[Congressional Record Volume 147, Number 81 (Tuesday, June 12, 2001)]
[Senate]
[Pages S6129-S6140]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. BUNNING (for himself and Mr. Harkin):
S. 1014. A bill to amend the Social Security Act to enhance privacy
protections for individuals, to prevent fraudulent misuse of the Social
Security account number, and for other purposes; to the Committee on
Finance.
Mr. BUNNING. Mr. President, I rise today to re-introduce legislation
that is designed to protect the privacy of all Americans from identity
theft caused by theft or abuse of an individual's Social Security
number, SSN.
Identity theft is the fastest growing financial crime in the Nation,
affecting an estimated 500,000 to 700,000 people annually. Allegations
of fraudulent Social Security number use for identity theft increased
from 62,000 in 1999 to over 90,000 in 2000--this is a 50 percent
increase in just one year.
It's no wonder why, in Wall Street Journal poll last year,
respondents ranked privacy as their number one concern in the 21st
century, ahead of wars, terrorism, and environmental disasters.
All to often, the first clue someone has that their identity has been
stolen comes when retail stores, banks, or credit card companies send
letters wanting payment on bad checks or overdue bills that the
individual hadn't written or knew nothing about.
More than 75 percent of the time identity theft cases that take place
are ``true name'' fraud. That is when someone uses your social security
number to open new accounts in your name. The common criminal can apply
for credit cards, buy a car, obtain personal, business, auto, or real
estate loans, do just about anything in your name and you may not even
know about it for months or even years. Across the country there are
people who can tell you about losing their life savings or having their
credit history damaged, simply because someone had obtained their
Social Security number and fraudulently assumed their identity.
This bill prohibits the sale of Social Security numbers by the
private sector, Federal, State and local government agencies. This bill
strengthens existing criminal penalties for enforcement of Social
Security number violations to include those by government employees. It
amends the Fair Credit Reporting Act to include Social Security number
as part of the information protected under the law, enhances law
enforcement authority of the Office of Inspector General, and allows
Federal courts to order defendants to make restitution to the Social
Security trust funds.
This bill would also prohibit the display of Social Security numbers
on drivers licenses, motor vehicles registration, and other related
identification records, like the official Senate ID Card.
This new legislation reflects a small number of fair and appropriate
modifications, including the following: Since the Federal Trade
Commission does not have jurisdiction over financial institutions, our
bill would now authorize the U.S. Attorney General to issue regulations
restricting the sale and purchase of Social Security numbers in the
private sector; similar to our provisions affecting the public sector,
we make explicit our intent that the prohibition of sale, purchase, or
display of Social Security numbers in the private sector would not
apply if Social Security numbers are needed to enforce child support
obligations; to help prevent other individuals from suffering the same
tragic fate as Amy Boyer, we include a new provision that prohibits a
person from obtaining or using another person's Social Security number
in order to locate that individual with the intent to physically injure
or harm the individual or use their identity for an illegal purpose;
and we have clarified the provision that would prohibit businesses from
denying services to individuals an exception for those businesses that
are required by Federal law to submit the individual's Social Security
number to the Federal Government.
I think that it is high time that we get back to the original purpose
of the social security number. Social Security numbers were designed to
be used to track workers and their earnings so that their benefits
could be accurately calculated when a worker retires--nothing else.
I urge my colleagues to cosponsor this very important piece of
legislation.
______
By Mr. LEVIN (for himself, Ms. Stabenow, and Mr. Durbin):
S. 1015. A bill to require the Secretary of Transportation to issue
regulations to address safety concerns and to minimize delays for
motorists at railroad grade crossings; to the Committee on Commerce,
Science, and Transportation.
Mr. LEVIN. Mr. President, today I am pleased to introduce the
Railroad Crossing Delay Reduction Act with Senator Stabenow and Senator
Durbin. This legislation requires the Secretary of Transportation to
issue regulations within one year to address the safety concerns that
arise when trains block traffic at railroad crossings.
Sixteen States and many more municipalities have passed statutes and
ordinances limiting the amount of time a train is allowed to stop at
and thus block a railroad grade crossing. There are specific safety
reasons for limiting the time roadways can be blocked by trains.
However, the U.S. District Court for the Eastern District of Michigan
struck down a Michigan statute regulating the length of time that a
train may block a roadway, opening up the safety issues that my bill
will address. The ordinance in question prohibited trains from
obstructing free passage of any street for longer than five minutes in
order to minimize safety problems within communities.
The court concluded that the ordinance was preempted by the Federal
Railway Safety Act, FRSA. Unfortunately, there is no Federal regulation
[[Page S6130]]
addressing the length of time a train may block a grade crossing. That
means the State of Michigan and all of its political subdivisions are
now without the authority to provide this regulation and have no other
remedy. They are urging the passage of Federal legislation to regulate
the length of time a train may block a roadway in the interest of
public health and safety. They are calling for Federal action to give
them relief from the 45 minutes or more that trains are currently
sitting in railway crossings and blocking their roadways.
Believe it or not, trains actually stop in the middle of
intersections for 45 minutes or longer at a time. I have been given
examples of trains in Michigan that have sat for hours at crossings.
You can imagine the ramifications of major intersections being
completely blocked for so long.
This nationwide problem is amplified in Southeast Michigan because of
the number of rail lines in the region. For example, this lack of
regulation is causing a lot of problems for some of the older
municipalities in Michigan as train tracks literally cris-cross their
cities. For instance, in Trenton, MI, there is an entire neighborhood
that is bordered on one side by water on two sides by train tracks,
forming a triangle. If two trains block the tracks at the same time,
which has happened, the residents are literally trapped. Worse than the
residents being trapped is the fact that ambulances, police and fire
trucks are trapped out of town, or delayed in getting to their
emergency destinations.
Unless we take action and require the FRA to act, communities with
rail crossings are vulnerable. The problems range from the problem of
traffic congestion and delays to the literal inability of emergency
vehicles to get in or out of a community. Many Michigan cities have
railroad crossings at a number of important intersections that, when
closed by trains, severely limits their ability to provide emergency
service to its residents. Medical emergency crews in Michigan have
specifically complained to me that they face the daily problem of
trains blocking road traffic. They tell me this has the potential to
put in jeopardy their patients best chance of recovery. As we all
understand, time is of the essence in emergency situations.
Trains blocking railroad crossings also pose a threat for pedestrians
and children who may be tempted to crawl under or between rail cars
during long waits in order get to or from school. Vehicles may also be
tempted to speed around a train before it gets to the crossing in order
to avoid long delays. Both situations unnecessarily put lives in
danger.
Michigan businesses have also complained to me that trains have
blocked important roads for extensive periods of time during plant
shift changes. This has resulted in unnecessary lost wages and lost
production when employees cannot get to work.
Dozens of Michigan's towns and cities have pleaded for Federal action
to resolve this intolerable situation and have even passed resolutions
in support of this legislation. They include: Charter Township of
Huron, City of Lincoln Park, City of Plymouth, City of Riverview, City
of Rockwood, City of Southgate, City of Trenton, City of Westland, to
name only a few. Our community leaders believe it is essential to the
public health, safety and welfare of the residents of their cities that
blocked crossings be kept to a reasonable minimum, so that emergency
vehicles may have ready access to their citizens.
The legislation I am introducing today will give the Federal Railroad
Administration the push it needs to enact much needed regulations to
address this safety problem.
My bill would simply require the Secretary of Transportation to issue
regulations addressing these safety concerns. It is a reasonable
approach with nothing controversial or complicated about it.
Congressman Dingell has sponsored an identical bill in the House.
We need to stop the delays and remove potentially dangerous
situations by minimizing how long trains can stop at grade crossings.
Its time to address this lingering safety concern and reduce the risk
to motorists, pedestrians, and citizens at large. This is a very simple
bill that aims to stop the abuse of trains unnecessarily blocking
railroad crossings. It simply directs the FRA, the agency tasked with
overseeing railroad safety, to take action in this area. I hope this
legislation will be enacted quickly.
The Railroad Crossing Delay Reduction Act has the support of local
mayors, fire and police departments and emergency organizations. There
is currently no Federal limit to how long trains can sit and block
railroad crossings. This bill would require that one be instituted, in
the name of the public's safety.
I ask unanimous consent that the text of the bill be printed in the
Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1015
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Railroad Crossing Delay
Reduction Act''.
SEC. 2. REGULATIONS.
Not later than one year after the date of enactment of this
Act, the Secretary of Transportation shall issue regulations
regarding trains that block traffic at railroad grade
crossings to address safety concerns and to minimize delays
encountered by motorists that are caused by such trains.
Ms. STABENOW. Mr. President, I am proud to join my colleague from
Michigan, Senator Levin, in introducing the ``Railroad Crossing Delay
Reduction Act of 2001.''
Trains needlessly blocking traffic at railroad grade crossings is a
longstanding nationwide problem, that puts lives and property at grave
risk. When trains unnecessarily block vital intersections, it can cost
police, firefighters and emergency medical workers, critical minutes
when responding to an emergency situation. They also increase train-
automobile accidents, because many motorists dangerously speed through
railroad crossing intersections, in an attempt to avoid being delayed
for an extended period by an oncoming train. Train blockage also
prevents pedestrians, often young children on the way to and from
neighborhood schools, from crossing a railroad intersection resulting
in pedestrians climbing through trains to reach the other side.
Across the country, there are reports that fire trucks, ambulances,
and police vehicles have been unnecessarily delayed at train crossings.
The loss of a few minutes in an emergency situation can mean the
difference between life and death. A fire in a home or business can
double in size every 20 seconds, and a person suffering from a heart
attack can die after only six minutes without oxygen. In my home State
of Michigan, fire and EMS units in Delta Township were blocked by a
train for a few extra minutes as a boy burned to death on the other
side of the railroad crossing.
Last year, a Federal judge in Michigan struck down a State law
limiting the amount of time a train can block a crossing on the grounds
that it was a Federal issue and involved interstate commerce under the
Commerce Clause of the U.S. Constitution. Over 30 communities in
Michigan alone have passed resolutions asking for Congress to act on
this important safety issue.
The ``Railroad Crossing Delay Reduction Act of 2001'' addresses this
important national problem by requiring the Department of
Transportation to issue regulations to address these serious safety
concerns with respect to trains blocking traffic at railroad grade
crossings, and to minimize delays to automobile traffic resulting from
these blockages. I urge my Senate colleagues to support this
legislation and help address this critical railroad safety issue.
______
By Mr. BINGAMAN (for himself, Mr. Lugar, Mr. McCain, Mr. Corzine,
and Mrs. Lincoln):
S. 1016. A bill to amend titles XIX and XXI of the Social Security
Act to improve the health benefits coverage of infants and children
under the medicaid and State children's health insurance program, and
for other purposes; to the Committee on Finance.
