[Congressional Record Volume 149, Number 67 (Wednesday, May 7, 2003)]
[Senate]
[Pages S5860-S5877]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. CAMPBELL:
[[Page S5861]]
S. 1008. A bill to provide for the establishment of summer health
career introductory programs for middle and high school students; to
the Committee on Health, Education, Labor, and Pensions.
Mr. CAMPBELL. Mr. President, today I am introducing legislation aimed
at addressing the long term shortage of workers in our health care
system.
In recent months, America's health care workforce shortage has made
headline news. While most of the stories have focused on the lack of
nurses, the shortage of health care professionals also includes
radiology technicians, respiratory therapists, clinical laboratory
scientists, imaging technologists, rehabilitation professionals,
pharmacists and others.
This shortage is different than the one hospitals have experienced in
the past because it is only the prelude to a long-term shortage of
crisis proportions. The demand for health care is increasing as
Americans are living longer than previous generations, and advances in
medicine have let more people live with chronic and age-related
diseases. With the demand for hospital services increasing because of a
growing and aging population, the workforce shortages present our
Nation with a potential health care crisis. I believe we must do
something to change this disturbing trend.
In my State of Colorado, a task force made up of community colleges,
universities, corporations, hospitals, social services and interested
community activists has been convened to actively find solutions for
the workforce shortages. One of the proposals would be to hold a health
career summer youth camp under the title, Gee Whiz Jobs, where young
people would be introduced to a full range of career possibilities in
the health care field. I believe this idea and their program can become
a model for other such programs throughout the country.
The legislation I am introducing today attempts to build on the
career camp idea. It authorizes the Secretary of Health and Human
Services to make demonstration grants to accredited universities and/or
community colleges to establish summer health career introductory
programs for middle school and high school students.
Many students are not prepared in the necessary levels of math,
science and reading to enter health education programs directly out of
high school. Many others have never been exposed to health careers and
do not even consider them as a possibility. And, a significant number
have little knowledge of the range of career possibilities or what the
working environments may be like. Summer school exposure to health
careers which allows young people to visit hospitals, doctors' offices,
emergency rooms, and community health clinics and witness professionals
at work in providing health care services may be just what they need to
guide them into a health career.
I believe that we must broaden the base of health care workers by
designing strategies that attract and retain a diverse workforce. We
must collaborate with others--hospitals, health care and professional
associations, educational institutions, corporations, philanthropic
organizations, and government to attract new entrants to the health
professions. And, we must begin these efforts early in the lives of our
young people.
It is going to take all of us--educators, government and community
officials, hospital leaders, health care workers, and the public--
working together to meet the challenge facing our health care system
today. That is why I urge my colleagues to act quickly on this
legislation. Let's begin to aggressively address the health care worker
shortage in a way that will carry us into the future.
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. 1008
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SUMMER HEALTH CAREER INTRODUCTORY PROGRAMS.
(a) Findings.--Congress finds that--
(1) the success of the health care system is dependent on
qualified personnel;
(2) hospitals and health facilities across the United
States have been deeply impacted by declines among nurses,
pharmacists, radiology and laboratory technicians, and other
workers;
(3) the health care workforce shortage is not a short term
problem and such workforce shortages can be expected for many
years; and
(4) most States are looking for ways to address such
shortages.
(b) Grants.--The Secretary of Health and Human Services,
acting through the Bureau of Health Professions of the Health
Resources and Services Administration, may award not to
exceed 5 grants for the establishment of summer health career
introductory programs for middle and high school students.
(c) Eligibility.--To be eligible to receive a grant under
subsection (b) an entity shall--
(1) be an institution of higher education (as defined in
section 101(a) of the Higher Education Act of 1965 (20 U.S.C.
1001(a)); and
(2) prepare and submit to the Secretary of Health and Human
Services an application at such time, in such manner, and
containing such information as the Secretary may require.
(d) Duration.--The term of a grant under subsection (b)
shall not exceed 4 years.
(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, such sums as
may be necessary for each of fiscal years 2004 through 2007.
______
By Mr. HARKIN (for himself, Mr. Specter, and Mr. Kennedy):
S. 1010. A bill to enhance and further research into paralysis and to
improve rehabilitation and the quality of life for persons living with
paralysis and other physical disabilities; to the Committee on Health,
Education, Labor, and Pensions.
Mr. HARKIN. Mr. President, I am pleased to be joined by Senators
Specter and Kennedy today in re-introducing legislation that will give
new hope to Americans with paralysis.
Recent news reports about the medical miracle Christopher Reeve has
experienced over the two past years is an inspiration for every
American living with paralysis as a result of a spinal cord injury.
When it was announced that, for the first time since his accident in
1995, Chris regained sensation and movement in parts of his body,
providing inspiration for some of the two million Americans with
paralysis. Most recently, Chris has started weaning himself from a
ventilator, breathing on his own for the first time since his accident.
Today, through the Christopher Reeve Paralysis Act of 2003, we seek
to achieve two primary goals. First, to further advance the science
needed to promote spinal regeneration. And second, to build quality of
life programs throughout the country that will further advance full
participation, independent living, self-sufficiency and equality of
opportunity for individuals with paralysis and other physical
disabilities.
Chris' recovery and recent scientific evidence show that progress is
possible. At research centers in the United States, Europe and Japan,
techniques of rigorous exercise have helped numerous persons with
paraplegia with limited sensations in their lower bodies walk for short
distances, unassisted or using walkers.
While the results of these new methods are quite promising, the
limits of what physical exercise can do for patients remains grossly
understudied. While each person and each injury is unique, and some
people recover spontaneously, an estimated 250,000 Americans are living
with spinal cord injuries that have not improved. Which therapy or
combination of therapies will work for each person is unknown. Today
two million Americans are living with paralysis, including spinal cord
injury, stroke, cerebral palsy, multiple sclerosis, ALS and spina
bifida. We need research to see how these new interventions work on the
entire population of individuals with paralysis.
What we do know is the ordinary repetitive motions used in most
rehabilitation centers, like squeezing a ball, are almost certainly not
enough to appropriately address neurological injuries.
Patients are usually told that after one year, two at the most, they
will never make further progress in their abilities to move or feel
sensation. Yet eight years after his accident, through a rigorous
exercise plan, Chris is finally seeing results.
Due to efforts led by the National Institutes of Health and the
Christopher Reeve Paralysis Foundation, our Nation stands on the brink
of amazing
[[Page S5862]]
breakthroughs in science for those with paralysis. However, the biotech
and pharmaceutical industries have not invested in paralysis research
because they believe the market does not support the private
investment. There is an urgent need for the Federal Government to
further step up its commitment in this area. The Christopher Reeve
Paralysis Act would do just that.
By establishing Paralysis Research Consortia at the National
Institute of Neurological Disorders and Stroke, we can substantially
increase our ability to capitalize on research advances in paralysis.
These consortia would be formed to explore unique scientific expertise
and focus across the existing research centers at NINDS in an effort to
further advance treatments, therapies and developments on one or more
forms of paralysis that result from central nervous system trauma and
stroke.
Additional breakthroughs are underway in rehabilitation research on
paralysis. Federal funding for rehabilitation research at the National
Center for Medical Rehabilitation Research at NIH is showing real
potential to improve functional mobility; prevent secondary
complications like bladder and urinary tract infections and ulcers; and
to develop improved assistive technology. These rehabilitation
interventions have the potential to greatly reduce pain and other
complications for people with neurological disorders and stroke and, at
the same time, save millions in health care costs.
Over the past 20 years, overall days in the hospital and
rehabilitation center for those with paralysis have been cut in half.
Those with paralysis face astronomical medical costs, and our best
estimates tell us that only one-third of those individuals remain
employed after paralysis. At least one-third of those with paralysis
have incomes of $15,000 or less.
To date, there are no State-based programs at CDC that address
paralysis and other physical disability with the goal of improving
health outcomes and prevent secondary complications. This bill will,
for the first time, ensure that individuals with paralysis get the
information they need; have access to public health programs; and
support in their communities to navigate services. Ultimately these
programs will help remove the barriers to community participation and
help improve quality of life. The bill also establishes hospital-based
registries on paralysis to collect needed data on the true numbers of
individuals with these conditions, and it invests in population-based
research to see how various therapies impact different people.
We are on the brink of major breakthroughs for individuals with
neurological disorders and stroke that result in paralysis. This bill
will ensure that the federal government does its part to help more than
2 million Americans.
When Christopher Reeve was injured, he put a face on an issue that
has been neglected for too long. Since then, his tireless efforts to
walk again, coupled with his passion and commitment to improve quality
of life for others with paralysis, make him an inspiration to all
Americans.
It is a pleasure and an honor to lead a bipartisan group of Senators,
along with the support of a number of disability groups, including the
American Stroke Association, the American Heart Association, the
Christopher Reeve Paralysis Foundation, the National Family Caregivers
Association, the National Spinal Cord Injury Association, Paralyzed
Veterans of America and Easter Paralyzed Veterans, in introducing this
bill.
______
By Mr. BINGAMAN (for himself, Mr. Corzine, Mrs. Clinton, Mr.
Kerry, Mr. Lautenberg, Mr. Dayton, and Mr. Johnson):
S. 1012. A bill to amend title XIX of the Social Security Act to
provide fiscal relief and program simplification to States, to improve
coverage and services to medicaid beneficiaries, and for other
purposes; to the Committee on Finance.
Mr. BINGAMAN. Mr. President, our Nation's States and health safety
net are simultaneously facing a crisis. According to State budget
officers, the states are facing a nearly $30 billion budget shortfall
this year and an $80 billion gap in fiscal year 2004 due to the
economic recession. At the same time, it is estimated that the number
of uninsured increased from 41 to 45 million this past year. And, due
to the State budget shortfalls, the numbers of uninsured may increase
even further.
In fact, the lead paragraph in the New York Times in an article
entitled ``Cutbacks Imperil Health Coverage for States' Poor'' on April
28, 2003, reads, ``Millions of low-income Americans face the loss of
health insurance or sharp cuts in benefits, like coverage for
prescription drugs and dental care, under proposals now moving through
state legislatures around the country.''
The article continues, ``State officials and health policy experts
say the cuts will increase the number of uninsured, threaten recent
progress in covering children and impose severe strains on hospitals,
doctors and nursing homes.''
As a result, I believe the Federal Government should take immediate
steps to fundamentally reassert and reassert its role in helping the
States with this fiscal crisis and rising Medicaid costs, lowering the
number of uninsured, and finally, confronting infant and maternal
mortality and morbidity statistics that are unworthy of our great
Nation.
To address these issues, today and tomorrow, I will be introducing
three relevant bills. The first addresses the fiscal crisis confronting
States and the Medicaid program entitled ``Strengthening Our States,''
or the ``SOS Act.''
The second addresses our Nation's long-standing and growing crisis of
the uninsured that is entitled the ``Health Coverage, Affordability,
Responsibility, and Equity Act'' or the ``Health CARE Act.''
The final bill takes on our Nation's high infant and mortality rates
and is called the ``Start Healthy, Stay Health Act.''
First things first. In any campaign--whether in sports, business, or
politics--you have to have both offensive and defensive strategies. In
trying to reduce the number of uninsured in our country, we must first,
as an emergency room doctor would, stop the bleeding. Therefore, our
first priority should be to support and strengthen the Medicaid
program.
Unfortunately, the Center on Budget and Policy Priorities estimated
in March that as many as 1.7 million Americans could lose coverage
altogether under proposals advanced by governors or adopted by State
legislative committees this year.
Therefore, I am introducing today with Senators Corzine, Clinton,
Kerry, Lautenberg, Dayton, and Johnson legislation entitled the
``Strengthening Our States Act of 2003.'' This bill is a companion bill
to that being introduced by Representative Dingell, Brown of Ohio,
Waxman, and others and is aimed at improving Medicaid and providing
support to States to enhance their ability to provide coverage to their
uninsured residents in these difficult times.
The SOS Act uses a combination of approaches which: first, provide
additional Federal fiscal relief to States; second, provide additional
flexibility to States in administering and improving the Medicaid
program; and third, provide incentives and assistance to stave off cuts
to existing coverage, and facilitate coverage expansions in the future.
The legislation will simplify Medicaid and enable States to
strengthen the program and stands in sharp contrast to the President's
proposal to convert Medicaid into a block grant that would erode health
insurance coverage.
In fact, the Administration's prescription is the wrong medicine for
the wrong ailment. The Federal Government should be stepping up its
commitment to seniors, people with disabilities, and low-income
children rather than stepping away and leaving States holding the bag.
First and foremost, our legislation acknowledges and reflects on the
important role that Medicaid plays in our entire health care system. As
Diane Rowland and Jim Tallon of the Kaiser Commission on Medicaid and
the Uninsured have noted: ``. . . it is hard to envision our health
system and society without a program like Medicaid. Medicaid is the
glue that helps hold our health system together and takes on the
highest-risk, sickest, and most expensive populations from private
insurance and Medicare. For low-income Medicare beneficiaries, Medicaid
picks
[[Page S5863]]
up Medicare premiums and some cost sharing as well as filling the gaps
in coverage for long-term care services, prescription drugs, and vision
and dental care.''
Medicaid addresses the failure of the marketplace to deliver
affordable health coverage to our Nation's most fragile and vulnerable
citizens. However, there is no reason why it should also have to play
the role of picking up the slack of the Medicare program. A central
tenet of our SOS proposal is for the Federal Government to begin taking
the steps to assume 100 percent of the costs associated with care and
services in Medicaid for Medicare beneficiaries, also known as dual
eligibles.
This, I would add, is in keeping with long-standing policy of the
National Governors' Association, or NGA, and is in sharp contrast to
the Administration's proposal to maintain the current Medicaid
financing system for mandatory populations and services while block
granting care of optional populations and services to States. Who are
these optional populations? They are largely the elderly and people
with disabilities, many of whom are dually eligible for Medicare and
Medicaid.
According to the Kaiser Commission on Medicaid and the Uninsured, 83
percent of all Medicaid spending on the elderly is for either optional
populations or services, such as prescription drugs and long-term care.
In fact, according to Cindy Mann of Georgetown University and a former
Medicaid director under the Clinton Administration, an estimated 35
percent of all State Medicaid costs are for so-called ``dual
eligibles.''
Therefore, rather than stepping up to the plate, the Administration
is instead stepping away from its commitment to the elderly and
disabled, which should be our responsibility at the Federal level, by
moving these groups and their health care services into a block grant.
Groups representing the elderly and disabled communities have already
spoken out against this.
As AARP Executive Director and CEO Bill Novelli says, ``This
[Administration's block grant] proposal handcuffs states because it
leaves people more vulnerable in future years as States struggle to
meet increased needs with decreased dollars.''
The Consortium for Citizens with Disabilities adds, ``The Bush
Administration proposal fails people with disabilities and dishonors
the Nation's commitment to its residents--it is not in the national
interest. . . . What the Medicaid program calls `optional' services
are, in reality, mandatory disability services for the children and
adults who need them. These services often are not only life-saving,
but also the key to a positive quality of life--something everyone in
our nation deserves.''
Again, the Federal Government should be stepping up its commitment to
seniors and people with disabilities rather than stepping away, as the
President's proposal does.
With respect to the fiscal crisis facing states, the Administration
has long opposed fiscal relief to States as part of its economic
stimulus package. Instead, the Administration points out that its
Medicaid block grant proposal provides more funding up front to States,
in the amount of $3.5 billion over one year and $12.7 billion over the
first seven years to help States. But the proposal has strong elements
of a typical bait and switch by yanking every dime of that money away
starting in 2011. Secretary Thompson noted at the press conference that
he would not be around at the time of the $12.7 billion in reductions
eight years from now and the plan clearly counts on the fact that most
of this crop of governors would not be either.
