[Congressional Record Volume 151, Number 125 (Friday, September 30, 2005)]
[Senate]
[Pages S10784-S10791]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   UNANIMOUS CONSENT REQUEST--S. 1716

  Mr. BAUCUS. Mr. President, there are an estimated 1.5 million 
individuals who survived Hurricane Katrina who are now scattered across 
the Nation. The stories of what they have already experienced are 
harrowing. They are suffering deprivation beyond what many of us could 
imagine, and their needs, especially for health care services, are 
greater than most of us hope to ever know.
  Today I come to the floor to share with you a few stories of those 
survivors and the problems they are facing in getting the health care 
services they need. Many are uninsured and without means to pay for 
food and shelter, let alone prescription drugs or a doctor's visit.
  As I said when I spoke on the Senate floor on Wednesday night, one in 
three survivors who have applied for Medicaid in Louisiana have been 
turned away. Why? Because they do not meet Medicaid's traditional 
eligibility criteria.
  These people need help. The Grassley-Baucus bill would deliver it to 
them without delay, without uncertainty.
  As we consider moving forward on this legislation, I remind my 
colleagues of the faces of those we are trying to help. The survivors 
of Hurricane Katrina are people such as Eugene Johnson, age 57, a 
retired plumber and a diabetic who lost his home to Katrina. He, his 
wife, and four of his five children have moved from shelter to shelter. 
He needs eye medicine that he left behind in New Orleans, but he cannot 
afford the $119 cost of the prescription. Without his medicine, he will 
go blind.
  An aid group, the Children's Health Fund, provided him with the 
medicine and responded with these words:

       We're a stopgap. Nothing more.
  Maude Jordan, who slept on top of her refrigerator for 3 days before 
being rescued in New Orleans, penniless and diabetic, was taken to a 
relief center in Baton Rouge. Her application was rejected by Medicaid. 
However, she was unable to establish eligibility because she could not 
establish categorical eligibility; that is, she was rejected because--
this is what Medicaid said--she

[[Page S10785]]

was ``unable to establish eligibility because cannot establish 
categorical eligibility.'' Give me a break. She needs help now. That is 
what our bill does.
  Dwayne Russ, 44, who had lived independently in a specially outfitted 
apartment in New Orleans and maneuvered in an electric wheelchair, lost 
his wheelchair when he was evacuated to Georgia and was placed in a 
nursing home. The local director of advocacy at a specialty hospital 
and rehabilitation center helped him out but stated:

       Dwayne is just one person but he demonstrates there's lots 
     of people out there in his same predicament who are not 
     getting the help they need.

  Tom Leynes, age 49, was a carpenter with an apartment just off the 
beach, a happy family man. After Katrina, he found the bodies of his 
two little girls holding hands. Now he is struggling with depression, 
living in a tent, taking medication, and trying to deal with the pain. 
He needs help.
  Theresa Bieller, 39, Gulfport, MS, was following a 15-pill regimen 
for a heart problem and other conditions before the storm. Most of her 
prescriptions were already low or empty. To make matters worse, she had 
no electricity to operate a nebulizer for her 2-year-old asthmatic 
daughter, Chloe. After a few days without medicine, her chest pain and 
weakness mounting, Bieller checked into a hospital. She came out the 
next day with a mere 3 days' supply, not 15. She has no insurance and 
little cash to buy the expensive drugs. She needs help.
  ``Precious'' is the name given by nursing home staff to an elderly 
woman evacuated from New Orleans to Tennessee who cannot remember her 
name. Precious can talk, but she is unable to tell staff who she is or 
what her health care problems are. She spent 4 days in a hospital 
before becoming a resident at Bordeaux Long-Term Care. Who and how her 
care will be paid for is unknown.
  These survivors and hundreds of thousands like them are waiting for 
Congress to act to make sure they can get the health care services they 
need. They cannot afford to wait another moment for this assistance, 
and neither can we. I urge my colleagues to join me in supporting this 
motion which I will now offer by unanimous consent on the Grassley-
Baucus Emergency Health Care Relief Act.
  I ask unanimous consent that the Senate proceed to the immediate 
consideration of Calendar No. 214, S. 1716; that the Grassley-Baucus 
substitute bill which is at the desk be considered and 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 all of this occur with 
no intervening action or debate.
  The PRESIDING OFFICER. Is there objection?
  The Senator from New Hampshire.
  Mr. SUNUNU. Mr. President, if I might momentarily reserve the right 
to object, Mr. Baucus, the Senator from Montana, has given a powerful 
description of people who are in great need of help. There is no 
question about that. Many of the States that are affected and other 
States have taken steps to provide help in many areas, to set up 
uncompensated care funds to provide assistance to evacuees. I think the 
Senator from Montana would argue that it is not enough, he would like 
to do more, and his intention is obviously to bring this bill to the 
floor to deal with some of these concerns. I have spoken before on this 
and will not speak at great length now. I do not believe this bill is 
the right way and the best way to address those concerns. It has a cost 
of $9 billion. It does include provisions for assistance to States 
regardless of whether they have evacuees located in them, regardless 
whether they were hit by the hurricanes.
  I and other Members have been working with Senator Grassley and 
Senator Baucus and their staffs to try to come to some agreement, but 
that has not happened. The question is not whether we should or want to 
provide assistance, but we want to make sure we do it in a way that 
ensures that resources get where they are most needed and in a way that 
takes advantage of the $45 billion or so that has already been 
appropriated but has not been committed yet.
  So I do object to the unanimous consent request. I know Senator 
Lincoln from Arkansas and Senator Landrieu from Louisiana wish to speak 
on this issue, and I will be more than happy to let each of them do so 
before returning to the floor, if I am able to do so today, and offer a 
few remarks.
  I do object at this time.
  The PRESIDING OFFICER. The objection is heard.
  The Senator from Louisiana.
  Ms. LANDRIEU. Mr. President, I rise to support my colleague from 
Montana and his counterpart from Iowa, Chairman Grassley, who have 
stepped up to the plate, along with the Senator from Arkansas on the 
Finance Committee and other Members, to put forward a bill that is 
absolutely crucial for the hundreds of thousands, in fact millions, of 
people who have been impacted directly by these two storms and the 
subsequent failing of a levee system in a major metropolitan area of 
this Nation.
  This is an unprecedented natural disaster. We have said it so much 
that maybe it is a cliche and people are not quite understanding the 
magnitude of this, but these hurricanes and the subsequent levee breaks 
have truly displaced 1.5 million people who are without homes, without 
businesses, without their churches, without their synagogues, without 
their extended families around them, without their pharmacists, without 
their doctors, and they need help now.
  I wish we had organized, funded, and resourced FEMA in such a way 
that this could be taken care of, and actually the next time this 
happens I hope we will have done just that. But for today, for the 
people of Louisiana, Mississippi, Alabama, and now Texas, who were also 
hit with this last storm Rita just 6 days ago, we have not had time to 
reform and reorganize FEMA. So if we wait for FEMA to do this, these 
people will not get the help they so desperately need.
  We need some additional resources. That has been documented on radio, 
television, in print newspapers from conservative to liberal to right 
up the middle that FEMA is not functioning as well as it once did. This 
is not about blaming anybody, this is about recognizing that fact and 
moving on. So Senators Baucus and Grassley, the good leaders that they 
are, in a bipartisan fashion, without trying to blame anyone, have 
said: OK, let us step in the gap. We have people who need help. We have 
the money to help them. Let us help them. They have put a bill together 
that will do that.
  We are now 31 days since Katrina made landfall, the most powerful 
storm and subsequent levee break in the history of the country, and 6 
days since Rita. Maybe people can wait another week or two, maybe 
three, maybe the people who just got hit 6 days ago can hold on 
literally to their life, their health, their children, their parents, 
with no health insurance, nowhere to get medical coverage, maybe they 
can, but maybe they cannot. Why should we again make them victims of 
our inability to act?
  This is not a Democratic bill. This is not a Republican bill. This is 
a bill put together by Republicans and Democrats, tightly and carefully 
drawn. Maybe some other additional compromises can be made; I do not 
know, but what I do know is we have to pass this bill very shortly or 
we are going to end up spiraling downward instead of upward in this 
region.
  The needs are great. It is not just health care and not just 
unemployment benefits, but when there are big cities and small towns 
from the Texas coast to the Louisiana coast to the Mississippi coast 
that are obliterated, they are not functioning, there is not a building 
standing--in some communities such as Waveland or in parts of Biloxi or 
Cameron Parish, which is a large but sparsely populated parish in my 
State, 10,000 people, there is not a structure standing as far as the 
eye can see, except the courthouse that was built in the early 1930s.
  In New Orleans, still a large part in the West of the city is like a 
ghost town. The mayor is doing a good job getting people back to the 
city. Our city council is working hard. Our sheriffs, our policemen, 
our firemen--all of them are working very hard trying to get people 
back to the city. The health care system that existed just 32 days ago 
in New Orleans does not exist anymore. The one that existed in Waveland 
is completely gone. The one that was in Cameron is gone.

