[Congressional Record (Bound Edition), Volume 145 (1999), Part 20]
[Extensions of Remarks]
[Page 29070]
[From the U.S. Government Publishing Office, www.gpo.gov]



  MEDICARE, MEDICAID, AND SCHIP BALANCED BUDGET REFINEMENT ACT OF 1999

                                 ______
                                 

                               speech of

                          HON. JERROLD NADLER

                              of new york

                    in the house of representatives

                        Friday, November 5, 1999

  Mr. NADLER. Mr. Speaker, I rise today to explain my vote against H.R. 
3075, the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act. 
This bill makes several important restorations of cuts that were made 
to the Medicare program in the Balanced Budget Act of 1997. However, 
this bill also includes a provision that would hurt New York City's 
teaching hospitals and render meaningless the other positive measures 
in this bill.
  Mr. Speaker, America's hospitals are hurting and they need relief 
from the mammoth cuts made by the Balanced Act. I was one of the few 
lawmakers who voted against the Balanced Budget Act because I knew it 
would have these consequences. We should not be surprised that cutting 
over $200 billion from Medicare would cause the quality of care to 
suffer in many hospitals. In New York State alone, it has been 
estimated that hospitals have lost over $550 million so far and could 
face up to $3 billion more in cuts over 5 years without new 
legislation. H.R. 3075 would make a small, but important, down payment 
toward restoring those cuts.
  However, it is shameful that in the name of providing relief, this 
bill would create even more pain for New York. At the last minute, a 
provision was added to change the methodology by which Medicare 
reimburses teaching hospitals for their direct medical education costs 
from one based on actual cost to one based on national average costs. 
This would shift over $45 million a year from New York State, where 
costs are well above the national average, to other parts of the 
country. In my district alone, teaching hospitals would lose almost $12 
million in the first five years this provision would be in effect. 
Teaching hospitals help train the next generation of physicians. It 
would be unwise to shortchange this investment for the future.
  It is unfortunate that this provision was inserted at the last minute 
during the final negotiations, from which Democrats were frozen out. In 
addition, H.R. 3075 was brought up under suspension of the rules, 
allowing little debate and no opportunity to offer an amendment to 
rectify the situation.
  America's hospitals need relief from the deep cuts made in 1997. I 
hope that we will find a way to do this without pitting states against 
each other.

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