[Congressional Record Volume 146, Number 155 (Friday, December 15, 2000)]
[Senate]
[Pages S11816-S11821]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
OMNIBUS APPROPRIATIONS BILL
Mr. KENNEDY. Mr. President, I expect to support the omnibus
legislation that will implement the final appropriations agreement for
this Congress because it makes the kinds of investments in education,
health, and work opportunities that are needed by all American
families. In the long run, only through these basic investments can we
preserve our capacity to keep our nation strong. I commend my
colleagues for their diligence in crafting legislation that respects
the highest priorities of the American people. Senator Harkin and
Senator Specter have shown the power of bipartisan cooperation
throughout their work on this legislation. We have all benefitted from
the example and leadership of Senator Stevens and Senator Byrd as well.
While this legislation is not perfect and certainly is no substitute
for the unfinished work of the 106th Congress, it is good for the
American people, and it shows what is possible when we resolve to work
together. In this sense, it offers considerable hope for the 107th
Congress.
EDUCATION
In the critical area of education and the nation's schools, this
appropriations agreement is a resounding victory for parents and
communities across the country. Congress has lived up to its commitment
to increase education funding. We are taking a giant step forward to
ensure that children across the country receive the support they need
to succeed in school and to make college more affordable for every
qualified student. I'm proud to highlight a few of the key education
accomplishments.
For the first time, communities across the country will qualify for
over $1.2 billion in federal aid to address their most urgent school
building repair needs, such as fixing roofs, plumbing and electrical
systems, and meeting fire and safety codes.
Schools across the country will receive $1.623 billion, a 25 percent
increase over last year, to continue hiring and training new teachers
to reduce class sizes in the early grades. This year's funding increase
will place 8,000 more teachers in classrooms, placing the goal of
100,000 new teachers well within reach.
Teacher quality will improve as well this year. Schools will receive
$485 million, a 45 percent increase over last year, to help teachers
improve their skills through professional development activities,
reducing the number of uncertified and out-of-field teachers.
Title I of the Elementary and Secondary Education Act, which helps
disadvantaged students master the basics and achieve to high standards,
is increased by $506 million, for a total of $8.4 billion.
We know that children are most likely to engage in risky behavior in
the hours just after school. Congress has responded by increasing
support for after-school programs by 87 percent this year, to $851
million. This increase will help more children stay out of trouble
after school and get extra help with their schoolwork.
The bill also provides an additional $91 million, for a total of $225
million, to support state and local efforts to turn around low-
performing schools.
Vocational and technical education programs received $1.240 billion,
a $48 million increase, to improve programs that give students skills
they need in order to meet the demands of the new high tech workforce.
College students will also receive much needed support under this
bill. The GEAR UP programs will receive $295 million, an increase of
$95 million, and TRIO programs will receive $730 million, a $85 million
increase, to help more low-income and minority middle and high school
students prepare for college and succeed in college.
Of all high school students in Boston, 80 percent of them now are
tied into colleges. We have 12 different colleges that are tied into
the high schools, where they are not just taking the individuals who
show promise, which the TRIO Program does and does with extraordinary
success, but to try to take the whole class together and move the whole
class up. It is a relatively new concept and one which has worked very
successfully in the several pilot areas where it has been tried. We are
finding extraordinary response, positive response from colleges that
engage in this undertaking, and extraordinary response from the
schools. I think it will be one of the more important programs to
enhance academic achievement for high school students.
This legislation will also enable more undergraduate and graduate
students to pay for college through part-time work assistance because
the Federal Work Study program received a $77 million increase.
This bill also strengthens Pell Grants, enabling many more students
to take advantage of them. The maximum grant is increasing by $450--
from $3,300 to $3,750. Because there are so many young people who, even
though they are eligible for the maximum Pell Grant, just couldn't make
it with the lower maximum, this is perhaps the most important
educational enhancement we have. It recognizes that many children are
advantaged in their academic achievement and accomplishment but
disadvantaged in the amount of resources they have.
Early Learning
As we strengthen our commitment to quality education at the
elementary, secondary, and college levels, a strong body of research
challenges us to broaden our commitment to education as well. Education
is a continuum that begins at birth and continues long after
graduation. On the birth-to-kindergarten side, we have much work to do.
