[Congressional Record (Bound Edition), Volume 145 (1999), Part 21]
[Senate]
[Pages 30552-30555]
[From the U.S. Government Publishing Office, www.gpo.gov]



           TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT

  Mr. JEFFORDS. Mr. President, I thank the Senator from Massachusetts. 
I would be happy if he desires to more fully discuss what we have done. 
I was not here to hear his full speech. I thank him. We have worked 
together. He was here years before I came to the Senate. In 1975, we 
had the initial big step forward for the disabled and were able to set 
up the 94142, as it was called then, to make sure all children got a 
good education, and specially those with disabilities.
  As we have walked through this over a period of many years, we have 
fought year by year to remove block by block what the disabled 
community has had to face. Finally, we are at that point where we are 
opening the final door to allow them to do what all disabled want to 
do, and that is to have a meaningful life, to be able to seek 
employment, and get employment without having the doors slammed because 
they lost their benefits.
  I can't thank the Senator enough for what he has done. Also, there 
are others, some who have left this body, such as Bob Dole, who was 
another leader for the disabled. I praise him also for the work he did, 
and especially in this area where he helped us introduce the bill that 
we were so happy to be able to cosponsor and to see it put into the 
final steps.
  I thank the Senator from Massachusetts profusely for all he has done. 
I would be happy to yield for any further comment.

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  Mr. KENNEDY. As I mentioned earlier, this has been a continuing 
process beginning with the passage of the Americans With Disabilities 
Act, when we put into law protections for the disabled so they wouldn't 
be discriminated against in the workplace based upon their disability.
  As the Senator knows very well, that has been enormously important 
and has been effective. But as the Senator has pointed out, with this 
legislation complimenting what has been achieved with the Americans 
With Disabilities Act, we can open an entirely new dawn for millions 
who have some disability.
  As we are getting closer to achieving that, I am sure the Senator 
agrees with me that when we finally have the President's signature on 
this, there will be people saying: What has taken them so long? This is 
such a commonsense approach. But as the Senator knows, this has been a 
battle every step of the way. There have been those who have felt that 
if we do this for this particular group, we might be establishing some 
form of precedent that may be used somewhere down the road, and worry 
if we know where it might lead.
  There are a number of strong negative voices out there. Nonetheless, 
I think with the leadership of the Senator from Vermont and others--he 
mentioned certainly Senator Dole, Senator Weicker, and our good friend 
on our human resources committee, Tom Harkin, who is generally 
recognized in this body as one of the real authorities on disability 
issues--this has been a common effort of this institution. It is an 
area of public policy where this institution has done what it is 
challenged to do; and that is to find common ground in a bipartisan way 
to address a common concern that affects millions of Americans and make 
progress on it.
  I again thank the Senator from Vermont for the opportunity to work 
with him. We still have a ways to go to make sure the legislation 
actually reaches the people and addresses the regulations in the way it 
is intended. But I think this is going to be enormously important--and 
I hope soon to finally have the President's signature on this 
legislation. We are much closer today than we have ever been in the 
past.
  I join with the Senator to thank him for his good work. We hope to 
see that this is actually put into place and implemented so it will 
benefit those that it should benefit.
  I thank the Senator.
  Mr. JEFFORDS. Mr. President, again, I thank the Senator from 
Massachusetts for those comments and for all the work he has done.
  I am delighted to stand before you today, to speak about an extremely 
important piece of legislation. The bill we are sending to the 
President today, a bill I know he is eager to sign into law, will have 
a tremendous impact on people with disabilities. In fact, this 
legislation is the most important piece of legislation for the 
disability community since the Americans with Disabilities Act.
  My reason for sponsoring this particular piece of legislation is 
quite simple. The Work Incentives Improvement Act of 1999 addresses a 
fundamental flaw in current law. Today, individuals with disabilities 
are forced to make a choice . . . an absurd choice. They must choose 
between working and receiving health care. Under current federal law, 
