[Congressional Record Volume 146, Number 141 (Tuesday, October 31, 2000)]
[House]
[Pages H11681-H11682]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




MOTION TO INSTRUCT CONFEREES ON H.R. 4577, DEPARTMENTS OF LABOR, HEALTH 
AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS 
                                ACT 2001

  Mr. BENTSEN. Mr. Speaker, I offer a motion to instruct conferees on 
H.R. 4577.
  The SPEAKER pro tempore. The Clerk will report the motion.
  The Clerk read as follows:

       Mr. Bentsen moves that the managers on the part of the 
     House at the conference on the disagreeing votes of the two 
     Houses on the Senate amendment to the bill H.R. 4577 be 
     instructed, in resolving the differences, between the two 
     Houses on the funding level for program management in 
     carrying out titles XI, XVIII, XIX, and XXI of the Social

[[Page H11682]]

     Security Act, to choose a level that reflects a requirement 
     that State plans for medical assistance under such title XIX 
     provide for adequate reimbursement of physicians, providers 
     of services, and suppliers furnishing items and services 
     under the plan in the State.

  The SPEAKER pro tempore. Under rule XXII, the gentleman from Texas 
(Mr. Bentsen) and the gentleman from Florida (Mr. Bilirakis) each will 
control 30 minutes.
  The Chair recognizes the gentleman from Texas (Mr.  Bentsen).
  Mr. BENTSEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, let me say at the outset that in a couple of minutes I 
am going to move to withdraw this motion and I will tell my colleagues 
why, but I do want to take just a couple of minutes to talk about it.
  Let me start out by saying what this motion would do is, in effect, 
would call on the conferees to reinstate what has been known as the 
Boren amendment which would require that States establish reasonable 
rates of reimbursement under the Medicaid program. As my colleagues 
know, the Boren amendment was repealed in the 1997 Balanced Budget Act, 
but we still find that in many cases for providers, both hospitals and 
individual medical providers, that the reimbursement rates under the 
Medicaid program by the States is not sufficient; and, in fact, a 
recent study found that in some cases those rates are as low as 65 
percent of the comparable Medicare reimbursement rate. This is 
something that raises concerns when we consider that more than a third 
of the births in this country are funded through the Medicaid program 
and yet we have these low reimbursement rates.
  My personal concern in this has to do in trying to stand up for my 
district and my State. The largest medical center in the world is in my 
congressional district with the largest children's, independent 
children's hospital, as well as another children's hospital and a very 
large public hospital system, where they have a very large, 
disproportionate share census that they have to deal with in not 
getting sufficient reimbursement. I think Members around the country 
would find that is true.
  Mr. Speaker, as we know today the National Governors Association and 
the National Conference of State Legislators sent out letters with some 
questionable arguments against this motion, and I am not going to 
pursue it because I do not want to put Members on either side of the 
aisle in a difficult situation.

                              {time}  2100

  Mr. Speaker, I will say this. Last week when the House considered the 
tax bill with the balanced budget revision that was in it, I would 
remind my Republican colleagues that that included an uptick in the 
reimbursement for managed care companies, for Medicare providers; and I 
actually joined my Republican colleagues in voting for that. There were 
not a lot of Democrats who did, but I was one of the ones who did. I 
thought it could be a better bill, but I was willing to take what we 
could get at the time.
  I guess what I want to say is what is good for the goose is good for 
the gander, and that we may want to take a look at the Medicare bill as 
well to see how we may want to make that a better program for the 
people who rely on the Medicaid program.
  Now, let me just say with respect to what the Conference of State 
Legislatures said, and the governors. I think it is somewhat of a 
stretch for the Conference of State Legislatures to say that by going 
back to the Boren Amendment language that somehow they would not be 
able to move forward with the breast and cervical cancer bill that this 
House passed overwhelmingly and was signed into law by the President 
just last week, or the Ticket to Work program that was passed. I and 
others were cosponsors of both of those bills. I think that is a little 
bit of a red herring on their part. I do not, quite frankly, think this 
is an issue that we are going to deal with this year, but it is 
something that I think Members on both sides of the aisle do want to 
take a look at.
  Mr. RODRIGUEZ. Mr. Speaker, I stand before you today in support of 
the motion to instruct conferees on H.R. 4577 by my friend and 
colleague, Representative Ken Bentsen.
  The Bentsen motion to instruct urges conferees to do the right thing 
by providing adequate funding levels for Medicaid.
  We face a health crisis in our states because the Balanced Budget Act 
of 1997 put Medicaid rates too low.
  Everyone is impacted: physicians, hospitals, home health providers, 
and nursing homes.
  Many of the health care providers in my district and throughout my 
state face severe financial difficulties due to low Medicaid rates.
  These Medicaid reimbursement reductions have especially hurt our 
nursing homes. The situation in Texas is a good example of why we need 
immediate action.
  Today I released a special report prepared by the minority staff of 
the House Committee on Government Reform, ``Nursing Home Conditions in 
Texas,'' which found widespread inadequacies--sometimes horrible 
situations--in our nursing homes.
  In many nursing homes in Texas and across the country, our parents 
and grandparents suffer intolerable conditions.
  More than half of the nursing homes in Texas had violations of 
federal health and safety standards that caused actual harm to 
residents, or placed them at risk of death or serious injury.
  Another 29 percent of Texas nursing homes had violations that created 
potentially dangerous situations.
  In other words, 4 out of 5 nursing homes in Texas violated federal 
health and safety standards during recent state inspections.
  Why are the conditions so bad?
  One reason is inadequate levels of staffing.
  In Texas, more than 90 percent of the homes do not have the minimal 
staffing levels recommended by the U.S. Department of Health and Human 
Services.
  And why are staffing levels so low? Because the low level of funding 
makes it impossible for nursing homes to provide adequate care.
  This Congress still has the opportunity to address these glaring 
problems. The Bentsen motion would be a bold step in defense of our 
most vulnerable seniors by requiring states to provide adequate 
reimbursements to all health care providers.
  Mr. BENTSEN. With that, Mr. Speaker, I withdraw my motion to 
instruct.

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