[Congressional Record Volume 149, Number 136 (Tuesday, September 30, 2003)]
[Senate]
[Pages S12209-S12210]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
[[Page S12209]]
EXTENDING TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK GRANT PROGRAM
Mr. McCONNELL. Mr. President, I ask unanimous consent that the Senate
proceed to the immediate consideration of H.R. 3146, which is at the
desk.
The PRESIDING OFFICER. The clerk will report the bill by title.
The assistant legislative clerk read as follows:
A 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.
There being no objection, the Senate proceeded to consider the bill.
Mr. GRASSLEY. Mr. President, I thank the majority leader for his work
on the extension for the Temporary Assistance for Needy Families
program. Unfortunately, this program has had to be extended several
times while the Senate finance Committee worked to complete a very
ambitious agenda.
Happily, though, the Senate finance Committee was able to report a
welfare reauthorization bill on September 10, 2003. I plan to file the
committee bill shortly. It is critical that the Senate act swiftly to
complete action on this legislation. This program has languished,
unauthorized, for a year. States need to make plans to adjust to the
new provisions. Recipients need some assurances that the program will
continue.
It was my preference that Senate action on the welfare bill take
place this fall, but I understand that the time frame for adjournment
is fluid and this impacts what the Leader is able to bring to the
floor. Additionally, I would have preferred a shorter extension, in
order to keep the process moving forward. I do not want to send the
signal that since we are passing a 6-month extension, this means that
there will be no action on this legislation until March next year. If
that should occur, we would find ourselves in the position of having to
seek yet another extension. This is a situation which can only be
avoided, in my view, by prompt action on this legislation.
I understand why the majority leader wants a 6-month extension
because I recognize that it is nearly impossible to envision a scenario
in which the Senate passes a bill, the House and Senate have a
conference, a conference report is drafted and filed and the measure
goes back to both houses for a final vote, prior to a possible
adjournment date in late November. But if it becomes at all possible
for the Senate to act on the legislation in what remains of this
session, leaving conference committee consideration for early next
year, we should certainly do that.
It is my intention, if a window of opportunity does open up before we
adjourn for the year, to work with the Leadership to bring this
legislation up for consideration. In the event that such a window of
opportunity does not open up in what remains of this session, I am
confident that this bill will be among the first pieces of legislation
brought up for consideration as soon as we reconvene next year.
montana's welfare waiver
Mr. BAUCUS. Mr. President, as we have worked over the last 2 years to
reauthorize the 1996 landmark welfare reform law, I have often talked
with pride about the welfare reform program in my own State of Montana.
Montana was a welfare reform pioneer, embarking on reform under a
waiver before 1996. We have continued to operate a program under that
waiver and it has served us well.
The number of Montana families receiving monthly welfare checks is
down sharply since the early 1990s. Under the waiver program, Montana
achieved a participation rate of 84 percent in fiscal year 2002,
despite a struggling economy. Montana is a regular recipient of ``high
performance'' bonus awards, especially for the key criteria of moving
welfare recipients quickly into jobs. An independent study by Abt
Associates concluded that under Montana's program ``a Work First model
has been implemented effectively in varied rural settings, including
Indian reservations and remote areas'' and that it reflects an
``efficient and successful'' strategy. In other words, we're on the
right track.
However, the waiver expires on December 31. We would like it
extended. Given our track record, we think it is only common sense to
continue a successful model. Others, unfortunately, have opposed such
an extension. It is an issue we expect to be debated during
consideration of the full 5 year reauthorization bill.
As we extend the Temporary Assistance for Needy Families, or TANF,
program for 6 months, I want to confirm with the distinguished chairman
of the Finance Committee, that he is willing to work with me to ensure
that the welfare reauthorization bill allows Montana to maintain the
successful direction of the program it has operated under its waiver.
Given his efforts to work in a bipartisan manner, I am optimistic we
will be able to reach an understanding on these policies.
Mr. GRASSLEY. Mr. President, I understand the concerns of the Senator
from Montana, and look forward to continuing to work with him to
reauthorize the TANF program in the coming months. I appreciate his
concern for the need for Montana to pursue welfare policies it believe
make sense in that State. I agree that we will discuss these and other
issues as we reauthorize the TANF program and am also optimistic we
will be able to reach an understanding on these policies.
Mr. President, current law penalizes rural and small urban facilities
by paying them 1.6 percent less on every inpatient discharge than their
counterparts in urban areas of a million or more people. This is one
reason for MedPAC's finding that Medicare inpatient profit margins are
substantially worse for rural and small urban facilities than for those
located in large urban areas.
The provision raises the inpatient base rate for hospitals in rural
and small urban areas to the same rate as that in large urban areas
from October 1, 2003 through March 31, 2004. Every State except Rhode
Island has rural or small urban hospitals, so 49 States will benefit
from this provision.