[[Page S10786]]

  So I wish FEMA had showed up the next day and said: Here are your 
health care cards, here is what you do, here is help. But that did not 
happen. I am not here to fuss with FEMA; I am here to fix the problem. 
We do not have a lot of time.
  Let me say something else to my colleagues. Congress normally does 
not work quickly. It is not what we are created to do. I understand 
that. I have been in the Senate now 6 years. We are created to sort of 
go slowly. It is because the Founders did not want us in passion to 
move too quickly. I understand that. But we were also supposed to take 
the responsibility to create agencies that could act quickly, 
efficiently, and effectively. In large measure, we have failed to do 
that. It was not the Republicans' fault or the Democrats' fault or this 
administration or the previous administration. I am not interested in 
that. I am just saying the reality is the people--2 million and more 
because other people have been impacted--need help. We have to provide 
it.
  There are some problems over in the House of Representatives, and 
people know about those problems. I can understand that. But the 
Senate, Republicans and Democrats, has put together not just this bill, 
we have put together four or five bills on education, health care, 
small business tax relief, community development block grants, getting 
people immediate help to relieve their mortgage payments. If we do not 
do this in the next few days, the economy of the gulf coast will begin 
a downward spiral, and I do not know what else it will take with it.
  Everybody keeps saying this is a local problem, this is about New 
Orleans or Plaquemine or Saint Bernard or just Waveland. It is not. It 
is a regional crisis. It is a very important region for our country. It 
is the heart of the oil and gas industry. It is the largest river 
system in the Nation. It is the largest fisheries and maritime complex 
in the country. This is not time to cower.
  The Presiding Officer is from the South, a different part of the 
South, but as a Governor he most certainly understands the dynamics of 
the Washington-Virginia region, and if it was impacted in such a way, 
it could have national ramifications. The Chair most certainly 
understands that. That is what is happening in our region.
  Slidell, a population of 25,000--direct hit, the eye. Most of these 
people work at the Stennis Space Center in Mississippi or they work in 
New Orleans East, which is completely gone--most of the residents are--
at NASA at the Michoud plant. A lot of people in Slidell are poor, 
middle income and wealthy. The neighborhoods have all been hurt and 
affected. Some are doctors, some are small businesses.
  Lake Charles, 71,000--not a direct hit but took a big hit in the 
hurricane, and the small cities around there, Sulphur and White Lake. I 
have mentioned Waveland and Pass Christian, MS, Beaumont, TX, Bay Saint 
Louis, MS, just to name a few. These are the people, the working folks 
who support the maritime and the energy industry.

