[Congressional Record Volume 151, Number 154 (Friday, November 18, 2005)]
[Extensions of Remarks]
[Page E2412]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     DEFICIT REDUCTION ACT OF 2005

                                 ______
                                 

                               speech of

                          HON. ELIOT L. ENGEL

                              of new york

                    in the house of representatives

                      Thursday, November 17, 2005

  Mr. ENGEL. Mr. Speaker, the majority should be absolutely ashamed of 
the bill before us today. It is simply unconscionable that the majority 
is not only moving forward with reconciliation but that they are 
increasing cuts all under the guise of paying for Hurricane Katrina 
relief. Under their rules, they won't even allow amendments to this 
monstrosity--shutting down any meaningful opportunity of offering even 
slight improvements to this bill. The fact of the matter is that the 
irresponsible tax cuts for the wealthy have run our country's fiscal 
order into the red with over $8 trillion in debt. Even before Hurricane 
Katrina, the budget resolution called for $35 billion in cuts to 
programs for the poor to partially offset the $106 billion in tax cuts 
in the same budget resolution. The math simply doesn't add up.
  It is interesting that the majority continues to use terms like 
personal responsibility when justifying the draconian cuts to services, 
cruel penalties and cost sharing for the poor that will essentially 
block access to care while failing to exercise the same responsibility 
in their own fiscal disorder. The general fund of the Government of the 
United States is paid for with borrowed money, over $1 billion a day. 
To make ends meet while continuing to pass tax cuts, we borrow heavily 
from China, Japan and other foreign nations, knowing full well our 
children and grandchildren will one day be saddled with our debt. In 
the meantime, they pretend we can shore up our economy with a few 
simple reforms that will have devastating consequences for the most 
vulnerable children, seniors and other impoverished people, which won't 
really affect the trillions of dollars of debt created by the 
majority's fiscal irresponsibility.
  What is irresponsible are the billions of dollars in cuts the 
majority is making to the Medicaid program. We already have 45 million 
uninsured Americans. Without Medicaid and SCHIP, the percentage of 
uninsured Americans, including children, would be a lot higher. As we 
all know, health care coverage isn't meaningful unless it is accessible 
and comprehensive. The proposals included in this bill will undoubtedly 
prove to be a barrier to care as it permits States to significantly 
increase the amounts Medicaid beneficiaries payout of pocket for 
premiums and copayments for healthcare services, again, all in the name 
of personal responsibility.
  Mr. Speaker, but what about the low-income mother trying to care for 
her family by stretching her budget to cover housing, electricity, 
clothing and now increased cost-sharing and copayments for medical 
care? Why are we setting her up for failure when she has to make 
choices between her medical care and her children and her utility 
bills, all important to the wellbeing of her and her family? How have 
we fulfilled our professional responsibility if we put her in the 
position of making these impossible choices? I can assure you, these 
mothers are as familiar with personal responsibility and strapped 
budgets as any Member of Congress in this room.
  Part of the problem that I have with these proposals are that the 
``reforms'' are budget driven in that the solutions offered are far 
less important than the anticipated savings associated with them. I 
urge this committee to scrap these massive changes to Medicaid. While 
there are certainly ways to modernize, improve, and reform this 
program, it must be done with the compassion and thoughtful 
consideration it deserves.
  A sensible improvement to this bill would be to permit early 
treatment under Medicaid to those with HIV. Under current Medicaid 
rules, most HIV positive people must meet both an income standard and 
be disabled--by AIDS--before they can receive access to Medicaid 
provided care and treatment that could have prevented them from 
becoming ill so quickly. This policy runs counter to current Federal 
HIV treatment guidelines which call for early access to medical care 
and treatment including the use of combination antiretroviral therapy. 
Medical costs for those with advanced AIDS are significantly higher 
than costs for caring for HIV positive people, and this is a burden on 
the States' Medicaid budgets.
  I offered an amendment in the Energy and Commerce Committee markup 
for Medicaid reform to give States the OPTION of amending their 
Medicaid eligibility requirements to included uninsured, pre-disabled 
low-income people living with HIV. ETHA, which has been introduced by 
Leader Pelosi in prior Congresses and Senator Smith and Senator Clinton 
in the Senate, is modeled after the successful Breast and Cervical 
Cancer Prevention and Treatment Act, BCCA, that allows States to 
provide early access to Medicaid to women with cancer. Forty nine 
States have implemented the BCCA, designed to preserve health and 
prevent unnecessary and high-cost medical interventions. As with the 
BCCA, ETHA includes an enhanced Federal match rate of 65 percent to 83 
percent to encourage States to participate in offering the services.
  Although my amendment failed in committee, Senators Clinton and Smith 
successfully offered a demonstration version of the Early Treatment for 
HIV Act on the Senate floor. I tried to offer that amendment on the 
House floor but the Republican leadership would not permit any 
amendments. It is my fervent hope that this provision survives 
conference.
  Outside of the jurisdiction of the Energy and Commerce Committee, on 
which I serve, are even more cruel cuts to working families and 
vulnerable populations. Billions in cuts to student aid programs, child 
support enforcement, foster care and SSI disability payments. They cut 
food stamps, eliminated nutritional school lunch and breakfast programs 
for hundreds of thousands of families and children--the list goes on.
  Mr. Speaker, you should be ashamed to allow our Congress to even 
consider such proposals, let alone vote on them, while continuing to 
promote tax cuts for the wealthy. I vote ``no'' on this monstrosity and 
urge my colleagues to do the same.

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