For the sake of each child, the nation, and our education system
itself, all children must have access to the early learning
opportunities that will enable them to enter school ready to learn.
Today, 12 million children under age five have mothers who work
outside the home. Yet many of these children are assigned to waiting
lists instead of quality early learning programs because federal
funding isn't adequate to meet existing needs, and more and more
parents are accepting the responsibility of work under welfare reform.
[[Page S11817]]
In Massachusetts, 14,000 children are wait-listed, as are 200,000
children in California. Today's minimum wage for a full-time worker is
$10,720 per year. This doesn't begin to cover the cost of quality early
learning opportunities, which can be as high as ten thousand dollars a
year.
All of us remember a number of years ago when the Governors,
Republicans and Democrats, met in Charlottesville and announced goals
for the Nation in education. Their first goal is to have children ready
to learn when they enter kindergarten and first grade, to build the
skills they bring to school. The skills that little children need to
develop as infants and toddlers self-confidence, self-awareness, some
degree of self-esteem, inquisitiveness in academics, and, interestingly
enough, a sense of humor.
Eleven years ago, Senator McCain and I introduced the Military Child
Care Act, which turned military child care into an early learning model
for the nation. Today's legislation takes three important steps toward
building on that success in civilian America.
First, it increases federal child care subsidies by 69 percent,
enabling states to remove 150,000 children from waiting lists next
year. This increase was very much patterned upon the child care
initiatives of our colleague, Senator Dodd, and I am deeply grateful
for his leadership on this issue.
Next, this legislation enables 70,000 of the nation's most at-risk
children to participate in Head Start, which is highly regarded because
it delivers the promise of early learning so effectively. The
legislation also begins implementing the Early Learning Opportunities
Act, which Senator Stevens, Senator Jeffords, and Senator Dodd and I
supported over the past two years. This new law provides for parental
education and support services, increased collaboration among early
leaning providers, and incentives to improve the quality of early
learning services. Its goal is to help the nation build an effective
infrastructure of local councils to help each community evaluate how
best to put the research on infant and toddler brain development into
practice.
The Head Start Program, the Early Head Start Program, and the new
Early Learning Opportunities Act included in this appropriations bill
will improve early learning in important ways. The Carnegie Commission
and other experts who have studied the development of a child's brain
in the early years, and made a series of recommendations. With this
legislation we are beginning now to follow up on these recommendations
by investing in children at early ages. That is extremely important.
These steps show important momentum toward turning the research on
children's brain development into sensible national policy, and we
should build on this momentum in the next Congress. We can learn much
more from the military's experience with early learning. We can build
these lessons into the Child Care and Development Block Grant when it
is reauthorized in the next Congress. We can pass additional
legislation to turn the current patchwork of federal child care and
early learning programs into a seamless structure directed at one
goal--quality services to ensure that children enter school ready to
learn. We also must continue expanding Head Start until it is available
to all children who need it.
The health funding in this bill is also a win for the American
people.
GRADUATE MEDICAL EDUCATION
I will now address the excellent work that has been done under the
balanced budget act, or BBA, programs, in particular the funding level
for pediatric graduate medical education. This is not an area that has
a history of proper federal attention. Last year, it received $40
million and virtually no funding prior to that time.
The Medicare Program has provided the funding for the training of
much of the American medical personnel who, without question, are the
best trained medical personnel in the country. It was funded through
the Medicare system. The area of pediatrics never made it, so these
children's hospitals, which train the majority of pediatricians, had to
provide the additional training services and educational services
without the support available to every other physician training
program.
That has been significantly corrected with this legislation. There
are over 50 major children's hospitals across this country that will
benefit from this program. We can be sure that as a result of today's
work, the part of the medical profession that is focused upon caring
for children will be significantly advanced, and I commend the
appropriators for this.
I am particularly pleased with the funding level for pediatric
graduate medical education. The legislation allocates $235 million to
support medical education costs incurred by freestanding children's
hospitals. This figure is nearly a 500 percent increase over last
year's appropriation of $40 million, and puts us much closer to fully
funding the program.