However, that is exactly when our Nation's baby boomers hit
retirement age in rapidly increasing numbers and the long term care
costs within Medicaid will significantly increase.
In sharp contrast, the SOS Act includes a temporary increase in the
Federal matching assistance percentage, or FMAP, to state Medicaid
programs in the amount of $15 billion and another $15 billion in
additional aid to States--far more than the temporary $3 billion
offered by the Administration.
Also, unlike a block grant, the current Medicaid matching rate is
responsive to States in times of recessions by providing Federal
matching funds to States for each additional person who becomes
eligible for Medicaid. Moreover, our SOS Act recognizes the formula can
be even more responsive by preserving coverage during difficult times
and includes a General Accounting Office study of ways to make the
formula more responsive to fiscal distress during either a national or
State recession.
In addition, the Strengthening Our States Act would increase Federal
payments for certain services critical for special populations or
federally-imposed services. It would provide enhanced Federal funding
for urban Indian health services, translation services, outstationed
workers, and reimbursement to health providers for emergency services
delivered undocumented individuals who are otherwise eligible for
Medicaid. Again, the Administration's proposal simply block grants
funding for these services and steps away from its Federal
responsibility.
For example, services delivered to Native Americans by Indian Health
Service providers and health organizations are reimbursed at 100
percent federal match currently in recognition of the Federal
responsibility and role in delivering services to Native Americans
apart from States. Under a block grant, the Federal match is eliminated
and the Federal role in providing care to Native Americans is
abandoned. This is contrary to longstanding Federal policy and its
relationship with tribes and tribal organizations and to policy by the
National Governors' Association.
And finally, with respect to giving States flexibility and assistance
to expand upon existing coverage options, the Strengthening Our States
Act is far better and responsive to states than a block grant. Block
grants do not adjust for population changes, recessions, or efforts to
expand coverage by States. At its unveiling, Secretary Thompson spoke
about the added options the block grants offer States to expand
coverage. However, it does so with no new funding. This offer of
flexibility is, therefore, illusory.
In fact, because Federal funding is capped for optional opulations by
the Administration's block grant, states cannot draw down additional
Federal support when it chooses to expand coverage. Under current law
and the SOS Act, they can. Some of the more ground-breaking efforts by
states such as those by Vermont, Washington, Minnesota, Rhode Island,
Hawaii, and even Wisconsin, would have likely never come to pass
without that added Federal support.
Therefore, the SOS Act continues and expands upon that Federal
support by giving States additional coverage options, such as to set
uniform eligibility levels for families rather than covering parents
and children separately. The SOS Act also would make States eligible
for enhanced matching funds to cover low-income working parents under
Medicaid.
States should also beware of the Administration's promise of 9
percent growth rates for the next 10 years. Earlier this year, the
House of Representatives passed a budget that would have reduced
Medicaid spending by $92 billion over 10 years. While that was rejected
in conference, such efforts become much easier under the rubric of a
block grant. Again, recent history contains many such promises and
examples.
For example, as the NGA policy on the Social Service Block Grant
notes, during passage of TANF, ``Congress and the Administration made a
commitment to Governors to fund SSBG at $2.38 billion each year through
fiscal year 2002, with the funding increasing to $2.8 billion in fiscal
2003 and each year thereafter.'' The reality is that funding has been
reduced to $1.7 billion in fiscal years 2002 and 2003, 65 percent below
the promised funding levels.
There is an old saying, which goes, ``Fool me once, shame on you.
Fool me twice, shame on me.'' When members of Congress and future
Administrations see 9 percent growth rates in these Medicaid block
grants and have a particular tax cut, Medicare change, transportation
program, or whatever they wish to fund, you can already hear them
saying, ``What if we just reduce the growth rates to 8 percent or 7
percent or 6 percent or 5 percent. . . .'' Well, we all can see where
this rapidly heads and we have all been fooled once before.
[[Page S5864]]
Some governors, including Secretary Thompson, seem to have a short
memory on these matters. On April 14, 1997, 41 Governors, including
Secretary Thompson, Bush Administration Cabinet Members Tom Ridge, and
Christine Todd Whitman, wrote President Clinton, and said: ``We
adamantly oppose a cap on federal Medicaid spending in any form.
Unilateral caps in federal Medicaid spending will result in cost shifts
to states, enabling the federal government to balance its budget at the
expense of the states.''
What was true then remains true 6 years later.
Moreover, on behalf of the NGA, Governors Bob Miller of Nevada and
Mike Leavitt testified before the Senate Finance Committee and made the
following statement: ``. . . caps could result in states becoming
solely responsible for unexpected program costs, such as a loss in a
lawsuit on reimbursement rates or the development of expensive new
therapies that drive up treatment costs beyond the federal allowable
rate.
They added: ``. . . the cost shift resulting from a unilateral cap
would present states with a number of bad alternatives. States
essentially would have to choose between cutting back on payment rates
to providers, eliminating optional benefits provided to recipients,
ending coverage for optional beneficiaries, or coming up with
additional state funds to absorb 100 percent of the cost of services.''
I do not see why this needs to be an all-or-nothing proposition. Why
do we have to throw out the entire Medicaid financing structure, which
benefits States, beneficiaries, and providers, in order to grant States
additional flexibility to their programs?
In 1997, we rejected the all-or-nothing proposal and worked with the
States and gave them a package of added flexibility, including the
ability to enroll much of their Medicaid population in managed care
without the need for a waiver.
Secretary Thompson talks a great deal about the flexibility the block
grant offers and cites the need to allow States the ability to move
people out of institutional settings into more appropriate home- and
community-based settings and is right. Under the block grant, States
are only granted additional flexibility to do so if they accept a block
grant. In contrast, the SOS Act provides States an enhanced Federal
matching rate to provide home- and community-based services.
However, rather than saying to States that they can only do so
through the acceptance of a block grant, why can't we provide them this
option without the imposition of a Federal limit on funding? Both
states and beneficiary groups are asking for it and we can and should
act.
It is on this point that I must add that the Medicaid program was not
created for Federal officials or governors. We all clearly need to be
reminded that there are other stakeholders in the Medicaid program,
including the 43 million people served by the program.
As Alan Weil of the Urban institute and the former Medicaid director
of the State of Colorado wrote in a recent article published in Health
Affairs: ``If money is at the heart of debates over Medicaid, the
millions of indigent people whose varied and complex medical needs are
met by the program are its sole. The amount of human suffering the
program alleviates is immense.''
As the Administration attempts to proceed on negotiations with the
governors on a deal on block grants, let's not forget the children,
mothers, seniors, and people with disabilities served by Medicaid. The
SOS Act provides a far better alternative.
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. 1012
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
``Strengthening Our States Act of 2003'' or the ``SOS Act of
2003''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents.
TITLE I--STRENGTHENING FEDERAL RESPONSIBILITY FOR MEDICARE
BENEFICIARIES
Sec. 101. Assuming Federal responsibility for all medicare cost-
sharing.
Sec. 102. Expanded protections for low income medicare beneficiaries.
TITLE II--PROVIDING STATES FISCAL RELIEF
Sec. 201. Temporary increase of medicaid FMAP.
Sec. 202. Temporary grants for State fiscal relief.
Sec. 203. Increasing medicaid DSH allotments.
Sec. 204. Increased State access to unspent SCHIP funds.
Sec. 205. Federal responsibility for emergency care for illegal
immigrants.
Sec. 206. Increased Federal responsibility for translation services.
Sec. 207. Increased Federal matching rates for certain services.
TITLE III--HELPING STATES WITH COMMITMENT TO ELDERLY AND DISABLED;
FAMILY OPPORTUNITY ACT
Subtitle A--Elderly and Persons with Disabilities
Sec. 301. Full accounting of savings in determining cost-effectiveness.
Sec. 302. Extension of medicaid coverage under the ticket to work
program to cover spouses.
Sec. 303. Encouraging transition to home and community care.
Sec. 304. Enhanced matching rate for disabled individuals awaiting
medicare eligibility.
Sec. 305. Providing initial term of 5 years for section 1915 waivers.
Sec. 306. Optional coverage of community-based attendant services and
supports under the medicaid program.
Subtitle B--Family Opportunity Act
Sec. 311. Short title.
Sec. 312. Opportunity for families of disabled children to purchase
medicaid coverage for such children.
Sec. 313. Treatment of inpatient psychiatric hospital services for
individuals under age 21 in home or community-based
services waivers.
Sec. 314. Demonstration of coverage under the medicaid program of
children with potentially severe disabilities.
Sec. 315. Development and support of family-to-family health
information centers.
Sec. 316. Restoration of medicaid eligibility for certain SSI
beneficiaries.
TITLE IV--FACILITATING PROGRAM ADMINISTRATION AND PRESERVING COVERAGE
Sec. 401. Allowing uniform coverage of all low income Americans.
Sec. 402. Facilitating coverage of families.
Sec. 403. Assistance with coverage of legal immigrants under the
medicaid program and SCHIP.
Sec. 404. Flexibility in eligibility determinations.
TITLE I--STRENGTHENING FEDERAL RESPONSIBILITY FOR MEDICARE
BENEFICIARIES
SEC. 101. ASSUMING FEDERAL RESPONSIBILITY FOR ALL MEDICARE
COST-SHARING.
(a) In General.--Section 1905(b) of the Social Security Act
(42 U.S.C. 1396d(b)) is amended--
(1) by striking ``and'' before ``(4)''; and
(2) by inserting before the period the following: ``, and
(5) the Federal medical assistance percentage shall be 100
percent with respect to medical assistance provided with
costs described in section 1905(p)(3)''.
(b) Conforming Amendment.--Section 1902 of such Act (42
U.S.C. 1396a) is amended by striking subsection (n).
(c) Effective Date.--The amendments made by this section
shall apply to medical assistance for medicare cost-sharing
for months beginning with July 2003.
SEC. 102. EXPANDED PROTECTIONS FOR LOW INCOME MEDICARE
BENEFICIARIES.
(a) In General.--Section 1902(a)(10)(E) of the Social
Security Act (42 U.S.C. 1396a(a)(10)(E)) is amended--
(1) by adding ``and'' at the end of clause (ii);
(2) in clause (iii), by striking ``110 percent in 1993 and
1994, and 120 percent in 1995 and years'' and inserting ``135
percent''; and
(3) by striking clause (iv).
(b) Conforming Amendment.--Section 1933 of such Act (42
U.S.C. 1396v) is repealed.
(c) Effective Date.--The amendments made by subsection (a),
and the repeal made by subsection (b), shall apply to months
after September 2003.
TITLE II--PROVIDING STATES FISCAL RELIEF
SEC. 201. TEMPORARY INCREASE OF MEDICAID FMAP.
(a) Permitting Maintenance of Fiscal Year 2002 FMAP for
Last 2 Calendar Quarters of Fiscal Year 2003.--
Notwithstanding any other provision of law, but subject to
subsection (e), if the FMAP determined without regard to this
section for a State for fiscal year 2003 is less than the
FMAP as so determined for fiscal year 2002, the FMAP for the
State for fiscal year 2002 shall be substituted for the
State's FMAP for the third and fourth calendar quarters of
fiscal year 2003, before the application of this section.
(b) Permitting Maintenance of Fiscal Year 2003 FMAP for
Fiscal Year 2004.--
[[Page S5865]]
Notwithstanding any other provision of law, but subject to
subsection (e), if the FMAP determined without regard to this
section for a State for fiscal year 2004 is less than the
FMAP as so determined for fiscal year 2003, the FMAP for the
State for fiscal year 2003 shall be substituted for the
State's FMAP for each calendar quarter of fiscal year 2004,
before the application of this section.
(c) General 3.73 Percentage Points Increase for Last 2
Calendar Quarters of Fiscal Year 2003 and Fiscal Year 2004.--
Notwithstanding any other provision of law, but subject to
subsections (e) and (f), for each State for the third and
fourth calendar quarters of fiscal year 2003 and each
calendar quarter of fiscal year 2004, the FMAP (taking into
account the application of subsections (a) and (b)) shall be
increased by 3.73 percentage points.
(d) Increase in Cap on Medicaid Payments to Territories.--
Notwithstanding any other provision of law, but subject to
subsection (f), with respect to the third and fourth calendar
quarters of fiscal year 2003 and each calendar quarter of
fiscal year 2004, the amounts otherwise determined for Puerto
Rico, the Virgin Islands, Guam, the Northern Mariana Islands,
and American Samoa under subsections (f) and (g) of section
1108 of the Social Security Act (42 U.S.C. 1308) shall each
be increased by an amount equal to 7.46 percent of such
amounts.
(e) Scope of Application.--The increases in the FMAP for a
State under this section shall apply only for purposes of
title XIX of the Social Security Act and shall not apply with
respect to--
(1) disproportionate share hospital payments described in
section 1923 of such Act (42 U.S.C. 1396r-4); or
(2) payments under title IV or XXI of such Act (42 U.S.C.
601 et seq. and 1397aa et seq.).
(f) State Eligibility.--
(1) In general.--Subject to paragraph (2), a State is
eligible for an increase in its FMAP under subsection (c) or
an increase in a cap amount under subsection (d) only if the
eligibility under its State plan under title XIX of the
Social Security Act (including any waiver under such title or
under section 1115 of such Act (42 U.S.C. 1315)) is no more
restrictive than the eligibility under such plan (or waiver)
as in effect on September 2, 2003.
(2) State reinstatement of eligibility permitted.--A State
that has restricted eligibility under its State plan under
title XIX of the Social Security Act (including any waiver
under such title or under section 1115 of such Act (42 U.S.C.
1315)) after September 2, 2003, but prior to the date of
enactment of this Act is eligible for an increase in its FMAP
under subsection (c) or an increase in a cap amount under
subsection (d) in the first calendar quarter (and subsequent
calendar quarters) in which the State has reinstated
eligibility that is no more restrictive than the eligibility
under such plan (or waiver) as in effect on September 2,
2003.
(3) Rule of construction.--Nothing in paragraph (1) or (2)
shall be construed as affecting a State's flexibility with
respect to benefits offered under the State medicaid program
under title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.) (including any waiver under such title or under section
1115 of such Act (42 U.S.C. 1315)).
(g) Definitions.--In this section:
(1) FMAP.--The term ``FMAP'' means the Federal medical
assistance percentage, as defined in section 1905(b) of the
Social Security Act (42 U.S.C. 1396d(b)).
(2) State.--The term ``State'' has the meaning given such
term for purposes of title XIX of the Social Security Act (42
U.S.C. 1396 et seq.).
(h) Repeal.--Effective as of October 1, 2004, this section
is repealed.
SEC. 202. TEMPORARY GRANTS FOR STATE FISCAL RELIEF.
(a) In General.--Title XX of the Social Security Act (42
U.S.C. 1397-1397f) is amended by adding at the end the
following:
``SEC. 2008. ADDITIONAL TEMPORARY GRANTS FOR STATE FISCAL
RELIEF.
``(a) In General.--For the purpose of providing State
fiscal relief allotments to States under this section, there
are hereby appropriated, out of any funds in the Treasury not
otherwise appropriated, $15,000,000,000. Such funds shall be
available for obligation by the State through June 30, 2005,
and for expenditure by the State through September 30, 2005.
This section constitutes budget authority in advance of
appropriations Acts and represents the obligation of the
Federal Government to provide for the payment to States of
amounts provided under this section.