if people with disabilities work and earn over $700 per month, they 
will lose cash payments and health care coverage under Medicaid or 
Medicare. This is health care coverage that they need. This is health 
care coverage that they cannot get in the private sector. This is not 
right.
  Once enacted, the Work Incentives Improvement Act of 1999 will allow 
individuals with disabilities, in states that elect to participate, 
continuing access to health care when they return to work or remain 
working. In addition, those individuals who seek it, will have access 
to job training and job placement assistance from a wider range of 
providers than is available at this time. Currently, there are 9.5 
million individuals with disabilities across the country who receive 
cash payments and health care coverage from the federal government. 
Approximately 24,000 of these individuals live in my home state, 
Vermont. Once enacted, the Work Incentives Improvement Act will 
actually save the federal government money. For example, let's assume 
that 200 Social Security disability beneficiaries in each state return 
to work and forgo cash payments. That would be 10,000 individuals out 
of the 9.5 million individuals with disabilities across the country. 
The annual savings to the Federal Treasury in cash payments for just 
these 10,000 people would be $133,550,000! Imagine the savings to the 
Federal Treasury if this number were higher. Clearly, the Work 
Incentives Improvement Act of 1999 is fiscally responsible legislation.
  I began work on this bill in 1996. Though it was a long and sometimes 
difficult task, many hands made light work. Senator Kennedy, Ranking 
Member on the HELP Committee, joined me in March of 1997. Senators Roth 
and Moynihan, Chairman and Ranking Member on the Finance Committee 
signed on as committed partners in December of 1998. Last January, 35 
of our colleagues, from both sides of the aisle, joined us in 
introducing S. 331, the Senate version of this legislation. One week 
later, in a Finance Committee hearing, we heard compelling testimony 
from our friend, former Senator Dole, a strong supporter of this 
legislation. A month later, we marked this legislation out of the 
Finance Committee with an overwhelming majority in favor of the bill. 
Finally, on June 15th, with a total of 80 cosponsors, we passed this 
legislation on the floor of the United States Senate, with a unanimous 
vote of 99-0.
  Four months later, over 35 of our colleagues in the House of 
Representatives, took to the floor of their chamber, and spoke 
eloquently for their version of this legislation. Later that day, the 
bill passed the floor of the House with a vote of 412-9. Since then, 
the Senate and House Conferees have been working diligently in effort 
to reach common ground. I am very pleased today, that the differences 
in policy in the two different bills have been resolved and consensus 
has been reached on a conference agreement. This agreement does not 
compromise the original intent of the legislation, retaining key 
provisions from S. 331.
  From my perspective, the Work Incentives Improvement Act of 1999 
represents a natural and important progression in federal policy for 
individuals with disabilities. That is, federal policy increasingly 
reflects the premise that individuals with disabilities are cherished 
by their families, valued and respected in their communities, and are 
an asset and resource to our national economy. Today, most federal 
policy promotes opportunities for these individuals, regardless of the 
severity of their disabilities, to contribute to their maximum 
potential--at home, in school, at work, and in the community.
  I have been committed to improving the lives of individuals with 
disabilities throughout my Congressional career. Providing a solid 
elementary and secondary education for children with disabilities, so 
that they will be equipped, along with their peers, to benefit from 
post-secondary and employment opportunities is crucial. When I came to 
Congress in 1975, Public Law 94-142, the Education for all Handicapped 
Children Act, now the Individuals with Disabilities Education Act 
(IDEA), was enacted into law. IDEA assures each child with a 
disability, a free and appropriate public education. I am proud to be 
one of the original drafters of this legislation which has reshaped 
what we offer to and expect of children with disabilities in our 
nation's schools.
  In addition, I have been committed to providing job training 
opportunities for individuals with disabilities. In 1978, I played a 
central role in ensuring access to programs and services offered by the 
federal government for individuals with disabilities through an 
amendment to the Rehabilitation Act. I believe that this amendment 
alone laid the foundation for significant legislation that followed, 
including the Technology-Related Assistance for Individuals with 
Disabilities Act of 1988, now the Assistive Technology Act of

