[Congressional Record Volume 149, Number 136 (Tuesday, September 30, 2003)]
[House]
[Pages H9008-H9011]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
EXTENDING TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT PROGRAM
Mrs. JOHNSON of Connecticut (during special order of Mr. Chocola).
Madam Speaker, I ask unanimous consent to take from the Speaker's table
the bill (H.R. 3146) to extend the Temporary Assistance for Needy
Families block grant program, and certain tax and trade programs, and
for other purposes, with a Senate amendment thereto, and concur in the
Senate amendment.
The Clerk read the title of the bill.
The Clerk read the Senate amendment, as follows:
Senate amendment:
Page 10, after line 16, insert:
SEC. 402. EXTENSION OF PROVISION EQUALIZING URBAN AND RURAL
STANDARDIZED MEDICARE INPATIENT HOSPITAL
PAYMENTS.
(a) In General.--Paragraphs (1) and (2) of section 402(b)
of the Miscellaneous Appropriations Act, 2003 (Public Law
108-7; 117 Stat. 548) are each amended by striking
``September 30, 2003'' and insert ``March 31, 2004''.
(b) Effective Date.--
(1) In general.--Subject to paragraph (2), the amendments
made by subsection (a) shall take effect as if included in
the enactment of the Miscellaneous Appropriations Act, 2003.
(2) Authority to delay implementation.--
(a) In general.--If the Secretary of Health and Human
Services (in this subsection referred to as the
``Secretary'') determines that it is not administratively
feasible to implement the amendments made by subsection (a),
notwithstanding such amendments and in order to comply with
Congressional intent, the Secretary may delay the
implementation of such amendments until such time as the
Secretary determines to be appropriate, but in no case later
than November 1, 2003.
(B) Temporary adjustment for remainder of fiscal year 2004
to effect full rate change.--If the Secretary delays
implementation of the amendments made by subsection (a) under
subparagraph (A), the Secretary shall make such adjustment to
the amount of payments affected by such delay, for the
portion of fiscal year 2004 after the date of the delayed
implementation, in such manner as the Secretary estimates
will ensure that the total payments for inpatient hospital
services so affected with respect to such fiscal year is the
same as would have been made if this paragraph had not been
enacted.
(C) No effect on payments for subsequent payment periods.--
The application of subparagraphs (A) and (B) shall not affect
payment rates and shall not be taken into account in
calculating payment amounts for services furnished for
periods after September 30, 2004.
[[Page H9009]]
(D) Administration of provisions.--
(i) No rulemaking or notice required.--The Secretary may
carry out the authority under this paragraph by program
memorandum or otherwise and is not required to prescribe
regulations or to provide notice in the Federal Register in
order to carry out such authority.
(ii) Limitation of review.--There shall be no
administrative or judicial review under section 1869 or 1878
of the Social Security Act (42 U.S.C. 1395ff and 1395oo), or
otherwise of any delay or determination made by the Secretary
under this paragraph or the application of the payment rates
determined under this paragraph.
Mrs. JOHNSON of Connecticut (during the reading). Madam Speaker, I
ask unanimous consent that the Senate amendment be considered as read
and printed in the Record.
The SPEAKER pro tempore (Mrs. Miller of Michigan). Is there objection
to the request of the gentlewoman from Connecticut?
There was no objection.
The SPEAKER pro tempore. Is there objection to the initial request of
the gentlewoman from Connecticut?
Mr. CARDIN. Madam Speaker, reserving the right to object, I do not
intend to object, but under my reservation, I yield to the gentleman
from Oregon (Mr. Wu).
Mr. WU. I thank the gentleman from Maryland for yielding. Madam
Speaker, I rise to express my grave concern with the potential
termination of the successful Welfare Waiver Program in my State of
Oregon because of Federal action or inaction. Today we are moving
forward again on legislation to extend the Temporary Assistance for
Needy Families, or TANF, Program through a period of time until we can
do the full reauthorization. Also today in Oregon, a successful State-
designed welfare-to-work program which has provided a gateway from
welfare to work for thousands of Oregonians may expire through our
action or inaction.