``(b) Allotment.--Funds appropriated under subsection (a)
shall be allotted by the Secretary among the States in
accordance with the following table:
------------------------------------------------------------------------
``State Allotment (in dollars)
------------------------------------------------------------------------
Alabama $170,940,139
Alaska $42,076,374
Amer. Samoa $414,007
Arizona $261,264,449
Arkansas $133,398,723
California $1,583,851,051
Colorado $143,030,332
Connecticut $207,204,156
Delaware $38,537,434
District of Columbia $65,034,813
Florida $624,655,953
Georgia $368,582,068
Guam $669,845
Hawaii $46,337,939
Idaho $48,659,904
Illinois $543,631,283
Indiana $271,629,605
Iowa $130,309,854
Kansas $94,370,028
Kentucky $212,122,967
Louisiana $239,827,085
Maine $92,781,591
Maryland $236,000,265
Massachusetts $472,765,757
Michigan $435,451,207
Minnesota $302,429,550
Mississippi $176,956,163
Missouri $302,534,081
Montana $36,437,168
Nebraska $79,550,313
Nevada $52,331,624
New Hampshire $54,101,351
New Jersey $411,954,920
New Mexico $112,850,197
New York $2,383,327,447
North Carolina $439,742,488
North Dakota $27,253,781
N. Mariana Islands $233,880
Ohio $616,448,513
Oklahoma $146,240,811
Oregon $167,002,460
Pennsylvania $745,862,667
Puerto Rico $18,916,230
Rhode Island $80,098,624
South Carolina $184,217,430
South Dakota $30,302,145
Tennessee $350,273,887
Texas $814,722,031
Utah $63,422,131
Vermont $40,549,714
Virgin Islands $624,499
Virginia $215,155,129
Washington $298,697,312
West Virginia $95,818,709
Wisconsin $270,901,128
Wyoming $17,496,788
------------------------------------------------------------------------
Total $15,000,000,000
------------------------------------------------------------------------
``(c) Use of Funds.--Funds appropriated under this section
may be used by a State for services directed at the goals set
forth in section 2001, subject to the requirements of this
title.
``(d) Payment to States.--Not later than 30 days after
amounts are appropriated under subsection (a), in addition to
any payment made under section 2002 or 2007, the Secretary
shall make a lump sum payment to a State of the total amount
of the allotment for the State as specified in subsection
(b).
``(e) Definition.--For purposes of this section, the term
`State' means the 50 States, the District of Columbia, and
the territories contained in the list under subsection
(b).''.
(b) Repeal.--Effective as of October 1, 2005, section 2008
of the Social Security Act, as added by subsection (a), is
repealed.
(c) GAO Study and Report.--
(1) Study.--The Comptroller General of the United States
shall conduct a study to determine an appropriate index that
could be used to temporarily adjust the Federal medical
assistance percentage for purposes of programs authorized
under the Social Security Act either with respect to all
States during a period of national recession or with respect
to a specific State when the State's economy takes a
significant turn for the worse.
(2) Report.--Not later than 1 year after the date of the
enactment of this Act, the Comptroller General of the United
States shall submit a report to Congress on the study
conducted under paragraph (1).
SEC. 203. INCREASING MEDICAID DSH ALLOTMENTS.
(a) Continuation of Medicaid DSH Allotment Adjustments
Under BIPA 2000.--
(1) In general.--Section 1923(f) of the Social Security Act
(42 U.S.C. 1396r-4(f))--
(A) in paragraph (2)--
(i) in the heading, by striking ``through 2002'' and
inserting ``through 2000'';
(ii) by striking ``ending with fiscal year 2002'' and
inserting ``ending with fiscal year 2000''; and
(iii) in the table in such paragraph, by striking the
columns labeled ``FY 01'' and ``FY02'';
(B) in paragraph (3)(A), by striking ``paragraph (2)'' and
inserting ``paragraph (4)''; and
(C) in paragraph (4), as added by section 701(a)(1) of the
Medicare, Medicaid, and SCHIP Benefits Improvement and
Protection Act of 2000 (as enacted into law by section
1(a)(6) of Public Law 106-554)--
(i) by striking ``for fiscal years 2001 and 2002'' in the
heading;
(ii) in subparagraph (A), by striking ``Notwithstanding
paragraph (2), the'' and inserting ``The'';
(iii) in subparagraph (C)--
(I) by striking ``No application'' and inserting
``Application''; and
(II) by striking ``without regard to'' and inserting
``taking into account''.
(2) Increase in medicaid dsh allotment for the district of
columbia.--
(A) In general.--Effective for DSH allotments beginning
with fiscal year 2003, the item in the table contained in
section 1923(f)(2) of the Social Security Act (42 U.S.C.
1396r-4(f)(2)) for the District of Columbia for the DSH
allotment for FY 00 (fiscal year 2000) is amended by striking
``32'' and inserting ``49''.
(B) Construction.--Nothing in subparagraph (A) shall be
construed as preventing the application of section 1923(f)(4)
of the Social Security Act (as amended by subsection (a)) to
the District of Columbia for fiscal year 2003 and subsequent
fiscal years.
[[Page S5866]]
(3) Effective date.--The amendments made by this subsection
shall apply to DSH allotments for fiscal years beginning with
fiscal year 2003.
(b) Increase in Floor for Treatment As an Extremely Low DSH
State to 3 Percent in Fiscal Year 2003.--
(1) Increase in dsh floor.--Section 1923(f)(5) of the
Social Security Act (42 U.S.C. 1396r-4(f)(5)) is amended--
(A) by striking ``fiscal year 1999'' and inserting ``fiscal
year 2001'';
(B) by striking ``August 31, 2000'' and inserting ``August
31, 2002'';
(C) by striking ``1 percent'' each place it appears and
inserting ``3 percent''; and
(D) by striking ``fiscal year 2001'' and inserting ``fiscal
year 2003''.
(2) Effective date.--The amendments made by paragraph (1)
take effect as if enacted on October 1, 2002, and apply to
DSH allotments under title XIX of the Social Security Act for
fiscal year 2003 and each fiscal year thereafter.
SEC. 204. INCREASED STATE ACCESS TO UNSPENT SCHIP FUNDS.
(a) Retained and Redistributed Allotments for Fiscal Years
1998 and 1999.--Paragraphs (2)(A)(i) and (2)(A)(ii) of
section 2104(g) of the Social Security Act (42 U.S.C.
1397dd(g)) are each amended by striking ``fiscal year 2002''
and inserting ``fiscal year 2004''.
(b) Extension and Revision of Retained and Redistributed
Allotments for Fiscal Year 2000.--
(1) Permitting and extending retention of portion of fiscal
year 2000 allotment.--Paragraph (2) of such section 2104(g)
is amended--
(A) in the heading, by striking ``and 1999'' and inserting
``through 2000''; and
(B) by adding at the end of subparagraph (A) the following:
``(iii) Fiscal year 2000 allotment.--Of the amounts
allotted to a State pursuant to this section for fiscal year
2000 that were not expended by the State by the end of fiscal
year 2002, 50 percent of that amount shall remain available
for expenditure by the State through the end of fiscal year
2004.''.
(2) Redistributed allotments.--Paragraph (1) of such
section 2104(g) is amended--
(A) in subparagraph (A), by inserting ``or for fiscal year
2000 by the end of fiscal year 2002,'' after ``fiscal year
2001,'';
(B) in subparagraph (A), by striking ``1998 or 1999'' and
inserting ``1998, 1999, or 2000'';
(C) in subparagraph (A)(i)--
(i) by striking ``or'' at the end of subclause (I),
(ii) by striking the period at the end of subclause (II)
and inserting ``; or''; and
(iii) by adding at the end the following new subclause:
``(III) the fiscal year 2000 allotment, the amount
specified in subparagraph (C)(i) (less the total of the
amounts under clause (ii) for such fiscal year), multiplied
by the ratio of the amount specified in subparagraph (C)(ii)
for the State to the amount specified in subparagraph
(C)(iii).'';
(D) in subparagraph (A)(ii), by striking ``or 1999'' and
inserting ``, 1999, or 2000'';
(E) in subparagraph (B), by striking ``with respect to
fiscal year 1998 or 1999'';
(F) in subparagraph (B)(ii)--
(i) by inserting ``with respect to fiscal year 1998, 1999,
or 2000,'' after ``subsection (e),''; and
(ii) by striking ``2002'' and inserting ``2004''; and
(G) by adding at the end the following new subparagraph:
``(C) Amounts used in computing redistributions for fiscal
year 2000.--For purposes of subparagraph (A)(i)(III)--
``(i) the amount specified in this clause is the amount
specified in paragraph (2)(B)(i)(I) for fiscal year 2000,
less the total amount remaining available pursuant to
paragraph (2)(A)(iii);
``(ii) the amount specified in this clause for a State is
the amount by which the State's expenditures under this title
in fiscal years 2000, 2001, and 2002 exceed the State's
allotment for fiscal year 2000 under subsection (b); and
``(iii) the amount specified in this clause is the sum, for
all States entitled to a redistribution under subparagraph
(A) from the allotments for fiscal year 2000, of the amounts
specified in clause (ii).''.
(3) Conforming amendments.--Such section 2104(g) is further
amended--
(A) in its heading, by striking ``and 1999'' and inserting
``, 1999, and 2000''; and
(B) in paragraph (3)--
(i) by striking ``or fiscal year 1999'' and inserting ``,
fiscal year 1999, or fiscal year 2000''; and
(ii) by striking ``or November 30, 2001'' and inserting
``November 30, 2001, or November 30, 2002'', respectively.
(c) Extension and Revision of Retained and Redistributed
Allotments for Fiscal Year 2001.--
(1) Permitting and extending retention of portion of fiscal
year 2001 allotment.--Paragraph (2) of such section 2104(g),
as amended in subsection (b)(1)(B), is further amended--
(A) in the heading, by striking ``2000'' and inserting
``2001''; and
(B) by adding at the end of subparagraph (A) the following:
``(iv) Fiscal year 2001 allotment.--Of the amounts allotted
to a State pursuant to this section for fiscal year 2001 that
were not expended by the State by the end of fiscal year
2003, 50 percent of that amount shall remain available for
expenditure by the State through the end of fiscal year
2005.''.
(2) Redistributed allotments.--Paragraph (1) of such
section 2104(g), as amended in subsection (b)(2), is further
amended--
(A) in subparagraph (A), by inserting ``or for fiscal year
2001 by the end of fiscal year 2003,'' after ``fiscal year
2002,'';
(B) in subparagraph (A), by striking ``1999, or 2000'' and
inserting ``1999, 2000, or 2001'';
(C) in subparagraph (A)(i)--
(i) by striking ``or'' at the end of subclause (II),
(ii) by striking the period at the end of subclause (III)
and inserting ``; or''; and
(iii) by adding at the end the following new subclause:
``(IV) the fiscal year 2001 allotment, the amount specified
in subparagraph (D)(i) (less the total of the amounts under
clause (ii) for such fiscal year), multiplied by the ratio of
the amount specified in subparagraph (D)(ii) for the State to
the amount specified in subparagraph (D)(iii).'';
(D) in subparagraph (A)(ii), by striking ``or 2000'' and
inserting ``2000, or 2001'';
(E) in subparagraph (B)--
(i) by striking ``and'' at the end of clause (ii);
(ii) by redesignating clause (iii) as clause (iv); and
(iii) by inserting after clause (ii) the following new
clause:
``(iii) notwithstanding subsection (e), with respect to
fiscal year 2001, shall remain available for expenditure by
the State through the end of fiscal year 2005; and''; and
(F) by adding at the end the following new subparagraph:
``(D) Amounts used in computing redistributions for fiscal
year 2001.--For purposes of subparagraph (A)(i)(IV)--
``(i) the amount specified in this clause is the amount
specified in paragraph (2)(B)(i)(I) for fiscal year 2001,
less the total amount remaining available pursuant to
paragraph (2)(A)(iv);
``(ii) the amount specified in this clause for a State is
the amount by which the State's expenditures under this title
in fiscal years 2001, 2002, and 2003 exceed the State's
allotment for fiscal year 2001 under subsection (b); and
``(iii) the amount specified in this clause is the sum, for
all States entitled to a redistribution under subparagraph
(A) from the allotments for fiscal year 2001, of the amounts
specified in clause (ii).''.
(3) Conforming amendments.--Such section 2104(g) is further
amended--
(A) in its heading, by striking ``and 2000'' and inserting
``2000, and 2001''; and
(B) in paragraph (3)--
(i) by striking ``or fiscal year 2000'' and inserting
``fiscal year 2000, or fiscal year 2001''; and
(ii) by striking ``or November 30, 2002,'' and inserting
``November 30, 2002, or November 30, 2003,'', respectively.
(d) Authority for Qualifying States To Use Portion of SCHIP
Funds for Medicaid Expenditures.--Section 2105 of the Social
Security Act (42 U.S.C. 1397ee) is amended by adding at the
end the following:
``(g) Authority for Qualifying States To Use Certain Funds
for Medicaid Expenditures.--
``(1) State option.--
``(A) In general.--Notwithstanding any other provision of
law, with respect to allotments for fiscal years 1998, 1999,
2000, 2001, for fiscal years in which such allotments are
available under subsections (e) and (g) of section 2104, a
qualifying State (as defined in paragraph (2)) may elect to
use not more than 20 percent of such allotments (instead of
for expenditures under this title) for payments for such
fiscal year under title XIX in accordance with subparagraph
(B).
``(B) Payments to states.--
``(i) In general.--In the case of a qualifying State that
has elected the option described in subparagraph (A), subject
to the total amount of funds described with respect to the
State in subparagraph (A), the Secretary shall pay the State
an amount each quarter equal to the additional amount that
would have been paid to the State under title XIX for
expenditures of the State for the fiscal year described in
clause (ii) if the enhanced FMAP (as determined under
subsection (b)) had been substituted for the Federal medical
assistance percentage (as defined in section 1905(b)) of such
expenditures.
``(ii) Expenditures described.--For purposes of clause (i),
the expenditures described in this clause are expenditures
for such fiscal years for providing medical assistance under
title XIX to individuals who have not attained age 19 and
whose family income exceeds 150 percent of the poverty line.
``(iii) No impact on determination of budget neutrality for
waivers.--In the case of a qualifying State that uses amounts
paid under this subsection for expenditures described in
clause (ii) that are incurred under a waiver approved for the
State, any budget neutrality determinations with respect to
such waiver shall be determined without regard to such
amounts paid.
``(2) Qualifying state.--In this subsection, the term
`qualifying State' means a State that--
``(A) as of April 15, 1997, has an income eligibility
standard with respect to any 1 or more categories of children
(other than infants) who are eligible for medical assistance
under section 1902(a)(10)(A) or under a waiver under section
1115 implemented on January 1, 1994, that is up to 185
percent of the poverty line or above; and
[[Page S5867]]
``(B) satisfies the requirements described in paragraph
(3).
``(3) Requirements.--The requirements described in this
paragraph are the following:
``(A) SCHIP income eligibility.--The State has a State
child health plan that (whether implemented under title XIX
or this title)--
``(i) as of January 1, 2001, has an income eligibility
standard that is at least 200 percent of the poverty line or
has an income eligibility standard that exceeds 200 percent
of the poverty line under a waiver under section 1115 that is
based on a child's lack of health insurance;
``(ii) subject to subparagraph (B), does not limit the
acceptance of applications for children; and
``(iii) provides benefits to all children in the State who
apply for and meet eligibility standards on a statewide
basis.
``(B) No waiting list imposed.--With respect to children
whose family income is at or below 200 percent of the poverty
line, the State does not impose any numerical limitation,
waiting list, or similar limitation on the eligibility of
such children for child health assistance under such State
plan.