  It is a complex and comprehensive plan that is necessary for 
rebuilding, and we are working on the pieces of how to do that. There 
are many different ideas that are floating around. Something will come 
together, whether it is done for each individual State or whether we 
end up coming together as a gulf coast region and doing something. I am 
confident, with the good ideas I have heard expressed here, some 
compromise will come together.
  But we can't wait for this huge structure of rebuilding before we 
take care of some of the urgent and immediate needs: water, 
electricity, food, health care--the basic needs, the basic fundamentals 
of those governments, so small businesses can actually have a permit to 
stay in business, so businesses who want to locate actually have 
somewhere to send their letter: ``Dear Mr. Mayor, I would like to 
locate in your town.''
  If there is no city hall, there are no people on the payroll, there 
is no executive assistant to the mayor, where do they send the letter 
to open a business?
  I know I might be exaggerating a little bit, but I do it to make the 
point that, yes, we need tax cuts, yes, we need incentives for small 
business, but no small businesses can operate on an island by 
themselves. They actually have to plug into electricity and hook up to 
water. They have to be able to file their permits with city hall.
  We have cities right now deciding whether they need to lay off all of 
their employees, half of their employees--maybe we will lay off 10 
percent every week until somebody in Washington hears us.
  I don't know why we have trouble hearing in Washington. I am not 
certain; maybe we talk too much. I most certainly myself could be 
blamed for that. I do a lot of talking. People say, Mary, you talk a 
lot, and I have to admit I probably talk too much and maybe I need to 
listen a little bit more. But I am starting to think a lot of people in 
Washington are not listening because the people in my State are crying 
desperately for help. I can hear people from Mississippi and Texas and 
Alabama crying for help. I know we do not normally act quickly, but we 
have to figure out a way to do it.
  I am not talking about taking the Treasury and dumping money down 
there. I am talking about passing the bill of Senators Baucus and 
Grassley that was worked out by Democrats and Republicans. Maybe we can 
tighten it even more. Maybe there is a compromise even further to be 
had. But there are a lot of Republicans supporting this bill. We need 
the House and we need this administration to support this bill and get 
it passed before we leave next week.
  I am going to conclude because Senator Lincoln, who is truly an 
expert on this subject, wants to speak about this particular bill. But 
when we come back next week, I, as the Senator from Louisiana, want my 
colleagues to understand it is going to be very difficult for any of 
us--and for me particularly--to go home next weekend for a break when 
nobody in Louisiana, very few people in Texas, Mississippi, or Alabama 
have had any break and will not for a while. The only thing they are 
going to get as a break is broken homes and broken hearts, displaced 
families. We cannot go home without helping them to more quickly get 
back home.
  We are grateful for the hospitality of Arkansas and New York. I went 
to New York to personally thank New York Mayor Bloomberg and the police 
and firemen for everything they did to help us. I have had people from 
all over the world in my office, thanking them for coming to our aid--
internationally as well as nationally--but we cannot go home next week 
without helping the people from the gulf coast get home. We have to fix 
the education crisis. I am going to list a few things we have to do 
before we leave:
  We have to fix the education crisis. Lamar Alexander, the Senator 
from Tennessee, has been working very hard all week on a compromise. I 
would like to see his bill passed.
  We have to pass the Grassley-Baucus, or Baucus-Grassley Medicaid 
proposal for health care for people.
  We are going to have to pass some kind of mortgage relief. We have 
hundreds of thousands of people for whom--some of them--their home was 
their largest asset. If we do not give them some relief, they are going 
to lose the largest asset, the only real asset they have. Some people 
have more than that, but most people have their wealth in their home. 
They are getting ready to lose it all because of the conflicts between 
the insurance companies and whether it was wind or whether it was 
flood. We are not asking for forgiveness, but a break for 6 months. We 
have to give them that.
  My staff told me today, a few minutes before I came down here--and I 
am sorry I do not have the document--that the report just came out that 
there has been the highest number of people in the history of the 
country who have defaulted on credit card payments. Does anybody wonder 
why? Is anyone confused about why this month, this report would show 
the highest number of people in the history of the country to default 
on credit card payments? It is because the people who are lucky enough 
to have credit cards and who still have not yet hit their limit are 
using their credit cards and their cash cards to literally stay alive. 
They have no health insurance, no hospital, no job, and virtually no 
action from Congress. They have a credit card and they will hit their 
limit.
  So if we do not get some response quickly, in a bipartisan manner--I 
see Harry Reid on the floor, our leader,

