[Congressional Record Volume 153, Number 145 (Thursday, September 27, 2007)]
[Senate]
[Pages S12255-S12258]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MAKING CONTINUING APPROPRIATIONS FOR THE FISCAL YEAR 2008
The PRESIDING OFFICER. Under the previous order, the Senate will
proceed to the consideration of H.J. Res. 52, which the clerk will
report.
The bill clerk read as follows:
A joint resolution (H.J. Res. 52) making continuing
appropriations for the fiscal year 2008, and for other
purposes.
The Senate proceeded to consider the joint resolution.
extending the medicare section 508 program
Mr. SPECTER. Mr. President, Senator Casey and I, along with our
colleagues, Senators Stabenow, Conrad, Lautenberg, Schumer and Dorgan,
filed an amendment to H.J. Res. 52, the appropriations continuing
resolution for fiscal year 2008, to extend the Medicare section 508
program for 2 years. For a considerable period of time, there have been
a number of hospitals in Pennsylvania and across the country that have
been suffering from low Medicare wage index reimbursement, which has
caused them great disadvantage in comparison to surrounding areas.
Hospitals in these counties are surrounded by MSAs--metropolitan
statistical areas--with higher Medicare reimbursements, and as a
result, a flight of critical medical personnel occurs as hospitals are
not able to provide employees with competitive wages.
During the consideration of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003, I met with Finance
Committee chairman Charles Grassley and ranking member Max Baucus about
the bill provisions, including the need for a solution to the Medicare
area wage index reclassification problem in Pennsylvania. Section 508
was included in the bill, which provided $300 million per year for 3
years to increase funding for hospitals nationally to be reclassified
to locations with higher Medicare reimbursement rates. As part of the
Tax Relief and Health Care Act, which was signed into law on December
20, 2006, a 6-month extension of the section 508
[[Page S12256]]
Medicare wage index program until September 30, 2007, was included.
Mr. CASEY. I thank my colleague, Senator Specter, for his important
work over the years on this issue, and I greatly appreciate our
collaboration since I have taken office to find both an immediate and a
long-term solution to the wage index problem. This issue is critical to
ensuring that health care is available to Pennsylvanians and all
Americans in areas that are being underfunded by the Medicare wage
index reimbursement system. Further complicating this issue are the
exceptions to the Medicare wage index regulations. Since 1987,
exceptions have been created to the wage index program for rural
facilities, new facilities and others. In fact, in 1999, Congress
passed legislative reclassifications for specific hospitals to allow
selected facilities to move to a new MSA and receive greater Medicare
reimbursement. While these reclassifications have improved funding for
those hospitals, hospitals that did not receive improved funding are
being further disadvantaged.
Mr. CONRAD. I, too, want to lend my support for a 2-year extension of
the Medicare section 508 hospital program. As the chairman and ranking
member well know, I worked within the Finance Committee during the
Medicare Modernization Act to create this vital program. For too long,
Medicare has shortchanged Rural States, like North Dakota, in the wage
index formula by not accurately reflecting real wages. Furthermore, the
reclassification system has been biased towards urban areas and has
failed to take into account the rural health care system experience
where service areas overlap and facilities routinely compete across
several hundreds of miles for professional staff. The section 508
program has helped to somewhat level the playing field for these
hospitals--allowing them to improve their wages and make other
significant investments--but its continuation is critical to ensuring
the financial viability of many hospitals in North Dakota. The Congress
must pass Medicare legislation this fall that includes a 2-year
extension of the section 508 program.
Mr. BAUCUS. I appreciate the leadership my colleagues have shown on
this important issue. Extending the section 508 program is a priority
of the Finance Committee. Unfortunately, an agreement could not be
reached to include this provision in this bill.
Mr. GRASSLEY. I thank my colleagues for introducing this amendment.
This program provides vital funding for many hospitals including those
in Iowa, and I was very disappointed that the House blocked our attempt
to extend this program. It is unfortunate. Extending this program,
however, does not address fundamental problems related to the wage
index system. As mandated under the Tax Relief and Health Care Act of
2006, the Medicare Payment Advisory Commission, MedPAC, released their
report examining an alternative Medicare wage index methodology. The
legislation also requires the Secretary of Health and Human Services to
propose revisions to the wage index in the fiscal year 2009 Medicare
hospital inpatient prospective payment system proposed rule. I look
forward to considering this proposal as we continue our work to make
Medicare hospital payments more equitable.