Mr. BINGAMAN. Mr. President, I rise today to introduce bipartisan
legislation with Senators Lugar, McCain, Corzine, and Lincoln. This
legislation is entitled the ``Start Healthy, Stay Healthy Act of
2001.'' The purpose of the legislation is to significantly reduce the
number of uninsured children
[[Page S6131]]
and pregnant women by improving outreach to and enrollment of children
and by expanding coverage to pregnant women through Medicaid and CHIP.
An estimated 11 million children under age 19 were without health
insurance in 1999, including 129,000 in New Mexico, representing 15
percent of all children in the United States and 22 percent of children
in New Mexico. Unfortunately, due to variety of factors, including the
lack of knowledge by families about CHIP and bureaucratic barriers to
coverage such as lengthy and complex applications, an estimated 6.7
million of our Nation's uninsured children are eligible for but
unenrolled in either Medicaid or CHIP.
In addition, an estimated 4.3 million, or 32 percent, of mothers
below 200 percent of poverty are uninsured. According to the March of
Dimes, ``Over 95 percent of all uninsured pregnant women could be
covered through a combination of aggressive Medicaid outreach,
maximizing coverage for young women through [CHIP], and expanding CHIP
to cover income-eligible pregnant women regardless of age.''
It is a travesty that our Nation ranks 25th in infant mortality and
21st in maternal mortality in the world, which is the worst among
developed nations. Our legislation would address the problems related
to these issues.
Giving children a healthy start: The legislation provides States with
an enhanced Medicaid matching rate to ensure that children eligible for
Medicaid or CHIP leave the hospital insured and remain so through the
first year of life. The legislation provides States with the option to
further extend coverage to pregnant women through Medicaid and CHIP to
reduce infant and maternal mortality and low birthweight babies.
Helping children stay healthy: The legislation provides States with
an enhanced Medicaid matching rate to reduce the barriers to care for
children to keep them healthy throughout their childhood. And, the
legislation provides States with the option to increase CHIP
eligibility from 200 percent of federal poverty level to 250 percent
and to extend coverage to children through age 20.
As an example of an imposed barrier to health coverage, as of March
of this year, eight States continued to impose an asset test on
children and their families prior to receiving Medicaid coverage. This
results in a rather burdensome and complicated application in each of
these States. For example, in Colorado, the Denver Department of Human
Services received 15,330 application for Medicaid and 3,700 were denied
for having an asset, such as a car, in 1999. As the Denver Post pointed
out, ``Acquire an asset more than $1,500, such as a car, and you've
traded in health insurance for your children.''
In addition to creating a high percentage of denials, the imposition
of an assets test significantly complicates the Medicaid or CHIP
enrollment applications. For example, some States require reporting on
everything from whether anyone in the household has any resource such
as a checking account, life insurance, burial insurance, a saving
account, or any personal items above a certain amount to documenting
things such as work income, alimony, child support, interest from
savings, CD's, etc. over a period of time, including several months in
the past.
This can be a nightmare for some families. In Colorado, of the
families that do attempt to fill out the Medicaid or CHIP application,
it is estimated that 37 percent of all families are denied coverage
because the application is incomplete. In Texas, Medicaid applicants
can face a 17-page application, up to 14 forms and up to 20
verifications of those forms.
As a story in last Friday's Washington Post entitled ``Health
Coverage for Kids Low-Cost but Little Used,'' it was noted that about
100 students from Yale Medical School, likely some of our Nation's best
and brightest, filled out applications forms as part of their training
to enroll families and that not one was able to complete the form
adequately. If Yale Medical School students cannot fill out the forms
properly, is it any wonder that families across the country are having
a difficult time with the bureaucratic paperwork?
Fortunately, New Mexico eliminated its assets test a few years ago in
an effort to simplify its Medicaid application and make it easier for
families to apply. According to a recent report by the Kaiser Family
Foundation, States that have eliminated the asset test from Medicaid
have been able to streamline the eligibility determination process,
adopt automated eligibility determination systems, improve the
productivity of eligibility workers, establish Medicaid's identity as a
health insurance program distinct from welfare, make the enrollment
process for families friendlier and more accessible, and achieve
Medicaid administrative cost savings.
In addition, the State of Texas has enacted legislation in recent
days that seeks to simplify its enrollment process.
And yet, there are also reports from other States such as Kentucky
and Idaho that are moving to impose additional bureaucratic barriers to
coverage.
As the Denver Rocky Mountain News writes, ``The logic of erecting
such paperwork obstacles escapes us. Government doesn't have to offer
insurance to the children of the working poor, but having made the
decision to do so, it's hardly fair then to smother the program beneath
layers of red tape.''
There are also problems related to the poor coordination between
government agencies that are supposed to serve low-income families.
My good friend, Senator Lugar, recognized this very point and
successfully passed language in the ``Agricultural Risk Protection Act
of 2000'' to improve the coordination between the school lunch program
and both Medicaid and CHIP. His language makes it easier to disclose
information from the school lunch program application to Medicaid and
CHIP agencies. Since children that qualify for the school lunch program
are almost certainly eligible for either Medicaid or CHIP, this simple
but important language is already having an important impact on the
enrollment of children into Medicaid or CHIP.
According to a report by Covering Kids, the Albuquerque Public
Schools have successfully worked to improve coordination between
Medicaid and the school lunch program. As the report reads, ``The
team's record of success shows that a well-designed process and
dedicated staff can make [Medicaid enrollment] work. In August and
September of 2000, Albuquerque Public Schools determined 386 children
to be presumptively eligible for health coverage. Of these, 371 were
enrolled and only 15 were denied. That's a 96 percent acceptance rate.
And the numbers are growing.''
This coordination between Medicaid and the school lunch program is
being replicated across the country as a result of Senator Lugar's
language. However, we still have a number of problems with regard to
coordination between Medicaid and CHIP across the states that this bill
seeks to address.
Why is this important? Why should we make additional efforts to
reduce the number of uninsured children? According to the American
College of Physicians--American Society of Internal Medicine, uninsured
children, compared to the insured, are: up to 6 times more likely to
have gone without needed medical, dental or other health care; 2 times
more likely to have gone without a physician visit during the previous
year; up to 4 times more likely to have delayed seeking medical care;
up to 10 times less likely to have a regular source of medical care;
1.7 times less likely to receive medical treatment for asthma; and, up
to 30 percent less likely to receive medical attention for any injury.
This is equally true of expanded coverage to children and pregnant
women in government health programs. In fact, one study has ``estimated
that the 15 percent rise in the number of children eligible for
Medicaid between 1984 and 1992 decreased child mortality by 5
percent.'' This expansion of coverage for children occurred, I would
add, during the Reagan and Bush Administrations, so this is clearly a
bipartisan issue that deserves further bipartisan action.
We, as a Nation, should be doing much better by our children. It
should be unacceptable to all of us that the United States ranks 25th
in infant mortality and 21st in maternal mortality in the world.
Therefore, in addition to seeking to improve health insurance
coverage
[[Page S6132]]
among children, the bill builds off legislation sponsored in the last
Congress by Senator Lincoln entitled the ``Improved Maternal and
Children's Health Coverage Act'' and makes an important change to CHIP
to allow pregnant women to be covered. Thus, the first two words of our
bill, ``Start Healthy.''
Throughout our Nation's history, there has been long-standing Federal
policy linking programs for pregnant women and infants, including
Medicaid, WIC, and the Maternal Child Health Block Grant. CHIP,
unfortunately, failed to provide coverage to pregnant women beyond the
age of 18. As a result, it is more likely that children eligible for
CHIP are not covered from the moment of birth, and therefore, miss
those first critical months of life until their CHIP application is
processed. They are also more likely not to have had prenatal care.
By expanding coverage to pregnant women in the Children's Health
Insurance Program, this legislation recognizes the importance of
prenatal care to the health and development of a child. As Dr. Alan
Waxman of the University of New Mexico School of Medicine notes,
``Prenatal care is an important factor in the prevention of birth
defects and the prevention of prematurity, the most common causes of
infant death and disability. Babies born to women with no prenatal care
or late prenatal care are nearly twice as likely to [be] low
birthweight or very low birthweight as infants born to women who
received early prenatal care.''
Unfortunately, according to a recent report by the Centers for
Disease Control and Prevention, New Mexico ranked worst in the nation
in the percentage of mothers receiving late or no prenatal care last
year. The result is often quite costly, both in terms of the health of
the mother and child but also in terms of long-term expenses since the
result can be chronic, lifelong health problems.
In fact, according to the Agency for Healthcare Research and Quality,
``four of the top 10 most expensive conditions in the hospital are
related to care of infants with complications (respiratory distress,
prematurity, heart defects, and lack of oxygen).'' As a result, in
addition to reduced infant mortality and morbidity, the provision to
expand coverage of pregnant women and prenatal care can be cost
effective.
The Start Healthy, Stay Healthy Act also eliminates the unintended
Federal incentives through CHIP that covers pregnant women only through
the age of 18 and cut off that coverage once the women turn 19 years of
age. Should the government tell women that they are more likely to
receive prenatal care coverage only if they become pregnant as a
teenager?
I certainly think not, and certainly it is unlikely there is a single
Senator that would think it wise to send such a message. This
legislation corrects this unfortunate and unintentional policy
by allowing pregnant women to be covered through CHIP regardless of
age.
And finally, this legislation imposes no Federal mandates on States
to achieve these goals. Rather, through financial incentives, States
that adopt ``best practices'' and less cumbersome enrollment processes
for children would be rewarded.
The budget resolution contains $28 billion over 10 years to reduce
the number of uninsured in this country. Although the Congress passed
CHIP in 1997, 11 million children remain uninsured. It is time we
finish the job of ensuring that we, as the President says, ``leave no
child behind.''
This bipartisan legislation has already received the endorsement of
the following organizations: the March of Dimes, the American Academy
of Pediatrics, the American College of Obstetricians and Gynecologists,
the American Academy of Family Physicians, the American Academy of
Pediatric Dentistry, the American Academy of Child and Adolescent
Psychiatry, the National Association of Community Health Centers, the
American Hospital Association, the National Association of Children's
Hospitals, the Federation of American Health Systems, the National
Association of Public Hospitals and Health Systems, Catholic Health
Association, Premier, Family Voices, the Association of Maternal and
Child Health Programs, the National Health Law Program, the National
Association of Social Workers, Every Child By Two, and the United
Cerebral Palsy Associations. I urge its passage as soon as possible.
