[Congressional Record Volume 149, Number 131 (Tuesday, September 23, 2003)]
[Senate]
[Pages S11780-S11781]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  DEPARTMENT OF THE INTERIOR AND RELATED AGENCIES APPROPRIATIONS ACT, 
                                  2004

  The PRESIDING OFFICER. Under the previous order, the Senate will 
resume consideration of H.R. 2691, which the clerk will report.
  The legislative clerk read as follows:

       A bill (H.R. 2691) making appropriations for the Department 
     of the Interior and related agencies for the fiscal year 
     ending September 30, 2004, and for other purposes.

  Pending:

       Reid amendment No. 1731, to prohibit the use of funds for 
     initiating any new competitive sourcing studies.
       Reid amendment No. 1732, to authorize the Secretary of the 
     Interior to acquire certain lands located in Nye County, 
     Nevada.
       Reid amendment No. 1733, to provide for the conveyance of 
     land to the city of Las Vegas, Nevada, for the construction 
     of affordable housing for seniors.
       Daschle further modified amendment No. 1734, to provide 
     additional funds for clinical services of the Indian Health 
     Service, with an offset.
       Daschle further modified amendment No. 1739, to strike 
     funding for implementation of the Department of the 
     Interior's reorganization plan for the Bureau of Indian 
     Affairs and the Office of Special Trustee and to transfer the 
     savings to the Indian Health Service.
       Bingaman amendment No. 1740, to ban commercial advertising 
     on The National Mall.


                           Amendment No. 1734

  The PRESIDING OFFICER. Under the previous order, there will be 10 
minutes equally divided prior to the vote in relation to the amendment 
No. 1734.
  The Senator from South Dakota.
  Mr. DASCHLE. Mr. President, I will take 5 minutes to talk briefly 
about this amendment.
  I have had an opportunity to come to the floor on a couple of 
occasions. Basically this comes down to whether or not we mean it when 
we say we will provide meaningful health care to our Native American 
population. That is what we are talking about today. Unfortunately, as 
most people know, we are far from that promise. It would take about $5 
billion for us to fulfill the promise and to live up to the 
expectations on the reservations that we see with health care delivery 
in the rest of the country--$5 billion for the IHS clinical services 
account.
  This year's budget is $1.9 billion--less than half of what it would 
take to meet that obligation. As a result, today there is severe 
rationing of health care on every reservation--rationing so severe that 
they call it the ``life or limb'' test. Unless your life or limb is in 
jeopardy, you often do not get care on a reservation today.
  This chart shows as clearly as anything can just what the commitment 
made to the Native American people is today when it comes to health 
care.
  We spend about $5,915 per capita on Medicare. We spend about $5,200 
per capita within the VA. We spend about $5,000 per capita in our 
population generally for health care. We spend about $3,800 per capita 
for every Federal prisoner--$3,800 a year goes to our Federal prisons 
on a per capita basis for health care alone. We spend $1,900 for Indian 
children and their families, in spite of commitments we have made for 
four generations.
  What this amendment does is very simple. Last spring, when we had 
this debate and when we offered the amendment to the budget resolution 
to make whole the Indian health care budget, it was defeated. We 
proposed that we try to level the playing field. That was defeated.

  What the Senate agreed to, reluctantly on my part, but agreed to 
nonetheless, was $292 million, one-tenth of the amount required to make 
the IHS clinical services budget whole, to provide some parity between 
Indian health and prison health. That was incorporated in the Senate 
version of the budget.
  Now we are simply saying: Let's live up to what the Senate said we 
would do on Indian health this year during the budget debate. Let's 
provide that $292 million, one-tenth of the amount required, if we are 
going to do this right.
  For the life of me, I cannot understand how someone could vote 
against this, knowing, as we do, we are giving one-half the amount of 
money to Indian children as we are to Federal prisoners. We are giving 
a fraction to the Native-American population that we give to Medicare 
beneficiaries.
  This amendment simply acknowledges our need to rectify that 
extraordinary disparity, to deal with it in a way that only we can, to 
say it is not enough just to talk about it, not enough just to lament 
it, we have to do something about it. Granted, $292 million is a far 
cry from what is required, but at least it is what the Senate said we 
would do last spring. It is now time to put our money where our mouth 
was last spring. This amendment is intended to do that.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BURNS. Mr. President, this amendment provides an additional $292 
million for the Indian Health Service. There is no offset.
  I don't doubt the numbers the Senator from South Dakota presented. 
They are factual. I do not doubt his passion for this subject. But 
let's take a look at what is really happening.
  Since we have focused on that, over the last 5 years we have added 
$725 million funding to the IHS account. In addition, thanks to the 
work of my colleague from New Mexico, Senator Domenici, and the 
Balanced Budget Act of 1997, we have provided $30 million per year for 
diabetes efforts. We know that is one of the primary focuses in Indian 
health for the following 5 years. That amount was increased to a total 
of $100 million beginning in fiscal year 2001. Reauthorization of this 
program has ensured that $150 million for the next 5 years will be 
available beginning in fiscal year 2004. In short, over the last 5 
years, well over $1 billion in new money has been provided in order to 
improve the health care within our Native-American community.
  Within the extremely limited resources this subcommittee has been 
given over the past several years, we have been responsive to the needs 
of Native Americans and we will continue to make every effort to 
provide the additional dollars within the overall allocation we were 
given.
  We know well, and my colleagues on the other side of the aisle know 
well, what happened last year. Under their leadership, the IHS account 
was reduced by $75 million in the final hours before markup in order to 
reduce the subcommittee's allocation. Clinical services alone were 
reduced by $50 million.
  Saying that, despite the decrease, we still have a problem even with 
the additional moneys we put in this year. We understand the problems 
in the Indian Health Service. We are $88 million over last year's 
level, and the adoption of this amendment would exceed the 
subcommittee's allocation and is subject to a point of order.
  Mr. DASCHLE. If the Senator yields the floor, I will be recognized 
for what remaining time I have.
  This amendment is not offset. Yes, we are told we cannot afford $292 
million. We need $2.9 billion. We are told

