[Congressional Record (Bound Edition), Volume 145 (1999), Part 20]
[Extensions of Remarks]
[Page 29682]
[From the U.S. Government Publishing Office, www.gpo.gov]



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

                                 ______
                                 

                               speech of

                        HON. MICHAEL E. CAPUANO

                            of massachusetts

                    in the house of representatives

                        Friday, November 5, 1999

  Mr. CAPUANO. Mr. Speaker, this morning I voted for the Medicare 
Balanced Budget Refinement Act of 1999 (H.R. 3075) in an effort to 
address the issues associated with the Balanced Budget Act of 1997 
(BBA). While this bill represents an important step toward addressing 
the serious pitfalls contained in the BBA, I remain gravely concerned 
about sections of this bill and the overall ramifications this 
legislation will have on the financial problems affecting our nation's 
health care system.
  In particular, I am concerned in the manner with which this bill was 
brought to the floor. This legislation was finished last night, leaving 
our side with just a few hours to review the legislation. Democrats 
were all but left out of the negotiations between the Ways and Means 
and Commerce Committee Republicans over this new package. Moreover, as 
the bill was placed on this month's calendar as a suspension bill, 
Members were stripped of their rights to offer amendments and were 
allowed only twenty minutes of debate time to present their views on 
this bill. This, my friends, is the wrong way to approach legislation 
that is so critical to the delivery of health care.
  However, the Medicare Balanced Budget Refinement Act represents a 
modest downpayment towards stabilizing a health system that is in midst 
of a fiscal crisis. The BBA, was intended to reduce Medicare spending 
by $115 billion over five years but, as the act's provisions have been 
implemented, the actual reduction in Medicare spending is nearly twice 
that amount--$220 billion. Simply put, the BBA overshot its mark.
  Already, the 1999 losses for Boston teaching hospitals have exceeded 
$150 million with two-thirds of the state's hospitals losing money on 
operations. This bill would translate into only $125 million being 
restored to the state's health care institutions. Hospitals in 
Massachusetts, even under the most optimistic scenarios, are expected 
to recover only 10% of the $1.7 billion cut by the BBA. With respect to 
teaching hospitals, this bill provides a one-year freeze on Indirect 
Medical Education payments at FY2000 levels of 6.0%.
  Passage of H.R. 3075 represents an important step towards providing 
critically needed BBA relief for such providers of health care as 
teaching hospitals, home health agencies, skilled nursing facilities, 
and therapy services. This represents a first-step in trying in 
confronting the consequences of the BBA and averting the impending 
fiscal crisis facing health care providers nationwide. I therefore 
voted for this bill and hope that Democratic concerns be addressed in 
Conference.

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