Ms. STABENOW. I also wish to thank Senators Specter and Casey for
raising this issue. We have worked together to ensure the continuation
of 508 while we work to ensure that Medicare reimbursement more
adequately reflects our hospitals' true costs. Section 508 funding has
provided crucial assistance to a number of hospitals in my State,
although I note that there are still inequities in the reimbursement
system that must be corrected.
Mr. SCHUMER. Mr. President, I am, like my colleagues, strongly in
favor of extending the section 508 program. This is a critical program
for some New York hospitals, and I appreciate the chairman's commitment
to include the extension in future Medicare legislation.
Mr. LAUTENBERG. I would also like to thank the chairman and ranking
member for their leadership on this issue and Senators Specter and
Casey for their continued support. Without an extension of the section
508 program, hospitals in New Jersey stand to lose over $22 million.
These hospitals cannot afford to sustain this loss and still provide
the care needed to New Jersey residents. I look forward to working with
my Senate colleagues to provide an extension of this important program.
Mr. DORGAN. I thank Senators Specter and Casey for raising this
issue. Extending the section 508 program is critical for many North
Dakota hospitals and is an important step to address the long-standing
inequities in Medicare payment between urban and rural providers. I
appreciate the commitment of the chairman and ranking member of the
Finance Committee and look forward to working with them to see that
this extension is enacted.
Mr. CASEY. I thank the chairman and ranking member of the Finance
Committee for their support on this issue. The House of Representatives
has already moved forward to pass legislation that would extend this
program. This program is scheduled to expire on September 30, 2007, and
action to extend the program for 2 years must be taken. Mr. Chairman, I
appreciate our conversations about this issue in which you expressed
your commitment to working to pass an extension to the section 508
Medicare wage index program this fall that will also make hospitals
whole to the date of expiration.
Mr. SPECTER. I understand that the Senate is likely to take up
legislation which will include a number of Medicare provisions during
this session of Congress. I would appreciate the assurance of the
chairman and ranking member of the Finance Committee that any Medicare
related legislation that is considered by the Senate this session
include a 2-year extension of the section 508 program that is
retroactive to October 1, 2007.
Mr. BAUCUS. I assure my colleagues that I am committed to working to
address concerns about this issue as part of any Medicare related
legislation that may come before the Senate.
Mr. GRASSLEY. I look forward to working with Chairman Baucus and
other Finance Committee members to address this issue.
Mr. SPECTER. I thank my colleagues and look forward to working with
them on this issue.
Mr. CASEY. I thank my colleagues as well and look forward to
resolving this issue.
eas
Mr. CARDIN. Mr. President, with regard to the fiscal year 2008
continuing resolution that the Senate is taking up today, I would like
to pose a question to the Senators from West Virginia and Washington.
It is my understanding that the Commerce Committee has drafted a bill
to reauthorize the Federal Aviation Administration, FAA, and that bill,
S. 1300, should reach the Senate floor this session. That bill includes
language with regard to Essential Air Service, EAS, to extend the
state-determined mileage waiver. I thank the Committee for its work on
that provision as it affects an airport in my State, as well as
airports in South Dakota and Pennsylvania. In the interim, I would like
to clarify that it is the intention of the Appropriations and Commerce
Committees that EAS support continue for the airports in Hagerstown,
MD; Brookings, SD; and Lancaster, PA along with the other airports
nationwide that will continue to receive EAS funding through the
Continuing Resolution today. I would direct this question to the
chairman of the Commerce Subcommittee on Aviation Operations, Safety &
Security if it his intent to continue EAS support for airports in
Hagerstown, MD; Brookings, SD; and Lancaster, PA?
Mr. ROCKEFELLER. Yes. We do hope to pass the full FAA authorization
this session, and it contains the EAS mileage waiver. In the interim,
it is the intent of the Committee that EAS funding should continue to
these airports.
Mr. CARDIN. I would further like to get the views of the chairman of
the Appropriations Subcommittee on Transportation, Housing and Urban
Development, and Related Agencies on this matter.