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who knows this well. For the last 2 weeks he has been working to keep 
Democrats and Republicans working together to get this done--we are 
going to be in a serious situation. There are some things we have to 
get done next week.
  In conclusion, I thank Senator Baucus and Senator Grassley for 
bringing their bill up again to the floor. We are going to have to get 
some things done before we can go home next Friday. I look forward to 
working with my colleagues in that regard next week.
  The PRESIDING OFFICER. The Democratic leader.
  Mr. REID. Mr. President, words to express my consternation are 
difficult to come by right now.
  First, to express my appreciation to Senator Baucus for his tireless 
efforts. Montana is a State without a lot of people. It is a State that 
grows hardy stock. I have been there. Every time I have been there, it 
has been with Senator Baucus. It is a beautiful State--big sky country. 
Senator Baucus does not have many people in his State that this 
legislation he is attempting to put forward would help. He is doing it 
for the precious people in the world, not just the one he talked about 
with the name Precious, but precious people who have no place else to 
go than to someone like Senator Baucus, who is a leader from the State 
of Montana, who finds himself in a situation of responsibility in which 
he must reach out.
  He first is a Senator from the State of Montana. But most important, 
his title is a U.S. Senator. He is concerned about the people of 
Louisiana, about the people who may not be named Precious, but they are 
precious. People in the State of Arkansas, because of close proximity 
to the areas where the hurricane struck, took in as many as 65,000 
people. They are not all there now--most of them are there--but 
wherever they have gone, they have left in the State of Arkansas a lot 
of unpaid bills. That is not because they are trying to get away from 
responsibilities they have. It is because this Government has programs 
that are supposed to protect people such as Precious. The State of 
Arkansas deserves more from us than they have gotten.
  This legislation Senator Baucus is propounding has the support of the 
vast majority of the Senate--I hope on a bipartisan basis.
  While I am talking about bipartisanship, I have also to throw a 
bouquet to the chairman of the committee, Senator Grassley. He has 
taken a lot of grief for working with Senator Baucus to come up with 
this legislation. Why did Chuck Grassley do that? Because he is a 
United States Senator and has responsibilities outside the State of 
Iowa. This legislation is a model for bipartisan compromise.
  Senator Lincoln was misled, I say with all due respect to some of my 
colleagues, because she filed a similar amendment to the Commerce, 
Justice appropriations bill. Why did she withdraw this? She withdrew 
the amendment in exchange for the promise that the Finance Committee 
would reach a bipartisan agreement, which they did, and it would be 
brought to the floor and we would vote on it. We have had no vote on 
it. Senators Baucus and Grassley fulfilled their promise. Her 
legislation wasn't exactly like this, but it was so close it is not 
worth discussing the difference at this time. A handful of Senators 
have blocked consideration of this bill on the floor, twice already 
that I know of, and I think maybe three times.
  The administration has the audacity to argue that this is not 
necessary. They want to do it with a bunch of waivers. Anyone who 
understands Government knows that is absolutely ridiculous. Their 
approach creates more bureaucracy while failing to provide funding 
guarantees for the States that badly need this. More important, their 
approach not only leaves but has left tens of thousands of Katrina's 
victims without care. We need to provide swift access to health care 
for Katrina's victims with guarantees of full Federal funding for the 
States who are generous and step forward at a time of need.
  This is the time to allow us to pass this legislation. We are here 
now on a Defense appropriations bill. That is what we are going to be 
doing now. Couldn't we set aside 20 minutes, 10 minutes of debate on 
each side, and vote on this? We have a handful, maybe a half dozen 
Senators, holding up this legislation. Couldn't we spare the American 
people 20 minutes of debate time on the Senate floor to deal with 
people who are in dire need of help? As Senator Baucus explained, these 
are people who cannot even speak. We want to help them.
  Continued failure to do so ignores the support of the bipartisan 
majority of the Senate. It also ignores the wishes of this country's 
bipartisan Governors. The Governor from the State of Arkansas is a 
Republican. The Governor from the State of Louisiana is a Democrat. 
They want help. Mayors, county commissioners, patients, hospitals, 
nurses, doctors--my good friend, the majority leader of the Senate, is 
a physician, a prominent, eminent transplant surgeon. I know how he 
cares about people who are sick. But we need the majority leader to 
push aside the loud voices of this very small minority over here and 
stop this. He needs to stop this and let us move forward with this 
legislation.
  He has decided not to run for reelection. He is going to be here a 
year plus a few months. Is this a legacy that he wants to leave? 
Katrina? People, after 5 weeks, with no health care? Is it going to be 
7 weeks? 5 months? Maybe ignore them, maybe that is what they want, 
ignore them.
  These few Senators are standing complaining about maybe it costs too 
much. Maybe the first place the majority leader should look, with his 
friends who are holding this up--let's look at the budget that is out 
here, of which Protestant leaders of this country, on the night it was 
passed, said it would be an immoral document.

  I am very grateful to the Senator from Louisiana, Ms. Landrieu, and 
my friend of many years, Senator Baucus, for doing what they are doing, 
and the advocacy of Senator Lincoln from Arkansas. I so appreciate 
their not letting this issue die in the eyes of the American people. We 
must continue doing this. It is the right thing to do.
  The PRESIDING OFFICER. The Senator from Arkansas.
  Mrs. LINCOLN. Mr. President, I come to the floor today to join my 
colleagues in what we hope to be an opportunity to bring about an 
awareness of the dire need, not only of the evacuees, of those 
individuals in the affected States who have received such incredible, 
devastating natural disasters, but also the other Americans who are 
involved in this circumstance, the other Americans who have opened 
their hearts and their homes, their hospitals and clinics, their 
pharmacies and their community centers, their church basements--these 
communities who have recognized what it means to be an American. They 
have recognized what it means to be fellow Americans. They have 
recognized what it means to be a good neighbor--I was, I guess--tongue 
in cheek--perhaps I was criticized being a little overpassionate on 
this issue, so I will resume my good, soft-spoken, and commonsense 
approach to what I think to be a very real problem--to have deeper 
roots, in terms of what are the values we as Americans do profess and 
for which we are willing to put our money where our mouth is when we 
speak of these values to really talk about not the immediate impact but 
also the long-term impact of the decisions that we make or we fail to 
make in a timely way.

  I will come at it from a different perspective. Maybe keeping my 
compassion down a little bit will be helpful, but it is hard when we 
look out and see the kind of compassion in the faces of the incredible 
constituents that we serve, that we represent, that we have the 
privilege of coming to this floor to represent each and every day.
  We also look out at the private sector, for which we also can be 
proud, our Nation's health care providers and States that have been 
there, at a time when vulnerable Americans need them the most.
  The moment that Hurricane Katrina hit the gulf coast--now about a 
month ago--they jumped into action. They didn't have to be asked. They 
didn't have to be told what their job was. Medical, professional, and 
community leaders knew what their job was. Their job was to reach out 
to their neighbors, to their fellow Americans, and to their fellow 
human beings, who were in unbelievably devastating circumstances.
  Cities and States all around the country opened their doors to 
welcome Katrina survivors from throughout the

[[Page S10788]]