My State of Oregon currently operates its welfare program under a
Federal waiver. In Oregon, the program is known as the Oregon option
and in the last 6 years, it has seen caseload reduction rates above the
national average. Our innovative program allows Oregon the flexibility
to consider individuals on a case-by-case basis. Some folks simply need
a little job training or job search skills and then they are ready to
transition back into the workforce. Others need more extensive drug and
alcohol treatments or basic education before they are able to hold down
a job. This combination of rehabilitative services to the most needy
and more education and job training activities for others has proved to
be a great success. For 18 months, I have sought to protect and extend
the successful State innovation. My friends and colleagues have
acknowledged the success of the Oregon program and the importance of
preserving individual State innovation. However, with the passage of
today's extension, we find ourselves punishing, rather than rewarding,
innovation.
I ask the gentlewoman from Connecticut to assist the citizens of
Oregon and the Nation in this matter, and I am seeking it here tonight.
Mr. CARDIN. Madam Speaker, I yield to the gentlewoman from
Connecticut.
Mrs. JOHNSON of Connecticut. I thank the gentleman for yielding. I
certainly appreciate my colleague from Oregon's concern with his
State's inventive approach and successful program in support of women
on welfare, individuals on welfare seeking the independence of
returning to the workforce. I am pleased that the next round of welfare
reform will allow a great deal more flexibility in State programs.
As the gentleman is aware, a number of State waiver programs have
expired in recent years. In June 2003, Oregon Senators were informed by
Secretary Thompson that, despite the expiration of Oregon's waiver that
month, Oregon was not in danger of failing to satisfy work rate
requirements in the future. The reason is because Oregon's caseload
reduction credits totally wipe out any effective work rate requirement
in the State.
Here is how Secretary Thompson put it:
``Oregon is not in violation and, based on Oregon's history, is not
expected to be in violation, and, therefore, Oregon will not be subject
to penalties for the next 3 months or until reauthorization. Even
without its waiver, Oregon's program would have met its all-family work
participation requirement in 2002 because it effectively had no
participation requirement. Should reauthorization not occur prior to
the end of the fiscal year and current law be extended again, I would
remain confident, based on the facts that I have before me, that Oregon
could continue to operate its program without becoming subject to
participation rate penalties.''
As the gentleman knows, the House-passed welfare reauthorization
bill, H.R. 4, includes provisions that would allow States to apply for
new waivers of the TANF program. That reflects additional flexibility
for States and is a positive step. I will fight in conference for
enhanced waiver authority for States in conference with the Senate.
Mr. WU. If the gentleman will yield further, I would make inquiry of
the gentlewoman from Connecticut, I would like to make two inquiries,
and let me do them separately. Oregon has had a terrible unemployment
situation. Out of the last 24 months, we have topped the Nation in
unemployment 17 out of those 24 months. We have oscillated between 8.1
percent unemployment and 8.8 percent unemployment. I believe we are
currently at a seasonally-adjusted 8.5 percent unemployment rate.
My first inquiry of the gentlewoman from Connecticut is that the
factual predicate, upon which the Secretary's letter is written, is
based on weighted averages of caseload reduction. Given the terrible
situation that our State of Oregon is in, it may take some time for
this Congress to reauthorize TANF. If it does take a substantial amount
of time, there may come a time that, given our unemployment rate, our
caseload reduction may no longer be able to meet some of the current
statutory requirements. Is it the gentlewoman's intention to work on a
bipartisan basis to encourage the Secretary and the administration to
continue to extend those State waivers which are being informally
extended currently by the Secretary?
Mrs. JOHNSON of Connecticut. It is simply my belief that within the
time frame of this extension, we will be able to permanently
reauthorize the welfare program and add to it the more flexible
provisions that are in the underlying bill with some interest that the
Senate has expressed in additional waivers.