This program was created last year to address the historical
inequities in federal support for graduate medical education activities
occurring at independent children's hospitals. Until last year, the
federal government has paid for hospital costs related to physician
training from Medicare. However, because children's hospitals generally
treat very few Medicare patients, they were historically and
dramatically underpaid for teaching activities. Prior to enactment of
this program, children's hospitals were given just \1/200\th of the
federal support for teaching activities that other teaching hospitals
received.
Children's hospitals, which represent less than one percent of all
hospitals in the country, train approximately 30 percent of the
nation's pediatricians and the majority of many pediatric specialists.
It is long past time for the federal government to support these
activities. Next year, it is my hope that we will achieve permanent,
full funding for this essential program.
Children's hospitals around the country will benefit from the
increased funds in this legislation. It will enable these important
institutions to continue to be regional and national referral centers
for children around the country. It will support new and continuing
research activities that benefit children and adults alike. And, most
importantly, it will help assure a steady supply of pediatricians and
pediatric specialists to treat the nation's children now and in the
future.
With approximately 200 full-time employees in training at any one
time, Boston Children's Hospital has the largest teaching program among
independent children's hospitals. It has a top-notch faculty, and
provides excellent teaching, research and patient care. These funds
will assure its continued contribution to health of children in
Massachusetts, the nation, and the world.
NATIONAL INSTITUTES OF HEALTH
This bill also includes an increase of 13 percent for the National
Institutes of Health, raising the NIH budget to more than $20 billion.
These new resources will enable NIH to increase its support for the
medical research that is urgently needed to develop new cures for the
diseases that afflict millions of Americans.
Massachusetts is a leader in medical science. It receives more than
one out of every ten dollars that NIH spends on research grants--more
than any other state except California--and Boston receives more NIH
grant money than any other city in the nation.
Last year alone, doctors and scientists in Massachusetts were awarded
more than $1.5 billion in research grants from NIH. The new
appropriations bill will increase this already impressive total by more
than $180 million, so that Massachusetts will receive an estimated $1.7
billion in NIH research grants in the coming year.
NIH supports essential research across the state. In Boston, research
supported by NIH very recently discovered an important relationship
between the immune system and the brain that may lead to better
treatments for diseases like multiple sclerosis. In Worcester, NIH
funds are helping to build a new center for cancer research that will
become a leader in this important field. In Cambridge, NIH will help
support a major new center to study the nervous system, so that we can
better understand brain diseases like Alzheimer's, schizophrenia and
depression. NIH grants are essential for funding the basic research
that is often considered too risky to be funded by private companies,
and ensure that the results of this work are available to all
researchers.
[[Page S11818]]
The investment that NIH makes in medical research is the foundation
on which the nation's thriving biotechnology industry is built. More
than 250 biotech companies in Massachusetts provide good jobs for
thousands of professionals across the state, and contribute millions of
dollars every year to the state's economy. New partnerships between
universities and biotechnology companies form almost every day,
embarking research ideas from the academic world to be developed
rapidly into new medical breakthroughs that will improve the health of
patients across the nation.
By helping develop new cures for deadly diseases and by fostering the
important new industry of biotechnology, the renewed commitment to the
NIH that we make here today is an investment that will pay dividends
now and for many years to come.
Balanced Budget Reform Act
This legislation provides ``financial CPR'' for hospitals, home
health agencies, nursing homes, and other important Medicare providers
around the country. It also takes important steps to improve access to
health care through CHIP and Medicaid, though more is needed.
Nearly one million senior citizens and persons with disabilities
depend on Medicare to provide high-quality care in Massachusetts. The
health care industry is a critical component of the state economy.
Today, we are saying that help is on the way.
The Medicare, Medicaid and CHIP Beneficiary Improvement and
Protection Act is the most significant relief package since passage of
the Balanced Budget Act in 1997. Medicare spending will total $30
billion over five years, and spending for Medicaid and the Children's
Health Insurance Program will total $6 billion. In fact, the net cost
of the entire package is likely to be closer to $15 billion over five
years, because of the offsetting effect of savings achieved by a
forthcoming regulation limiting the ability of states to obtain union
funded Medicaid payments.
The savings from the Medicaid regulation should be used to expand
coverage to low-income populations. I strongly support the provider
relief in this package, but I am disappointed that the Republican
leadership opposed bipartisan efforts to enable states to extend health
benefits to low-income pregnant women and children who are legal
immigrants, but who would otherwise be eligible for CHIP and Medicaid.