``(C) Additional requirements.--The State has implemented
at least 3 of the following policies and procedures (relating
to coverage of children under title XIX and this title):
``(i) Uniform, simplified application form.--With respect
to children 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 title XIX and
this title.
``(ii) Elimination of asset test.--The State does not apply
any asset test for eligibility under section 1902(l) or this
title with respect to children.
``(iii) Adoption of 12-month continuous enrollment.--The
State provides that eligibility shall not be regularly
redetermined more often than once every year under this title
or for children described in section 1902(a)(10)(A).
``(iv) Same verification and redetermination policies;
automatic reassessment of eligibility.--With respect to
children 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 this
title, and, as part of such redeterminations, provides for
the automatic reassessment of the eligibility of such
children for assistance under title XIX and this title.
``(v) Outstationing enrollment staff.--The State provides
for the receipt and initial processing of applications for
benefits under this title and for children under title XIX at
facilities defined as disproportionate share hospitals under
section 1923(a)(1)(A) and Federally-qualified health centers
described in section 1905(l)(2)(B) consistent with section
1902(a)(55).''.
(e) Effective Date.--Subsections (a) through (c), and the
amendments made by such subsections, shall be effective as if
this section had been enacted on September 30, 2002, and
amounts under title XXI of the Social Security Act (42 U.S.C.
1397aa et seq.) from allotments for fiscal years 1998 through
2000 are available for expenditure on and after October 1,
2002, under the amendments made by such subsections as if
this section had been enacted on September 30, 2002.
SEC. 205. FEDERAL RESPONSIBILITY FOR EMERGENCY CARE FOR
ILLEGAL IMMIGRANTS.
(a) In General.--Section 1903(a)(3) of the Social Security
Act (42 U.S.C. 1396b(a)(3)) is amended--
(1) in subparagraph (D), by striking ``plus'' at the end
and inserting ``and''; and
(2) by adding at the end the following:
``(E) 100 percent of the sums expended with respect to
costs incurred during such quarter as are attributable to the
provision of care and services that are furnished to an alien
described in subsection (v)(1) that are necessary for the
treatment of an emergency medical condition, as defined in
subsection (v)(3); and''.
(b) Effective Date.--The amendment made by subsection (a)
shall take effect on July 1, 2003.
SEC. 206. INCREASED FEDERAL RESPONSIBILITY FOR TRANSLATION
SERVICES.
(a) In General.--Section 1903(a)(3) of the Social Security
Act (42 U.S.C. 1396b(a)(3)), as amended by section 205(a), is
amended by adding at the end the following:
``(F) 90 percent of the sums expended with respect to costs
incurred during such quarter as are attributable to the
provision of language services, including oral
interpretation, translations of written materials, and other
language services, for individuals with limited English
proficiency who apply for, or receive, medical assistance
under the State plan; and''.
(b) SCHIP.--Section 2105(A)(1) of the Social Security Act
(42 U.S.C.1397ee(a)(1)) is amended--
(1) in the matter preceding subparagraph (A), by striking
``section 1905(b))'' and inserting ``section 1905(b)) or, in
the case of expenditures described in subparagraph (D)(iv),
90 percent''; and
(2) in subparagraph (D)--
(A) in clause (iii), by striking ``and'' at the end;
(B) by redesignating clause (iv) as clause (v); and
(C) by inserting after clause (iii) the following:
``(D) for expenditures attributable to the provision of
language services, including oral interpretation,
translations of written materials, and other language
services, for individuals with limited English proficiency
who apply for, or receive, child health assistance under the
plan; and''.
(c) Effective Date.--The amendments made by this section
shall take effect on July 1, 2003.
SEC. 207. INCREASED FEDERAL MATCHING RATES FOR CERTAIN
SERVICES.
(a) Outstationed Workers.--Section 1903(a)(3) of the Social
Security Act (42 U.S.C. 1396b(a)(3)), as amended by sections
205(a) and 206(a), is amended by adding at the end the
following:
``(G) 90 percent of the sums expended with respect to costs
incurred during such quarter as are attributable to providing
for the receipt and initial processing of applications of
children and pregnant women for medical assistance consistent
with the requirements of section 1902(a)(55); plus''.
(b) 100 Percent Matching Rate for Urban Indian Health
Services.--The third sentence of section 1905(b) of the
Social Security Act (42 U.S.C. 1396d(b)) is amended--
(1) by inserting ``or program'' after ``facility'';
(2) by striking ``or by'' and inserting ``, by''; and
(3) by inserting ``, or by an urban Indian organization
pursuant to a grant or contract with the Indian Health
Service under title V of the Indian Health Care Improvement
Act'' before the period.
(c) Effective Date.--The amendments made by this section
shall take effect on July 1, 2003.
TITLE III--STRENGTHENING STATE AND FEDERAL COMMITMENT TO THE ELDERLY
AND PERSONS WITH DISABILITIES; FAMILY OPPORTUNITY ACT
Subtitle A--Elderly and Persons with Disabilities
SEC. 301. FULL ACCOUNTING OF SAVINGS IN DETERMINING COST-
EFFECTIVENESS.
(a) In General.--Section 1915(c)(2)(D) of the Social
Security Act (42 U.S.C. 1396n(c)(2)(D)) is amended by
inserting ``(reduced by average per capita reductions in
spending under other Federal mandatory spending programs
resulting from operation of the waiver)'' after ``with
respect to such individuals''.
(b) Effective Date.--The amendment made by subsection shall
take effect on the date of the enactment of this Act.
SEC. 302. EXTENSION OF MEDICAID COVERAGE UNDER THE TICKET TO
WORK PROGRAM TO COVER SPOUSES.
(a) In General.--Section 1902(a)(10)(A)(ii) of the Social
Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
(1) in clause (i)(II), by inserting before the comma at the
end the following: ``, and at the option of a State, any
individual who is the spouse of such an individual'';
(2) in clause (ii)(XIII), by inserting before the semicolon
at the end the following: ``, and at the option of a State,
any individual who is the spouse of such an individual'';
(3) in subclause (XV), by inserting before the semicolon at
the end the following: ``, and at the option of a State, any
individual who is the spouse of such an individual''; and
(4) in subclause (XVI), by inserting before the semicolon
at the end the following: ``, and at the option of a State,
any individual who is the spouse of such an individual''.
(b) Conforming Amendment.--Section 1905(a)(xii) of such Act
(42 U.S.C. 1396d(a)(xii)) is amended by inserting ``and
spouses described in clauses (i)(II), (ii)(XIII), (ii)(XV),
and (ii)(XVI) of section 1902(a)(10)(A)'' after ``subsection
(v))''.
(c) Effective Date.--The amendments made by this section
take effect on October 1, 2003, whether or not regulations
implementing such amendments have been issued.
SEC. 303. ENCOURAGING TRANSITION TO HOME AND COMMUNITY CARE.
(a) In General.--Section 1905(b) of the Social Security Act
(42 U.S.C. 1396d(b)), as amended by section 101(a), is
amended--
(1) by striking ``and'' before ``(5)''; and
(2) by inserting before the period the following: ``, and
(6) the Federal medical assistance percentage shall be equal
to the enhanced FMAP described in section 2105(b) with
respect to medical assistance provided under a waiver under
section 1915(c)''.
(b) Conforming Amendment.--Section 1915(c) of such Act (42
U.S.C. 1396n(c)) is amended by adding at the end the
following new paragraph:
``(11) For purposes of determining the amount of
expenditures under this section or a State plan for purposes
of applying any test of cost-effectiveness or similar test in
carrying out this subsection, the provisions of section
1905(b)(6) shall not be taken into account.''.
(c) Effective Date.--The amendments made by this section
shall apply to medical assistance for items and services
furnished on or after July 1, 2003, regardless of whether the
waiver under which such assistance is provided was approved
before, on, or after the date of the enactment of this Act.
SEC. 304. ENHANCED MATCHING RATE FOR DISABLED INDIVIDUALS
AWAITING MEDICARE ELIGIBILITY.
(a) In General.--Section 1905(b) of the Social Security Act
(42 U.S.C. 1396d(b)), as
[[Page S5868]]
amended by sections 101(a) and 303(a), is amended--
(1) by striking ``and'' before ``(6)''; and
(2) by inserting before the period the following: ``, and
(7) the Federal medical assistance percentage shall be equal
to 100 percent with respect to medical assistance provided to
individuals who are not entitled to benefits under part A of
title XVIII pursuant to section 226(b) but who would be
entitled to such benefits pursuant to such section but for
the application of a 24-month waiting period under such
section''.
(b) Effective Date.--The amendments made by this section
shall apply to medical assistance for items and services
furnished on or after October 1, 2003.
SEC. 305. PROVIDING INITIAL TERM OF 5 YEARS FOR SECTION 1915
WAIVERS.
(a) In General.--Subsections (d)(3) and (e)(3) of section
1915 of the Social Security Act (42 U.S.C. 1396n) are each
amended by striking ``3 years'' and inserting ``5 years''.
(b) Effective Date.--The amendments made by subsection (a)
shall apply to waivers granted on or after the date of the
enactment of this Act.
SEC. 306. OPTIONAL COVERAGE OF COMMUNITY-BASED ATTENDANT
SERVICES AND SUPPORTS UNDER THE MEDICAID
PROGRAM.
(a) Optional Coverage.--Section 1902(a)(10)(D) of the
Social Security Act (42 U.S.C. 1396a(a)(10)(D)) is amended--
(1) by inserting ``(i)'' after `(D)'';
(2) by adding ``and'' after the semicolon; and
(3) by adding at the end the following new clause:
``(ii) at the option of the State and subject to section
1935, for the inclusion of community-based attendant services
and supports for any individual who--
``(I) is eligible for medical assistance under the State
plan;
``(II) with respect to whom there has been a determination
that the individual requires the level of care provided in a
nursing facility or an intermediate care facility for the
mentally retarded (whether or not coverage of such
intermediate care facility is provided under the State plan);
and
``(III) who chooses to receive such services and supports;
insofar as such services are appropriate for the individual's
condition according to the individual's plan of care;''.
(b) Community-Based Attendant Services and Supports
Option.--
(1) In general.--Title XIX of the Social Security Act (42
U.S.C. 1396 et seq.) is amended--
(A) by redesignating section 1935 as section 1936; and
(B) by inserting after section 1934 the following:
``community-based attendant services and supports
``Sec. 1935. (a) Coverage.--
``(1) In general.--A State may provide through a plan
amendment for the inclusion of community-based attendant
services and supports (as defined in subsection (g)(1)) for
individuals described in section 1902(a)(10)(D)(ii) in
accordance with this section.
``(2) Enhanced FMAP for Coverage.--Notwithstanding section
1905(b), in the case of a State with an approved plan
amendment under this section during that period that also
satisfies the requirements of subsection (c) the Federal
medical assistance percentage shall be equal to the enhanced
FMAP described in section 2105(b) with respect to medical
assistance in the form of community-based attendant services
and supports provided to individuals described in section
1902(a)(10)(D)(ii) in accordance with this section.
``(b) Development and Implementation of Benefit.--In order
for a State plan amendment to be approved under this section,
a State shall develop and implement the proposal through a
public process which includes individuals with disabilities,
elderly individuals, their representatives, and providers,
and include in that proposed plan amendment--
``(1) a State process to notify and inform individuals
(including individuals who live in nursing facilities,
individuals who live in intermediate care facilities for the
mentally retarded, and individuals who live in the community
and who have an unmet need for such services) of the
availability of such services and supports under the this
title, and of other items and services that may be provided
to the individual under this title or title XVIII; and
``(2) a quality assurance program that will maximize
consumer independence and consumer control and will --
``(A) train consumers to appropriately manage their own
attendant;
``(B) provide a quality review process; and
``(C) provide for investigation and resolution of
allegations of neglect, abuse, or exploitation in connection
with the provision of such services and supports.
``(c) No Effect on Ability To Provide Coverage Under a
Waiver.--
``(1) In general.--Nothing in this section shall be
construed as affecting the ability of a State to provide
coverage under the State plan for community-based attendant
services and supports (or similar coverage) under a waiver
approved under section 1915, section 1115, or otherwise.
``(2) Eligibility for enhanced match.--In the case of a
State that provides coverage for such services and supports
under a waiver, the State shall not be eligible under section
1935 for the enhanced FMAP for the provision of such coverage
under this unless the State submits a plan amendment to the
Secretary that meets the requirements of this section.
``(d) Definitions.--In this title:
``(1) Community-based attendant services and supports.--
``(A) In general.--The term `community-based attendant
services and supports' may include one or more of the
following: attendant services and supports furnished to an
individual, as needed, to assist in accomplishing activities
of daily living, instrumental activities of daily living, and
health-related functions through hands-on assistance,
supervision, or cueing--
``(i) under a plan of services and supports that is based
on an assessment of functional need and that is agreed to by
the individual or, as appropriate, the individual's
representative;
``(ii) in a home or community setting, which may include a
school, workplace, or recreation or religious facility, but
does not include a nursing facility or an intermediate care
facility for the mentally retarded;
``(iii) under an agency-provider model or other model (as
defined in paragraph (2)(C)); and
``(iv) the furnishing of which is selected, managed, and
dismissed by the individual, or, as appropriate, with
assistance from the individual's representative.
``(B) Included services and supports.--Such term may
include one or more of the following:
``(i) Tasks necessary to assist an individual in
accomplishing activities of daily living, instrumental
activities of daily living, and health-related functions.
``(ii) The acquisition, maintenance, and enhancement of
skills necessary for the individual to accomplish activities
of daily living, instrumental activities of daily living, and
health-related functions.
``(iii) Backup systems or mechanisms (such as the use of
beepers), as defined by the State according to the client's
needs, to ensure continuity of services and supports.
``(iv) Voluntary training on how to select, manage, and
dismiss attendants.
``(C) Excluded services and supports.--Subject to
subparagraph (D), such term does not include--
``(i) the provision of room and board for the individual;
``(ii) special education and related services provided
under the Individuals with Disabilities Education Act and
vocational rehabilitation services provided under the
Rehabilitation Act of 1973;
``(iii) assistive technology devices and assistive
technology services;
``(iv) durable medical equipment; or
``(v) home modifications.
``(D) Flexibility in transition to community-based home
setting.--Such term may include expenditures for transitional
costs required for an individual to make the transition from
a nursing facility or intermediate care facility for the
mentally retarded to a community-based home setting where the
individual resides.
``(E) Clarification of permitting payment of relatives for
providing services and supports.--Nothing in this section
shall be construed as preventing community-based attendant
services and supports from being furnished to an individual
by others who are related to that individual and for such
others being paid for so furnishing such services and
supports.
``(2) Additional definitions.--
``(A) Activities of daily living.--The term `activities of
daily living' includes eating, toileting, grooming, dressing,
bathing, and transferring.
``(B) Consumer controlled.--The term `consumer controlled'
means a method of providing services and supports that allow
the individual, or where appropriate, the individual's
representative, maximum control of the community-based
attendant services and supports, regardless of who acts as
the employer of record.
``(C) Delivery models.--
``(i) Agency-provider model.--The term `agency-provider
model' means, with respect to the provision of community-
based attendant services and supports for an individual, a
method of providing consumer controlled services and supports
under which entities contract for the provision of such
services and supports.
``(ii) Other models.--The term `other models' means
methods, other than an agency-provider model, for the
provision of consumer controlled services and supports. Such
models may include direct cash payments or use of a fiscal
agent to assist in obtaining services.
``(D) Health-related functions.--The term `health-related
functions' means functions that can be delegated or assigned
by licensed health-care professionals under State law to be
performed by an attendant.
