serious about raising public awareness of SBA programs and
services--and I think that is a good thing to do--then it will do one
simple thing: Delay the SBA Day Plan for 1 month. They can begin it in
December instead of November. That would avoid any hint of impropriety.
If however, SBA continues with the SBA Day Plan in the days before the
election, we have no choice but to conclude that a complete political
takeover of SBA had occurred with a goal of advancing the
administration's candidates in the November election.
I don't know if this SBA pre-election campaign has been coordinated
with the national political campaign or local political campaigns
across the country. Frankly, we don't need to know, if this issue can
be taken off the table right now. I urge SBA to remove any doubts and
postpone this action. I have written to Administrator Aida Alvarez
urging her to protect SBA from the taint of political interference.
I ask unanimous consent that the letter and the attached SBA Day Plan
be printed in the Record following my remarks.
The PRESIDING OFFICER. Without objection, it is so ordered.
(See Exhibit 1.)
Mr. BOND. Mr. President, I say to all of the outside organizations
and individuals who may be contacted by the
[[Page S11229]]
SBA, I hope they understand they are free to choose to participate or
to not participate in any such activities if they are requested to do
so. We intend to be around to continue oversight responsibilities next
year, and we will ensure that there is no reprisal against any SBA
employee or non-SBA employee who chooses not to participate in a
political endeavor.
Mr. President, I yield the floor and reserve the remainder of my
time.
Exhibit 1
U.S. Senate,
Committee on Small Business,
Washington, DC, October 27, 2000.
Aida Alvarez,
Administrator, U.S. Small Business Administration,
Washington, DC.
Dear Administrator Alvarez: The purpose of this letter is
to express my alarm over the potential politicalization of
the Small Business Administration (SBA) in the days leading
up to the national elections on November 7, 2000. Employees
at SBA have brought to my attention SBA plans for a major
public relations campaign across the country in the first day
of November.
The Administration's use of SBA personnel, offices,
programs and private-sector partners to influence public
perception of the Administration only days before the
election raises the specter of a pernicious manipulation of
the federal government for political means. Most alarming is
the directive from SBA headquarters to make as many
government guaranteed loans as possible during the week
before election day. Putting taxpayer money at risk for pre-
election campaigning is totally unacceptable.
The ``SBA Day Plan'' received by my office details SBA
plans to:
Close or get commitments for as many new SBA guaranteed
loans as possible during the week of October 30-November 2,
2000;
Release media announcements by all SBA offices on the
success of these efforts;
Encourage [local lenders] to make joint media announcements
with SBA;
Coordinate advertising [with local lenders] regarding SBA
Day at their local offices/branches;
Place at least one person [from SBA District Offices, Small
Business Development Centers, Women Business Centers, Service
Corps of Retired Executives Chapters of U.S. Export
Assistance Centers] in lender offices/branches throughout the
country during the week of October 30-November 3, 2000; and
Make every effort to target lender offices/branches in key
communities (i.e. Hispanic, African-American, Asian, Native
American, Export, Women).
The work of the Small Business Administration is vital to
fostering small business across the country. I share your
commitment to bringing these benefits to historically
underutilized areas, which is why I sponsored and Congress
overwhelmingly passed the HUBZone program.
Therefore, I am sure you will agree that SBA should
reschedule its SBA Day Plan from the beginning of November to
the beginning of December. This would avoid any taint of
political manipulation. If you have any questions regarding
this issue, please contact Paul Cooksey at 224-5175. Thank
you in advance for your attention to this matter.
Sincerely,
Christopher S. Bond,
Chairman.
____
SBA Day Plan
goal
1. Raise public awareness of SBA programs and services and
the impact these have on local communities.
2. Tout SBA accomplishments and announce SBA loan numbers
for fiscal year 2000.
3. Kick off the new fiscal SBA year (2001) positively and
collaboratively.
4. Close or get commitments for as many new SBA guaranteed
loans as possible during the week of October 30-November 3,
2000.
Concept
Week of October 30-November 3, 2000
SBA District Offices, with the collaboration of SCORE
Chapters, district SBDCs, USEACs, and WBCs, will place at
least one person in lender offices and branches throughout
the country during the week of October 30-November 3, 2000.
In particular, SBA district offices will make every effort to
target lender offices/branches in key communities. (i.e.
Hispanic, African-American, Asian, Native American, Export,
Women)
Local lenders will be encouraged to make joint media
announcements with SBA and coordinate advertising regarding
SBA Day at their local offices/branches.
Tuesday, October 31, 2000
Media Announcement by all SBA offices of year-end
accomplishments/loan numbers. A follow-up news release will
be made the following week regarding the success of SBA Day.
SBA central office will announce national accomplishments
and year end numbers for FY2000 and will make mention of the
hundreds of events going on all over the country kicking off
SBA's new fiscal year.
SBA regional and district offices will incorporate regional
and local accomplishments and year-end numbers for FY2000
into the central office national announcement and will
publicize their local SBA Day events taking place at lender
locations throughout their region/district.
The PRESIDING OFFICER. The Senator from Montana.
Mr. BAUCUS. Mr. President, I yield myself such time as I may consume.
Very simply put, we have a tax bill before us which includes some
provisions that are unbalanced. That is unfair. There has not been
anything that would approximate consultation between the majority and
minority, including the White House. It is going to pass with a
majority vote. It is going to be vetoed by the President, as it should.
Frankly, I know the majority party will vote for this bill very
quickly when we get back together, and we will pass a balanced bill in
consultation with both parties and with the White House. After all,
that is by and large what the American people want. They want us to
work together. They want us to pass legislation that is balanced.