The fiscal year 2003 omnibus Appropriations bill included a 6-month
version of this policy. The policy ends on September 30, 2003. A
permanent version of this policy was included in the Senate- and House-
passed prescription drug bills this summer. MedPAC has endorsed a
permanent version of this policy in its 2003 recommendations.
The cost of the provision is $300 million, for the 6-month period
beginning October 1, 2003 and ending March 31, 2004, according to
preliminary scores from CBO.
I ask unanimous consent to print in the Record the preliminary CBO
estimates.
There being no objection, the material was ordered to be printed in
the Record, as follows:
PRELIMINARY CBO ESTIMATE OF THE FEDERAL BUDGET EFFECTS OF H.R. 3146--BASED ON DRAFT LEGISLATIVE LANGUAGE, THOMAS.068, DATED SEPTEMBER 29, 2003 (11:22
AM)--ESTIMATED USING CBO MARCH 2003 BASELINE
[By fiscal year, in millions of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2004-2008 2004-2013
--------------------------------------------------------------------------------------------------------------------------------------------------------
CHANGES IN DIRECT SPENDING
Title I: Family assistance Provisions
Fund Supplemental Grants for 2 quarters:
Budget Authority............................. 191 0 0 0 0 0 0 0 0 0 191 191
Outlays...................................... 96 38 19 19 19 0 0 0 0 0 191 191
Increase Transfer Authority to 10 percent for 2
quarters:
Budget Authority............................. 0 0 0 0 0 0 0 0 0 0 0 0
Outlays...................................... 77 -14 -28 -15 -15 -5 0 0 0 0 5 0
Extend TMA through March 2004:
Budget Authority............................. 86 135 19 4 0 -1 0 0 0 -1 244 242
Outlays...................................... 83 130 20 5 0 0 0 1 0 0 238 239
[[Page S12210]]
Extend Abstinence Education Grants for 2
quarters:
Budget Authority............................. 25 0 0 0 0 0 0 0 0 0 25 25
Outlays...................................... 7 9 3 2 1 0 0 0 0 0 22 22
Extend TANF Research Funding for 2 quarters:
Budget Authority............................. 8 0 0 0 0 0 0 0 0 0 8 8
Outlays...................................... 1 3 4 0 0 0 0 0 0 0 8 8
Extend Child Welfare Research Funding for 2
quarters:
Budget Authority............................. 3 0 0 0 0 0 0 0 0 0 3 3
Outlays...................................... (\1\) 1 2 0 0 0 0 0 0 0 3 3
Subtotal Title I:
Budget Authority......................... 313 135 19 4 0 -1 0 0 0 -1 471 469
Outlays.................................. 264 167 20 11 5 -5 0 1 0 0 467 463
Title III: Trade Provisions
Extend Custom User Fees through March 2004:
Budget Authority............................. -698 0 0 0 0 0 0 0 0 0 -698 -698
Outlays...................................... -698 0 0 0 0 0 0 0 0 0 -698 -698
Title IV: Medicare Cost-Sharing Provisions
Extend Medicare Cost-Sharing through March 2004:
Budget Authority............................. 42 0 0 0 0 0 0 0 0 0 42 42
Outlays...................................... 42 0 0 0 0 0 0 0 0 0 42 42
Extend Inpatient Hospital SPA Equalization
through March 2004:
Budget Authority............................. 292 0 0 0 0 0 0 0 0 0 292 292
Outlays...................................... 292 0 0 0 0 0 0 0 0 0 292 292
Subtotal Title IV:
Budget Authority......................... 334 0 0 0 0 0 0 0 0 0 334 334
Outlays.................................. 334 0 0 0 0 0 0 0 0 0 334 334
Total Direct Spending:
Budget Authority..................... -51 135 19 4 0 -1 0 0 0 -1 107 105
Outlays.............................. -100 167 20 11 5 -5 0 1 0 0 103 99
CHANGES IN REVENUE
Title II: Tax Provisions
33 8 0 0 0 0 0 0 0 0 41 41
Net Effect on Deficit/Surplus.................... -133 159 20 11 5 -5 0 1 0 0 62 58
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Notes: TANF=Temporary Assistance for Needy Families. TMA=Transitional Medical Assistance. SPA=Standardized PaAmount.
Mr. McCONNELL. Mr. President, I ask unanimous consent that the
amendment that is at the desk be agreed to; that the bill, as amended,
be read a third time and passed; that the motion to reconsider be laid
upon the table; and that any statements relating to the bill be printed
in the Record.
The PRESIDING OFFICER. Without objection, it is so ordered.
The amendment (No. 1793) was agreed to, as follows:
(Purpose: 6-month extension of provision equalizing urban and rural
standardized payment amounts under Medicare Inpatient Hospital
Prospective Payment System)
At the end of title IV, insert:
SEC. ____. 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 inserting ``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.
(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 on 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.
The bill (H.R. 3146), as amended, was read the third time and passed.
____________________