Mr. CARDIN. Madam Speaker, under my reservation, let me just
compliment the gentleman from Oregon for raising this issue. There are
States that have operated under waiver authority that has expired. I
can assure you, although we have not been able to work out a bipartisan
bill, there is bipartisan agreement to maintain the flexibility of the
States under the waiver authority. I know that there are efforts to
extend it and expand it, but at least there is agreement that we want
to maintain at least where the States are today in their ability to use
authority to tailor programs for their individual State needs. That is
a bipartisan understanding, and I believe, also, there is a lot of
support in the other body.
I thank the gentleman for raising these issues, because I think they
are very important as we move forward in the debate, not only to Oregon
but to other States. I know the gentleman is fighting very hard for his
own State. We appreciate that very much. We certainly do not want to
see a diminished ability of your State to perform its services.
Mr. WU. I thank the gentleman from Maryland. I will take the
gentlewoman's response as we certainly aspire to extend this to the
full reauthorization within the limits of this extension, but that on a
best efforts basis, should we not be able to do that within this period
of time, which I believe is March of 2004, that we will endeavor
together to continue on this informal basis to extend the waivers under
which Oregon and other States have operated.
Mrs. JOHNSON of Connecticut. It will certainly be an issue that we
will discuss together before the expiration if we think reauthorization
cannot be finalized.
{time} 2115
Mr. WU. Madam Speaker, if I may make my second inquiry of the
gentlewoman from Connecticut, I would like to inquire of the
gentlewoman as to her intent to assist Oregon and other States with an
extension specifically for States on welfare waivers in the
[[Page H9010]]
TANF reauthorization bill as it is currently being considered before
this Congress and this body and the other body.
Mr. CARDIN. Madam Speaker, before I yield to the gentlewoman from
Connecticut, it has been the position at least of this body by its
formal actions to expand the authority to what is known as a
superwaiver. That is controversial, and I am not sure there is
certainly not an agreement on a bipartisan basis for a superwaiver;
however, the superwaiver sort of consumes the individual State waivers.
It is certainly the position of the majority of this House on both
sides of the aisle that the States have at least the waiver authorities
that they had under the expiring TANF laws. I will be glad to yield to
the gentlewoman from Connecticut, but I am not certain that there is an
agreement right now as to individual State waivers as compared to
broader authority. I can tell the position that I would like to see is
individual States, but I understand there is no consensus yet on that
issue.
Mrs. JOHNSON of Connecticut. Madam Speaker, will the gentleman yield?
Mr. CARDIN. Further reserving the right to object, I yield to the
gentlewoman from Connecticut.
Mrs. JOHNSON of Connecticut. Madam Speaker, I agree with the
gentleman from Maryland. There is a lot of interest in the States
having flexibility to tailor their programs to their own specific
needs, but exactly the structure of that authority is a matter of
disagreement at this time; and we will look to see how the Senate
resolves those issues and then in conference find an agreement that we
think will meet the needs of the majority of the States.
Mr. CARDIN. Madam Speaker, I appreciate what the gentlewoman said. I
think it is, in fairness to the gentleman from Oregon, certainly our
desire to make sure the States maintain the type of authority Oregon
has been able to use to create creative programs, and I really do thank
the gentleman for bringing this to our attention. It is a very
important issue to our States.
Mr. WU. Madam Speaker, will the gentleman yield?
Mr. CARDIN. Further reserving the right to object, I yield to the
gentleman from Oregon.
Mr. WU. Madam Speaker, I thank the gentleman for yielding.
I would like to inquire one more time of the gentlewoman from
Connecticut as to her intention to work in this body in conference and
with the Senate with respect to specific State waiver authority as we
go forward with this reauthorization.
Mr. CARDIN. Madam Speaker, I think the gentlewoman has already
answered that. Further reserving the right to object, I yield to the
gentlewoman from Connecticut again if she wants to further clarify it.
Mrs. JOHNSON of Connecticut. Madam Speaker, I would indicate to the
gentleman that the bill that passed the House has a very broad waiver
of authority in it. There are some that think it is too broad and would
like narrower waiver authority. We will see what the Senate has done,
and then we will see if the conference committee can come to a
conclusion about the structure of the waiver authority in the future.