I ask unanimous consent that the text of the bill and a fact sheet be
printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
S. 1016
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Start
Healthy, Stay Healthy Act of 2001''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents.
TITLE I--START HEALTHY
Sec. 101. Enhanced Federal medicaid match for States that opt to
continuously enroll infants during the first year of life
without regard to the mother's eligibility status.
Sec. 102. Optional coverage of low-income, uninsured pregnant women
under a State child health plan.
Sec. 103. Increase in SCHIP income eligibility.
TITLE II--STAY HEALTHY
Sec. 201. Enhanced Federal medicaid match for increased expenditures
for medical assistance for children.
Sec. 202. Increase in SCHIP appropriations.
Sec. 203. Optional coverage of children through age 20 under the
medicaid program and SCHIP.
TITLE I--START HEALTHY
SEC. 101. ENHANCED FEDERAL MEDICAID MATCH FOR STATES THAT OPT
TO CONTINUOUSLY ENROLL INFANTS DURING THE FIRST
YEAR OF LIFE WITHOUT REGARD TO THE MOTHER'S
ELIGIBILITY STATUS.
(a) State Option.--Section 1902(e)(4) of the Social
Security Act (42 U.S.C. 1396a(e)(4)) is amended by adding at
the end the following new sentence: ``A State may elect
(through a State plan amendment) to apply the first sentence
of this paragraph without regard to the requirements that the
child remain a member of the woman's household and the woman
remains (or would remain if pregnant) eligible for medical
assistance.''.
(b) Enhanced FMAP.--The first sentence of section 1905(b)
of the Social Security Act (42 U.S.C. 1396d(b)) is amended--
(1) by inserting ``(A)'' after ``only''; and
(2) by inserting ``, or (B) on the basis of a State
election made under the third sentence of section
1902(e)(4)'' before the period.
(c) Effective Date.--The amendments made by this section
apply to medical assistance provided on or after October 1,
2001.
SEC. 102. OPTIONAL COVERAGE OF LOW-INCOME, UNINSURED PREGNANT
WOMEN UNDER A STATE CHILD HEALTH PLAN.
(a) In General.--Title XXI of the Social Security Act (42
U.S.C. 1397aa et seq.) is amended by adding at the end the
following new section:
``SEC. 2111. OPTIONAL COVERAGE OF LOW-INCOME, UNINSURED
PREGNANT WOMEN.
``(a) Optional Coverage.--Notwithstanding any other
provision of this title, a State child health plan (whether
implemented under this title or title XIX) may provide for
coverage of pregnancy-related assistance for targeted low-
income pregnant women in accordance with this section, but
only if the State has established an income eligibility level
under section 1902(l)(2)(A) for women described in section
1902(l)(1)(A) that is 185 percent of the income official
poverty line.
``(b) Definitions.--For purposes of this section:
``(1) Pregnancy-related assistance.--The term `pregnancy-
related assistance' has the meaning given the term child
health assistance in section 2110(a) as if any reference to
targeted low-income children were a reference to targeted
low-income pregnant women, except that the assistance shall
be limited to services related to pregnancy (which include
prenatal, delivery, and postpartum services) and to other
conditions that may complicate pregnancy.
``(2) Targeted low-income pregnant woman.--The term
`targeted low-income pregnant woman' has the meaning given
the term targeted low-income child in section 2110(b) as if
any reference to a child were deemed a reference to a woman
during pregnancy and through the end of the month in which
the 60-day period (beginning on the last day of her
pregnancy) ends.
``(c) References to Terms and Special Rules.--In the case
of, and with respect to, a State providing for coverage of
pregnancy-related assistance to targeted low-income pregnant
women under subsection (a), the following special rules
apply:
``(1) Any reference in this title (other than subsection
(b)) to a targeted low income child is deemed to include a
reference to a targeted low-income pregnant woman.
``(2) Any such reference to child health assistance with
respect to such women is deemed a reference to pregnancy-
related assistance.
``(3) Any such reference to a child is deemed a reference
to a woman during pregnancy and the period described in
subsection (b)(2).
[[Page S6133]]
``(4) The medicaid applicable income level is deemed a
reference to the income level established under section
1902(l)(2)(A).
``(5) Subsection (a) of section 2103 (relating to required
scope of health insurance coverage) shall not apply insofar
as a State limits coverage to services described in
subsection (b)(1) and the reference to such section in
section 2105(a)(1) is deemed not to require, in such case,
compliance with the requirements of section 2103(a).
``(6) There shall be no exclusion of benefits for services
described in subsection (b)(1) based on any pre-existing
condition and no waiting period (including any waiting period
imposed to carry out section 2102(b)(3)(C)) shall apply.
``(d) No Impact on Allotments.--Nothing in this section
shall be construed as affecting the amount of any initial
allotment provided to a State under section 2104(b).
``(e) Application of Funding Restrictions.--The coverage
under this section (and the funding of such coverage) is
subject to the restrictions of section 2105(c).
``(f) Automatic Enrollment for Children Born to Women
Receiving Pregnancy-Related Assistance.--Notwithstanding any
other provision of this title or title XIX, if a child is
born to a targeted low-income pregnant woman who was
receiving pregnancy-related assistance under this section on
the date of the children's birth, the child shall be deemed
to have applied for child health assistance under the State
child health plan and to have been found eligible for such
assistance under such plan (or, in the case of a State that
provides such assistance through the provision of medical
assistance under a plan under title XIX, to have applied for
medical assistance under such title and to have been found
eligible for such assistance under such title) on the date of
such birth and to remain eligible for such assistance until
the child attains 1 year of age. During the period in which a
child is deemed under the preceding sentence to be eligible
for child health or medical assistance, the child health or
medical assistance eligibility identification number of the
mother shall also serve as the identification number of the
child, and all claims shall be submitted and paid under such
number (unless the State issues a separate identification
number for the child before such period expires).''.
(b) State Option To Use Enhanced FMAP and SCHIP Allotment
for Coverage of Additional Pregnant Women under the Medicaid
Program.--Section 1905 of the Social Security Act (42 U.S.C.
1396d) is amended--
(A) in the fourth sentence of subsection (b), by inserting
``and in the case of a State plan that meets the condition
described in subsections (u)(1) and (u)(4)(A), with respect
to expenditures described in subsection (u)(4)(B) for the
State for a fiscal year'' after ``for a fiscal year,''; and
(B) in subsection (u)--
(i) by redesignating paragraph (4) as paragraph (5); and
(ii) by inserting after paragraph (3) the following new
paragraph:
``(4)(A) The condition described in this subparagraph for a
State plan is that the plan has established an income level
under section 1902(l)(2)(A) with respect to individuals
described in section 1902(l)(1)(A) that is 185 percent of the
income official poverty line.
``(B) For purposes of subsection (b), the expenditures
described in this paragraph are expenditures for medical
assistance for women described in section 1902(l)(1)(A) whose
income exceeds the income level established for such women
under section 1902(l)(2)(A)(i) as of the date of the
enactment of this paragraph but does not exceed 185 percent
of the income official poverty line.''.
(c) No Waiting Periods or Cost-Sharing.--
(1) No waiting period.--Section 2102(b)(1)(B) of the Social
Security Act (42 U.S.C. 1397bb(b)(1)(B)) is amended--
(A) by striking ``, and'' at the end of clause (i) and
inserting a semicolon;
(B) by striking the period at the end of clause (ii) and
inserting ``; and''; and
(C) by adding at the end the following new clause:
``(iii) may not apply a waiting period (including a waiting
period to carry out paragraph (3)(C)) in the case of a
targeted low-income pregnant woman, if the State provides for
coverage of pregnancy-related assistance for such women in
accordance with section 2111.''.
(2) No cost-sharing for pregnancy-related benefits.--
Section 2103(e)(2) of such Act (42 U.S.C. 1397cc(e)(2)) is
amended--
(A) in the heading, by inserting ``and pregnancy-related
services'' after ``preventive services''; and
(B) by inserting before the period at the end the
following: ``or for pregnancy-related services, if the State
provides for coverage of pregnancy-related assistance for
targeted low-income pregnant women in accordance section
2111''.
(d) Presumptive Eligibility.--
(1) In general.--Section 1920A(b)(3)(A)(i)(III) of the
Social Security Act (42 U.S.C. 1396r-1a(b)(3)(A)(i)(III)) is
amended by inserting ``a child care resource and referral
agency,'' after ``a State or tribal child support enforcement
agency,''.
(2) Application to presumptive eligibility for pregnant
women under medicaid.--Section 1920(b) of the Social Security
Act (42 U.S.C. 1396r-1(b)) is amended by adding at the end
after and below paragraph (2) the following flush sentence:
``The term `qualified provider' includes a qualified entity
as defined in section 1920A(b)(3).''.
(3) Application under title xxi.--
(A) In general.--Section 2107(e)(1)(D) of the Social
Security Act (42 U.S.C. 1397gg(e)(1)) is amended to read as
follows:
``(D) Sections 1920 and 1920A (relating to presumptive
eligibility).''.
(B) Exception from limitation on administrative expenses.--
Section 2105(c)(2) of the Social Security Act (42 U.S.C.
1397ee(c)(2)) is amended by adding at the end the following
new subparagraph:
``(C) Exception for presumptive eligibility expenditures.--
The limitation under subparagraph (A) on expenditures shall
not apply to expenditures attributable to the application of
section 1920 or 1920A (pursuant to section 2107(e)(1)(D)),
regardless of whether the child or pregnant woman is
determined to be ineligible for the program under this title
or title XIX.''.
(e) Program Coordination With the Maternal and Child Health
Program (Title V).--
(1) In general.--Section 2102(b)(3) of the Social Security
Act (42 U.S.C. 1397bb(b)(3)) is amended--
(A) in subparagraph (D), by striking ``and'' at the end;
(B) in subparagraph (E), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following new subparagraph:
``(F) that operations and activities under this title are
developed and implemented in consultation and coordination
with the program operated by the State under title V in areas
including outreach and enrollment, benefits and services,
service delivery standards, public health and social service
agency relationships, and quality assurance and data
reporting.''.
(2) Conforming medicaid amendment.--Section 1902(a)(11) of
such Act (42 U.S.C. 1396a(a)(11)) is amended--
(A) by striking ``and'' before ``(C)''; and
(B) by inserting before the semicolon at the end the
following: ``, and (D) provide that operations and activities
under this title are developed and implemented in
consultation and coordination with the program operated by
the State under title V in areas including outreach and
enrollment, benefits and services, service delivery
standards, public health and social service agency
relationships, and quality assurance and data reporting''.
(3) Effective date.--The amendments made by this subsection
take effect on January 1, 2002.