[[Page 30554]]

1998, both of which I drafted. Most importantly, this legislation 
opened the doors for the most comprehensive piece of legislation of 
all, the Americans with Disabilities Act of 1990. This legislation 
prohibits discrimination on the basis of disability in employment, 
public services, public accommodations, transportation, and telephone 
service.
  These laws have forever changed the social landscape of America. They 
serve as models for other countries who recognize that their citizens 
with disabilities are an untapped resource. In our country, individuals 
with disabilities are seen everywhere, doing everything. Just this past 
weekend, thousands of physically disabled individuals participated in 
the New York City Marathon, as they have been doing for years. The 
expectations that these people set for themselves and the standards we 
apply to them have increasingly been raised, and now in many 
circumstances equal those set and applied to other individuals.
  Unfortunately, one major inequity remains. That is, the loss of 
health care coverage if an individual on the Social Security disability 
rolls chooses to work. Individuals with disabilities want to work. They 
have told me this. In fact, a Harris survey found that 72 percent of 
Americans with disabilities want to work, but only one-third of them do 
work. With today's enactment of the Work Incentives Improvement Act of 
1999, individuals with disabilities will no longer need to worry about 
losing their health care if they choose to work a forty-hour week, to 
put in overtime, or to pursue career advancement. Individuals with 
disabilities are sitting at home right now, waiting for this 
legislation to become law. Having a job will provide them with a sense 
of self-worth. Having a job will allow them to contribute to our 
economy. Having a job will provide them with a living wage, which is 
not what one has through Social Security.
  In addition to continuing health care coverage and providing job 
training opportunities for individuals with disabilities, this 
legislation offers many other substantial long-term benefits. The Work 
Incentives Improvement Act of 1999 will give us access to data 
regarding the numbers, the health care needs, and the characteristics 
of individuals with disabilities who work. Furthermore, this 
legislation will provide the federal government as well as private 
employers and insurers, the facts upon which to craft appropriate 
future health care options for working individuals with disabilities. 
It will allow employers and insurers to factor in the effects of 
changing health care needs over time for this population. Hopefully, it 
will even improve the way in which employers operate return-to-work 
programs. Through increased tracking of data, we will learn the 
benefits of intervening with appropriate health care, when an 
individual initially acquires a disability. We will also learn the 
value of continuing health care to a working individual with a 
disability. If an individual, even with a severe disability, knows that 
he or she has access to uninterrupted, appropriate health care, the 
individual will be a healthier, happier and thus more productive 
worker.
  I would like to take the time now to briefly outline the major 
provisions which have remained as part of this legislation. The 
conference agreement retains the two state options of establishing 
Medicaid buy-ins for individuals on Social Security disability rolls, 
who choose to work and exceed income limits in current law, as well as 
for those who show medical improvement, but still have an underlying 
disability. For working individuals with disabilities, the conference 
agreement extends access, beyond what is allowed in current law, to 
Medicare. In addition, the legislation before us today retains several 
key provisions from S. 331, including, the authority to fund Medicaid 
demonstration projects to provide access to health care to working 
individuals with a potentially severe disability; the State 
Infrastructure Grant Program, to assist states in reaching and helping 
individuals with disabilities who work; work incentive planners and 
protection and advocacy provisions; and finally, most of the provisions 
in the Ticket to Work Program.
  In order to control the cost of this legislation, compromises were 
made. Although the purpose of the State Infrastructure Grant Program 
and the Medicaid Demonstration Grant Program remain the same, the terms 
and conditions of these grants were altered in conference. As a result, 
states are not required to offer a Medicaid buy-in option to 
individuals with disabilities on Social Security, who work and exceed 
income limits in current law, prior to receiving an Infrastructure or a 
Medicaid Demonstration Grant.
  Also in Conference, the extended period of eligibility for Medicare 
for working individuals with disabilities has been changed from 24 to 
78 months. During this extended period, the federal government is to 
cover the cost of the Part A premium of Medicare for a working 
individual with a disability, who is eligible for Medicare. S. 331 
would have extended such coverage for an individual's working life, if 
he or she became eligible during a 6-year time period.
  I would like to note two changes to the Ticket to Work program made 
during Conference. The new legislation shifts the appointment authority 
for the members of the Work Incentives Advisory Panel from the 
Commissioner of Social Security to the President and Congress. In 
addition, language regarding the reimbursements between employment 
networks and state vocational rehabilitation agencies was deleted in 
Conference. The new legislation gives the Commissioner of Social 
Security the authority to address these matters through regulation.
  Although several changes have been made from the original Work 
Incentives bill, I am still very pleased with what we are adopting 
today. This is legislation that makes sense, and it will contribute to 
the well-being of millions of Americans, including those with 
disabilities and their friends, their families, and their co-workers. 
Today's vote provides us the opportunity to bring responsible change to 
federal policy and to eliminate a misguided result of the current 
system--if you don't work, you get health care; if you do work, you 
don't get health care. The Work Incentives Improvement Act of 1999 
makes living the American dream a reality for millions of individuals 
with disabilities, who will no longer be forced to choose between the 
health care coverage they so strongly need and the economic 
independence they so dearly desire.
  In closing, I would like to thank the many people who contributed to 
reaching this day. I especially thank the conferees, Majority Leader 
Lott, Senators Roth and Moynihan, and in the House, Majority Leader 
Armey, and Congressmen Archer, Bliley, Rangel, and Dingell. I also 
thank their staff who worked so closely in effort to reach this day. 
From my staff, I thank Pat Morrissey, Lu Zeph, Leah Menzies, Chris 
Crowley, and Kim Monk. I want to recognize and extend my appreciation 
to the staff members of my three fellow sponsors of this bill; Connie 
Garner in Senator Kennedy's office, Jennifer Baxendell and Alexander 
Vachon with Senator Roth, and Kristen Testa, John Resnick, and Edwin 
Park from Senator Moynihan's staff. Finally, I wish to thank Ruth Ernst 
with the Senate Legislative Counsel for her drafting skill and 
substantive expertise, her willingness to meet time tables, and most of 
all, her patience.
  In addition to staff, we received countless hours of assistance and 
advice from the Work Incentives Task Force of the Consortium for 
Citizens with Disabilities. These individuals worked tirelessly to 
educate Members of Congress about the need for and the effects of this 
legislation.
  Finally, I would like to urge my colleagues in both chambers to set 
aside any concerns about peripheral matters and to focus on the central 
provisions of this legislation. Let's focus on what today's vote will 
mean to the 9.5 million individuals with disabilities across the 
nation. At last, these individuals will be able to work, to preserve 
their health, to support their families, to become independent, and 
most importantly, to contribute to their communities, the economy, and 
the nation. We are making a statement, a noble

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statement and we must do the right thing. Let's send this bill to the 
President.
  Thank you, Mr. President.
  Mr. DURBIN. Mr. President, under the unanimous consent agreement, how 
much time remains in morning business?
  The PRESIDING OFFICER (Mr. Bennett). We are in morning business until 
1 o'clock, with the time equally divided between the two sides.
  Mr. DURBIN. The remaining time on the Democratic side?
  The PRESIDING OFFICER. Twenty-six minutes.

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