gulf coast region. Hospitals evacuated those who needed immediate 
attention. Doctors, nurses, and other health care providers have come 
together to provide health care to thousands of victims of this 
horrific natural disaster in the gulf coast. And they did all of it 
with no questions asked. They didn't ask: Who is going pay for this? 
Who is going to reimburse us? Who is going to take care of us? When the 
high numbers of Medicaid patients jump way beyond a survivable number, 
who is going to make us whole?
  They did not ask those questions because they believed in this 
country. They believed in who we are in this body as Americans, who 
know our responsibility as neighbors. I happen to be somewhat of a 
neighbor of the President in the chair today. When my family is here 
and we are in session, northern Virginia provides an incredible 
neighborhood for us, just like our neighborhood in Little Rock.
  We reach out to our fellow neighbors out there, as we do our 
neighbors in Arkansas.
  It is what we are about in this country. It is being there for our 
fellow man. That is what these providers have done. Now it is our time.
  We have an opportunity in this body to demonstrate that we understand 
what that means, we understand what it means to be a good American, to 
be a good neighbor and to provide to our fellow man who is in the 
neediest time in his life the kind of care and love and support that he 
needs--he or she--at that time without asking questions.
  We could pass the Emergency Health Care Relief Act that Senator 
Baucus and Senator Grassley have worked so hard, in a bipartisan way, 
to bring about. I offered an amendment a month ago. I could see from my 
providers, those doctors and nurses, those pharmacists who worked 24-7, 
who spent their entire Labor Day weekend taking care of their neighbors 
from Mississippi and Louisiana, who didn't ask questions, I could see 
that there was going to be a tremendous need down the road to provide 
them piece of mind--that not only they were doing the right thing in 
helping those neighbors but also that they could continue to do the 
good job in providing services to the constituency, the community, and 
the neighbors they have known all of their lives.
  Many of our communities in east Arkansas, particularly in the Delta 
region, are already disproportionately poverty counties. Hospitals and 
clinics, community health centers before Katrina were already 
disproportionately Medicaid and Medicare facilities. They were already 
heavily dependent.
  Tomorrow, they are going to take a cut. To save money in this 
country, to look at where we are going to save money, we are going to 
reduce the Federal share of their Medicaid reimbursement as of October 
1. Out of the 29 States that are going to see a cut in their Medicaid 
reimbursement, the most affected 7 States in the country by this 
natural disaster will see a cut tomorrow in their reimbursement for the 
neediest, those who depend on the health care safety net of this 
country because we are so trapped, so paralyzed in the redtape that we 
want to create in this body.
  We do have an opportunity, though, to not only provide for Katrina 
survivors and victims of such an incredible natural disaster, but to 
also prove to the private industry of this Nation that we can react 
without the unbelievable web of redtape that leaves them hanging, that 
leaves them holding the bag for the cost of something that we should be 
held accountable for--not just held accountable because we are the 
Government but held accountable because we are the institution that 
wraps its arms around the American people when they are most in need. 
We can do so in an efficient and effective way.
  To my colleagues on the other side who are so desperately worried 
about the cost of what we are doing, who are so afraid of helping one 
too many needy people, I say to you: Look at what we have become.
  We have worked hard to keep the costs down. We have made it temporary 
so it wouldn't explode or overexpand--yes--an already very expansive 
program.
  These people are not going home tomorrow.
  I saw a piece in my hometown of Helena about a couple that left in 
haste out of New Orleans. They went to Jackson and could find no help. 
They went to Memphis and were sent to Tunica, MS. In Tunica, at the Red 
Cross facility, they were told there was already overcapacity, and they 
were simply sent away. They went to the next bridge that crossed the 
great Mississippi River and into my hometown, remembering someone they 
had grown up with in their childhood from Chicago, and called him 
hoping that he would be there. He was. He was a pastor of a church. He 
had opened his church doors and his home. He and his wife opened their 
home and welcomed them in, as well as other families that were already 
living there. They reached out to one of the most poverty-stricken 
counties already in the country--reached out to a small health care 
foundation that this community had managed to put together over the 
last several years to try to reinvigorate their health care 
infrastructure because they know how important it is as a component of 
rebuilding the vitality of their community and creating jobs for those 
who want to get into a more independent situation.
  But who locates businesses, or factories, or jobs in an area where 
you don't have the necessary health care to begin with?
  So you have a small nonprofit health care foundation paying for this 
couple's health care because the providers have no earthly idea whether 
their Federal Government is going to be there for them.
  We are bigger than that. We are not talking about an open-ended 
payment.
  We are talking about a temporary ability to give peace of mind to the 
people who, since day one when this disaster struck, have not asked 
questions, have put their full faith and hope in this Federal 
Government--that for once it will disregard the redtape, look wisely at 
something that we already have in place, and look wisely at past 
experience such as 9/11, when we were able to temporarily offer a 
health care safety net to survivors, and expect that we could come up 
with the wisdom and the courage in this body to provide them the peace 
of mind that what they have done for their fellow man was the right 
thing to do.
  We are talking about ensuring full Federal funding within the area 
where medical care has been provided for victims of the hurricane.
  Medicaid is our health care safety net in this country. I think this 
crisis itself has shown us how important this safety net is to our 
Nation.
  We have to make sure it does not unravel in the face of this national 
emergency.
  Do we have concerns about Medicaid? Do we feel as though there are 
places where we could be more efficient and effective in that program? 
You bet there are places we can be more efficient and effective.
  Chairman Grassley has suggested some in terms of the cost of 
prescription drugs through Medicaid that can be negotiated in a better, 
more efficient way, to provide more cost-effective drugs in that 
program and hopefully lead the way to seeing us provide more cost-
effective pharmaceuticals for all other programs, as we do with the 
Veterans' Administration. We can do that when we work together.
  To scrap a program designed as a safety net for people who are in the 
most devastating circumstances is not the way to do that.
  The administration promised they wanted to make whole financially the 
States that were providing health coverage to evacuees. They say there 
is no need for the Grassley-Baucus initiative to provide full Federal 
funding for Medicaid because they want to use waiver policy. What they 
did not say is there is no Federal funding, no Federal dollars in 
providing that waiver policy. There are no dollars that they will put 
behind that.
  They have asked Louisiana, Mississippi, and Alabama, the affected 
States, to sign memorandums of understanding to agree to be on the hook 
financially for a portion of the Medicaid costs of the survivors. How 
humiliating to go to a State that has been devastated and say: We are 
going to put you on the hook right here and now for the costs of what 
your neighbors want to provide. And we, as a nation, supposedly the 
wealthiest nation in the world, should be able to care for our American 
citizens.