(f) Application of Annual Aggregate Cost-Sharing Limit.--
Section 2103(e)(3)(B) of the Social Security Act (42 U.S.C.
1397cc(e)(3)(B)) is amended by adding at the end the
following new sentence: ``In the case of a targeted low-
income pregnant woman provided coverage under section 2111,
or the parents of a targeted low-income child provided
coverage under this title under an 1115 waiver or otherwise,
the limitation on total annual aggregate cost-sharing
described in the preceding sentence shall be applied to the
entire family of such woman or parents.''.
(g) Effective Date.--Except as provided in subsection (e),
the amendments made by this section take effect on the date
of the enactment of this Act and apply to expenditures
incurred on or after that date.
SEC. 103. INCREASE IN SCHIP INCOME ELIGIBILITY.
(a) Definition of Low-Income Child.--Section 2110(c)(4) of
the Social Security Act (42 U.S.C. 42 U.S.C. 1397jj(c)(4)) is
amended by striking ``200'' and inserting ``250''.
(b) Effective Date.--The amendment made by subsection (a)
applies to child health assistance provided, and allotments
determined under section 2104 of the Social Security Act (42
U.S.C. 1397dd), for fiscal years beginning with fiscal year
2002.
TITLE II--STAY HEALTHY
SEC. 201. ENHANCED FEDERAL MEDICAID MATCH FOR INCREASED
EXPENDITURES FOR MEDICAL ASSISTANCE FOR
CHILDREN.
(a) Enhanced FMAP.--Section 1905(b) of the Social Security
Act (42 U.S.C. 1396d(b)) is amended by adding at the end the
following new sentence: ``Notwithstanding the first sentence
of this subsection, in the case of a State plan that meets at
least 7 of the conditions described in subsection (x)(1) (as
determined by the Secretary in consultation with States
(including the State agencies responsible for the
administration of this title and title V), beneficiaries
under this title, providers of services under this title, and
advocates for children), with respect to expenditures
described in subsection (x)(2) for the State for a fiscal
year, the Federal medical assistance percentage is equal to
the percentage determined for the State under subsection
(x)(3).''.
(b) Conditions and Expenditures Described.--Section 1905 of
the Social Security Act (42 U.S.C. 1396d) is amended by
adding at the end the following new subsection:
``(x)(1) For purposes of subsection (b), the conditions
described in this subsection are the following:
``(A) Highest schip income eligibility.--The State has a
State child health plan under title XXI which (whether
implemented under such title or under this title) has the
highest income eligibility standard permitted under title XXI
as of January 1, 2001, does not limit the acceptance of
applications, and provides benefits to all children in
[[Page S6134]]
the State who apply for and meet eligibility standards.
``(B) Uniform, simplified application form.--With respect
to children under age 19 (or such higher age as the State has
elected under section 1902(l)(1)(D)) who are eligible for
medical assistance under section 1902(a)(10)(A), the State
uses the same uniform, simplified application form
(including, if applicable, permitting application other than
in person) for purposes of establishing eligibility for
benefits under this title and also under title XXI.
``(C) Coordinated enrollment process.--The State has an
enrollment process that is coordinated with that under title
XXI so that a family need only interact with a single agency
in order to determine whether a child is eligible for
benefits under this title or title XXI, and that allows for
the transfer of enrollment, without a gap in coverage, for a
child whose income eligibility status changes but who remains
eligible for benefits under either title.
``(D) Same verification and redetermination policies;
automatic reassessment of eligibility.--With respect to
children under age 19 (or such higher age as the State has
elected under section 1902(l)(1)(D)) who are eligible for
medical assistance under section 1902(a)(10)(A), the State
provides for initial eligibility determinations and
redeterminations of eligibility using the same verification
policies (including with respect to face-to-face interviews),
forms, and frequency as the State uses for such purposes
under title XXI, and, as part of such redeterminations,
provides for the automatic reassessment of the eligibility of
such children for assistance under this title and title XXI.
``(E) No asset test.--The State does not impose an asset
test for eligibility under section 1902(l) or title XXI with
respect to children.
``(F) 12-month continuous enrollment.--The State has
elected the option of continuing enrollment under section
1902(e)(12) and has elected a 12-month period under
subparagraph (A) of such section.
``(G) Compliance with outstationing requirement.--The State
is providing for the receipt and initial processing of
applications of children for medical assistance under this
title at facilities defined as disproportionate share
hospitals under section 1923(a)(1)(A) and Federally-qualified
health centers described in subsection (l)(2)(B) of this
section consistent with the requirements of section
1902(a)(55).
``(H) No waiting period longer than 6 months.--The State
does not impose a waiting period for children who meet
eligibility standards to qualify for assistance under such
plan that exceeds 6 months (and may impose a shorter period
or no period) for purposes of complying with regulations
promulgated under title XXI to ensure that the insurance
provided under the State child health plan under such title
does not substitute for coverage under group health plans.
``(I) Sufficient provider payment rates.--The State
demonstrates that it is meeting the requirements of section
1902(a)(30)(A) through payment rates sufficient to enlist
enough providers so that care and pediatric, obstetrical,
gynecologic, and dental services are available under the plan
at least to the extent that such care and services are
available to the general population in the geographic area.
``(2)(A) For purposes of subsection (b), the expenditures
described in this paragraph are expenditures for medical
assistance for children described in subparagraph (B) for a
fiscal year, but only to the extent that such expenditures
exceed the base expenditure amount, as defined in
subparagraph (C).
``(B) For purposes of subparagraph (A), the children
described in this subparagraph are--
``(i) individuals who are under 19 years of age (or such
higher age as the State may have elected under section
1902(l)(1)(D)) who are eligible and enrolled for medical
assistance under this title; and
``(ii) individuals who--
``(I) would be described in clause (i) but for having
family income that exceeds the highest income eligibility
level applicable to such individuals under the State plan;
and
``(II) would be considered disabled under section
1614(a)(3)(C) (determined without regard to the reference to
age in that section but for having earnings or deemed income
or resources (as determined under title XVI for children)
that exceed the requirements for receipt of supplemental
security income benefits.
``(C) For purposes of subparagraph (A), the term `base
expenditure amount' means the total expenditures for medical
assistance for children described in subparagraph (B) for
fiscal year 1996.
``(3) For purposes of subsection (b), the Federal medical
assistance percentage with respect to expenditures described
in paragraph (2) for a fiscal year is equal to the following:
``(A) In the case of a State that meets 7 of the conditions
described in paragraph (1), the Federal medical assistance
percentage (as defined in the first sentence of subsection
(b)) for the State increased by a number of percentage points
equal to 50 percent of the number of percentage points by
which (1) such Federal medical assistance percentage for the
State is less than (2) the enhanced FMAP for the State
described in section 2105(b).
``(B) In the case of a State that meets 8 of the conditions
described in paragraph (1), the Federal medical assistance
percentage (as so defined) for the State increased by a
number of percentage points equal to 75 percent of the number
of percentage points by which (1) such Federal medical
assistance percentage for the State is less than (2) the
enhanced FMAP for the State (as so described).
``(C) In the case of a State that meets all of the
conditions described in paragraph (1), the enhanced FMAP (as
so described).''.
(c) Collection of Data.--The Secretary of Health and Human
Services shall modify such data collection and reporting
requirements under title XIX of the Social Security Act as
are necessary to determine the expenditures and base
expenditure amount described in section 1905(x)(2) of that
Act (as added by subsection (b)), particularly with respect
to expenditures and the base expenditure amount related to
children described in section 1905(x)(2)(B)(ii) of that Act.
(d) Effective Date.--The amendments made by subsections (a)
and (b) apply to medical assistance provided on or after
October 1, 2001.
SEC. 202. INCREASE IN SCHIP APPROPRIATIONS.
Section 2104(a) of the Social Security Act (42 U.S.C.
1397dd(a)) is amended by striking paragraphs (5) through (9)
and inserting the following:
``(5) for fiscal year 2002, $3,500,000,000;
``(6) for fiscal year 2003, $4,000,000,000;
``(7) for fiscal year 2004, $4,300,000,000;
``(8) for fiscal year 2005, $4,500,000,000;
``(9) for fiscal year 2006, $4,500,000,000; and''.
SEC. 203. OPTIONAL COVERAGE OF CHILDREN THROUGH AGE 20 UNDER
THE MEDICAID PROGRAM AND SCHIP.
(a) Medicaid.--
(1) In general.--Section 1902(l)(1)(D) of the Social
Security Act (42 U.S.C. 1396a(l)(1)(D)) is amended by
inserting ``(or, at the election of a State, 20 or 21 years
of age)'' after ``19 years of age''.
(2) Conforming amendments.--
(A) Section 1902(e)(3)(A) of such Act (42 U.S.C.
1396a(e)(3)(A)) is amended by inserting ``(or 1 year less
than the age the State has elected under subsection
(l)(1)(D))'' after ``18 years of age''.
(B) Section 1902(e)(12) of such Act (42 U.S.C.
1396a(e)(12)) is amended by inserting ``or such higher age as
the State has elected under subsection (l)(1)(D)'' after ``19
years of age''.
(C) Section 1920A(b)(1) of such Act (42 U.S.C. 1396r-
1a(b)(1)) is amended by inserting ``or such higher age as the
State has elected under section 1902(l)(1)(D)'' after ``19
years of age''.
(D) Section 1928(h)(1) of such Act (42 U.S.C. 1396s(h)(1))
is amended by inserting ``or 1 year less than the age the
State has elected under section 1902(l)(1)(D)'' before the
period at the end.
(E) Section 1932(a)(2)(A) of such Act (42 U.S.C. 1396u-
2(a)(2)(A)) is amended by inserting ``(or such higher age as
the State has elected under section 1902(l)(1)(D))'' after
``19 years of age''.
(b) Title XXI.--Section 2110(c)(1) of such Act (42 U.S.C.
1397jj(c)(1)) is amended by inserting ``(or such higher age
as the State has elected under section 1902(l)(1)(D))''.
(c) Effective Date.--The amendments made by this section
take effect on October 1, 2001, and apply to medical
assistance and child health assistance provided on or after
such date.
____
Fact Sheet--Start Healthy, Stay Healthy Act of 2001
Sens. Jeff Bingaman (D-NM), Richard Lugar (R-IN), John
McCain (R-AZ), Jon Corzine (D-NJ), and Blanche Lincoln (D-AR)
introduced the ``Start Healthy, Stay Healthy Act of 2001'' on
June 12, 2001. The legislation would significantly reduce the
number of uninsured children and pregnant women by improving
outreach to and enrollment of children and by expanding
coverage to pregnant women through Medicaid and the State
Children's Health Insurance Program (CHIP).