In addition, the Republican leadership refused to include the
bipartisan Grassley-Kennedy Family Opportunity Act, which would have
enabled children with disabilities to obtain or maintain health
coverage through Medicaid.
Massachusetts providers have estimated that they will receive
approximately $450 million--close to half a billion dollars--over the
next five years as a result of this legislation. While it is the most
significant step Congress has taken to date to restore the unintended
cuts made by the Balanced Budget Act of 1997, this Congress failed to
finish the job, and we will be back at it again in the 107th Congress.
The record budget surpluses now and projected for the years ahead are
largely due to the savings achieved by cutting Medicare payments in the
Balanced Budget Act of 1997. Those cuts were expected to total $116
billion over five years, and nearly $400 billion over ten years--more
than double the amount ever enacted in any previous legislation.
In reality, these cuts are now estimated to total $200 billion over
five years and more than $600 billion over 10 years. These excessive
cuts, combined with low payments from private payors and Medicaid
programs, have placed many outstanding health care institutions at
risk, and threaten quality of care for millions of elderly, disabled
and low-income Americans.
In Massachusetts, two out of every three hospitals are losing money
on patient care. Community hospitals across the state are struggling to
survive. Key providers are questioning whether to participate in HMOs,
and HMOs are deciding to cut benefits and trim service areas.
Twenty-five percent of home health agencies in the state no longer
serve Medicare patients, and 20 agencies have closed their doors since
the BBA was enacted. The remainder see fewer patients, and see them
less often.
Forty-three nursing homes have closed in Massachusetts since 1998.
One in four are in bankruptcy. One in seven nursing positions are
unfilled, because Massachusetts nursing homes are unable to compete for
staff.
Congress has been slowly restoring these Medicare cuts year-by-year.
In 1998, we included $1.65 billion in the FY99 Omnibus Appropriations
bill for Medicare home health agencies as a stop-gap measure. The
Balanced Budget Refinement Act of 1999 restored $16 billion over five
years. And the legislation we are voting on today takes an even more
significant step toward fixing the problems created by the BBA. But it
does not finish the job. In fact, it contains new cuts for hospitals
and nursing homes. Clearly, we will need to revisit this issue in the
107th Congress. There is no need to turn funding for entitlement
programs into an annual appropriations process, but that is precisely
what this annual exercise has unfortunately become.
In addition to the much-needed provider relief contained in this
legislation, it also includes two other important improvements in
Medicare benefits. First, it requires Medicare coverage of drugs that
are not usually self-administered by a patient. This change restores
and preserves coverage for certain drugs that are vital for senior
citizens and persons with debilitating chronic illnesses. This
provision will ensure that in determining whether a drug is usually
self-administered, HCFA should only consider whether a majority of
Medicare patients with the disease or condition actually administer the
drug to themselves, reversing a contrary 1997 policy. This improvement
will help assure that millions of elderly and disabled Americans have
continued access to life-saving and life-improving drugs.
Second, the bill improves coverage for immunosuppressive drugs for
Medicare patients who have had an organ transplant. These drugs are
needed to prevent rejection of the transplanted organ. Assuring
permanent coverage will improve the quality of life for transplant
patients, and assure a wiser use of scarce resources and scarce organs
by helping patients to remain healthy after transplantation.
CHIP AND MEDICAID
This legislation also includes several provisions that are important
to working families whose children are eligible for CHIP or Medicaid.
First, the legislation includes a redistribution mechanism to assure
use of the funds allocated to insure low-income children through CHIP
and Medicaid. The formula is fair, and it allows all states to benefit
from unspent FY98 dollars in a manner that will assure continued
enrollment of eligible children. Those states that have been slow to
spend their initial CHIP allocation will now have additional time to
spend their FY98 funds by reaching out and enrolling more children in
these programs. Those states that spent all of their FY98 dollars
because they were able to get their programs up and running early will
obtain additional funds to continue their momentum. The result is a
win-win for America's children.