[[Page S10789]]

  We know those States are in no position financially to incur that 
kind of cost. Those three Governors testified before the Committee on 
Finance earlier this week. One of the Governors mentioned she did not 
even have the resources through her State legislature to overcome the 
increase in costs they were going to see because of the loss of Federal 
dollars they are going to experience tomorrow when their Federal 
matching portion of Medicaid is cut. That was before Katrina ever hit. 
Before this devastation hit, they could not find the resources in their 
State--with a disproportionate share of low income, dependent on that 
safety net--to be able to cover that. That was before the disaster.
  Those Governors were highly concerned. They expressed it in their 
testimony and in their questions and comments about making sure the 
Federal Government would be there for them to make them whole, to 
extend help to their States--Louisiana, Mississippi, and Alabama--when 
they were unable to deal with that under their current budgets.
  For Arkansas, what does it mean? Does it mean we are left holding the 
bag due to budgetary issues, due to the fact that there are a few 
people in the Senate that are more worried about the temporary spending 
to help the neediest of this devastation than they were about the $62 
billion we vetted for FEMA? Nobody objected to that. I have no 
objections for taking the money from that. FEMA will probably come back 
and ask for more money anyway.
  If it were your mother or your sister or brother or niece or nephew, 
uncle or parents or grandparents who had been displaced, who found 
themselves in a strange community with a chronic illness--whether it 
was heart disease, diabetes, perhaps cancer patients in need of 
treatment, perhaps it was a child who needed health care--can you 
imagine the fear of thinking you would not be able to access it? Or to 
find the provider that was providing it for you was scared to death 
that it was going to push them over the edge; that if they helped 
enough of the people without any assurance or piece of mind, eventually 
their doors would be closed and they would no longer be able to provide 
that kind of care.
  As I toured the evacuee camps, there was an unbelievable feeling of 
gratitude among those displaced at a time when they had to have been 
devastated. A woman was about to get married who had lost her wedding 
dress in New Orleans. But the people in our community in Arkansas 
provided a wedding dress and a wedding for people who had been 
displaced who did not know where their other family members were, who 
were separated, yet who were still so grateful for the food, the 
warmth, the hospitality, the love and the arms that enveloped them in 
the evacuee camps where they found themselves. Some of them have 
dispersed and gone to stay with cousins, aunts or uncles, sisters or 
brothers in other States. That is one of the reasons we want the 
expansion.
  We do not want it just for the State of Arkansas. We know we have 
already sent many evacuees to Pennsylvania, West Virginia, North 
Carolina, Iowa, Utah. They too are going to need health care because 
they do not know when they will be able to go back, and they do not 
know what they will be going back to. They do not know what happened to 
their jobs, the health care they may have had which is provided for in 
this bill to keep private insurance still in the go-along to make sure 
we make it whole as well, that we put as few people as possible into 
that Federal safety net.
  We have an opportunity. I hope as a nation we can realize spending 
more and more time to try to bring up convoluted waivers--and our State 
Medicaid directors know that most of what is in the waivers is an empty 
promise. Last night in Arkansas, we got a waiver from HHS, but it 
certainly has contributed only to more redtape in addition to what has 
already been created. It provides more questions than answers. There is 
no money attached to it so it really is an empty promise that they will 
do something about that.

  The survivors, the health care providers in the States, have received 
no relief, no legitimate help. They are out there doing this without 
any assurance of from where it will come.
  We do not know in the waivers what services will be cut. How do we 
expect providers to know what they can provide and what they can't? 
Most of them were given the assurances from their State: Don't worry, 
we are part of a great Nation.
  When you treated those people over the weekend on Labor Day, we are 
going to ask them to go back in their minds 4 months and fill out the 
kind of paperwork to ensure they can get reimbursed for a tetanus shot 
or for a procedure, whatever it might have been. They, in good faith, 
have filled out what the State has asked them to fill out to make sure 
they are accountable for the services they have provided. Yet through 
the waiver processes, there is yet one more piece of redtape, one more 
form to be filled out, one more web of Washington bureaucracy they will 
have to deal with, without any guarantee that there is money behind it, 
that there are resources to actually pay for that.
  As we look at the waivers that have been offered, they create 
uncertainty about reimbursement. The administration has suggested 
creating a new uncompensated care pool to reimburse health care 
providers. When we asked where was the money going to come from, that 
is what they told us--a new uncompensated care pool. Why wouldn't we 
use something that already exists, that already has fraud and abuse 
stipulations and cautions? Why wouldn't we use a system that we can 
continually improve on? But we will create a new uncompensated care 
pool. We will not know where the money will come from.
  I question my colleagues who are looking at fiscal responsibility. A 
new uncompensated care pool does not have any parameters to it, it does 
not have any protections from fraud and abuse.
  Health care providers receive no guarantee about which services and 
how much care will actually be reimbursed through this uncompensated 
care pool. I go back to the story I used in committee the other day 
about the woman who survived on top of her refrigerator. She was 
reported in The Economist. She survived on her refrigerator for 3 days 
and was able to finally get out. She made it as far as Baton Rouge. She 
was a diabetic and quite in need of care. She went to seek out health 
care and was told she was categorically incorrect and could not get 
care.
  That is the kind of redtape we will perpetuate if we do not look at 
the reasonable proposal that Senator Grassley and Senator Baucus have 
come together to produce.
  Does it go as far as I would like it to go? It does not. I have been 
out there and have seen what the people are up against--both the 
providers and the evacuees. I see what their families are going 
through--not just the lack of care, the lack of essentials or the 
communities that are trying to provide for them, but the dignity they 
want to maintain while finding themselves without a home, without any 
possessions, dislocated from their family, their neighbors, the people 
who care for them and love them, finding themselves in strange places 
with people who are trying desperately to give them that sense of 
dignity and care.
  In my soft-spoken and commonsense way, I appeal to my colleagues. We 
can be fiscally responsible. We can look for ways we can provide care 
and peace of mind to those who need the health care and to those who, 
without reservation, are providing it to some of the neediest, most 
destitute of Americans at this time in our country. I ask my 
colleagues: Please, do not put this off for yet another week. Don't 
send us home to our States to tell our providers, to tell the Americans 
that have evacuated the gulf coast, that they are not important enough 
for Congress to deal with this issue in a more timely fashion.
  I compliment my friend from Montana for his and Senator Grassley's 
attempt to work through this issue and to bring about something that is 
not only practical and common sense-oriented, that is limited in its 
timeframe, but that is also compassionate toward our fellow Americans.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Mr. President, I know the people in the State of Arkansas 
already know how much their Senator fights for them. I state my 
perspective: The Senator from Arkansas is one of the best. She is a 
believer. She fights