An estimated 11 million children under age 19 were without
health insurance in 1999, representing 15% of all children in
the United States. Due to a variety of factors, including
governmental barriers to coverage, such as bureaucratic ``red
tape,'' and the lack of knowledge of families about CHIP, an
estimated 6.7 million of our nation's uninsured children are
eligible for but are unenrolled in either Medicaid or CHIP.
In addition, an estimated 4.3 million, or 32%, of mothers
below 200% of poverty are uninsured. According to the March
of Dimes, ``Over 95 percent of all uninsured pregnant women
could be covered through a combination of aggressive Medicaid
outreach, maximizing coverage for young women through [CHIP],
and expanding CHIP to cover income-eligible pregnant women
regardless of age.''
The legislation would reduce the number of uninsured
children and pregnant women by:
Start healthy
Providing states with an enhanced Medicaid matching rate to
ensure that children eligible for Medicaid or CHIP leave the
hospital insured and remain so through the first year of
life.
Providing states with the option to further extend coverage
to pregnant women through Medicaid and CHIP to reduce infant
and maternal mortality and low birthweight babies.
Stay healthy
Providing states with an enhanced Medicaid matching rate to
reduce the barriers to care for children to keep them healthy
throughout their childhood.
[[Page S6135]]
Providing states with the option to increase CHIP
eligibility from 200% of federal poverty level to 250% and to
extend coverage to children through age 20.
As a result of these provisions, the legislation would
achieve the following additional objectives:
Reduces Infant and Maternal Mortality: The United States
ranks 25th in infant mortality and 21st in maternal
mortality, the worst among developed nations. Studies with
respect to the previous expansions of Medicaid coverage to
pregnant women and children during the Reagan and Bush
Administrations indicate those expansions reduced infant
mortality and improved child health (GAO, ``Insurance and
Health Care Access,'' November 1997). By reducing the number
of uninsured children and pregnant women in this country, the
legislation would also reduce infant and maternal mortality
as well.
Eliminates Bureaucratic Barriers to Coverage and Promotes
Best Practices by States: Building on the successful
enactment of Senator Lugar's amendment to the ``Agricultural
Risk Protection Act of 2000'' to make it easier to disclose
information from the school lunch program application to
Medicaid and CHIP agencies, this legislation seeks to further
improve coordination between Medicaid, CHIP, and the Maternal
and Child Health (MCH) Block Grant in order to expand health
insurance coverage to eligible but unenrolled children. The
bill also provides states financial incentives to remove
bureaucratic barriers to health insurance coverage in
Medicaid and CHIP for children. These provisions reward
states for ``best practices'' and also eliminates the
negative incentive for states to enroll children improperly
in CHIP (with the higher matching rate, higher cost sharing,
and reduced benefits) rather than Medicaid (with a lower
matching rate, reduced cost sharing, and increased benefits).
Addresses the ``CHIP Dip'': There is a ``dip'' in federal
funding, known as the ``CHIP dip'' in fiscal years 2002
through 2006 that states have complained will cause them to
limit their CHIP programs out of fear of not having enough
funding in those years. The bill addresses that problem by
raising CHIP funding levels in fiscal years FY 2002 through
2006.
Eliminates Unintended Federal Incentives Regarding Teenage
Pregnant Women: Current federal law allows pregnant women to
receive coverage through CHIP through age 18--creating a
perverse federal incentive of covering only teenage pregnant
women and cutting off that coverage once they turn 19 years
of age. This legislation would eliminate this problem by
allowing states to cover pregnant women through CHIP,
regardless of age. This also eliminates the unfortunate
separation between pregnant women and infants that has been
created through CHIP, which has been contrary to long-
standing federal policy through programs such as Medicaid,
WIC, MCH, etc.
Imposes No Mandates on States: This legislation imposes no
mandates on states. However, states would, just as we have
done in the Temporary Assistance for Needy Families (TANF),
be provided financial incentives and accountability for the
additional money this legislation provides in return for
reducing governmental barriers to coverage for children and
pregnant women.
Remains Within the Budget Framework: The budget provides
for $28 billion over 10 yeas for the purpose of reducing the
number of uninsured. This proposal will meet those budgetary
limits.
This bipartisan legislation has received the endorsement of
the following organizations: the March of Dimes, the American
Academy of Pediatrics, the American College of Obstetricians
and Gynecologists, the American Academy of the Family
Physicians, the American Academy of Pediatric Dentistry, the
American Academy of Child and Adolescent Psychiatry, the
National Association of Community Health Centers, the
American Hospital Association, the National Association of
Children's Hospitals, the Federation of American Health
Systems, the National Association of Public Hospitals and
Health Systems, Catholic Health Association, Premier, Family
Voices, the Association of Maternal and Child Health
Programs, the National Health Law Program, the National
Association of Social Workers, Every Child by Two, and the
United Cerebral Palsy Associations.
legislative summary
This legislation is split into two titles:
Title I: Start healthy
Provides states through Medicaid with the CHIP enhanced
matching rate if they choose the option to continuously
enroll infants from birth through the first year of life, as
allowed under current law, regardless of the woman's status
during that year.
Provides states with an option to further cover pregnant
women through Medicaid and CHIP (above 185% of poverty up to
the full CHIP eligibility levels) in order to reduce infant
mortality and the delivery of low birthweight babies.
Title II: Stay healthy
Provides states through Medicaid with the CHIP enhanced
matching rate for children above a certain base expenditure
level such as a state's spending on children in 1996) if they
choose to meet the following conditions: States must expand
coverage to children up to the full extent that is allowed
under CHIP (to 200% of poverty or 50 percentage points above
where the coverage levels were prior to passage of Title
XXI); adoption of a simplified, joint mail-in application;
adoption of application procedures (e.g., verification and
face-to-face interview requirements) that are no more
extensive, onerous, or burdensome in Medicaid than in CHIP,
elimination of assets test; adoption of 12-month continuous
enrollment; adoption of procedures that simplify the
redetermination/coverage renewal process by allowing families
to establish their child's continuing eligibility by mail
and, in states with separate CHIP programs, by establishing
effective procedures that allow children to be transferred
between Medicaid and the separate program without a new
application a gap in coverage when a child's eligibility
status changes; compliance with the OBRA-89 outstationed
workers requirement, which provide for outstationed
eligibility workers in Medicaid DSH hospitals and community
health centers, impose waiting periods no longer than 6
months for children seeking to enroll in CHIP (ensure
flexibility for states to impose shorter periods, if at all);
and demonstrate that the State has adopted payments rates
sufficient to enlist enough providers so that care and
pediatric, obstetrical/gynecologic and dental services are
available at least to the extent such care and services are
available to the general population in the geographic area.
States meeting these conditions would receive the full
enhanced CHIP matching rate. If a state meets 8 of these
conditions, it would receive 75% of the difference between
the regular Medicaid matching rate and the CHIP enhanced
matching rate. If a state meets 7 of the conditions, it would
receive 50% of the difference.
Expand CHIP eligibility to 250% of poverty for children and
pregnant women.
Expand CHIP eligibility up to age 21 (adding 19 and 20
year-olds).
The legislation also increases the CHIP allotments in FY
2002 to $3.5 billion, in FY 2003 to $4 billion, in FY 2004 to
$4.3 billion in FY 2005 to $4.5 billion, and in FY 2006 to
$4.5 billion.
______
By Mr. DODD (for himself, Mr. Chafee, Mr. Leahy, Mr. Lugar, Mr.
Roberts, Mr. Baucus, Mr. Levin, Mrs. Boxer, Mr. Jeffords, Mr.
Kennedy, Mr. Akaka, Mr. Wellstone, Mr. Dorgan, Mr. Bingaman,
Mr. Durbin and Mr. Hagel):
S. 1017. A bill to provide the people of Cuba with access to food and
medicines from the United States, to ease restrictions on travel to
Cuba, to provide scholarships for certain Cuban nationals, and for
other purposes; to the Committee on Foreign Relations.
Mr. DODD. Mr. President, last year 26 Senators cosponsored
legislation to help the Cuban people and American farmers and
businesses by allowing sales of food and medicine to Cuba. Later, with
passage of the FY2001 Agriculture Appropriations Bill, the 106th
Congress approved the issuance one year licenses for the sale of food
and medicine to Cuba, but placed restrictions on the financing of these
sales. This was a beginning, and now we need to expand on this small
success by continuing to move forward in constructing bridges to the
Cuban people.
Toward that end, I am today joined by a bipartisan group of my
colleagues in introducing the Bridges to the Cuban People Act, an
expanded version of the legislation that was passed last year. Among
those joining as original cosponsors are Senators Chafee, Leahy, Lugar,
Roberts, Baucus, Levin, Boxer, Jeffords, Kennedy, Akaka, Wellstone,
Dorgan, Bingaman, and Durbin. This bill comprehensively updates U.S.
policy toward Cuba by increasing humanitarian trade between Cuba and
the United States, increasing our people-to-people contacts, and
enhancing the flexibility of the President with respect to our foreign
policy towards Cuba. I would like to take a few moments to outline the
various sections of this bill, and to explain to my colleagues the
reasons why enactment of this legislation is so vital.
First, let me be clear. This new legislation will not end the embargo
on Cuba. Rather, this bill creates specific exceptions to the embargo
that will allow American farmers and businesses to sell food, medicine,
and agricultural equipment to Cuba without the burden of securing
annual licenses and will allow our farmers and businesses to use
American banks and American financing to conduct these sales. Both of
these changes, along with the lifting of shipping restrictions, are
designed to allow sales to move forward in a way that is less
burdensome to American farmers and businesses. Additionally, this bill
would mandate that the President submit a report to Congress each year
describing the number and types of sales to Cuba so that we will have
some official record of these sales.
[[Page S6136]]
The Building Bridges to the Cuban People Act would also lift the
embargo on the exports of goods or services intended for the exclusive
use of children. No embargo should include children as its victims, and
this provision would allow us to give special attention to children in
Cuba.
This bill also modernizes our approach to Cuba's medical exports.
Cuba is currently involved in the development of some medicines that
are not available in the United States, such as the Meningitis B
vaccine, but that could save American lives. This legislation would
allow Cuba, with the approval of the Secretary of Health and Human
Services, to export to the United States medicines for which there is a
medical need in the United States, provided the medicine is not
currently being manufactured in our country. In this way we can build
on the strong tradition of medical research in Cuba and encourage the
free exchange of ideas and experiments between scholars.