``(E) Instrumental activities of daily living.--The term
`instrumental activities of daily living' includes meal
planning and preparation, managing finances, shopping for
food, clothing, and other essential items, performing
essential household chores, communicating by phone and other
media, and other activities needed to participate in the
community, as appropriate.
``(F) Individual's representative.--The term `individual's
representative' means a parent, a family member, a guardian,
an advocate, or an authorized representative of an
individual.''.
[[Page S5869]]
(c) Investigation by State .--Section 1903(q)(4)(A)(i) of
such Act (42 U.S.C. 1396b(q)(4)(A)(i)) is amended by
inserting ``and for investigation and resolution of
allegations of neglect, abuse, or exploitation in connection
with the provision of community-based attendant services and
supports under section 1935(b)(2)(C)'' before the semicolon.
(d) Effective Date.--The amendments made by this section
take effect on October 1, 2003, and apply to medical
assistance provided for community-based attendant services
and supports described in section 1935 of the Social Security
Act furnished on or after that date.
Subtitle B--Family Opportunity Act
SEC. 311. SHORT TITLE.
This subtitle may be cited as the ``Family Opportunity Act
of 2003'' or the ``Dylan Lee James Act''.
SEC. 312. OPPORTUNITY FOR FAMILIES OF DISABLED CHILDREN TO
PURCHASE MEDICAID COVERAGE FOR SUCH CHILDREN.
(a) State Option To Allow Families of Disabled Children To
Purchase Medicaid Coverage for Such Children.--
(1) In general.--Section 1902 (42 U.S.C. 1396a) is
amended--
(A) in subsection (a)(10)(A)(ii)--
(i) by striking ``or'' at the end of subclause (XVII);
(ii) by adding ``or'' at the end of subclause (XVIII); and
(iii) by adding at the end the following new subclause:
``(XIX) who are disabled children described in subsection
(cc)(1);''; and
(B) by adding at the end the following new subsection:
``(cc)(1) Individuals described in this paragraph are
individuals--
``(A) who have not attained 18 years of age;
``(B) who 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; and
``(C) whose family income does not exceed such income level
as the State establishes and does not exceed--
``(i) 300 percent of the income official poverty line (as
defined by the Office of Management and Budget, and revised
annually in accordance with section 673(2) of the Omnibus
Budget Reconciliation Act of 1981) applicable to a family of
the size involved; or
``(ii) such higher percent of such poverty line as a State
may establish, except that no Federal financial participation
shall be provided under section 1903(a) for any medical
assistance provided to an individual who would not be
described in this subsection but for this clause.''.
(2) Interaction with employer-sponsored family coverage.--
Section 1902(cc) (42 U.S.C. 1396a(cc)), as added by paragraph
(1), is amended by adding at the end the following new
paragraph:
``(2)(A) If an employer of a parent of an individual
described in paragraph (1) offers family coverage under a
group health plan (as defined in section 2791(a) of the
Public Health Service Act), the State may--
``(i) require such parent to apply for, enroll in, and pay
premiums for, such coverage as a condition of such parent's
child being or remaining eligible for medical assistance
under subsection (a)(10)(A)(ii)(XIX) if the parent is
determined eligible for such coverage and the employer
contributes at least 50 percent of the total cost of annual
premiums for such coverage; and
``(ii) if such coverage is obtained--
``(I) subject to paragraph (2) of section 1916(h), reduce
the premium imposed by the State under that section (if any)
in an amount that reasonably reflects the premium
contribution made by the parent for private coverage on
behalf of a child with a disability; and
``(II) treat such coverage as a third party liability under
subsection (a)(25).
``(B) In the case of a parent to which subparagraph (A)
applies, if the family income of such parent does not exceed
300 percent of the income official poverty line (referred to
in paragraph (1)(C)(i)), a State may provide for payment of
any portion of the annual premium for such family coverage
that the parent is required to pay. Any payments made by the
State under this subparagraph shall be considered, for
purposes of section 1903(a), to be payments for medical
assistance.''.
(b) State Option To Impose Income-Related Premiums.--
Section 1916 (42 U.S.C. 1396o) is amended--
(1) in subsection (a), by striking ``subsection (g)'' and
inserting ``subsections (g) and (h)''; and
(2) by adding at the end the following new subsection:
``(h)(1) With respect to disabled children provided medical
assistance under section 1902(a)(10)(A)(ii)(XIX), subject to
paragraph (2), a State may (in a uniform manner for such
children) require the families of such children to pay
monthly premiums set on a sliding scale based on family
income.
``(2) A premium requirement imposed under paragraph (1) may
only apply to the extent that--
``(A) the aggregate amount of such premium and any premium
that the parent is required to pay for family coverage under
section 1902(cc)(2)(A)(i) does not exceed 5 percent of the
family's income; and
``(B) the requirement is imposed consistent with section
1902(cc)(2)(A)(ii)(I).
``(3) A State shall not require prepayment of a premium
imposed pursuant to paragraph (1) and shall not terminate
eligibility of a child under section 1902(a)(10)(A)(ii)(XIX)
for medical assistance under this title on the basis of
failure to pay any such premium until such failure continues
for a period of not less than 60 days from the date on which
the premium became past due. The State may waive payment of
any such premium in any case where the State determines that
requiring such payment would create an undue hardship.''.
(c) Conforming Amendment.--Section 1903(f)(4) (42 U.S.C.
1396b(f)(4)) is amended in the matter preceding subparagraph
(A) by inserting ``1902(a)(10)(A)(ii)(XIX),'' after
``1902(a)(10)(A)(ii)(XVIII),''.
(d) Effective Date.--The amendments made by this section
shall apply to medical assistance for items and services
furnished on or after January 1, 2004.
SEC. 313. TREATMENT OF INPATIENT PSYCHIATRIC HOSPITAL
SERVICES FOR INDIVIDUALS UNDER AGE 21 IN HOME
OR COMMUNITY-BASED SERVICES WAIVERS.
(a) In General.--Section 1915(c) (42 U.S.C. 1396n(c)) is
amended--
(1) in paragraph (1)--
(A) in the first sentence, by inserting ``, or inpatient
psychiatric hospital services for individuals under age 21,''
after ``intermediate care facility for the mentally
retarded''; and
(B) in the second sentence, by inserting ``, or inpatient
psychiatric hospital services for individuals under age 21''
before the period;
(2) in paragraph (2)(B), by striking ``or services in an
intermediate care facility for the mentally retarded'' each
place it appears and inserting ``, services in an
intermediate care facility for the mentally retarded, or
inpatient psychiatric hospital services for individuals under
age 21'';
(3) by striking paragraph (2)(C) and inserting the
following:
``(C) such individuals who are determined to be likely to
require the level of care provided in a hospital, nursing
facility, or intermediate care facility for the mentally
retarded, or inpatient psychiatric hospital services for
individuals under age 21, are informed of the feasible
alternatives, if available under the waiver, at the choice of
such individuals, to the provision of inpatient hospital
services, nursing facility services, services in an
intermediate care facility for the mentally retarded, or
inpatient psychiatric hospital services for individuals under
age 21;''; and
(4) in paragraph (7)(A)--
(A) by inserting ``, or inpatient psychiatric hospital
services for individuals under age 21,'' after ``intermediate
care facility for the mentally retarded''; and
(B) by inserting ``, or who would require inpatient
psychiatric hospital services for individuals under age 21''
before the period.
(b) Effective Date.--The amendments made by subsection (a)
apply with respect to medical assistance provided on or after
January 1, 2003.
SEC. 314. DEMONSTRATION OF COVERAGE UNDER THE MEDICAID
PROGRAM OF CHILDREN WITH POTENTIALLY SEVERE
DISABILITIES.
(a) State Application.--A State may apply to the Secretary
of Health and Human Services (in this section referred to as
the ``Secretary'') for approval of a demonstration project
(in this section referred to as a ``demonstration project'')
under which up to a specified maximum number of children with
a potentially severe disability (as defined in subsection
(b)) are provided medical assistance under the State medicaid
plan under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.).
(b) Child With a Potentially Severe Disability Defined.--
(1) In general.--In this section, the term ``child with a
potentially severe disability'' means, with respect to a
demonstration project, an individual who--
(A) has not attained 21 years of age;
(B) has a physical or mental condition, disease, disorder
(including a congenital birth defect or a metabolic
condition), injury, or developmental disability that was
incurred before the individual attained such age; and
(C) is reasonably expected, but for the receipt of medical
assistance under the State medicaid plan, to reach the level
of disability defined under section 1614(a)(3) of the Social
Security Act (42 U.S.C. 1382c(a)(3)), (determined without
regard to the reference to age in subparagraph (C) of that
section).
(2) Exception.--Such term does not include an individual
who would be considered disabled under section 1614(a)(3)(C)
of the Social Security Act (42 U.S.C. 1382c(a)(3)(C))
(determined without regard to the reference to age in that
section).
(c) Approval of Demonstration Projects.--
(1) In general.--Subject to paragraph (3), the Secretary
shall approve applications under subsection (a) that meet the
requirements of paragraph (2) and such additional terms and
conditions as the Secretary may require. The Secretary may
waive the requirement of section 1902(a)(1) of the Social
Security Act (42 U.S.C. 1396a(a)(1)) to allow for sub-State
demonstrations.
(2) Terms and conditions of demonstration projects.--The
Secretary may not approve a demonstration project under this
section unless the State provides assurances satisfactory to
the Secretary that the following conditions are or will be
met:
[[Page S5870]]
(A) Independent evaluation.--The State provides for an
independent evaluation of the project to be conducted during
fiscal year 2006.
(B) Consultation for development of criteria.--The State
consults with appropriate pediatric health professionals in
establishing the criteria for determining whether a child has
a potentially severe disability.
(C) Annual report.--The State submits an annual report to
the Secretary (in a uniform form and manner established by
the Secretary) on the use of funds provided under the grant
that includes the following:
(i) Enrollment and financial statistics on--
(I) the total number of children with a potentially severe
disability enrolled in the demonstration project,
disaggregated by disability;
(II) the services provided by category or code and the cost
of each service so categorized or coded; and
(III) the number of children enrolled in the demonstration
project who also receive services through private insurance.
(ii) With respect to the report submitted for fiscal year
2006, the results of the independent evaluation conducted
under subparagraph (A).
(iii) Such additional information as the Secretary may
require.
(3) Limitations on federal funding.--
(A) Appropriation.--
(i) In general.--Out of any funds in the Treasury not
otherwise appropriated, there is appropriated to carry out
this section--
(I) $16,666,000 for each of fiscal years 2002 and 2003; and
(II) $16,667,000 for each of fiscal years 2004 through
2007.
(ii) Budget authority.--Clause (i) constitutes budget
authority in advance of appropriations Acts and represents
the obligation of the Federal Government to provide for the
payment of the amounts appropriated under clause (i).
(B) Limitation on payments.--In no case may--
(i) the aggregate amount of payments made by the Secretary
to States under this section exceed $100,000,000;
(ii) the aggregate amount of payments made by the Secretary
to States for administrative expenses relating to the
evaluations and annual reports required under subparagraphs
(A) and (C) of paragraph (2) exceed $2,000,000 of such
$100,000,000; or
(iii) payments be provided by the Secretary for a fiscal
year after fiscal year 2010.
(C) Funds allocated to states.--
(i) In general.--The Secretary shall allocate funds to
States based on their applications and the availability of
funds. In making such allocations, the Secretary shall ensure
an equitable distribution of funds among States with large
populations and States with small populations.
(ii) Availability.--Funds allocated to a State under a
grant made under this section for a fiscal year shall remain
available until expended.
(D) Funds not allocated to states.--Funds not allocated to
States in the fiscal year for which they are appropriated
shall remain available in succeeding fiscal years for
allocation by the Secretary using the allocation formula
established under this section.
(E) Payments to states.--The Secretary shall pay to each
State with a demonstration project approved under this
section, from its allocation under subparagraph (C), an
amount for each quarter equal to the Federal medical
assistance percentage (as defined in section 1905(b) of the
Social Security Act (42 U.S.C. 1395d(b))) of expenditures in
the quarter for medical assistance provided to children with
a potentially severe disability.
(d) Recommendation.--Not later than October 1, 2005, the
Secretary shall submit a recommendation to the Committee on
Commerce of the House of Representatives and the Committee on
Finance of the Senate regarding whether the demonstration
project established under this section should be continued
after fiscal year 2007.
(e) State Defined.--In this section, the term ``State'' has
the meaning given such term for purposes of title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.).
SEC. 315. DEVELOPMENT AND SUPPORT OF FAMILY-TO-FAMILY HEALTH
INFORMATION CENTERS.
Section 501 (42 U.S.C. 701) is amended by adding at the end
the following new subsection:
``(c)(1) In addition to amounts appropriated under
subsection (a) and retained under section 502(a)(1) for the
purpose of carrying out activities described in subsection
(a)(2), there is appropriated to the Secretary, out of any
money in the Treasury not otherwise appropriated, for the
purpose of enabling the Secretary (through grants, contracts,
or otherwise) to provide for special projects of regional and
national significance for the development and support of
family-to-family health information centers described in
paragraph (2), $10,000,000 for each of fiscal years 2002
through 2007. Funds appropriated under this paragraph shall
remain available until expended.
``(2) The family-to-family health information centers
described in this paragraph are centers that--
``(A) assist families of children with disabilities or
special health care needs to make informed choices about
health care in order to promote good treatment decisions,
cost-effectiveness, and improved health outcomes for such
children;
``(B) provide information regarding the health care needs
of, and resources available for, children with disabilities
or special health care needs;
``(C) identify successful health delivery models for such
children;
``(D) develop with representatives of health care
providers, managed care organizations, health care
purchasers, and appropriate State agencies a model for
collaboration between families of such children and health
professionals;
``(E) provide training and guidance regarding caring for
such children;
``(F) conduct outreach activities to the families of such
children, health professionals, schools, and other
appropriate entities and individuals; and
``(G) are staffed by families of children with disabilities
or special health care needs who have expertise in Federal
and State public and private health care systems and health
professionals.
``(3) The provisions of this title that are applicable to
the funds made available to the Secretary under section
502(a)(1) apply in the same manner to funds made available to
the Secretary under paragraph (1).''.
SEC. 316. RESTORATION OF MEDICAID ELIGIBILITY FOR CERTAIN SSI
BENEFICIARIES.
(a) In General.--Section 1902(a)(10)(A)(i)(II) (42 U.S.C.
1396a(a)(10)(A)(i)(II)) is amended--
(1) by inserting ``(aa)'' after ``(II)'';
(2) by striking ``or who are'' and inserting ``, (bb) who
are''; and
(3) by inserting before the comma at the end the following:
``, or (cc) who are under 21 years of age and with respect to
whom supplemental security income benefits would be paid
under title XVI if subparagraphs (A) and (B) of section
1611(c)(7) were applied without regard to the phrase `the
first day of the month following' ''.
(b) Effective Date.--The amendments made by subsection (a)
shall apply to medical assistance for items and services
furnished on or after the first day of the first calendar
quarter that begins after the date of enactment of this Act.
TITLE IV--FACILITATING PROGRAM ADMINISTRATION AND PRESERVING COVERAGE
SEC. 401. ALLOWING UNIFORM COVERAGE OF ALL LOW INCOME
AMERICANS.
(a) In General.--Section 1902(a)(10)(A)(ii) of the Social
Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
(1) by striking ``or'' at the end of subclause (XVII);
(2) by adding ``or'' at the end of subclause (XVIII); and
(3) by adding at the end the following the following new
subclause:
``(XIX) any individual age 21 through 64 whose family
income does not exceed 200 percent of the income official
poverty line (as defined by the Office of Management and
Budget, and revised annually in accordance with section
673(2) of the Omnibus Budget Reconciliation Act of 1981)
applicable to a family of the size involved;''.