[[Page S10790]]

for her people and all are grateful for that.
  I make a couple of points. One, this legislation to help the health 
care needs of evacuees and victims of Katrina is desperately needed. It 
will pass. It is a question of when that willful band of three or four 
Senators will finally recognize that so we can get on with it and help 
people who really need some people. That is what this comes down to.
  I hear a couple of complaints about this legislation. Let me briefly 
explain what this is all about. Basically, this is an effort to help 
people. It is a modest effort. It is legislation designed by the 
chairman of the committee, Senator Grassley, a Republican, and myself, 
the ranking Democrat. We have worked with all the members of the 
committee. We have worked with staffs of the committees.
  We have worked with Senators from States directly affected, asking 
their views. This has been scrubbed. This has been examined. This has 
been worked over many days in many ways. It is balanced. It is not 
nearly as extreme as some of the suggestions of some Senators. I might 
say, a couple of the Senators backed off and did not offer their 
legislation on the promise that we in the Finance Committee would come 
up with a bill, a balanced bill--Senator Grassley and myself--and bring 
that bill to the floor.
  Well, here we are. It is a couple weeks later. We in the Finance 
Committee did our part. It is up to the Senate now to do its part and 
take up this bill and pass it, recognizing that this is only temporary. 
This is only temporary relief, only temporary assistance for the health 
care needs of the people in Louisiana, Arkansas, Alabama, the States 
affected. This is not permanent. By ``temporary,'' I mean about 5 
months. My gosh, by the time we get this enacted, virtually a month 
will have already passed. We are talking about legislation which is 5 
months in duration.
  Some are concerned: Well, gee, this is an additional entitlement. It 
is more money. It is an entitlement.
  Well, I think it is important to remind ourselves that in our country 
we have a program called Medicaid. What is Medicaid? Medicaid is our 
safety net. It is kind of the last resort for people to get health care 
if they cannot afford it otherwise, or do not have it otherwise--they 
cannot get it at their place of employment, or if they are not wealthy, 
they cannot buy health insurance.
  So we have something called Medicaid. It is health care for low-
income people, people who do not have much money whatsoever. It is kind 
of a safety net to catch people who otherwise would fall between the 
cracks. It is directly designed for people such as those who are 
affected by Katrina.
  So many people in Louisiana and other States do not have health 
insurance. They do not have it. They do not have it for several 
reasons: One, they could not afford it; or they work for small 
businesses, which we know have a harder time providing health 
insurance; or their business has laid them off, so they do not have 
health insurance because they do not have the income. For whatever 
reason, they do not have health insurance and they need health care 
now--especially diabetics, especially people who need dialysis, 
especially seniors, or maybe not seniors, who have very definite, 
immediate, extraordinary health needs.
  One out of three Medicaid applications in the States affected--at 
least in Louisiana--has been turned down because they did not meet the 
criteria. The criteria, as we know today, are pretty low. Or I might 
say it differently. It is difficult to get on Medicaid if you have 
significant income or just some income, if you have some assets. If you 
have some income and some assets, you do not get health care.
  So we are saying, let's raise the eligibility criteria a little bit 
to the same measures we provided for victims of 9/11. It is the same 
provision. The income levels are increased only very modestly, very 
slightly, and the categories that are covered are virtually the same.
  I ask my colleagues, if the survivors of 9/11 could get this kind of 
Medicaid health care insurance, why in the world can't people who are 
affected by Katrina get the same coverage? It is the same. The people 
of New York City got help right away. It was passed very quickly. Why 
can't the people of Louisiana, Arkansas, Mississippi, and Alabama get 
the same coverage? It does not make any sense to me.
  Now, the catchall objection I heard earlier today was: Well, gee, 
this isn't quite right. It is not the best. Well, there is never going 
to be ``the best.'' We all know it is often important to not let 
perfection be the enemy of the good. Is it going to be perfect? No. Is 
it very, very good? Yes. Can we adjust it and change it if we need to 
make some changes? Certainly. But let's begin.
  This is an emergency. It is a bit reminiscent--I do not want to be 
too melodramatic about this, but we have had crises in our Nation's 
past, whether it was Pearl Harbor, Sputnik, or whatever it might have 
been, and this Congress reacted very quickly to those crises. This, 
too, is a crisis for these people in that part of the country. We need 
to act quickly. It is a crisis for them. If we do not act, many people 
will not get the health care they need; or, looking at it differently, 
they are going to be burdened with an additional concern, whether they 
are going to get their health care, whether they are covered under 
Medicaid, whether it is going to be there. That will be added to all 
the other problems they have: Where are they going to live? Where are 
some of their lost loved ones? What is next for them? Are they going to 
be able to make their car payment or house payment? The problems the 
people in Louisiana and these other States are coming up with are 
incredible. Why can't we, then, in a small way, help with health care?
  Now, I have heard the objection: Well, gee, Senator, your legislation 
does not allow a reduction in FMAP payments to 29 States. After all, 29 
States is a lot of States. There are only about three or four or five 
or six or seven States that are most affected.
  Let me explain this. Currently, there is a scheduled reduction in 
Federal payments to States. It is called FMAP. It is irrespective of 
Katrina. It is in the law. It is because certain States, a few years 
ago, had higher incomes. Because of averaging and data lags, the 
information is quite dated. But the point is, this legislation says, 
OK, for those 29 States that are going to have their Federal payments 
to cover Medicaid drop automatically, we are saying they will not 
drop--temporarily. We are not increasing the Federal payment to States. 
We are not increasing it at all. We are saying it will not drop for 29 
States for which it otherwise is scheduled to drop. And this is only 
temporary. I think it is for a year's term.
  Well, why is that so important? Why is it important not to let 
Federal payments drop to those States? It is pretty simple. These are 
States which have a lot of additional costs. A lot of evacuees are 
going to these States. Many are going to these States, which puts an 
additional burden on these States. Now, it is not just Medicaid 
burdens; these States are going to have to pay additional Medicaid 
costs or other social services costs, other education costs, to pay for 
the people who are now coming to their States and who need help.
  Let me give you a little bit of a flavor of what that means in terms 
of dollars and cents. Let's take the State of Arizona. They are 
scheduled to have about a half a percent reduction. That is a drop of 
$30 million in payments to the State of Arizona for Medicaid, and 
that State is now going to pick up at least 2,000 more people. That 
does not make a lot of sense.