In addition, this bill will lift restrictions on travel to Cuba. Cuba
does not now pose a threat to individual Americans, and it is time to
permit our citizens to exercise their constitutional right to travel to
Cuba. Surely we do not ban travel to Cuba out of concern for the safety
of Americans who might visit the island Nation. Today Americans are
free to travel to Iran, the Sudan, Burma, Yugoslavia, and North Korea,
but not to Cuba. This is a mistake. American influence, through person-
to-person and cultural exchanges, was one of the prime factors in the
evolution of our hemisphere from a hemisphere ruled predominantly by
authoritarian and military regimes to one where democracy is the rule.
Our current policy toward Cuba limits the United States from using our
most potent weapon in our effort to combat totalitarianism, and that is
our own people. They are some of the best ambassadors we have ever sent
anywhere, and the free exchange of ideas between Americans and the
Cuban people is one of the best ways to encourage democracy and build
bridges between the American and Cuban people.
Another provision in this new legislation would allow us to reach out
to Cuban students. Under this legislation, scholarships would be
provided for Cubans who would like to pursue graduate study in the
United States in the areas of public health, public policy, economics,
law, or other fields of social science. Throughout our history,
educational and cultural exchanges have proven to be valuable tools
that lead to understanding and friendship. This scholarship program is
a concrete example of the true people-to-people dialogue we should be
trying to foster with Cuba.
Nor does this legislation ignore the struggle of the Cuban-American
population in the United States. Cuban-Americans here have always had
the ability to send money to their families in Cuba, but the government
imposes restrictions on the total amount of money that can be sent.
This legislation would lift these limitations so that Americans would
be free to provide whatever assistance they wished to their loved ones.
And, finally, this bill would modernize the way our policies toward
Cuba are codified. At the present time, the President has the authority
to waive Title III of the Helms/Burton Act. This legislation would
extend the President's authority so that he could also waive Title I,
Title II, and Title IV of the Helms/Burton Act, at his discretion. When
Helms/Burton was enacted it contained a provision that codified all
existing Cuban embargo Executive Orders and regulations, but did not
provide for presidential waivers. This lack of waivers severely ties
the hands of the Administration if a decision is made to make changes
in our policy towards Cuba. The President should have the tools he
needs to conduct and modify our foreign policy, and this legislation
would give the President the flexibility to shape our relationship with
Cuba in a more positive way.
In conclusion, I believe that this bill will streamline our Cuban
policy so that it deals with the realities of the modern age, addresses
the needs of our American farmers, patients, and children, while
imposing the fewest restrictions on American citizens who wish to have
contact with the people of Cuba. The people of Cuba are not our enemy.
Our government's quarrel is with Fidel Castro, and our policies should
reflect that reality. Without doubt, the Castro regime has denied
rights to its citizens, but in our efforts to isolate him, we have
built walls that are hampering our goal of bringing democracy to the
Cuban people. As a measure that tears down those walls and replaces
them with bridges, this legislation is a good starting point for a
serious debate about how we can change U.S. policy in order to foster a
peaceful transition to democracy on the island of Cuba while
alleviating the hardship that our current policy has caused for the 11
million people who reside there. I hope to hold hearings in the near
future and will be discussing with the committee leadership dates for
the markup of this important legislation. Congressmen Serrano, Leach
and more than eighty of their House colleagues have introduced a
companion bill in the House today as well. I urge the rest of my
colleagues to join us in this endeavor.
Mr. BINGAMAN. Mr. President, I rise today in support of the Bridges
to Cuban People Act of 2001. As many of my colleagues know, I have been
vocal in my support of legislation that removes sanctions against the
Cuban people. I have supported such legislation for several reasons.
First, sanctions ultimately hurt the very people we proclaim we are
trying to help. It is obvious by now that barriers that either hinder
or prohibit the flow of food and medicine to Cuba do not impact the
Castro regime, but rather harms innocent men, women, and children.
Second, sanctions are counterproductive to our goal of bringing about
change in Cuba. There is no empirical evidence whatsoever that our
continued efforts to isolate Cuba has brought about any transformation
in the way the Castro regime sees or reacts to the world. Finally,
sanctions prevent U.S. firms from exporting to Cuba, allow their
counterparts in other countries to make sales our firms cannot, and
thus harm the U.S. economic interest.
I am convinced engagement on all fronts--social, economic, and
political--will make a substantial difference in Cuba, and it is way
past time that we begin that process. The bill today represents another
dramatic step forward in our policy in this regard. After considerable
debate over the years, we are now seeing consensus emerge among my
colleagues on this issue, as indicated by the bi-partisan support for
this bill. The components of this legislation--the unrestricted sales
of food, farm equipment, agricultural commodities and medicine, the
removal of restrictions on travel, the authorization of scholarships
for Cuban students to study in the United States, among others--are in
fact the humanitarian, responsible, and appropriate way to approach
Cuba at this time.
Let me emphasize today, as I have in the past, that the elimination
of sanctions on Cuba and the creation of new opportunities for the
Cuban people does not imply that I, or the Senate as a whole, agree
with the policies and politics of the Castro regime. Quite the
contrary. I believe the Castro regime to be distinctly out of touch
with current trends in the international system and their own people. I
personally deplore the Castro regime's oppressive tactics. The lack of
freedom and opportunity in that country stands in direct contrast to
most of the countries in the Western Hemisphere and throughout the
world. Cuba now stands alone in its inability to allow the growth of
democracy, to establish the protection of individual rights, and create
a semblance of economic security. It is a political system that should
be condemned at every opportunity.
But as a practical matter this legislation suggests that we cannot
effectively punish authoritarian regimes through their own people. Cuba
is ripe for change, and the best way to achieve positive change is to
allow Americans to communicate and associate with the Cuban people on
an intensive and ongoing basis, to re-establish cultural activities,
and to rebuild economic relations. To allow the Cuban system to remain
closed does little to assert United States influence over policy in
that country and it does absolutely nothing in terms of creating the
foundation for much-needed political economic transformation. The
spread of democracy comes from interaction, not isolation.
So, I strongly support this bill, and I urge my colleagues to do so
as well.
[[Page S6137]]
______
By Mr. LEVIN (for himself, Ms. Snowe, Mrs. Murray, Mr. Schumer,
Ms. Stabenow, and Ms. Cantwell):
S. 1018. A bill to provide market loss assistance for apple
producers; to the Committee on Agriculture, Nutrition, and Forestry.
Mr. LEVIN. Mr. President, I am today introducing a bill that seeks to
provide much needed assistance to our Nation's apple farmers. In the
past four years, due to weather related disasters, disease and the
dumping of Chinese apple juice concentrate, our Nation's apple
producers have lost over $1.4 billion dollars in revenue. This has left
many growers on the brink of financial disaster.
In the past three years, Congress has assisted America's farmers by
providing substantial assistance to agricultural producers. The U.S.
apple industry boasts a long history of self-sufficiency and has long
operated without relying upon federally funded farm programs. Last
year, Congress, recognized the problems facing apple growers and for
the first time ever, provided direct market loss assistance to apple
growers.
Even with this aid, a significant percentage of apply growers are
expected to go out of the business this year. Without some type of
financial relief, the numbers could indeed be staggering. Studies by
economists at Michigan State University estimated U.S. apple growers
will lose nearly $500 million this year alone. Such losses threaten to
devastate the entire U.S. apple industry. The Michigan Farm Bureau
states that the number of those leaving the business in some States is
running as high as 30 percent. Assistance is desperately needed to help
stabilize not only the production sector but entire communities and
subsidiary businesses that are dependent on the apple industry, not
only in Michigan, but nationwide.
The $250 million in assistance we are proposing will help those who
depend on the apple industry for their livelihood, and ensure that
American apple growers will be able to provide the United States and
the world with a quality product that is second to none.
Mrs. MURRAY. Mr. President, I rise today to express my strong support
for legislation to provide $250 million in emergency payments to apple
growers. I would like to thank Senators Levin and Snowe for their
leadership on this issue.
Rural communities and agricultural producers have not enjoyed
America's recent economic prosperity. Around the Nation, nearly all
commodity producers are enduring low prices and trade challenges. In
Washington State, these problems are compounded by a severe drought, an
energy crisis, and fish listings under the Endangered Species Act.
The combined impact is devastating. Apple growers in my State, from
Okanogan County to Walla Walla County, are going bankrupt. Many family
farmers have given up hope. On land that has produced high quality
fruit for generations, farmers are tearing out orchards. Farmer
cooperatives and other businesses that have been a part of rural
communities for decades have closed up shop. Local governments have
seen tax revenue decline. And non-farm businesses have struggled as
consumers no longer have the cash to buy their goods and services.
In the 106th Congress, we responded. Last year, I worked with my
colleagues to pass a $100 million emergency package for apple growers.
In 1999, I worked with the Clinton Administration to end the dumping by
Chinese companies of non-frozen apple juice concentrate. And on a host
of smaller issues, from fighting pests in abandoned orchards, to
securing research funding, to breaking down trade barriers, I worked
with the industry and other stakeholders to build a stronger foundation
for the future.
We can be proud of what we accomplished. But we still have more to do
in the 107th Congress.
If signed into law, this new legislation will provide $250 million in
emergency payments to apple growers nation-wide. This emergency
legislation will not save every producer. It will give the industry the
financial support it needs to get through another year of disastrous
prices. It will also give us the time we need to develop long-term
solutions as part of the next farm bill for apple and other specialty
crop growers.
I urge my colleagues to support this legislation. And I urge the
Senate Agriculture Committee and the Senate Appropriations Committee to
work with the sponsors of this bill to provide meaningful assistance to
all apple growers.
______
By Mrs. FEINSTEIN:
S. 1019. A bill to provide for monitoring of aircraft air quality, to
require air carriers to produce certain mechanical and maintenance
records, and for other purposes; to the Committee on Commerce, Science,
and Transportation.
Mrs. FEINSTEIN. Mr. President, today I am proud to introduce the
Aircraft Clean Air Act of 2001. The bill is designed to encourage
airlines to keep records of airplane cabin air quality complaints, as
well as complaints of illnesses that may be a result of poor air
quality.
Airlines are not required to maintain records of passenger and
crewmember complaints regarding cabin air quality, even if the
passenger or crewmember reports an illness as a result of poor air
quality.
As a result, potentially valuable information is lost to researchers
studying cabin air quality.
The Aircraft Clean Air Act allows passengers and crewmembers to
submit their complaints directly to the Federal Aviation Administration
and requires that the Administration record the complaint and pass it
on to the appropriate airline.
The bill requires airlines to maintain records of complaints for ten
years.
If a passenger or crewmember requests mechanical or maintenance
records with regard to their complaint, and the passenger or crewmember
has had a health care professional verify their symptoms, this
legislation requires that the airline provide the requested information
within 15 days. If the airline does not comply with the request, it is
subject to a civil penalty of $1,000 for each day it does not produce
the records.