The legislation also enables states to immediately enroll uninsured
children who are potentially eligible for CHIP or Medicaid in the
proper program, while awaiting confirmation of actual eligibility. This
step is important for improving enrollment rates. Unfortunately, the
bill limits its applicability to children found only through outreach
in primary and secondary schools. There is bipartisan support for a
broader proposal that would have extended presumptive eligibility to a
variety of other programs where uninsured eligible children or their
parents are likely to be identified, including child care resource
centers, child support agencies, housing agencies, and homeless
shelters. We will pursue this and other CHIP and Medicaid outreach and
enrollment improvements next year.
Finally, the legislation extends for one additional year the
Transitional Medical Assistance program, which allows families who are
leaving welfare for work to maintain Medicaid coverage during the
transition. Most post-welfare jobs do not offer health insurance. We
must do all we can to see that ``ending welfare as we knew it'' does
not contribute to America's already shameful uninsured rate.
[[Page S11819]]
LOW INCOME HOME ENERGY ASSISTANCE
I'm pleased that this year's final budget agreement includes $1.4
billion to help families heat their homes this winter under the Low
Income Home Energy Assistance Program. Massachusetts needs this 28
percent increase in its block grant to help more families cope with
higher heating costs this winter. Combined with LIHEAP emergency funds
that the Clinton Administration has already made available in
anticipation of this winter's needs, I am hopeful that the regular and
emergency LIHEAP funding contained in this budget deal should enable
low-income families to heat their homes throughout the winter that is
already upon us. I regret that this year's budget agreement does not
contain expected advance funding for the winter of 2002, so that
families can plan ahead for heating assistance next year. I intend to
do all I can to see that Congress corrects this omission as part of a
supplemental spending bill early next year or as part of the broader
national energy policy reevaluation likely to begin in the new
Congress. For this winter, though, today's budget agreement remains a
significant step forward for LIHEAP and the families who depend on it.
NEW MARKETS INITIATIVE
The New Markets Initiative is another key bipartisan agreement
included in this legislation. I am pleased that the Congress has joined
President Clinton in his efforts to revitalize those communities that
have been left behind at this time of record prosperity, and I commend
Speaker Hastert for his leadership in reaching this agreement.
This initiative increases the low-income housing tax credit, which is
long overdue in light of its strong bipartisan support. With the
growing regional and national economy, housing prices are rising faster
in Massachusetts than in any other state. We must increase production
in new affordable housing units to meet the overwhelming demand, and an
increase in the credit is critical. The agreement also accelerates the
private activity bond cap, which will also support increased
development of affordable housing, as well as industrial development.
The initiative also creates 40 Renewal Communities and 9 new
Empowerment Zones--all of which provide tax incentives for development
in those parts of the country that have struggled while others have
prospered.
Overall, this final budget agreement includes so many major
achievements--from Class Size reduction to Pediatric Graduate Medical
Education to dislocated worker assistance to New Markets development--
that the value of each part will only become apparent over time. Yet
even as we celebrate the progress made by this legislation, we must
also recognize that it is only a small part of the work that the public
expects us to complete. I share the concern of many of my colleagues
that the unfinished agenda of the 106th Congress is so long.
We still lack a Patients' Bill of Rights, leaving HMO's free to
sacrifice families' health needs in favor of their own economic
interests.
We still lack a prescription drug benefit for seniors, leaving our
parents and grandparents vulnerable to drug-company extortion for drugs
they need to stay alive.
We still lack a plan to reduce medical errors, leaving thousands of
hospital patients to die needlessly each year.
We still lack a fair minimum wage, leaving people who work full time
all year in difficult jobs to raise their children in poverty.
We still lack common-sense gun laws, leaving school children
vulnerable to ambush.
We still lack strong laws against hate crimes, leaving the most
vulnerable people in our society open to the most brutal acts
imaginable.
We still lack basic fairness in many of our immigration laws, leaving
our proud heritage and noble ideals out in the cold with so many
huddled masses.
We still lack the most basic protection for women's work, leaving
more women to raise their children in poverty because they consistently
earn less than their male colleagues.
We still lack a plan to protect people's privacy in the digital age,
leaving our medical, consumer, and other personal information exposed
to market demands.
Also left unresolved are major Medicare and Social Security reforms
that must be enacted now if we are to avoid a crisis for the seniors of
2025 and beyond. I also believe that we should still address how to
provide some tax relief for many families who bear a particular
financial burden because they need to provide long term care for their
loved ones.