(b) Conforming Amendments.--
(1) Section 1905(a) of such Act (42 U.S.C. 1396d(a)) is
amended, in the matter before paragraph (1)--
(A) by striking ``or'' at the end of clause (xii);
(B) by adding ``or'' at the end of clause (xiii); and
(C) by inserting after clause (xiii) the following new
clause:
``(xii) individuals described in section
1902(a)(10)(A)(ii)(XIX),''.
(2) Section 1903(f)(4) of such Act (42 U.S.C. 1396b(f)(4))
is amended by inserting ``1902(a)(10)(A)(ii)(XIX),'' after
``1902(a)(10)(A)(ii)(XVIII),''.
(c) Effective Date.--The amendments made by this section
shall take effect on October 1, 2003.
SEC. 402. FACILITATING COVERAGE OF FAMILIES.
(a) In General.--Section 1905(b) of the Social Security Act
(42 U.S.C. 1396d(b)), as amended by sections 101(a), 303(a),
and 304(a), is amended--
(1) by striking ``and'' before ``(7)''; and
(2) by inserting before the period the following: ``, and
(8) the Federal medical assistance percentage shall be equal
to the enhanced FMAP described in section 2105(b) with
respect to medical assistance provided for individuals who
are covered under section 1925 or section 1931 by virtue of
being a parent or other caretaker relative (as defined for
purposes of such section) of a child and whose income does
not exceed the percentage of the income official poverty line
applicable under section 1902(l)(2)(C) to children who are
eligible for medical assistance under section
1902(l)(1)(D)''.
(b) Construction.--Nothing in section 1905(b)(8) of the
Social Security Act, as added by subsection (a)(2), shall be
construed as preventing a State from providing medicaid
benefits for individuals whose income exceeds 100 percent of
the Federal poverty line at the regular FMAP.
(c) Effective Date.--The amendments made by this section
shall apply to medical assistance for items and services
furnished on or after July 1, 2003.
SEC. 403. ASSISTANCE WITH COVERAGE OF LEGAL IMMIGRANTS UNDER
THE MEDICAID PROGRAM AND SCHIP.
(a) Medicaid Program.--Section 1903(v) of the Social
Security Act (42 U.S.C. 1396b(v)) is amended--
[[Page S5871]]
(1) in paragraph (1), by striking ``paragraph (2)'' and
inserting ``paragraphs (2) and (4)''; and
(2) by adding at the end the following new paragraph:
``(4)(A) A State may elect (in a plan amendment under this
title) to provide medical assistance under this title,
notwithstanding sections 401(a), 402(b), 403, and 421 of the
Personal Responsibility and Work Opportunity Reconciliation
Act of 1996, for aliens who are lawfully residing in the
United States (including battered aliens described in section
431(c) of such Act) and who are otherwise eligible for such
assistance, within either or both of the following
eligibility categories:
``(i) Pregnant women.--Women during pregnancy (and during
the 60-day period beginning on the last day of the
pregnancy).
``(ii) Children.--Children (as defined under such plan),
including optional targeted low-income children described in
section 1905(u)(2)(B).
``(B) In the case of a State that has elected to provide
medical assistance to a category of aliens under subparagraph
(A), no debt shall accrue under an affidavit of support
against any sponsor of such an alien on the basis of
provision of assistance to such category and the cost of such
assistance shall not be considered as an unreimbursed
cost.''.
(b) SCHIP.--Section 2107(e)(1) of such Act (42 U.S.C.
1397gg(e)(1)) is amended by redesignating subparagraphs (C)
and (D) as subparagraph (D) and (E), respectively, and by
inserting after subparagraph (B) the following new
subparagraph:
``(C) Section 1903(v)(4) (relating to optional coverage of
categories of permanent resident alien children), but only if
the State has elected to apply such section to the category
of children under title XIX.''.
(c) Effective Date.--The amendments made by this section
take effect on October 1, 2003, and apply to medical
assistance and child health assistance furnished on or after
such date.
SEC. 404. FLEXIBILITY IN ELIGIBILITY DETERMINATIONS.
(a) In General.--Section 1902(e) of the Social Security Act
(42 U.S.C. 1396a(e)) is amended by adding at the end the
following:
``(13)(A) Subject to the requirements of this paragraph, at
the option of the State, the plan may provide that financial
eligibility requirements for medical assistance are met for
an individual under 19 years of age (or such higher age as
determined by the State) by using a determination (made
within a reasonable period, as found by the State, before its
use for this purpose) of the individual's family or household
income and resources, notwithstanding any differences in
budget unit, disregards, deeming, or other methodology, by a
Federal or State agency (or a public or private entity making
such determination on behalf of such agency) specified by the
plan, provided that such agency has fiscal liabilities or
responsibilities affected or potentially affected by such
determinations, provided that all information furnished by
such agency pursuant to this subparagraph is used solely for
purposes of determining eligibility for medical assistance
under the State plan approved under this title or for child
health assistance under a State plan approved under title
XXI.
``(B) Any State electing the option under subparagraph (A)
shall--
``(i) ensure that if an individual is determined under such
subparagraph to be not eligible for medical assistance under
the State plan approved under this title or for child health
assistance under a State plan under title XXI, the State must
subsequently determine if such individual is eligible for
such assistance using the methodology that would otherwise be
applicable in determining eligibility for such an individual;
and
``(ii) ensure that any information furnished by an agency
specified in such subparagraph shall be furnished with
reasonable promptness to the agency determining eligibility
for medical assistance under the State plan approved under
this title or for child health assistance under a State plan
approved under Title XXI.
``(C) Nothing in subparagraph (A) shall be construed to
restrict the ability of an individual under 19 years of age
(or such higher age as specified by the State) to apply for
medical assistance under a State plan approved under this
title or for child health assistance under a State plan
approved under title XXI under the methodology that would
otherwise be applicable in determining eligibility for such
an individual.''.
(b) Effective Date.--The amendment made by subsection (a)
takes effect on October 1, 2003.
Mr. JOHNSON. Mr. President, I rise today with my colleagues, Senators
Bingaman, Corzine, Lautenberg, Clinton, Kerry and Dayton, to introduce
the ``Strengthening Our States Act of 2003.'' I thank my colleagues for
joining me in introducing this legislation that marks a first step in
helping States being to deal with the fiscal crisis many are now
facing.
These challenging economic times have forced many States to make
tough decisions. Among areas affected, some States have had to start
cutting benefits in their Medicaid programs in order to make ends meet.
The result is less access to care and poorer health for our most
vulnerable populations including: low-income, minorities and the
elderly. Many States are also struggling to meet the needs of a growing
uninsured population which continues to worsen as more people lose
their jobs.
So far, my home State of South Dakota has been one of the lucky ones.
We have not had to cut Medicaid program benefits to date and our fiscal
health overall looks fairly good. I do not however have unrealistic
expectations that South Dakota is protected from the current economic
downturn and recognize that it is only a matter of time before my State
experiences the burden of our neighbors.
The Strengthening Our States Act or SOS Act provides several
strategies to address these issues by increasing coverage to the
uninsured, providing flexibility in existing State Medicaid program and
providing States with assistance to avoid cuts to existing Medicaid
coverage. Our proposal will improve the Medicaid program without
shifting costs to States as does the Bush Medicaid proposal which block
grants the program. I find it particularly troubling that in times when
State governments across the country are being forced to reduce or
eliminate Medicaid services in order to save money, the Administration
would propose to limit the Federal Government's long-term
responsibility for the only kind of health program many Americans can
afford.
This bill will provide temporary fiscal relief to States through a
$30 billion increase in the Federal share of Medicaid payments or FMAP.
Unlike the block grant program the Administration has proposed, our
bill is responsive to the immediate State needs for financial support
and will keep these important programs going. Other important bill
provisions include assistance with the costs of care of the elderly and
people with disabilities through 100 percent Federal financing of
Medicare premiums and cost-sharing for low-income groups. The bill
provides States with new flexibility in administering Medicaid and will
increase access to care for many uninsured groups. It will also close
several loopholes in existing law that prevent the disabled from
accessing health care services while waiting to qualify for Medicare
coverage. Finally, it will provide increased access to home and
community based services for people with disabilities through mandatory
waivers for this type of care.
States are at their wits end trying to juggle new health care
priorities. Between smallpox vaccination requirements, Severe Acute
Respiratory Syndrome surveillance and increased numbers of uninsured
individuals, States are in great need of every bit of help we can
provide. Senator Daschle and other colleagues in the Senate just rolled
out a tax cut proposal that recognizes the current fiscal situation
experienced in our States and this will provide important relief during
these challenging times.
The Strengthening Our States Act is a first step in supporting our
states and I hope additional steps will follow. By providing immediate
Medicaid relief, we can ease some of the burden currently faced by many
State governments and will hopefully prevent crises from erupting in
others that are working hard to just keep afloat. I urge the Senate to
support this important legislation.
______
By Mr. CORZINE (for himself and Mr. Lautenberg):
S. 1013. A bill to amend the Outer Continental Shelf Lands Act to
permanently prohibit the conduct of offshore drilling on the Outer
Continental Shelf in the Mid-Atlantic and North Atlantic planning
areas; to the Committee on Energy and Natural Resources.
Mr. CORZINE. Mr. President, today, along with Senator Lautenberg, I
am introducing legislation, the Clean Ocean and Safe Tourism, COAST,
Anti-Drilling Act, to ban oil and gas drilling off the Mid-Atlantic and
Northern Atlantic coast.
The people of New Jersey, and other residents of States along the
Atlantic Coast, do not want oil or gas rigs anywhere near their
treasured beaches and fishing grounds. Such drilling poses serious
threats not to our environment, but to our economy, which depends
heavily on tourism along our shore.
Until the Bush Administration came into office, there was no reason
to suspect that drilling was even a remote
[[Page S5872]]
possibility. Since 1982, a statutory moratorium on leasing activities
in most Outer Continental Shelf, OCS, areas has been included annually
in Interior Appropriations acts. In addition, President George H.W.
Bush declared a leasing moratorium on many OCS areas on June 26, 1990
under section 12 of the OCS Lands Act. On June 12, 1998, President
Clinton used the same authority to issue a memorandum to the Secretary
of the Interior that extended the moratorium through 2012 and included
additional OCS areas.
Given the long-standing consensus against drilling in these areas, I
was deeply disturbed to discover that on May 31, 2001, the Minerals
Management Service released a request for proposals, RFP, to conduct a
study of the environmental impacts of drilling in the Mid- and North-
Atlantic. The RFP noted that ``there are areas with some reservoir
potential, for example off the coast of New Jersey.'' In addition, the
RFP explained that the study would be conducted ``in anticipation of
managing the exploitation of potential and proven reserves.'' I believe
that the RFP was not only inappropriate, but probably illegal, and I
was pleased when at my urging, the Administration rescinded.
But the Administration is at it again in the energy bill now before
the Senate. The bill contains provisions that direct the Department of
Interior to inventory all potential oil and natural gas resources in
the entire Outer Continental Shelf, including areas off of the New
Jersey coast. The bill would allow the use of seismic surveys, dart
core sampling, and other exploration technologies, which could
negatively impact coastal and marine areas.
These provisions run directly counter to language that Congress has
included annually in appropriations bills to prevent leasing, pre-
leasing, and related activities in most areas of the Outer Continental
Shelf, including areas off the New Jersey coast.
In my view, it is time for Congress to act to resolve this question
once and for all. That is why I am introducing the COAST Anti-Drilling
Act. This bill would permanently ban drilling for oil, gas and other
minerals in the Mid- and North-Atlantic.
I look forward to working with my colleagues to enact this important
legislation. Doing so would ensure the people of New Jersey and
neighboring States that they need not fear the specter of oil rigs off
their beaches. I ask unanimous consent that the text of the legislation
be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1013
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 ``Clean Ocean and Safe Tourism
Anti-Drilling Act'' or the ``COAST Anti-Drilling Act''.
SEC. 2. PROHIBITION OF OIL AND GAS LEASING IN CERTAIN AREAS
OF THE OUTER CONTINENTAL SHELF.
Section 8 of the Outer Continental Shelf Lands Act (43
U.S.C. 1337) is amended by adding at the end the following:
``(p) Prohibition of Oil and Gas Leasing in Certain Areas
of the Outer Continental Shelf.--Notwithstanding any other
provision of this section or any other law, the Secretary of
the Interior shall not issue a lease for the exploration,
development, or production of oil, natural gas, or any other
mineral in--
``(1) the Mid-Atlantic planning area; or
``(2) the North Atlantic planning area.''.
______
By Mr. CORZINE (for himself and Mrs. Clinton):
S. 1014. A bill to amend title 38, United States Code, to require the
Secretary of Veterans Affairs in the management of health care services
for veterans to place certain low-income veterans in a higher health-
care priority category; to the Committee on Veterans' Affairs.
Mr. CORZINE. Mr. President, I rise today along with Senator Hillary
Rodham Clinton to change the way the Veterans' Administration defines
low-income veterans by taking into account variations in the cost of
living in different parts of the country. The Corzine-Clinton
legislation would make the Veterans Equitable Resource Allocation just
that: Equitable.
More specifically, this bill would replace the national income
threshold for consideration in Priority Group 5--currently $24,000 for
all parts of the country--with regional thresholds defined by the
Department of Housing and Urban Development. This simple but far-
reaching proposal would help low-income veterans across the country
afford quality health care and ensure that Veterans Integrated Service
Networks or VISNs receive adequate funding to care for their distinct
veteran populations.
Our Nation's veterans have made great sacrifics in defense of
American freedom and values, and we owe them a tremendous debt of
gratitude. The United States Congress must ensure that all American
veterans--veterans who have sweated in the trenches to defend liberty--
have access to quality health care.
In 1997, Congress implemented the Veterans Equitable Resource
Allocation system, or VERA, to distribute medical care funding provided
by the VA. The funding formula was established to better take into
account the costs associated with various veteran populations.
Unfortunately, the VERA formula that was created fails to take into
account regional differences in the cost of living, a significant
metric in determining veteran healthcare costs. This oversight in the
VERA formula dangerously shortchanges veterans living in regions with
high costs of living and elevated healthcare expenses.
To allocate money to the Veterans Integrated Service Networks, VISNs,
VERA divides veterans into eight priority groups. Veterans who have no
service-connected disability and whose incomes fall below $24,000 are
considered low income and placed in Priority Group 5, while veterans
whose incomes exceed this national threshold and qualify for no other
special priorities are placed in either Priority Group 7c or Priority
Group 8. VERA only reimburses the treating Medical Care facility for
the care that they provided to veterans in priority groups 1-5 and does
not provide any Federal reimbursement for the care provided to priority
group 7 and 8 veterans.
Using a national threshold for determining eligibility as a low-
income veteran puts veterans living in high cost areas at a decided
disadvantage. In New Jersey, HUD's fiscal year 2002 standards for
classification as ``low-income'' exceed $24,000 per year in every
single county. And some areas exceed the VA baseline by more than 50
percent. Similarly, HUD's ``low-income'' classification for New York
City is set at $35,150, and for Nassau and Suffolk Counties, at
$40,150.
As a result, regions that have a high cost of living, like VISN 3,
which encompasses substantial portions of New Jersey and New York, tend
to have a reduced population of Priority Group 5 veterans and an
inflated population of Priority Group 7c and 8 veterans.
The fundamental inequity of the VERA formula is apparent when you
consider the VERA allocations do not take into account the number of
veterans classified in Priority Groups 7c and 8. Because of the costs
associated with these Priority Groups 7c and 8 veterans are not
considered as part of the VERA allocation, and because high cost of
living areas have large populations of Priority Group 7c and 8
veterans, high cost regions must provide care to thousands of veterans
without adequate funding.