Airlines must be ready to provide maintenance records of all
chemicals used in or on the plan, from cleaning solvents to hydraulic
fluids.
The traveling public should have access to any chemicals to which
they may be exposed.
The Aircraft Clean Air Act addresses another issue, as well: aircraft
pressurization.
Planes are currently pressurized to 8,000 feet while in the air. That
means that even though the plane is flying at 30,000 feet, the cabin
has the same air pressure as it would at 8,000 feet.
Airplane manufacturers arrived at the 8,000 figure in the 1960s when
commercial air travel was booming. They agreed on the figure after
testing the effects of different pressurizations on young, healthy
pilots.
Because oxygen is absorbed into the blood at a much lower rate in
high altitudes, there is speculation that some illnesses experienced
during flight are a result of the 8,000 feet pressurization. Commonly
reported symptoms such as shortness of breath and numbness in the limbs
may be a direct result of the high altitude.
The Aircraft Clean Air Act directs the Federal Aviation
Administration to sponsor an aeromedical research project to determine
what cabin altitude limit should provide enough oxygen to passengers
and crew.
The bill allows universities to compete to conduct the study, and the
National Academy of Sciences' Committee on Air Quality in Passenger
Cabins of Commercial Aircraft to select the winner.
Researchers will examine the oxygen saturation in people of different
ages, weights, and body types at 5,000 feet through 8,000 feet. The
bill directs researchers to determine which altitude provides enough
oxygen to ensure that individuals' health is not adversely affected
either in the short-term or long-term.
It is unacceptable that airlines do not maintain records of air
quality complaints on their commercial flights. I hope my colleagues
will join me in this effort to protect the traveling public and the
hardworking men and women who make air travel possible.
______
By Mr. HARKIN (for himself, Mr. Craig, Mr. Bingaman, Mrs.
[[Page S6138]]
Murray, Mr. Feingold, Mr. Kohl, and Mr. Leahy):
S. 1020. A bill to amend title XVIII of the Social Security Act to
improve the provision of items and services provided to Medicare
beneficiaries residing in rural areas; to the Committee on Finance.
Mr. HARKIN. Mr. President, I am pleased to be joined today by my
colleagues, Senator Craig, Senator Bingaman, Senator Murray, Senator
Feingold, and Senator Kohl to introduce the Medicare Fairness in
Reimbursement Act of 2001. This legislation addresses the terrible
unfairness that exists today in Medicare payment policy.
According to the latest Medicare figures, Medicare payments per
beneficiary by State of residence ranged from slightly less than $3,000
to well in excess of $7,000. For example, in Iowa, the average Medicare
payment was $2,985, nearly 45 percent less than the national average of
$5,364. In Idaho, the average payment is $3,592, only 66 percent of the
national average.
This payment inequity is unfair to seniors in Iowa and Idaho, and it
is unfair to rural beneficiaries everywhere. The citizens of my home
State pay the same Medicare payroll taxes required of every American
taxpayer. Yet they get dramatically less in return.
Ironically, rural citizens are not penalized by the Medicare program
because they practice inefficient, high cost medicine. The opposite is
true. The low payment rates received in rural areas are in large part a
result of their historic conservative practice of health care. In the
early 1980's rural States' lower-than-average cost were used to justify
lower payment rate, and Medicare's payment policies since that time
have only widened the gap between low- and high-cost States.
Two years ago I wrote to the Health Care Financing Administration
(HCFA) and I asked them a simple question. I asked their actuaries to
estimate for me the impact on Medicare's Trust Funds, which at that
time were scheduled to go bankrupt in 2015, if average Medicare
payments to all states were the same as Iowa's.
I've always thought Iowa's reimbursement level was low. But HCFA's
answer surprised even me. The actuaries found that if all States were
reimbursed at the same rate as Iowa, Medicare would be solvent for at
least 75 years, 60 years beyond their projections.
I'm not suggesting that all States should be brought down to Iowa's
level. But there is no question that the long-term solvency of the
Medicare program is of serious national concern. And as Congress
considers ways to strengthen and modernize the Medicare program, the
issue of unfair payment rates needs to be on the table.
The bill we are introducing today, the Medicare Fairness in
Reimbursement Act of 2001 sends a clear signal. These historic wrongs
must be righted. Before any Medicare reform bill passes Congress, I
intend to make sure that rural beneficiaries are guaranteed access to
the same quality health care services of their urban counterparts.
Our legislation does the following: requires HCFA to improve the
fairness of payments under the original Medicare fee-for-services
system by adjusting payments for items and services so that no State is
greater than 105 percent above the national average, and no State is
below 95 percent of the national average. An estimated 31 States would
benefit under these adjustments, based on the Health Care Financing
Administration's projections of the 1999 payment data.
Requires HCFA to improve the fairness of payments to rural
practitioners who bill under Medicare Part B by narrowing the range of
the Geographic Payment Classification Indices, GPCIs. Currently, there
are dramatic geographic differences in payments for physician services
with little scientific data to support the disparity. Providers in
rural areas are under-compensated. This act would restrict the range
for each GPCI so that no GPCI is greater than 1.05 or less than .95 of
the standard index of 1.00. Practitioners who work in rural areas will
benefit from this change in geographic adjusters.
It ensures that beneficiaries are held harmless in both payments and
services, ensures budget neutrality, and automatically results in
adjustment of Medicare managed care payments to reflect increased
equity between rural and urban areas.
This legislation simply ensures basic fairness in our Medicare
payment policy. I urge my Senate colleagues, no matter what State
you're from, to consider our bill and join us in supporting this
commonsense Medicare reform.
______
By Mr. LUGAR (for himself, Mr. Biden, Mr. Chafee, Mr. Craig, Mr.
Kerry, Mr. Leahy, Mr. Lieberman, Mr. Murkowski, Mr. Reed, and
Mr. Roberts):
S. 1021. A bill to reauthorize the Tropical Forest Conservation Act
of 1998 through fiscal year 2004; to the Committee on Foreign
Relations.
Mr. LUGAR. Mr. President, Senator Biden and I are today introducing a
bill to reauthorize appropriations for the Tropical Forest Conservation
Act of 1998 for the Fiscal Years 2002, 2003 and 2004. We are joined in
this effort by Senators Chafee, Craig, Kerry, Leahy, Lieberman,
Murkowski, Reed and Roberts.
The United States has a significant national interest in protecting
tropical forests in developing countries. Tropical forests regulate the
hydrological cycle on which world agriculture depends. The genetic
diversity contained in tropical forests is important for plant
breeding. Twenty-five percent of prescription drugs come from tropical
forests. Tropical forests also serve as carbon sinks, storing carbon to
mitigate the potential effects of the increase in greenhouse gases on
the world's climate. Avoiding tropical deforestation is essential to
mitigating the threat of climate change.
Worldwide, there is a net loss of thirty million acres of forests
every year. The heavy debt burden of many developing countries
encourages them to engage in unsustainable exploitation of natural
resources in order to generate revenue to service external debt. At the
same time, these poor governments tend to have few resources available
to set aside and protect key areas.
The Tropical Forest Conservation Act addresses the economic pressures
on developing countries through ``debt for nature'' mechanisms that
reduce foreign debt while leveraging scarce funds available for
international conservation. Specifically, the Act authorizes the
President to reduce certain bilateral government debt owed to the
United States through three distinct mechanisms: debt buybacks; debt
restructuring and reduction; or debt swaps. In return, eligible
developing countries with significant tropical forests must establish
and place local currencies in tropical forest funds. These funds are
managed primarily by local, non-governmental organizations and make
grants for projects that are designed to protect or restore tropical
forests or to promote their sustainable economic use.
The debt for nature mechanisms in the Act effectively leverage the
limited funds available for international conservation. Under the
Tropical Forest Conservation Act, the host country places currencies in
its tropical forest fund, the value of which typically exceeds the cost
to the U.S. Treasury of the debt reduction agreement. Furthermore,
because these tropical forest funds have integrity and are broadly
supported within the host country, conservation organizations are
interested in contributing their own money to them, producing an
additional leverage of federal conservation dollars.
Our bill would reauthorize appropriations for the Act for three
years, with funding levels of $50 million in Fiscal Year 2002, $75
million in Fiscal year 2003 and $100 million in Fiscal Year 2002.
President Bush has indicated his strong support for the Tropical
Forest Conservation Act, which is modeled upon President George Herbert
Walker Bush's Enterprise for the Americas program as well as upon the
Biden-Lugar Global Environmental Protection Assistance Act of 1989.
These programs have helped to foster the development of responsible,
community-based conservation organizations that are capable of
addressing environmental problems at the local level and ensuring
successful program implementation.
The Tropical Forest Conservation Act encourages the repayment of debt
owed to the United States government, addresses the cash flow problems
of poorer nations, promotes cooperation
[[Page S6139]]
between governmental and local conservation organizations and helps to
save the world's outstanding tropical forests, which are disappearing
at an alarming rate.
It is my understanding that Congressmen Rob Portman and Tom Lantos
are introducing identical legislation in the House of Representatives.
Senator Biden and I plan to work with our colleagues in the House and
Senate toward speedy passage of this three year reauthorization bill.
I ask unanimous consent that the text of the bill and a summary be
printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
S. 1021
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. AUTHORIZATION OF APPROPRIATIONS TO SUPPORT
REDUCTION OF DEBT UNDER THE FOREIGN ASSISTANCE
ACT OF 1961 AND TITLE I OF THE AGRICULTURAL
TRADE DEVELOPMENT AND ASSISTANCE ACT OF 1954.
(a) Reauthorization.--Section 806 of the Tropical Forest
Conservation Act of 1998 (22 U.S.C. 2431d) is amended by
adding at the end the following new subsection:
``(d) Authorization of Appropriations for Fiscal Years
After Fiscal Year 2001.--For the cost (as defined in section
502(5) of the Federal Credit Reform Act of 1990) for the
reduction of any debt pursuant to this section or section
807, there are authorized to be appropriated to the President
the following:
``(1) $50,000,000 for fiscal year 2002.
``(2) $75,000,000 for fiscal year 2003.
``(3) $100,000,000 for fiscal year 2004.''.
(b) Conforming Amendment.--Section 808(a)(1)(D) of the
Tropical Forest Conservation Act of 1998 (22 U.S.C.
2431f(a)(1)(D)) is amended by striking ``to appropriated
under sections 806(a)(2) and 807(a)(2)'' and inserting ``to
be appropriated under sections 806(a)(2), 807(a)(2), and
806(d)''.