But there was a waiver authority in the last welfare bill. I think
there is universal agreement that States need flexibility to structure
their programs to meet the specific needs and circumstances of their
own people, and so this will be a significant issue that will be
addressed.
I cannot tell the gentleman at this point whether there will be
precisely the narrow State waiver authority there is under current law,
but I would also remind the gentleman that that waiver authority under
current law has a defect. The waivers expire and are not
reauthorizable. Under current law, they have to reapply for them. So
under current law there is a problem about how do we move the
successful waivered program into the mainstream, and I think that is an
issue that the conference needs to resolve as well because my State
also has a waiver that has expired as well as the same kind of
unemployment rate, unfortunately, that Oregon has.
So there will be a number of people in conference concerned about
this issue, but I certainly cannot assure the gentleman that there will
be exactly the same kind of state-based waiver authority in the
reauthorization that there has been in the past bill. There is a lot
more interest amongst many in a broader waiver authority that
encompasses a greater variety of bills so that they could better
integrate broad services for people coming off welfare. So it is a long
debate. We are not going to resolve it here, but I do appreciate the
gentleman from Oregon bringing to this floor his concern about his
State's rights to tailor its welfare program to meet the needs of its
people. In the end that is really what makes a Federal program
successful or not successful is that local control and local power, and
I agree with the gentleman that that is terribly important to the
quality of Federal programs and their success.
Mr. WU. Madam Speaker, will the gentleman yield?
Mr. CARDIN. Further reserving the right to object, I yield to the
gentleman from Oregon.
Mr. WU. Madam Speaker, I thank the gentleman for yielding.
The language of this body is beautiful for its specificity and
nonspecificity, and I fully appreciate that. I certainly do not expect
a solution to the problems of this particular reauthorization this
evening. I would like to simply note that under the plenary authority
that Congress has over many issues, including this one, that it is
within the ability of Congress in this bill to extend expired waivers,
and I would just like to log that as a point of departure for States
like Connecticut and Oregon, the waivers for which have expired; and if
there is a will, there will be a way.
Mr. CARDIN. Madam Speaker, further reserving my right to object, just
to respond to the gentleman, I agree completely with what he has said,
and it has been the position of some of us to do the extension of
individual States that had it prior to the expiration of the bill.
There has been a consensus, as I have indicated before, to give States
at least that flexibility; and the majority has decided to go beyond
that with the superwaiver in this body. So the gentleman's point is
very well stated, which I happen to personally agree with; and I
appreciate his bringing it to our attention.
Mr. WU. Madam Speaker, I thank the gentleman and I thank the
gentlewoman.
The Secretary of Health
and Human Services,
Washington, DC, June 24, 2003.
Hon. Ron Wyden,
U.S. Senate,
Washington, DC.
Dear Senator Wyden: Oregon has been operating its Temporary
Assistance for Needy Families (TANF) program under a waiver
since 1996 and this waiver is due to expire at the end of
this month. I thank you for raising with the Administration
your concerns about your State's TANF program and its waiver,
and I admire the tremendous efforts you have been making on
Oregon's behalf to see that your State has the ability to
operate the best TANF program it can. I believe that Oregon
will be able to maintain its current program through the end
of this fiscal year, and ask you to continue working with me
to complete reauthorization legislation that will improve
TANF for families across the nation.
The rigorous evaluation of your Portland program has
documented some of the most impressive impacts on increased
earnings, improved job quality and reductions in welfare
dependency of any program that has ever been evaluated. This
impressive record of accomplishment is one of which you can
be proud.
I know that your efforts in support of Oregon's program are
grounded in the lessons you have learned from the evaluation
of your State's success and these lessons will be important
in informing the debate on issues that will be considered in
TANF reauthorization. Your commitment and leadership on these
issues continues to benefit the people of Oregon.
Oregon's TANF program operates with a waiver granted under
the former Aid to Families with Dependent Children (AFDC)
program. When AFDC was converted into TANF as part of the
Personal Responsibility and Work Opportunity Reconciliation
Act of 1996 (PRWORA), the new law enabled States such as
Oregon that had previously approved waiver programs to
continue operating those waivers. However, there is no
provision in law that would permit the Administration to
extend such waivers, as it was anticipated that these
programs would eventually align themselves with the larger
TANF reforms upon completion of their waivers. Therefore,
extending existing waivers would require changing current
law.