Every item on this list remains of vital importance to the nation. I
must elaborate on a several of them.
Unfortunately, the leadership of the 106th Congress turned its back
on America's families who are raising children with disabilities. The
Family Opportunity Act has sweeping bipartisan support in both
chambers, including more than three-fourths of the Senate. There is no
reason that this legislation should not have become law this year.
Although Congress let American families down this year, I look forward
to working with Senator Grassley again next year to ensure that no
family in this nation has to turn down jobs, turn down raises, or give
up custody of their disabled child to get the health care each child
deserves.
Few issues touch Americans more deeply than quality health care for
themselves and their loved ones. This Congress failed to fulfill its
responsibility to act on three great health issues. It did not pass a
strong, effective patients' bill of rights to end the abuses of managed
care and other insurance programs. It did not provide coverage of
prescription drugs under Medicare. And it did not significantly expand
insurance coverage for the uninsured. Now it is up to the new Congress
that will assemble in January to do better. These three issues should
be top priorities.
Prompt passage of a patients' bill of rights is critical for every
one of the 161 million Americans with private health insurance
coverage. Every day that Congress fails to act more patients suffer.
A survey by the School of Public Health at the University of
California found that every day--each and every day--50,000 patients
endure added pain and suffering because of their actions of their
health plan. For 35,000 patients, needed care is delayed, or even
denied all together. Thirty-five thousand patients have a specialty
referral delayed or denied. Thirty-one thousand patients are forced to
change doctors. Eighteen thousand patients are forced to change
medications because of HMO abuses.
A survey of physicians by the Kaiser Family Foundation and the
Harvard School of Public Health found similar results. Every day, tens
of thousands of patients suffer serious declines in the their health as
the result of the action--or inaction--of their health plan.
Whether the issue is diagnostic tests, specialty care, emergency room
care, access to clinical trials, availability of needed drugs,
protection of doctors who give patients their best possible advice, or
women's ability to obtain gynecological services--too often, in all
these cases, HMOs and managed care plans make the company's bottom line
more important than the patient's vital signs. These abuses should have
no place in American medicine. Every doctor knows it. Every patient
knows it. And in their hearts, every member of Congress knows it.
The House passed a Patient Bill of Rights--the Norwood-Dingell bill--
that effectively addressed these abuses. A solid bi-partisan majority
of Congress supported the legislation. It is endorsed by 300 groups
representing doctors, nurses, patients and advocates for women,
children, and families. But in the Senate, it has been blocked by the
insurance industry and the Republican leadership. The new Senate, the
new Congress, and the new President have an obligation to pass this
legislation into law.
This is an issue which hopefully, given the strong voting and
interests of our colleagues and their constituents, we will be able to
resolve in a bipartisan way during the next Congress.
The Congress' failure to provide prescription drug coverage to our
nation's senior citizens is also unacceptable. Senior citizens need a
strong drug benefit under Medicare. They earned it by a lifetime of
hard work. They deserve it. And Congress and the new President owe it
to them to act.
Too many elderly Americans today must choose between food on the
table
[[Page S11820]]
and the medicine they need to stay healthy or to treat their illnesses.
Too many senior citizens take half the pills their doctor prescribes,
or don't even fill needed prescriptions --because they can't afford the
high cost of prescription drugs.
Too many seniors are paying twice as much as they should for the
drugs they need, because they are forced to pay full price, while
almost everyone with a private insurance policy benefits from
negotiated discounts. Too many seniors are ending up hospitalized--at
immense cost to Medicare--because they aren't receiving the drugs they
need at all, or can't afford to take them correctly. Pharmaceutical
products are increasingly the source of miracle cures for a host of
dread diseases, but millions of senior citizens are being left out and
left behind because Congress fails to act.
The crisis that senior citizens face today will only worsen if we
refuse to act, because insurance coverage continues to go down, and
drug costs continue to go up.
Twelve million senior citizens--one third of the total--have no
prescription drug coverage at all. Surveys indicate that only half of
all senior citizens have prescription drug coverage throughout the
year. Coverage through employer retirement plans is plummeting.