Mrs. MURRAY. This continuing resolution provides funding for the
Essential Air Service program at the current rate with the expectation
that the program shall continue to function as it is functioning now.
We expect the Department of Transportation to avoid any major policy
decisions that can impact
[[Page S12257]]
this program during the period of the continuing resolution--especially
given the fact that there is already legislation reported out of
committee and awaiting Senate action that addresses the continuation of
air service to these communities.
Ms. MIKULSKI. I commend my colleague from Maryland for addressing
this issue. I am a member of the Appropriations Committee and I, too,
understand that the Committee intends to continue EAS funding under the
continuing resolution to airports in Maryland, South Dakota, and
Pennsylvania that currently receive it.
Mr. SPECTER. This issue also affects an airport in my home State, in
Lancaster, PA. Based on the provisions in the full FAA authorization, I
agree that it is the intent of the committee that EAS funding should be
extended to the airports currently affected by the EAS state-
determination mileage waiver.
Mr. JOHNSON. An airport in Bookings, SD, is also affected by the
state-determination mileage waiver. So I am pleased to hear from all of
my fellow appropriators that EAS funding should continue uninterrupted
to the affected airports.
Mr. CARDIN. I thank all of my colleagues--both those responsible for
the FAA reauthorization and those responsible for appropriating the
funding for EAS--for making it clear that they expect the airports in
Hagerstown, Lancaster, and Bookings to receive EAS funding under the
continuing resolution.
Mr. FEINGOLD. Mr. President, I am disappointed that we are about to
begin the 2008 fiscal year without having enacted any of the
appropriations bills for that year. I am even more disappointed that we
are about to vote on a continuing resolution that provides tens of
billions of dollars to continue the misguided war in Iraq but does not
include any language to bring that war to a close. We need to keep the
Federal Government operating and make sure our brave troops get all the
equipment and supplies they need, but we should not be giving the
President a blank check to continue a war that is hurting our national
security. For that reason, I will be voting against this resolution.
Mr. COCHRAN. Mr. President, I would like to take a moment to speak
about the continuing resolution on which the Senate will soon vote. The
resolution itself is a reasonable product that is largely the result of
bicameral, bipartisan discussions. The resolution will allow the day-
to-day functions of our Government to continue and will provide at
least some of the additional funding that is necessary for our troops
in Iraq and Afghanistan to execute the mission with which they have
been tasked. It is also worth noting that the resolution does not
attempt to use its inherent leverage to force any significant or
controversial policy changes. I urge my colleagues to support passage
of the resolution.
But as we come to the end of the fiscal year, I must express my deep
concern about the lack of progress toward enacting the appropriations
bills. This lack of progress is not the fault of the Appropriations
Committee. Under Chairman Byrd's leadership, the committee reported all
twelve bills in ample time to be considered by the full Senate over the
course of the summer. But for whatever reason, to date the Senate has
passed only four of the twelve regular appropriations bills, and
prospects for consideration of the remaining bills appear uncertain at
best.
Last year, under Republican leadership, the Senate failed to send all
but two of the appropriations bills to the President. We were roundly
criticized for this, and rightly so. As a result we left Federal
agencies to limp along on a continuing resolution for 5 months, and
were then presented with a full-year, formula-driven joint funding
resolution to which no Senator had an opportunity to offer amendments.
That is a process that I hope will not be repeated. No Senator should
want that.
We simply need to buckle down and do our work. It is true that the
President has said he will veto many of the appropriations bills based
on his concerns about spending levels. It seems that there are people
on both sides of the aisle and both ends of Pennsylvania Avenue who
feel strongly about that question, and who are quite anxious to have
that debate. But we can't have the debate if we don't call up the
bills. The President can't veto what we haven't presented to him, and
Congress can't vote to uphold or override a veto that never gets
executed.
I understand that completing action on the remaining bills seems like
a daunting task. But I know of no better way to complete such a task
than to roll up our sleeves and get to work. I am pleased to hear the
majority leader suggest that next week we will consider the Defense and
the Commerce-Justice-Science appropriations bills. This is good news. I
urge my colleagues to offer their amendments promptly when these bills
are called up and to recognize that the opportunity to offer amendments
to the subsequent bills is dependent on completing action on the
pending bills.