TANF is currently authorized only through the end of this
month, and legislation is before the Senate that would
temporarily extend the program through September, 2003,
[[Page H9011]]
the end of FY 2003. The Administration strongly supports
passage of this emergency measure to keep the current program
operating, and enable Congress to complete work on
reauthorization. Without this measure, Oregon would be
denied access to over $40 million in TANF funding
scheduled to be made available for the fourth quarter next
week.
I understand Oregon will maintain its current program while
Congress completes work on reauthorization. Oregon is not in
violation and based on Oregon's history is not expected to be
in violation and therefore Oregon will not be subject to
penalties for the next three months or until reauthorization.
Let me explain. Oregon's current TANF program has many
elements, most of which are accommodated under TANF and are
permissible under current law. However, I understand the
State is concerned about its ability to continue operating
two particular policies when its waiver expires. Oregon's
waiver allows the State to count toward its required work
participation rate certain types of activities, such as
participation in substance abuse treatment and extended
education and training, which would not otherwise be
countable under TANF. Your State's waiver also permits
counting of certain adults who are participating but have not
attained at least 30 hours of participation per week, which
is also required under TANF law.
Importantly, even without its waiver, TANF would not
prohibit Oregon from engaging clients in the activities they
currently do, nor does it prohibit the State from assigning
hours for particular clients at levels below the current-law
standard. These issues are relevant in that States must meet
minimum participation rates. However, according to Oregon's
current data, the State would be likely to meet its required
participation in FY 2003, even though Oregon's ability to
count certain activities and clients under its waiver will
end at the end of this month.
Oregon achieved a participation rate for all its families
of 61.1% in FY 2002. It would have achieved only an 8.0% all-
family rate if it had operated the same way, but counted
participation without its current waiver. However, because
Oregon achieved such a dramatic reduction in TANF caseload
over the past several years, it enjoys a caseload reduction
credit that reduced its effective all-family participation
rate requirement to 0% in FY 2002. Thus, even without its
waiver, Oregon's program would have met its all-family
participation requirement in FY 2002 because it effectively
had no participation requirement.
Oregon's caseload reduction credit in FY 2001 was 56.2%,
and in FY 2002 was 58.3%. I would anticipate that this would
not change considerably in FY 2003, and because the required
all-family rate for FY 2003 remained at only 50%, the State
is very likely facing no participation requirement for the
current year as well. Furthermore, work participation rates
are measured on a full year basis, meaning that for FY 2003
Oregon's rate would be an average of what it achieved
throughout the year. Given Oregon's extremely high
participation rates under its waiver, and the fact it will
have operated under the waiver for three of the four quarters
of FY 2003, it should achieve a very high rate even if the
final quarter is calculated without the waiver.
Oregon also must meet a separate participation rate for its
2-parent families. With its waiver, the State achieved a
53.8% 2-parent rate in FY 2002, but due to the caseload
reduction credit it earned, only needed to meet a 31.7%
standard. Again, given the State's likely high 2-parent
participation for the first three quarters of FY 2003, it
should meet this standard as well.
Based upon this, I am confident that Oregon can continue to
operate its current TANF program through the end of this
fiscal year without concerns about becoming subject to
penalties for meeting its participation requirements. Should
reauthorization not occur prior to the end of the fiscal year
and current law be extended again, I would remain confident
based on the facts that I have before me that Oregon could
continue to operate its program without becoming subject to
participation rate penalties.
TANF is a great program, and with your help we can make it
work even better in the future. TANF provides States
tremendous flexibility to fund and operate work and job
preparation activities, and to provide supportive services
and benefits so clients can find work, support themselves and
build a better life for their families. I know you share my
interest in seeing the program reauthorized as quickly as
possible, and seeing that important improvements are made to
enable States to engage all cases in meaningful and helpful
activities so they can move into work quickly and
successfully. Reauthorization is crucial for Oregon. As you
know, the President's reauthorization proposal includes
changes that would enable States to count various barrier
removal activities toward their participation rates, as
Oregon is doing now. It would also eliminate the separate 2-
parent participation rate.