Summary of the Tropical Forest Conservation Act
The Tropical Forest Conservation Act of 1998 (Public Law
105-214) helps to protect the world's dwindling tropical
forests through ``debt for nature swaps.''
The TFCA focuses on tropical forest conservation, using the
same principles as the 1989 Global Environmental Protection
Act, Biden-Lugar, and former President Bush's Enterprise for
the Americas Initiative (EAI). The bill extends eligibility
for ``Debt for Nature'' swaps under the EAI to lower and
middle income countries in Africa and Asia with globally or
regionally outstanding tropical forests. It authorizes
appropriations to compensate the Treasury Department for
revenues foregone when debts with poorer developing nations
are restructured at less than their asset value.
The Tropical Forest Conservation Act of 1998 authorizes the
President to reduce certain bilateral government debt owed to
the United States under the Foreign Assistance Act of 1981 or
Title 1 of the Agricultural Trade Development and Assistance
Act of 1954. In exchange, the eligible developing country
would place local currencies in a tropical forest fund, which
would be used for projects to preserve, restore or maintain
its tropical forests. In some instances, debt swaps would
occur at no cost to the Federal Treasury since sovereign debt
would simply be reduced to its asset value under the Federal
Credit Reform Act of 1990. In other instances, poorer nations
will be allowed to restructure their debt at an amount
somewhat lower than its asset value and Federal
appropriations would have to be used to compensate the
Treasury for reductions in its anticipated revenue stream.
The law also allows private organizations to contribute their
funds to help facilitate a debt swap under the terms of the
bill.
To qualify for assistance, eligible countries must meet the
criteria established by Congress under EAI: the government
must be democratically elected, must not support acts of
international terrorism, must cooperate on international
narcotics control matters, must not violate internationally
recognized human rights, and must institute any needed
investment reforms.
To ensure accountability, an administrative body is
established in the beneficiary country. This body will
consist of one or more U.S. Government officials, one or more
individuals appointed by the recipient country's government,
and representatives of environmental, community development,
scientific, academic and forestry organizations of the
beneficiary country. It is authorized to make grants for
projects which would conserve its outstanding tropical
forests. Additionally, the existing Enterprise for Americas
Initiative Board is expanded by four new members and oversees
both the EAI and the Tropical Forest Conservation Act.
The authorization of appropriations for the 1998 Tropical
Forest Conservation Act expires at the end of fiscal year
2002. Legislation will be introduced to extend the
authorization of appropriations through fiscal years 2002 at
a level of $50,000,000 in FY 2002, $75,000,000 in FY 2003 and
$100,000,000 in FY 2004.
Mr. BIDEN. Mr. President, I am pleased to once again join my
distinguished colleague from Indiana, Senator Lugar, in introducing
legislation to protect the world's significant tropical forests through
``debt-for-nature'' mechanisms. We have shared a long and fruitful
bipartisan relationship on this important issue. I am gratified that we
have the bipartisan support of our original cosponsors noted by Senator
Lugar.
Tropical forests are a cornerstone of the global environment.
Figuratively speaking, they are the ``lungs'' of our planet, and they
can help to regulate and mitigate the process of climate change. They
guide global patterns of rainfall on which agriculture and fisheries
depend. They harbor pharmaceutical treasures that we are just beginning
to explore. They are home our planet's widest diversity of plants and
animals.
We have a responsibility, a duty, to be good stewards of these
essential resources, and it is in our direct economic interest to see
that they flourish.
In 1989, Senator Lugar and I coauthored the Global Environmental
Protection Assistance Act, which was enacted into law as title VII A of
the International Finance and Development Act of 1989 (Public Law 101-
240, December 19, 1989). That Act authorized US AID to use its funds
for Debt for Nature swaps. Under the authority of this Act, US AID has
used $95 million of its funds to establish environmental endowments
totaling $146 million in Costa Rica, Honduras, Indonesia, Jamaica,
Madagascar, Mexico, Panama and the Philippines.
President Bush's Enterprise for the Americas Initiative (EAI),
carried forward this linkage between debt reduction and the generation
of local funds to protect the environment. The EAI provided $876
million in debt relief and $154 million in local endowments at a
federal cost of $90 million in seven countries in Latin America and the
Caribbean: Argentina, Bolivia, Chile, Columbia, El Salvador, Jamaica
and Uruguay.
The Tropical Forest Conservation Act of 1998 extended the debt for
nature mechanism of the EAI to the protection of significant tropical
forests in lower and middle income developing countries throughout the
world, not just those in Latin America and the Caribbean. Furthermore,
the Tropical Forest Conservation Act (TFCA), authorizes the use of two
new, no cost ``debt-for-nature'' models, the Buy Back option and Debt
Swap option.
The basic premise behind this series of programs has not changed over
the years. Many of the world's important tropical forests are found in
countries that do not have the resources to protect them. Their own
patterns of economic development and their participation in the
international economy place irresistible pressures on them to turn
these irreplaceable global resources into quick local cash. One of the
important contributors to those pressures is too often the debt those
countries owe to us. That is one thing we can do something about.
The mechanisms in this bill will allow us to multiply the small
dollar cost of writing the debt of those countries off of our books,
leveraging substantially more resources to the cause of preserving
tropical forests around the world.
I look forward to taking this bill up in the Foreign Relations
Committee as soon as possible, and I fully expect it will continue to
enjoy the strong support it has had in the past. I also look forward to
working with the Administration to provide the funding that the
President has called for to implement this program.
______
By Mr. WARNER:
S. 1022. A bill to amend the Internal Revenue Code of 1986 to allow
Federal civilian and military retirees to pay health insurance premiums
on a pretax basis and to allow a deduction for TRICARE supplemental
premiums; to the Committee on Finance.
Mr. WARNER. Mr. President, today I am pleased to join my colleague in
the House of Representatives, Congressman Tom Davis, in introducing
legislation that will enable Federal and military retirees to take
advantage of premium conversion. Premium conversion allows individuals
to pay their health insurance premiums with pre-tax dollars.
This tax benefit was extended last year under a Presidential
directive to
[[Page S6140]]
current Federal employees who participate in the Federal Employees
Health Benefits Program, saving an average of over $400 per year on
their Federal income taxes. It is a benefit already available to many
private sector employees, and State and local government employees.
Although extending this benefit to Federal annuitants has broad
support, it requires a legislative change in the tax laws. The
legislation I am introducing today will do just that.
The Federal Employees Health Insurance Premium Conversion Act will
provide that the same health insurance premium conversion arrangement
afforded to employees in the Executive and Judicial branches of the
Federal government, be made available to Federal annuitants.
This year, retirees under the Civil Service Retirement System
received a 3.5 percent cost of living adjustment, and those who receive
an annuity under the Federal Employees Retirement System received a 2.5
percent adjustment.
This increase in benefits is nearly offset by severe increases in
FEHB premiums. In 2000, health premiums increased by an average of 9.3
percent. The Office of Personnel Management reports that a similar
increase is expected again this year.
I am deeply concerned about increases in Federal Employee Health
Benefit premiums in recent years. Health care coverage is provided to
over 9 million Federal employees, retirees and their families under
FEHBP. Ensuring affordable health care coverage for all Federal
employees and their dependents must remain a priority for Congress.
In addition, I am pleased that this bill will also allow uniformed
services retiree beneficiaries, their family members and survivors to
pay their TRICARE Prime enrollment fees and TRICARE Standard
supplemental insurance premiums with pre-tax dollars. TRICARE Standard
supplemental insurance premiums paid by active duty personnel are also
covered by the legislation which allows for an above the line deduction
to benefit active duty personnel and their families.
This is a critical issue to many retirees, especially those living on
a fixed income. Extending premium conversion will provide much needed
relief from the increasing cost of health care insurance. It will help
to ensure that more Federal retirees are able to afford continued
coverage under the Federal Employees Health Benefits program.
I encourage my colleagues to support this critical legislation and
show their support of these Federal civilian and military retirees for
their dedicated service. I ask unanimous consent that the text of the
bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1022
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. PRETAX PAYMENT OF HEALTH INSURANCE PREMIUMS BY
FEDERAL CIVILIAN AND MILITARY RETIREES.
(a) In General.--Subsection (g) of section 125 of the
Internal Revenue Code of 1986 (relating to cafeteria plans)
is amended by adding at the end the following new paragraph:
``(5) Health insurance premiums of federal civilian and
military retirees.--
``(A) FEHBP premiums.--Nothing in this section shall
prevent the benefits of this section from being allowed to an
annuitant, as defined in paragraph (3) of section 8901, title
5, United States Code, with respect to a choice between the
annuity or compensation referred to such paragraph and
benefits under the health benefits program established by
chapter 89 of such title 5.
``(B) TRICARE premiums.--Nothing in this section shall
prevent the benefits of this section from being allowed to an
individual receiving retired or retainer pay by reason of
being a member or former member of the uniformed services of
the United States with respect to a choice between such pay
and benefits under the health benefits program established by
chapter 55 of title 10, United States Code.''
(b) Effective Date.--The amendment made by this section
shall apply to taxable years beginning after the date of the
enactment of this Act.
SEC. 2. DEDUCTION FOR TRICARE SUPPLEMENTAL PREMIUMS.
(a) In General.--Part VII of subchapter B of chapter 1 of
the Internal Revenue Code of 1986 (relating to additional
itemized deductions for individuals) is amended by
redesignating section 223 as section 224 and by inserting
after section 222 the following new section:
``SEC. 223. TRICARE SUPPLEMENTAL PREMIUMS OR ENROLLMENT FEES.
``(a) Allowance of Deduction.--In the case of an
individual, there shall be allowed as a deduction the amounts
paid during the taxable year by the taxpayer for insurance
purchased as supplemental coverage to the health benefits
programs established by chapter 55 of title 10, United States
Code, for the taxpayer and the taxpayer's spouse and
dependents.
``(b) Coordination With Medical Deduction.--Any amount
allowed as a deduction under subsection (a) shall not be
taken into account in computing the amount allowable to the
taxpayer as a deduction under section 213(a).''
(b) Deduction Allowed Whether or Not Individual Itemizes
Other Deductions.--Subsection (a) of section 62 of such Code
is amended by inserting after paragraph (18) the following
new paragraph:
``(19) Tricare supplemental premiums or enrollment fees.--
The deduction allowed by section 223.''
(c) Clerical Amendment.--The table of sections for part VII
of subchapter B of chapter 1 of such Code is amended by
striking the last item and inserting the following new items:
``Sec. 223. TRICARE supplemental premiums or enrollment fees.
``Sec. 224. Cross reference.''
(d) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after the date of the
enactment of this Act.
____________________