[[Page S11781]]

we cannot afford that. I hope someone will come to the floor next week 
or the week after on the other side and say we cannot afford $87 
billion for Iraq, then, either. If we cannot afford $292 million for 
our Native-American population, who are experiencing life or limb 
tests, then I sure hope we will not hear the argument on the other side 
that somehow we can afford providing health care dollars to the Iraqi 
children. I bet that is exactly what we are going to hear--$87 billion 
worth of requests. It is a double standard.
  I yield the floor.
  Mr. BURNS. The pending amendment No. 1734, offered by the Senator 
from South Dakota, increases discretionary spending in excess of the 
302(b) allocation to the Subcommittee on Interior of the Appropriations 
Committee. Therefore, I raise a point of order against the amendment 
pursuant to section 302 of the Budget Act.
  Mr. DASCHLE. I move to waive the relevant portions of the balanced 
budget amendment and I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There is a sufficient second.
  The question is on agreeing to the motion. The clerk will call the 
roll.
  The legislative clerk called the roll.
  Mr. REID. I announce that the Senator from North Carolina (Mr. 
Edwards), the Senator from Florida (Mr. Graham), the Senator from 
Massachusetts (Mr. Kerry), the Senator from Connecticut (Mr. 
Lieberman), the Senator from Maryland (Ms. Mikulski) and the Senator 
from Georgia (Mr. Miller) are necessarily absent.
  I further announce that, if present and voting, the Senator from 
Massachusetts (Mr. Kerry) would vote ``yea.''
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The yeas and nays resulted--yeas 49, nays 45, as follows:

                      [Rollcall Vote No. 356 Leg.]

                                YEAS--49

     Akaka
     Baucus
     Bayh
     Biden
     Bingaman
     Boxer
     Breaux
     Byrd
     Campbell
     Cantwell
     Carper
     Clinton
     Coleman
     Collins
     Conrad
     Corzine
     Daschle
     Dayton
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Harkin
     Hollings
     Inouye
     Jeffords
     Johnson
     Kennedy
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lincoln
     McCain
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Pryor
     Reed
     Reid
     Rockefeller
     Sarbanes
     Schumer
     Stabenow
     Stevens
     Wyden

                                NAYS--45

     Alexander
     Allard
     Allen
     Bennett
     Bond
     Brownback
     Bunning
     Burns
     Chafee
     Chambliss
     Cochran
     Cornyn
     Craig
     Crapo
     DeWine
     Dole
     Domenici
     Ensign
     Enzi
     Fitzgerald
     Frist
     Graham (SC)
     Grassley
     Gregg
     Hagel
     Hatch
     Hutchison
     Inhofe
     Kyl
     Lott
     Lugar
     McConnell
     Nickles
     Roberts
     Santorum
     Sessions
     Shelby
     Smith
     Snowe
     Specter
     Sununu
     Talent
     Thomas
     Voinovich
     Warner

                             NOT VOTING--6

     Edwards
     Graham (FL)
     Kerry
     Lieberman
     Mikulski
     Miller
  The PRESIDING OFFICER. On this vote, the yeas are 49 and the nays are 
45. Three-fifths of the Senators duly chosen and sworn not having voted 
in the affirmative, the motion is rejected. The point of order is 
sustained and the amendment falls.

                          ____________________