I appreciate the impressive work you are doing for the
State of Oregon, and particularly your attention to this
critical program that has become so important to helping our
neediest families build better lives. The State of Oregon has
done a wonderful job with its TANF program over the years,
and we will continue to work with you on reauthorization
legislation to see that we build the best program for Oregon
and all of America.
The Office of Management and Budget advises that it has no
objection to this letter from the standpoint of the
Administration's program.
Sincerely,
Tommy G. Thompson.
Mr. CARDIN. Madam Speaker, this is very important legislation. It
extends the TANF programs and related programs for the next 6 months so
that we can try to work out a long-term, multiyear extension of the
TANF programs and related programs. I thank the gentlewoman for
bringing this legislation forward.
Mrs. JOHNSON of Connecticut. Madam Speaker, will the gentleman yield?
Mr. CARDIN. I yield to the gentlewoman from Connecticut.
Mrs. JOHNSON of Connecticut. Madam Speaker, this legislation is
nearly identical to H.R. 3146, a bill the House unanimously approved
last week. The only change is the addition of a 6-month extension of
expiring Medicare payment provisions affecting hospitals in small
cities and rural areas. These provisions need to be passed today and
signed into law immediately to ensure the continued smooth operation of
programs affecting health, welfare, and commerce throughout the
country. I urge the support of this body.
Mr. BEREUTER. Madam Speaker, this Member wishes to add his strong
support for H.R. 3146 and would like to commend the distinguished
gentleman from California [Mr. Thomas], the Chairman of the House Ways
and Means Committee, for introducing this important legislation and for
his efforts to extend the authorization for the Temporary Assistance
for Needy Families (TANF) program, as well as related welfare reform
initiatives, such as the mandatory child care program, the abstinence
education program, and the transitional medical assistance program.
Moreover, this Member would like to thank Chairman Thomas for including
language in H.R. 3146 to address Medicare payment disparities between
rural and urban hospitals.
The Rural Health Care Coalition, which this Member currently leads as
the Interim Co-Chairman, has been diligently working to bring equity to
the rural health care delivery system. One of the Coalition's key
priorities has been to address hospital payment disparities to ensure
that facilities in rural areas and small cities can stay in business
and continue serving patients who need care.
Medicare pays for inpatient services in large urban areas using a
standardized amount that is 1.6 percent larger than the standardized
amount used to reimburse hospitals in other areas (both rural areas and
small urban areas). The Consolidated Appropriations Act of 2003 (Public
Law No. 108-7) provided a six-month base payment increase for rural and
small urban hospitals from April 1, 2003 to September 30, 2003.
Specifically, this measure raised the inpatient base rate for hospitals
in rural and urban areas to the level of the rate for those in large
urban areas.
The bill before us today will extend this payment increase until
March 31, 2004. Such action is cruical--especially for cash-strapped
rural facilities which are near the breaking point and in need of
urgent aid. This policy will help maintain access to care in rural and
less populated urban areas of the country by better aligning hospitals'
payments to their average costs. The estimated impact of eliminating
the base rate differential for six more months will result in $3.8
million for Nebraska hospitals, according to the Nebraska Hospital
Association. This Member will continue to work on initiatives to bring
even greater Medicare equity to Nebraska this year.
In closing, this Member urges his colleagues to support H.R. 3146.
Reducing the difference in Medicare reimbursement levels between rural
and urban hospitals is critical. Rural hospitals receive less Federal
funding than hospitals in urban areas for providing the same services.
This legislation will keep base payments at the same level as those in
urban areas for six more months.
Mr. CARDIN. Madam Speaker, I withdraw my reservation of objection.
The SPEAKER pro tempore (Mrs. Miller of Michigan). Is there objection
to the initial request of the gentlewoman from Connecticut?
There was no objection.
A motion to reconsider was laid on the table.
____________________