Unfortunately, the bill before us is not balanced. It is very
lopsided and very much toward upper income levels. Also, it does not
include provisions to help lower middle income Americans, which I will
outline a little bit later.
In addition, the bill before us is one that was crafted by the
majority leadership, despite what has been said on the floor here,
without consultation that in any way is adequate with either the White
House or with the Democratic Party. That is unfortunate. I say that
also because the Senate Finance Committee not too long ago passed out
of the committee, on a unanimous vote, a balanced bill that addresses
the tax provisions in this bill.
What do I mean?
First of all, the bill that passed the Finance Committee on a
bipartisan basis, with a unanimous vote, had one-third of the tax cuts
directed to lower and moderate-income taxpayers to help them also save
for good times. It is true the bill also raised contribution limits for
people in moderate and upper income levels, as it should.
My point is not that those should not be raised. My point is there
are no provisions in the current bill which also give the incentives to
moderate- and low-income people.
In addition, it is important for us to reflect for a moment about the
importance of retirement income. Sixteen percent of today's retirees
depend exclusively and entirely on Social Security for their entire
income. Two-thirds of American seniors depend upon Social Security as
their primary source of retirement income. That is basically because
Social Security benefits only replace about 40 percent of the income
earned during retirement.
Who are those retirees who depend primarily on Social Security? They
are people who spend their entire working lives making minimum wage and
who earn just enough to make ends meet but not enough to save for
retirement.
Only one-third of American families with incomes under $25,000 are
saving for retirement either through a pension plan or through an IRA.
That compares with 85 percent of American families with incomes over
$50,000. Eighty-five percent of American families with incomes of
$50,000 or over are saving either through a pension plan or IRA.
That is why the bill that passed the Finance Committee--again,
unanimously--attempted to address that disparity by including a tax
credit for families with less than $50,000 in income to help them also
save for retirement. The credit was really one of two items in the bill
that helped provide that balance. It also made the bill more
progressive.
The unanimously passed, bipartisan Finance Committee bill had a
couple other incentives to help small businesses establish pensions for
their workers. These were very important provisions to help balance the
bill and raise limits for upper income Americans and also help provide
incentives for lower and moderate-income Americans.
You won't find these provisions in the bill before us today. You
won't find the provisions that passed the Finance Committee
unanimously, on a bipartisan basis, to help middle and lower income
Americans as well as upper income Americans. That pattern is repeated.
Measures that the Finance Committee, again, on a bipartisan basis,
passed to help balance the legislation before us are not included in
this, I might say, closed-door bill that we have before us today. For
example, the
[[Page S11230]]
section on health care spends $88 billion, with $56 billion of that
going to basically HMOs that subsidize people who already have health
insurance.
I ask: Where are the provisions designed to help the uninsured in
America? They are not there. There is no provision, for example, to
expand the Children's Health Insurance Program as part of the
compromise. You won't find other efforts to help encourage people who
are uninsured to get insurance.
As I mentioned and as many other speakers have mentioned, this bill
was slapped together in the last couple of days. There are parts of it
that almost no one saw before yesterday morning. We have no idea what
special interest provisions are in here, and we do not know what
mistakes are in it. There are probably going to be a few--again,
because it was not written in the sunshine.
I am even told there is a section here that may have accidentally
repealed the minimum wage altogether for 6 months. I don't know. It is
possible.
Again, good law is not made behind closed doors by a small number of
people. It is made by all of us here in the full light of sunshine.
I ask my colleagues to vote against this bill. But, more importantly,
when the President vetoes it, let's get together and do something that
is balanced for the American people.
I yield the floor.
The PRESIDING OFFICER. The Senator from Missouri.
Mr. BOND. Mr. President, we are about ready to conclude the debate on
this portion of the omnibus small business.
Let me point out before we go to the votes on District of Columbia/
Commerce-State-Justice and adopt the resolution numbered 245, there has
been a lot of talk about all of these things not having passed. Ninety
percent of the bill has been voted out of the House by a large margin,
and parts have come out of the Finance Committee.
I can tell you from the Small Business Committee that we took a
bipartisan, broadly supported bill, and we were not able to get all of
the things that we in the Senate wanted included. Frankly, one of the
key elements I wanted was rejected. I know a provision advocated by the
Senator from Minnesota was rejected. But I can assure you that it was
over my strong objections, and only at the last was it rejected.
This measure does many things to continue the small business programs
and to assure small businesses can provide jobs in areas where there
are great needs when there is poverty and unemployment. There are
provisions that are recommended by the Women's Business Conference.
There are provisions to bring jobs into needy low-income communities.
These bills together have many of the things that the President also
requested.
I regret to say that the President and some of our colleagues on the
other side of the aisle are pouting because they didn't get it all. I
can tell you something. I didn't get all that I wanted in this bill
either. I took some things I didn't want, that were wanted by the House
and that were wanted by other Members.
But this bill provides significant savings incentives and income-
limited savings incentives on IRAs that could do more to help savings.
Medicare give-backs will enable providers to continue to serve needy
people.
Those who ran against the HMOs are trying to make HMOs available in
States such as New Mexico and rural areas that do not have the
tremendous bonanza of the reimbursements that they do in New York
State.
There are many good provisions in this bill. An overwhelming number
of them have been supported and requested by the President and, at one
time or another, supported by the people on the other side of the
aisle. Unfortunately, they say: We are just not getting enough. Sixteen
billion dollars in school construction, two-thirds of what the
President wanted, is not enough. Our friends have never seen a tax cut
that they liked nor a tax surplus they didn't want to spend.
This strikes the happy medium. I hope ultimately we will adopt this
measure and have it signed by the President.
I yield the floor.
The PRESIDING OFFICER. The time of the Senator has expired.
____________________