It is particularly critical that we complete action on the Defense
appropriations bill and the supplemental appropriations necessary to
support the men and women in our Armed Forces and our diplomatic corps.
While I am encouraged that we may consider the regular Defense
appropriations bill next week, I am seriously concerned about reports
that Congress may not consider a supplemental appropriations bill for
the global war on terror until next year. While the continuing
resolution we will pass tonight contains some ``bridge'' funding to
support the troops through November 16, is an inadequate amount for the
longer term.
As directed by Congress, the President submitted an FY 2008 war
supplemental request in February. We expect to receive an amendment to
that request any day. The Appropriations Committee held a hearing on
these requests on Wednesday, and should be prepared in short order to
act on legislation to fund our troops in the field. Delaying
consideration of such legislation until next year is simply
unacceptable. We have spent the last 2 weeks, and much of this
Congress, in earnest and often useful debate on Iraq war policy.
Amendments have been offered and votes have been taken. Deeply felt
disagreements remain.
But the fact is that we have tens of thousands of American men and
women in Iraq and Afghanistan performing the mission that their
Government has assigned to them. The new fiscal year is upon us, and it
is time for us to get on with the business of providing our men and
women in uniform the resources they need to perform that mission
successfully. To try to change American policy in Iraq by slowly
starving our troops of those resources is unfair, and it is dangerous
to American interests.
I urge the Senate to both forge ahead to complete action on the
regular appropriations bills and to act promptly to provide our troops
with the supplemental funds that they need.
Mr. COBURN. Mr. President, I ask for the yeas and nays.
Mr. SANDERS. Is there a sufficient second? There appears to be a
sufficient second.
The question is on the third reading of the joint resolution.
The PRESIDING OFFICER. The joint resolution having been read the
third time, the question is on passage of the joint resolution.
The clerk will call the roll.
The bill clerk called the roll.
Mr. DURBIN. I announce that the Senator from Delaware (Mr. Biden),
the Senator from New York (Mrs. Clinton), and the Senator from Illinois
(Mr. Obama) are necessarily absent.
Mr. LOTT. The following Senators are necessarily absent: the Senator
from Kansas (Mr. Brownback) and the Senator from Arizona (Mr. McCain).
The PRESIDING OFFICER. Are there any other Senators in the Chamber
desiring to vote?
The result was announced--yeas 94, nays 1, as follows:
[Rollcall Vote No. 355 Leg.]
YEAS--94
Akaka
Alexander
Allard
Barrasso
Baucus
Bayh
Bennett
Bingaman
Bond
Boxer
Brown
Bunning
Burr
Byrd
Cantwell
Cardin
Carper
Casey
Chambliss
Coburn
Cochran
Coleman
Collins
Conrad
Corker
Cornyn
Craig
Crapo
DeMint
Dodd
Dole
Domenici
Dorgan
Durbin
Ensign
Enzi
Feinstein
Graham
Grassley
Gregg
Hagel
Harkin
Hatch
Hutchison
Inhofe
Inouye
Isakson
Johnson
Kennedy
Kerry
Klobuchar
Kohl
Kyl
Landrieu
Lautenberg
Leahy
Levin
[[Page S12258]]
Lieberman
Lincoln
Lott
Lugar
Martinez
McCaskill
McConnell
Menendez
Mikulski
Murkowski
Murray
Nelson (FL)
Nelson (NE)
Pryor
Reed
Reid
Roberts
Rockefeller
Salazar
Sanders
Schumer
Sessions
Shelby
Smith
Snowe
Specter
Stabenow
Stevens
Sununu
Tester
Thune
Vitter
Voinovich
Warner
Webb
Whitehouse
Wyden
NAYS--1
Feingold
NOT VOTING--5
Biden
Brownback
Clinton
McCain
Obama
The joint resolution (H.J. Res. 52) was passed.
The PRESIDING OFFICER. The majority leader.
Mr. REID. Mr. President, I move to reconsider the vote and I move to
lay that motion on the table.
The motion to lay on the table was agreed to.
Mr. REID. I ask unanimous consent to withdraw the order that relates
to Senator Menendez on this matter.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. REID. I also ask unanimous consent that the next votes be 10-
minute votes.
The PRESIDING OFFICER. Without objection, it is so ordered.
____________________