Medicare HMOs are drastically cutting back. Medigap plans are priced
out of reach of most seniors. The sad fact is that the only senior
citizens who have stable, reliable, affordable drug coverage are the
very poor on Medicaid.
Prescription drug costs themselves are out of control. Since 1996,
costs have grown at double-digit rates every year. Last year, the
increase was an unacceptable 16 percent, while the increase in the CPI
was only 2.7 percent. No wonder access to affordable prescription drugs
has become a crisis for so many elderly Americans
In the face of this declining coverage and soaring cost, more and
more senior citizens are being left out and left behind. The vast
majority of the elderly are of moderate means. They cannot possibly
afford to purchase the prescription drugs they need if serious illness
strikes.
Fifty-seven percent of seniors have incomes below $15,000 a year, and
78 percent have incomes below $25,000. Only 7 percent have incomes
above $50,000 a year. The older they are, the more likely they are to
be in poor health--and the more likely they are to have very limited
income to meet their health needs.
Few if any issues facing the next Congress are more important than
giving the nation's senior citizens the health security they have been
promised. The promise of Medicare will not be fulfilled until Medicare
protects senior citizens against the high cost of prescription drugs,
in the same way that it protects them against the high cost of hospital
and doctor care.
Despite the gaps in Medicare and the abuses of many private insurance
plans, those who have insurance coverage from these sources are still
more fortunate than the 43 million of their fellow citizens who have no
health insurance at all.
It's a national disgrace that so many Americans find the quality of
their health determined by the quantity of their wealth. In this age of
the life sciences, the importance of good medical care in curing
disease and improving and extending life is more significant than ever.
Denying any family the health care they need is unacceptable.
Every other industrialized society in the world except South Africa
achieved that goal in the 20th century--and under Nelson Mandela and
Thabo Mbeki, South Africa has taken giant steps toward universal health
care today. But in our country, the law of the jungle still too often
prevails. Forty-three million of our fellow citizens are left out and
left behind when it comes to health insurance.
The dishonor roll of suffering created by this national problem is a
long one.
Children fail to get a healthy start in life because their parents
cannot afford the eyeglasses or hearing aids or doctor's visits they
need.
A young family loses its chance to participate in the American dream,
when a breadwinner is crippled or dies because of lack of timely access
to medical care.
A teenager is condemned to go without a college education, because
the family's income and energy are sucked away by the high financial
and emotional cost of uninsured illness.
An older couple sees its hope for a dignified retirement dashed, when
the savings of a lifetime are washed away by a tidal wave of medical
debt.
Even in this time of unprecedented prosperity, more than 200,000
Americans annually file for bankruptcy because of uninsured medical
costs. And the human costs of being uninsured are often just as
devastating.
In any given year, one third of the uninsured go without needed
medical care.
Eight million uninsured Americans fail to take the medication that
their doctor prescribes, because they cannot afford to fill the
prescription.
Four hundred thousand children suffer from asthma but never see a
doctor. Five hundred thousand children with recurrent earaches never
see a doctor. Another five hundred thousand children with severe sore
throats never see a doctor.
Thirty-two thousand Americans with heart disease go without life-
saving and life-enhancing bypass surgery or angioplasty--because they
are uninsured.
Twenty-seven thousand uninsured women are diagnosed with breast
cancer each year. They are twice as likely as insured women not to
receive medical treatment before their cancer has already spread to
other parts of their bodies. As a result, they are 50 percent more
likely to die of the disease.
Overall, eighty-three thousand Americans die each year because they
have no insurance. The lack of insurance is the seventh leading cause
of death in America today. Our failure to provide health insurance for
every citizen kills more people than kidney disease, liver disease, and
AIDS combined.
Passage of the CHIP program in 1997 opened the door of health
insurance to a large majority of the 10 million uninsured children--but
too many children eligible for CHIP and Medicaid have still not been
enrolled. Legislation I sponsored with Congressman John Dingell would
have substantially increased enrollment of eligible children in CHIP.
It would have encouraged states to make more children eligible, and
would have provided assistance to the low and moderate income uninsured
parents of these uninsured children. This legislation received a vote
of the majority of the members of the Senate, but it was defeated on a
procedural motion.