  Let's take the State of Nevada: It is about a 1.14-percent drop in 
Federal payments under Medicaid. That is about $14 million less Nevada 
is going to otherwise receive. They have to pick up about 1,500 
additional people.
  Let's take the State of Oklahoma. It is almost a 2.25-percent 
reduction. That is about a $66 million reduction. There are about 4,000 
people, at least who we know of, who are going to be living 
temporarily, at least, in Oklahoma, and they will have to pick up those 
other costs.
  We are not asking for an increase. We are just saying: No reduction 
in Federal payments to States affected.
  I might add that 25 of the 29 States on this list are States where 
the President has declared a public health emergency because of 
Katrina. Twenty-five of the 29 States are States where the

[[Page S10791]]

President has declared a public health emergency, indicating there are 
additional pressures on those States and additional pressures on the 
people in those States. We are trying to provide some temporary help.
  Now, you hear sometimes: Well, the administration is suggesting a 
waiver. Senators mentioned the problems with the waiver. I will very 
briefly list them. One is that the waiver does not cover a lot of 
people who are going to need care. A major category is childless 
adults. If you are a single man or single woman, you do not get any 
assistance here. That does not make any sense. It does make sense to 
give assistance to women and children, but it does not make sense not 
to give any assistance to a single man or a single woman. That is an 
effect of the waiver that the administration is talking about.
  Why create all these additional misconceptions? Let's say, as the 
legislation does: OK, we are going to utilize this Medicaid safety net, 
and I don't care whether you are single, you are a parent, you are old, 
or what; if you do not have the income, you are covered. We are going 
to help you out for 5 months. What is wrong with that? Doesn't that 
make sense? To me, it makes a lot more sense.
  It is important to add, too, this legislation is strongly supported 
by the Governors in the States affected. It is bipartisan, supported by 
Republican Governors, Democratic Governors. Governor Riley of Alabama 
wants the legislation. Governor Barbour of Mississippi wants this 
legislation. Governor Blanco of Louisiana wants this legislation. It is 
supported by Republicans and Democrats.
  A lot of Senators around here say: Well, gee, the local people know 
what the needs are. The local people know best. We in Congress are too 
top-down. We issue these ultimatums, we pass this legislation, but it 
is the local people who know.
  It is important to note, the local people want this. It is the local 
people who are asking us for this. The Senators from Louisiana--from 
both sides of the aisle--want this. Senator Lott and Senator Cochran 
want this. It is the same with the Senators from Alabama, who are both 
Republicans. They want this legislation. It is the same with the 
Senators from Louisiana. One is a Republican and one is a Democrat. 
They want this. I mentioned the Governors want it. The House 
delegations want it. Again, I remind my colleagues, it is temporary. It 
is only for 5 months, this Medicaid help.
  Now let's get into the question of uncompensated care to hospitals. 
This legislation--again, scrubbed, worked over--provides for $800 
million of uncompensated care to providers in the States affected, to 
be administered by HHS, and grants for uncompensated care for those 
hospitals; whereas, the administration says: Well, we will give 
uncompensated care in waivers. But we are not saying how much. We are 
not saying how. It is only a promise. I am saying, it is deeds. It is 
not words. It is deeds.
  I might also add the waiver process the administration talks about as 
an alternative has huge, big problems, to be honest about it. What are 
they? Well, the basic problem is this. The administration says: OK, we 
will make you States whole under Medicaid; that is, you have the 
charges, then you bill us, and we will pay you. There is a real 
question whether they have the authority under the law to do that. It 
is a huge issue. In fact, coming to work today, I heard a George 
Washington professor talk about this. She says under the law they 
cannot do that.
  Do you know what I think is going to happen? Some are going to duck 
under this waiver ``idea'' saying: OK, it will make you whole, States. 
Then there will be a big debate whether legally the administration can 
do that. Then, well, it kind of fades away and--guess what--these 
States are not going to get it. These hospitals are not going to get 
that extra uncompensated care, either.
  All I am saying is, this is a quick, certain way. It is Medicaid. We 
all know Medicaid. We know it works. The provider networks are set up. 
The process is set up. The people are there. So let's raise the income 
levels a little bit--just a little bit--temporarily, for 5 months. 
Let's get on with it, rather than this very uncertain administrative 
idea of waivers and what they are, what they can and cannot do.
  We have already established under the law one thing they cannot do. 
They cannot give Medicaid assistance by picking and choosing in that 
picking and choosing, there is discrimination against who gets help and 
who does not.
  Katrina survivors need to know, are they going to get any help or 
not? They do not need the additional worry of whether they are going to 
be discriminated against.
  Finally, I would like to say, this question before us, to a large 
degree, tests us as a Nation, as a people, as a Senate, as a Congress. 
Who are we? What do we stand for? Are we going to stand here and bicker 
over minute details while people need help? Are we going to be kind of 
FEMA-like and be hesitant and not respond immediately? What signal does 
that send? What signal does that send to the people affected? What 
signal does that send to the rest of the country? What signal does that 
send to the world?
  Here we are, the Congress is bickering over whether to provide health 
care benefits to the people who need them, people who are down and out 
because of a natural disaster.

  We are supposed to be America, a big heart, model for the world. 
Sure, we have to make sure there is no waste. That is one of the 
reasons we should go through Medicaid. There are already antifraud 
provisions and protections set up under Medicaid today. That is already 
in existence. It is pretty simple. It doesn't take rocket science to 
figure this one out. Let's help these people. Let's do it now. We will 
take up other disaster assistance matters in subsequent weeks and days 
and have an opportunity then to make adjustments that may or may not 
seem necessary. But at the very least, let's pass this legislation now.
  We are going to pass it. Obviously, if you are going to do something, 
you might as well do it earlier rather than later and get on with it so 
we can get on with other things. We are going to pass this. I hope 
Senators who are opposed to this, for reasons I can't fully understand, 
will finally sit down and say: OK, sometimes discretion is the better 
part of valor. Let's pass it and get on with it.
  The PRESIDING OFFICER. The Senator from Arizona.

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