This additional financial burden on VISNs with large populations of
non-reimbursable veterans in Priority Group 7c and 8 has had a
tremendous impact on VISN 3. Since FY 1996, VISN 3 has experienced a
decline in revenue of 10 percent. As a result of the tremendous
shortfall in the VISN 3 budget, the VA cannot move forward with plans
to open clinics in various locations, including prospective clinics in
Monmouth and Passaic Counties. Consequently, veterans in VISN 3 are
forced to wait for unreasonably long periods to receive medical care
and travel long distances to existing clinics, and those veterans who
are able to access care are being treated in facilities operating under
tremendous financial difficulty.
Furthermore, miscategorizing which vets quality as Priority Group 5
unjustifiably reduces access to medical care for thousands of veterans.
Under existing rules, veterans placed in Priority and Groups 7c and 8
must provide a copayment to receive medical care at a VA medical
facility; Veterans placed in Priority Group 5 receive medical care free
of charge. Under the existing
[[Page S5873]]
framework, low-income vets in high cost areas are often inappropriately
placed in Priority Groups 7c and 8, and are forced to provide a
copayment.
Recent studies by both the RAND Institute and the General Accounting
Office identify this flaw in the VERA formula and recommend a
geographic means test like the one provided in our legislation to
improve the allocation of resources under VERA. Such a test would
ensure that the VERA formula allocation better reflects the true costs
of VA healthcare in the various VISNs in the United States.
Our legislation would make a simple adjustment to the VERA formula to
account for variations in the cost of living in different regions. The
bill would help veterans in high cost areas afford VA health care and
guarantee that VISNs across the country receive adequate compensation
for the care they provide.
I hope my colleagues will join Senator Clinton and me in supporting
this important bill, and I ask unanimous consent that the text of the
legislation be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1014
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE
PRIORITY FOR CERTAIN LOW-INCOME VETERANS BASED
UPON REGIONAL INCOME THRESHOLDS.
(a) Change in Priority Category.--Section 1705(a) of title
38, United States Code, is amended--
(1) in paragraph (5)--
(A) by inserting ``(A) who are'' after ``Veterans'';
(B) by inserting ``and'' after ``through (4)''; and
(C) by inserting before the period at the end the
following: ``, or (B) who are described in section 1710(a)(3)
of this title and are eligible for treatment as a low-income
family under section 3(b) of the United States Housing Act of
1937 (42 U.S.C. 1437a(b)) for the area in which such veterans
reside, regardless of whether such veterans are treated as
single person families under paragraph (3)(A) of such section
3(b) or as families under paragraph (3)(B) of such section
3(b)'';
(2) by striking paragraph (7); and
(3) by redesignating paragraph (8) as paragraph (7) and in
that paragraph by striking ``paragraph (7)'' and inserting
``paragraph (5)(B)''.
(b) Conforming Amendment.--Section 1710(f)(4) of such title
is amended by striking ``section 1705(a)(7)'' and inserting
``section 1705(a)(5)(B)''.
(c) Effective Date.--The amendments made by this section
shall take effect on October 2, 2002.
______
By Mr. DOMENICI:
S. 1016. A bill to amend title 10, United States Code, to provide
entitlement to health care for reserve officers of the Armed Forces
pending orders to initial active duty following commissioning; to the
Committee on Armed Services.
Mr. DOMENICI. Mr. President, I rise today to offer legislation
entitled the ``Jesse Spiri Military Medical Coverage Act of 2003.'' The
purpose of this legislation is to close a gap in medical coverage that
leaves a certain group of military officers without health care
benefits. Named in honor of a young New Mexican who fell victim to this
gap, this bill would extend coverage to commissioned officers who are
awaiting active duty status.
Jesse Spiri grew up in the heart of southwestern New Mexico where his
family instilled in him both a sense of patriotism and an appreciation
for higher education. Following his graduation from high school, he
enrolled at Western New Mexico University where he served in the United
States Marine Corps Reserves. His dedication to each of these endeavors
culminated on May 11, 2001 when he received both his bachelors degree
and his commission as a 2nd Lieutenant. Clearly, Jesse had laid a solid
foundation for success in his life and, naturally, his family was
extremely proud. Unfortunately, the pride and all the hopes that
accompany such a crowning moment were short-lived, because one day
after his graduation Jesse was diagnosed with brain cancer.
Under any circumstances, such a prognosis is demoralizing, but
Jesse's situation was even more grave because receiving his commission
had the effect of triggering his military status to that of ``inactive
reservist.'' Jesse was not scheduled to gain ``active duty'' status
until he began basic officer training in November, and since TRICARE
does not fully cover reservists, his family was left with the burden of
enormous medical bills--a burden they simply could not meet.
Despite the heroic efforts of the Spiri family, inquiries by my staff
and others in the New Mexico congressional delegation, as well as
efforts by Marine Corps lawyers to find a legal solution to the
problem, Jesse Spiri, an officer of the United States Marine Corps,
went without health care coverage and, hence, without proper treatment.
He lost his battle with cancer in July of 2001.
It is inconceivable to me, as I am sure it is for all Americans, that
because of a legislative quirk, an officer of the United States armed
forces could be left completely exposed to a dread disease without even
the hope of receiving available treatments. But Jesse's battle is proof
that if we do not, through legislative enactment, extend full medical
coverage to commissioned reservists, another promising life may be lost
in similar fashion.
I know that Jim Spiri, Jesse's dad, has vowed to dedicate his life to
ensuring that no family has to face what his experienced. This goal,
however, should not take a lifetime to achieve. By passing the ``Jesse
Spiri Military Medical Coverage Act of 2003,'' we can help give Jim and
the entire Spiri family peace in knowing that others will have hope
where Jesse did not.
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. 1016
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. ELIGIBILITY OF RESERVE OFFICERS FOR HEALTH CARE
PENDING ORDERS TO ACTIVE DUTY FOLLOWING
COMMISSIONING.
Section 1074(a) of title 10, United States Code, is
amended--
(1) by inserting ``(1)'' after ``(a)'';
(2) by striking ``who is on active duty'' and inserting
``described in paragraph (2)''; and
(3) by adding at the end the following new paragraph:
``(2) Members of the uniformed services referred to in
paragraph (1) are as follows:
``(A) A member of a uniformed service on active duty.
``(B) A member of a reserve component of a uniformed
service who has been commissioned as an officer if--
``(i) the member has requested orders to active duty for
the member's initial period of active duty following the
commissioning of the member as an officer;
``(ii) the request for orders has been approved;
``(iii) the orders are to be issued but have not been
issued; and
``(iv) the member does not have health care insurance and
is not covered by any other health benefits plan.''.
______
By Mr. DeWINE (for himself, Mr. Graham of South Carolina, Mr.
Hatch, Mr. Brownback, Mr. Santorum, Mr. Bunning, Mr. Chambliss,
Mr. Coleman, Mr. Ensign, Mr. Enzi, Mr. Fitzgerald, Mr.
Grassley, Mr. Inhofe, Mr. Kyl, Mr. McCain, Mr. Nickles, Mr.
Shelby, Mr. Talent, and Mr. Voinovich):
S. 1019. A bill to amend titles 10 and 18, United States Code, to
protect unborn victims of violence; read the first time.
Mr. DeWINE. Mr. President, the recent nationwide publicity
surrounding the murder of 27-year-old Laci Peterson and her unborn son,
Conner, has renewed public concern about violence against the unborn--
and rightfully so.
Not long ago, the bodies of Laci--who was eight months pregnant at
the time she disappeared--and Conner were discovered on a rocky
shoreline of the San Francisco Bay. Baby Conner was found near his
mother with his umbilical cord still attached.
Under California State law, intentionally killing a fetus is murder,
and California prosecutors are seeking to bring separate murder charges
in the deaths of Laci Peterson and her unborn son. But, I want make it
very clear to my colleagues here in the Senate that the murder charge
that California prosecutors will bring for the death of Laci's son
would not be permitted if that crime were being prosecuted under
current Federal law. And that--that is why we need to pass and get
signed into law the Unborn Victims of Violence Act. Let me explain.
[[Page S5874]]
In about half the States today, 26, if you commit a crime of violence
against a pregnant woman and her unborn baby dies, you can be punished
for the violence against both the mother and the unborn child. But,
tragically, if you commit a Federal crime of violence against a
pregnant woman and her baby dies, the death of the unborn child could
essentially go unpunished. Examples of such Federal crimes of violence
would include kidnapping across State lines, drug-related drive-by
shootings, or assaults on Federal property.
This gap in the law leads to glaring injustices. It is time that we
close this gap once and for all and let justice wrap its arms around
our society's most vulnerable members.
That is why, it is imperative that we pass the Unborn Victims of
Violence Act--once and for all. Today, along with several of my
distinguished colleagues--Senators Graham of South Carolina, Hatch,
Brownback, Santorum, Kyl, Voinovich, McCain, Ensign, Enzi, Inhofe,
Nickles, Bunning, Coleman, Chambliss, Grassley, Fitzgerald, Shelby, and
Talent--we are re-introducing our legislation. This is the fourth time
that I have introduced this bill--in fact, it was the first piece of
legislation that I introduced at the start of the 108th Congress. This
bill is strongly supported by President Bush, and a companion measure
passed the House of Representatives in two previous Congresses. I
intend to take procedural steps that would make this bill eligible to
be taken up directly by the Senate, without further Committee action.
I thank my colleagues for their support of this effort, and would
like to recognize especially Senator Graham of South Carolina, who
championed this issue on the House side before joining us in the
Senate. He has worked tirelessly to see to it that the most vulnerable
are protected. I also would like to thank our lead House sponsors--
Congresswoman Melissa Hart from Pennsylvania and my friend and
colleague from Ohio, Congressman Steve Chabot. They, too, are working
tirelessly to get this bill passed by the other Chamber and signed into
law.
Our bill would establish new criminal penalties for anyone injuring
or killing a fetus while committing certain Federal offenses.
Specifically, this bill would make any murder or injury of an unborn
child during the commission of certain existing Federal crimes a
separate crime under Federal law and the Uniform Code of Military
Justice. Twenty-six, 26, States already have criminalized the killing
or injuring of unborn victims during a crime.
We live in a violent world. And sadly, sometimes--perhaps more often
than we realize--even unborn babies are the targets, intended or
otherwise, of violent acts. We have to protect these innocent victims.
I'd like to share some disturbing examples with my colleagues of
situations where the deaths of unborn children would have gone
unpunished but for the existence of State criminal laws. If these same
crimes would have occurred in the 24 States today that don't have such
State laws, justice would not have been served, because there is simply
no Federal law in place to try these crimes.
First, let me talk about the example of Airman Gregory Robbins. In
1996, Airman Robbins and his family were stationed in my home State of
Ohio at Wright-Patterson Air Force Base in Dayton. At that time, Mrs.
Robbins was more than eight months pregnant with a daughter they named
Jasmine. On September 12, 1996, in a fit of rage, Airman Robbins
wrapped his fist in a T-shirt and savagely beat his wife by striking
her repeatedly about the head and abdomen. Fortunately, Mrs. Robbins
survived the violent assault. Tragically, however, her uterus ruptured
during the attack, expelling the baby into her abdominal cavity,
causing Jasmine's death.
Air Force prosecutors sought to prosecute Airman Robbins for
Jasmine's death, but neither the Uniform Code of Military Justice nor
the Federal code makes criminal such an act that results in the death
or injury of an unborn child. The only available Federal offense was
for the assault on the mother. This was a case in which the only
available Federal penalty did not fit the crime. So prosecutors
bootstrapped the Ohio unborn victims law to convict Airman Robbins of
Jasmine's death. Fortunately, upon appeal, the court upheld the lower
court's ruling.
If it hadn't been for the Ohio law that was already in place, there
would have been no opportunity to prosecute and punish Airman Robbins
for the assault against Baby Jasmine. That's why we need a Federal
remedy to avoid having to bootstrap State laws to provide recourse when
a violent act occurs during the commission of a Federal crime. A
Federal remedy will ensure that crimes within Federal jurisdiction
against unborn victims are punished.
Let me give you another example. In August 1999, Shiwona Pace of
Little Rock, AK, was days away from giving birth. She was thrilled
about her pregnancy. Her boyfriend, Eric Bullock, however, did not
share her joy and enthusiasm. In fact, Eric wanted the baby to die. So,
he hired three thugs to beat his girlfriend so badly that she lost the
unborn baby. According to Shiwona, who testified at a Senate Judiciary
hearing we held in Washington on February 23, 2000:
I begged and pleaded for the life of my unborn child, but
they showed me no mercy. In fact, one of them told me, ``Your
baby is dying tonight.'' I was choked, hit in the face with a
gun, slapped, punched, and kicked repeatedly in the stomach.
One of them even put a gun in my mouth and threatened to
shoot.
In this particular case, just a few short weeks before this vicious
attack, Arkansas passed its ``Fetal Protection Act.'' Under the State
law, Erik Bullock was convicted on February 9, 2001, of capital murder
against Shiwona's unborn child and sentenced to life in prison without
parole. He was also convicted of first-degree battery for harm against
Shiwona.
In yet another example--this one in Columbus--16-year-old Sean Steele
was found guilty of two counts of murder for the death of his
girlfriend Barbara ``Bobbie'' Watkins, age 15, and her 22-week-old,
unborn child. He was convicted under Ohio's unborn victims law, which
represented the first murder conviction in Franklin County, OH, in
which a victim was a fetus.
Ultimately, the fact is that it is just plain wrong that our Federal
Government does absolutely nothing to criminalize violent acts against
unborn children. We cannot allow criminals to get away with murder. We
must close this loophole.
As a civilized society, we must take a stand against violent crimes
against children--especially those waiting to be born. We must close
this loophole.
We purposely drafted this legislation very narrowly. Because of that,
our bill would not permit the prosecution for any abortion to which a
woman consented. It would not permit the prosecution of a woman for any
action, legal or illegal, in regard to her unborn child. Our
legislation would not permit the prosecution for harm caused to the
mother or unborn child in the course of medical treatment. And finally,
our bill would not allow for the imposition of the death penalty under
this Act.
This is about making sure justice is done when a pregnant woman is
attacked. And ultimately, I think that everyone in this Chamber would
agree that people who violently attack unborn babies should be
punished. When acts of violence against unborn victims fall within
federal jurisdiction, we must have a penalty. We have an obligation to
our unborn children who cannot speak for themselves. I think Shiwona
Pace said it best she testified at our hearing: ``The loss of any
potential life should never be in vain.''
I strongly urge my colleagues to join in support of this important
legislation.
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. 1019
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 ``Unborn Victims of Violence
Act of 2003''.
SEC. 2. PROTECTION OF UNBORN CHILDREN.
(a) In General.--Title 18, United States Code, is amended
by inserting after chapter 90 the following:
``CHAPTER 90A--PROTECTION OF UNBORN CHILDREN
``Sec.
``1841. Causing death of or bodily injury to unborn child.
[[Page S5875]]
``Sec. 1841. Causing death of or bodily injury to unborn
child
``(a)(1) Any person who engages in conduct that violates
any of the provisions of law listed in subsection (b) and
thereby causes the death of, or bodily injury (as defined in
section 1365) to, a child, who is in utero at the time the
conduct takes place, is guilty of a separate offense under
this section.
``(2)(A) Except as otherwise provided in this paragraph,
the punishment for that separate offense is the same as the
punishment provided for that conduct under Federal law had
that injury or death occurred to the unborn child's mother.