Today, our opportunity to end these millions of American tragedies is
greater than ever before. Our prosperous economy gives us large new
resources to invest in meeting this critical need. Recently, some
Republicans in Congress have finally joined Democrats in urging our
country to meet the challenge of providing health coverage to the 43
million Americans who are left out and left behind. President-elect
George Bush and Vice President Al Gore both campaigned on a pledge to
expand health insurance coverage for the uninsured. I regret that this
Congress did not take substantial steps to end this American tragedy,
but it should be at the top of the agenda of the new Congress and the
new Administration.
The minimum wage ranks at the top of the list as well. Our leader, in
a meeting of our Democratic caucus, indicated this afternoon that one
of his great disappointments in this session is failing to provide an
increase in the minimum wage for the 13 million Americans who need and
deserve an increase. The last time we increased it was 1997. We have
had unparalleled economic prosperity before and since. We have had
record low unemployment. We have had stability in inflation. It is
inexcusable that we have not increased the minimum wage for these
workers. I am strongly committed to working with our colleagues to
address that situation in the new Congress.
I join our Democratic leader in expressing my deep disappointment in
the failure of this Congress to increase the minimum wage. A fair
increase is long overdue. It is urgently needed to improve the lives of
over ten million hard-working, low-wage earners in this country. It is
shameful that Congress is holding the increase hostage to tax cuts for
the wealthy. It is even more shameful that Congress recently acted to
raise its own pay for the third time
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in four years--yet they have not found time in the past three years to
give any pay increase at all to the lowest paid workers.
The long period of inaction comes at a time when the country as a
whole is enjoying unprecedented prosperity--the longest period of
economic growth in the nation's history and the lowest unemployment
rate in three decades. In these strong economic times, Congress should
not be acting like Scrooge.
Millions of low income workers have dedicated their lives to building
this strong economy. Yet, in many cases they have been forced to labor
for increasingly longer and longer hours, with less and less time to
spend with their families, and without sharing fairly in the nation's
prosperity. Poverty has almost doubled among full-time, year-round
workers since the late 1970s--from about 1.5 million then to almost 3
million in 1998--and an unacceptably low minimum wage is part of the
problem.
Minimum wage employees working 40 hours a week, 52 weeks a year, earn
only $10,700 a year--$3,400 below the poverty line for a family of
three. At that rate, minimum wage workers now fail to earn enough to
afford adequate housing in any area of this country. Waitresses,
teacher's aides, child care workers, elder care workers and all other
employees deserve to be paid fairly for the work they do. No one who
works for a living should have to live in poverty.
By failing to increase the minimum wage, Congress has broken its
promise to American workers. We are denying them just compensation for
their many contributions to building a strong nation and a strong
economy.
We have broken our promise to women, since 60 percent of minimum wage
earners are women.
We have broken our promise to people of color, because 16 percent of
those who would benefit from a minimum wage increase are African
American and 20 percent of those who would be helped are Hispanic.
We have broken our promise to children, because 33 percent of minimum
wage earners are parents with children. In America today, 4.3 million
children live in poverty, despite living in a family where someone
works full-time, year-round.
And we have broken our promise to the American family, because too
many parents are required to spend more and more time away from their
families to make ends meet. On average, Americans are working 416 more
hours in 1999 then they were in 1979.
Each year we fail to act on the minimum wage, families across the
country fall farther behind. As the result of not implementing the
dollar increase we first proposed three years ago, when the clock
strikes midnight on the December 31st, minimum wage workers will have
lost over $3000 because of the inaction by Congress. Today, the real
value of the minimum wage is now $2.90 below what it was in 1968. To
have the purchasing power it had in 1968, the minimum wage would have
to be at least $8.05 an hour today, not $5.15.
We will never give up or give in on this issue, because it is an
issue of fundamental fairness. We will be back next year with a new
bill to raise the minimum wage. I hope that the new Congress will act
as quickly as possible to pass a fair increase that reflects the losses
suffered as the result of our shameful inaction this year.
President-Elect Bush has emphasized many of these priorities, and I
look forward to working with him. The lesson of the legislation before
us today is that when we fail to consider each other's ideas, only
gridlock results--but when we work together for the nation's good, the
result is the kind of progress that makes us all proud to serve the
American people.
The PRESIDING OFFICER (Mr. Abraham). The Senator from Nevada.
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