``(B) An offense under this section does not require proof
that--
``(i) the person engaging in the conduct had knowledge or
should have had knowledge that the victim of the underlying
offense was pregnant; or
``(ii) the defendant intended to cause the death of, or
bodily injury to, the unborn child.
``(C) If the person engaging in the conduct thereby
intentionally kills or attempts to kill the unborn child,
that person shall be punished as provided under section 1111,
1112, or 1113, as applicable, for intentionally killing or
attempting to kill a human being, instead of the penalties
that would otherwise apply under subparagraph (A).
``(D) Notwithstanding any other provision of law, the death
penalty shall not be imposed for an offense under this
section.
``(b) The provisions referred to in subsection (a) are the
following:
``(1) Sections 36, 37, 43, 111, 112, 113, 114, 115, 229,
242, 245, 247, 248, 351, 831, 844(d), 844(f), 844(h)(1),
844(i), 924(j), 930, 1111, 1112, 1113, 1114, 1116, 1118,
1119, 1120, 1121, 1153(a), 1201(a), 1203, 1365(a), 1501,
1503, 1505, 1512, 1513, 1751, 1864, 1951, 1952(a)(1)(B),
1952(a)(2)(B), 1952(a)(3)(B), 1958, 1959, 1992, 2113, 2114,
2116, 2118, 2119, 2191, 2231, 2241(a), 2245, 2261, 2261A,
2280, 2281, 2332, 2332a, 2332b, 2340A, and 2441 of this
title.
``(2) Section 408(e) of the Controlled Substances Act of
1970 (21 U.S.C. 848(e)).
``(3) Section 202 of the Atomic Energy Act of 1954 (42
U.S.C. 2283).
``(c) Subsection (a) does not permit prosecution--
``(1) for conduct relating to an abortion for which the
consent of the pregnant woman has been obtained or for which
such consent is implied by law in a medical emergency;
``(2) for conduct relating to any medical treatment of the
pregnant woman or her unborn child; or
``(3) of any woman with respect to her unborn child.
``(d) In this section--
``(1) the terms `child in utero' and `child, who is in
utero' mean a member of the species homo sapiens, at any
stage of development, who is carried in the womb; and
``(2) the term `unborn child' means a child in utero.''.
(b) Clerical Amendment.--The table of chapters for part I
of title 18, United States Code, is amended by inserting
after the item relating to chapter 90 the following:
``90A. Causing death of or bodily injury to unborn child....1841''.....
SEC. 3. MILITARY JUSTICE SYSTEM.
(a) Protection of Unborn Children.--Subchapter X of chapter
47 of title 10, United States Code (the Uniform Code of
Military Justice), is amended by inserting after section 919
(article 119) the following:
``Sec. 919a. Art. 119a. Causing death of or bodily injury to
unborn child
``(a)(1) Any person subject to this chapter who engages in
conduct that violates any of the provisions of law listed in
subsection (b) and thereby causes the death of, or bodily
injury (as defined in section 1365 of title 18) to, a child,
who is in utero at the time the conduct takes place, is
guilty of a separate offense under this section.
``(2)(A) Except as otherwise provided in this paragraph,
the punishment for that separate offense is the same as the
punishment for that conduct under this chapter had that
injury or death occurred to the unborn child's mother.
``(B) An offense under this section does not require proof
that--
``(i) the person engaging in the conduct had knowledge or
should have had knowledge that the victim of the underlying
offense was pregnant; or
``(ii) the defendant intended to cause the death of, or
bodily injury to, the unborn child.
``(C) If the person engaging in the conduct thereby
intentionally kills or attempts to kill the unborn child,
that person shall be punished as provided under section 918,
919, or 880 of this title (article 118, 119, or 80), as
applicable, for intentionally killing or attempting to kill a
human being, instead of the penalties that would otherwise
apply under subparagraph (A).
``(D) Notwithstanding any other provision of law, the death
penalty shall not be imposed for an offense under this
section.
``(b) The provisions referred to in subsection (a) are
sections 918, 919(a), 919(b)(2), 920(a), 922, 924, 926, and
928 of this title (articles 111, 118, 119(a), 119(b)(2),
120(a), 122, 124, 126, and 128).
``(c) Subsection (a) does not permit prosecution--
``(1) for conduct relating to an abortion for which the
consent of the pregnant woman has been obtained or for which
such consent is implied by law in a medical emergency;
``(2) for conduct relating to any medical treatment of the
pregnant woman or her unborn child; or
``(3) of any woman with respect to her unborn child.
``(d) In this section--
``(1) the terms `child in utero' and `child, who is in
utero' mean a member of the species homo sapiens, at any
stage of development, who is carried in the womb; and
``(2) the term `unborn child' means a child in utero.''.
(b) Clerical Amendment.--The table of sections at the
beginning of subchapter X of chapter 47 of title 10, United
States Code (the Uniform Code of Military Justice), is
amended by inserting after the item relating to section 919
the following:
``919a. 119a. Causing death of or bodily injury to unborn child.''.
Mr. HATCH. Mr. President, I rise today to offer my support for the
introduction of S. 119, the Unborn Victims of Violence Act of 2003. I
applaud Senators DeWine and Lindsey Graham for their longstanding and
essential leadership on this issue in the Senate and the House. The
importance of this issue is made tragically clear by the recent murder
of Laci Peterson and her unborn son, Conner.
In my home State of Utah, if a criminal assaults or kills a woman who
is pregnant and thereby causes death or injury to the unborn child, the
criminal faces the possibility of being prosecuted for having taken or
injured that unborn life. Twenty-five additional States have similar
laws on the books. Eleven of those States recognize the unborn child as
a victim throughout the entire period of prenatal development. This is
only proper and, it seems to me, only just.
But under existing Federal criminal statutes, if a criminal assaults
or kills a woman who is pregnant and thereby causes death or injury to
that unborn child, the criminal faces no consequences in our Federal
criminal justice system for taking or injuring that innocent, unborn
life. This is wrong and it is not justified.
This bill fixes the gap in Federal law by making it a separate
Federal offense to kill or injure an unborn child during the commission
of certain already-defined Federal crimes committed against the unborn
child's mother. This bill does not usurp jurisdiction over States that
do not currently have laws that protect unborn victims of violence. It
only applies to Federal crimes.
I cannot imagine why anyone would oppose this bill. The only reason
for opposition that I can suppose is that some in the pro-choice
movement believe that our bill draws attention to the effort to
dehumanize, desensitize, and depersonalize the unborn child. Given the
political and legal arguments of abortion supporters, it may be
difficult for them to concede an unborn child is human and therefore a
victim of a crime.
Nevertheless, it is not our intention in this bill to turn the debate
into a battle on abortion. In no way does this bill interfere with the
ability of a woman to have an abortion under current law. The bill
specifically does not apply to a woman who engages in any action, legal
or illegal, in regard to her unborn child. Therefore, it would not
apply to any abortion to which a woman consents. In my view, we should
all be able to support this modest effort to protect mothers and their
unborn children.
Some will try to claim that this bill weakens domestic violence laws
by diverting attention to the unborn. That is simply not true. I am a
strong supporter of domestic violence laws in this Nation. I believe
domestic violence is an evil plague that needs to be stopped.
For nearly 15 years, I have worked hard on the issue of domestic
violence and violence against women. And when I stand here today before
the entire United States Senate and offer my support for a bill, I
certainly make sure that bill does not diminish in any way our capacity
and will to curb domestic violence and protect women. This bill, in
fact, strengthens domestic violence laws by making it a separate
criminal offense under our Federal legal system to cause death or
injury to an unborn child as a result of violence.
For several months now, the Nation has watched in the media the
unfortunate and tragic story of Laci Peterson. She was an expectant
mother from California who mysteriously vanished shortly before
Christmas. In mid-April, her decomposing body and the body of her
unborn child washed ashore at a San Francisco-area beach.
[[Page S5876]]
The Nation has witnessed a community in mourning over the
disappearance and death of Laci Peterson and her unborn son, Conner.
Laci Peterson was the truly tragic victim of violence that not only
took her life but also the innocent life of her unborn son. This is a
truly devastating story, especially for those who knew and loved Laci
Peterson and eagerly awaited the birth of her son Conner. I want to do
what I can to see that justice is served if there is ever a case
similar to this that comes before our Federal judicial system, and that
is why I support this measure.
A Fox News/Opinion Dynamics Poll conducted on April 22 and 23
indicated that of the 900 registered voters polled, 49 percent
considered themselves pro-choice while only 41 percent said they are
pro-life. But what is even more interesting is this same poll showed 84
percent believed Scott Peterson should be charged with two counts of
homicide for murdering his wife and unborn son. California law permits
criminals to be charged with murder for killing an unborn child when it
has developed past the embryonic stage.
Now remember, the majority of those polled in this survey said they
were pro-choice. But the tragic murder of an innocent, unborn child is
shocking and twisted enough that, regardless of any stance on abortion,
the vast majority of Americans strongly believe an unborn life taken in
murder should result in murder charges brought against the perpetrator.
It is only fair and just to ask for our Federal judicial system to
incorporate such a strong desire of the American people.
Some will try to confuse the issue here. Let me be clear, the debate
on this bill is not about abortion--far from it. It does not affect
current law regarding abortion. This bill does not in any way interfere
with or weaken domestic violence laws or laws intended to prevent
violence against women. This is a simple remedy to a terrible crime. I
hope that Congress will seriously consider this bill and promptly pass
it.
______
By Mr. HATCH (for himself, Mr. Leahy, Mr. Cornyn, Mr. Kennedy,
Mr. Alexander, Mr. Chambliss, Mr. Durbin, and Ms. Collins):
S. 1023. A bill to increase the annual salaries of justices and
judges of the United States; to the Committee on the Judiciary.
Mr. HATCH. Mr. President, I rise to address the serious matter of the
erosion of pay for the Federal judiciary. There is consensus among all
who have seriously looked at this issue that the independence and
quality of the judiciary is at risk because of the inadequacy of the
current salaries of Federal judges.
The American Bar Association and Federal Bar Association issued a
report on this issue in February 2001. That report documented the
factors impacting erosion of judicial pay and the detrimental effects
on the judiciary. Because of the withholding of cost-of-living
adjustments, the impact of inflation, and the insufficient attempts to
stabilize judicial pay, Federal judges are increasingly choosing to
resign or retire. Furthermore, the report noted, the prospect of a
declining salary in real terms also discourages potential candidates
from seeking appointments to the bench.
In his 2002 Year-End Report, Supreme Court Chief Justice William
Rehnquist identified the need to increase judicial pay as the most
pressing issue facing the judiciary. He highlighted his concern that
salaries of Federal judges have not kept pace with those of lawyers in
private firms and in business. He observed, ``Inadequate compensation
seriously compromises the judicial independence fostered by life
tenure. That low salaries might force judges to return to the private
sector rather than stay on the bench risks affecting judicial
performance--instead of serving for life, those judges would serve the
terms their finances would allow, and they would worry about what
awaits them when they return to the private sector.''
In the Report of the National Commission on the Public Service,
issued January 2003, the Chairman of the Commission, Paul Volker, made
this observation: ``Judicial salaries are the most egregious example of
the failure of Federal compensation policies. Federal judicial salaries
have lost 24 percent of their purchasing power since 1969, which is
arguably inconsistent with the Constitutional provision that judicial
salaries may not be reduced by Congress. . . . The lag in judicial
salaries has gone on too long, and the potential for diminished quality
in American jurisprudence is now too large.'' Accordingly, the
Commission made the recommendation that Congress should grant an
immediate and significant increase in judicial, executive and
legislative salaries to ensure a reasonable relationship to other
professional opportunities.
Responding to this report and recommendation, the Judicial
Conference, at its recent meeting, unanimously adopted a Resolution
which contains in part the following:
``Whereas, the President at the request of the Chief
Justice has agreed to support legislation that would increase
judicial salaries by 16.5 percent, which will yield an
average of $24,948, across all levels of judicial offices;
Now therefore, the Committee on the Judicial Branch
recommends that the Judicial Conference endorse and
vigorously seek legislation that would increase judicial
salaries by 16.5 percent, which will yield an average of
$24,948, across all levels of judicial offices.''
Today, Senator Leahy and I, joined by Senator Cornyn, Senator
Kennedy, Senator Alexander, Senator Collins, Senator Durbin, and
Senator Chambliss are introducing a bill that will restore the lost
cost-of-living adjustments which were denied to the judiciary and will
help reduce the gap between Federal judicial salaries and private
sector salaries which still remains.
This legislation enacts a 16.5 percent increase in the salaries of
the justices of the Supreme Court and other Federal judges appointed
under Article III of the Constitution, an average salary increase of
about $25,000. It does so without altering the respective provisions of
title 28, United States Code, which defines their salary rates. The pay
adjustment would be effective with the first pay period beginning on or
after January 1, 2004, and would be applied before any annual salary
adjustment authorized under the Employment Cost Index approval
mechanism provided by 28 U.S.C. Sec. 461.
The judicial officers enumerated in this bill to receive the 16.5
percent pay increase are the Chief Justice of the United States,
associate justices of the Supreme Court, United States circuit judges,
United States district judges, and judges of the United States Court of
International Trade. In addition, this legislation would have the
effect of increasing salaries of the judges of the U.S. Court of
Federal Claims, bankruptcy judges and full-time United States
magistrate judges whose salaries are related to the rate of pay of
United States district judges.
This legislation will do much to improve retention on the bench and
will aid in the recruitment of outstanding judicial candidates. I urge
my colleagues to join Senator Leahy, Senator Cornyn, Senator Kennedy,
Senator Alexander, Senator Collins, Senator Durbin, Senator Chambliss
and me in this bipartisan measure.
I ask unanimous consent that the Judicial Conference Resolution, as
well as the text of the legislation be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Judicial Branch Committee Resolution
Whereas, in January 2003, the National Commission on the
Public Service declared that ``Congress should grant an
immediate and significant increase in judicial, executive,
and legislative salaries to ensure a reasonable relationship
to other professional opportunities;'' and
Whereas, the National Commission also declared that
``[j]udicial salaries are the most egregious example of the
failure of federal compensation policies''; and
Whereas, the National Commission found that ``that the lag
in judicial salaries has gone on too long, and the potential
for the diminished quality in American jurisprudence is now
too large''; and
Whereas, the National Commission recommended that Congress'
and the President's ``first priority should . . . be an
immediate and substantial increase in judicial salaries'';
and
Whereas, the President at the request of the Chief Justice
has agreed to support legislation that would increase
judicial salaries by 16.5 percent, which will yield an
average of $24,948 across all levels of judicial offices;
Now therefore, the Committee on the Judicial Branch
recommends that the Judicial Conference endorse and
vigorously seek legislation that would increase judicial
salaries
[[Page S5877]]
by 16.5 percent, which will yield an average of $24,948,
across all levels of judicial offices.
S. 1023
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. JUDICIAL SALARY INCREASE.
The annual salaries of the Chief Justice of the United
States, associate justices of the Supreme Court of the United
States, United States circuit judges, United States district
judges, judges of the United States Court of International
Trade, and judges of the United States Court of Federal
Claims are increased in the amount of 16.5 percent of their
respective existing annual salary rates, rounded to the
nearest $100 (or, if midway between multiples of $100, to the
next higher multiple of $100).
SEC. 2. COORDINATION RULE.
If a pay adjustment under section 1 is to be made for an
office or position as of the same date that any other pay
adjustment would take effect for such office or position, the
adjustment under this Act shall be made first.
SEC. 3. EFFECTIVE DATE.
This Act shall take effect on the first day of the first
applicable pay period beginning on or after January 1, 2004.
____________________