[Congressional Record (Bound Edition), Volume 148 (2002), Part 11]
[Senate]
[Pages 14420-14425]
[From the U.S. Government Publishing Office, www.gpo.gov]




  GREATER ACCESS TO AFFORDABLE PHARMACEUTICALS ACT OF 2001--Continued

  The PRESIDING OFFICER. Who yields time? The Senator from Oklahoma.
  Mr. NICKLES. Mr. President, how much time remains on both sides?
  The PRESIDING OFFICER. Almost 17 minutes on the Republican side and 7 
minutes on the Democrat's side.
  Mr. NICKLES. Will the Senator yield me 8 minutes?
  Mr. GRAMM. I would yield him 10 minutes. He deserves to be heard.
  Mr. NICKLES. Mr. President, I rise in support of the budget point of 
order that was raised by my colleague from Texas. I am a little 
disappointed that the chairman of the Budget Committee didn't raise it. 
It is the responsibility of the Budget Committee. I have had the 
pleasure of serving with my colleague from Texas on the Budget 
Committee. That is the reason why we have a Budget Committee and the 
reason why we tried to pass a budget. We didn't pass a budget this year 
for the first time since 1974. Shame on this Congress. Shame on this 
Senate. Shame on, frankly, the leadership in this Senate for not 
getting it done.
  It is maybe the most fiscally irresponsible thing we have not done 
and, as a result, there is no limit to how much money we can spend.
  A budget point of order still lies on an amendment such as this, or 
any amendment, until the end of September, so we are raising a budget 
point of order for good reason. My colleague from Texas and the 
sponsors of the amendment, say this is a $9 billion amendment. This 
will increase Federal spending. You can come up with a list to show 
that every State is going to benefit. I know my State is going to 
benefit $93 million. I am sure my Governor would send me a letter 
saying please vote for this; we need help. And they do.
  I agree with my colleague and very good friend from Maine. A lot of 
States are in very difficult times.
  If you have an amendment on the floor that says here is $9 billion, 
and cut it up, every State is going to benefit. You could have every 
State Governor saying pass this amendment. What is wrong with it? Yes, 
States are having a difficult time. The Federal Government is having a 
difficult time, too. The Senator from Texas pointed out that the 
Federal deficit is much

[[Page 14421]]

larger than the States' deficits. The Federal deficit, if you include 
Social Security, is $322 billion. Things may have deteriorated for 
State revenues, but they have deteriorated significantly for Federal 
revenues.
  It is not just borrowing against Social Security. It is borrowing 
against the American people. The American people are going to have to 
borrow this $9 billion. They will have to pay interest on it. My 
biggest concern is that it is not a $9 billion amendment. I know the 
amendment is temporary. I know it is retroactive.
  It is kind of interesting how we are going to spend retroactive 
money. This goes back and says we are going to increase spending going 
back to April of this year. And then presumably, we are going to do it 
through this September, and then next year.
  It is an amendment that is for about 1\1/2\ years. My concern is it 
won't be a year and a half. If you increase these formulas, States are 
going to still be in difficult times next year. They are going to say: 
Let's make this permanent. These formulas, in many respects, are good. 
We don't want them to ever go down. We never want the States to get 
less.
  If it is temporary, and here is a 1.35 percent increase in Federal 
match, what makes anybody think this won't be extended? This amendment 
is a $100 billion amendment. If it is extended, I can tell you if we 
pass this--and it may well be that my good friend from West Virginia 
has the votes. The administration is very opposed to it, illustrated in 
a letter from them that I have here. But if it becomes law, I have no 
doubt whatsoever that a year from now colleagues will say: Let's make 
this permanent. States are still in trouble. Governors will say: Let's 
make this permanent. Let's just increase the Federal share. It is free. 
It came from the Federal Government.
  I just happen to disagree with that. If this is made permanent, we 
are talking about spending $100 billion--$9 billion basically for the 
first year--$100 billion. We are just going to do that? Next year we 
may not be able to make a budget point of order if we don't figure out 
some way to get fiscal discipline. We are just going to pass $100 
billion, and have colleagues stand up and say: I can't believe these 
deficits are so high.
  This amendment increases the Federal share. It increases FMAP. Times 
are tough, and we are going to increase the Federal share on Medicare.
  Wait a minute. Times were good in the last several years when we had 
the largest surplus in the country. Did we see an increase in the 
Federal share when States were doing very well?
  We have never said this should be based on the economy or on States' 
ability to pay. The formula for the FMAP is based on the States' income 
relative to the Federal income. The States' income was much higher than 
the norm with Federal income. They paid a greater percentage, or they 
weren't subsidized to get as much. Another way to say this is that the 
poorer States were being subsidized more.
  This just kind of inverts and says the States that had the 
significant growth last year are going to get the biggest benefit out 
of this proposal.
  It doesn't do anything to fix some of the biggest fraud that is being 
perpetrated in this system right now--the upper payment limit. I wish 
my colleagues knew something about it. Maybe some do. Maybe former 
Governors do. But there is a fraud, an accounting scheme and scam that 
is going on today called upper payment limit. It is being done by about 
30 States that are ripping off the Medicaid Program and the Federal 
Government that is having difficulty. They devised a clever little 
gimmick to have the Federal Government--not pay 50 percent, not pay 60 
percent, not pay 70 percent--pay 100 percent of Medicaid costs.
  Are we fixing that? No. If we are going to deal with Medicaid, I tell 
my colleague from West Virginia and others that we are going to deal 
with the upper payment limit.
  It is sickening to me to think we are telling people we are going to 
hold private America to a strict accountability standard; we are going 
to have you sign truth-in-accounting statements, fiscal statements and 
financial statements; and, we have Governors who are ripping off the 
taxpayers of this country with an upper payment scheme and scam to 
where they get the Federal Government to pay 100 percent of their 
Medicaid costs.
  It is happening in State, after State, after State, after State.
  Have we fixed that? No. Should we fix it? Yes. Let us deal with that.
  If we are going to get into Medicaid reimbursements, let us wrestle 
with that. Have we had a markup in the Finance Committee? No. Have we 
requested it? Yes. Did we mark up this FMAP proposal? No.
  Some said: We will deal with the upper payment limits. This didn't go 
through the Finance Committee. Maybe it is just a continual stream. 
Maybe the Finance Committee, which used to be an important committee, 
doesn't matter whatsoever. Maybe we don't need hearings anymore. Maybe 
we don't need markups in committee. Maybe we will do everything on the 
floor of the Senate.
  I disagree with that. I disagree with the abuse that is being put on 
some States by the upper payment limit; and, then to come up with this 
amendment and say let us increase the Federal share on Medicaid--a 
Federal-State program--and have the Federal Government take more and 
more of the program. It used to be a Federal-State combination. Now 
there is this idea to let us make the Federal Government pay more.
  If you are going to do a 1.35 percent increase, why not make it all 
Federal? Make it 70 percent in every State, or make it 80 percent. 
There has to be some kind of limit. The Federal Government happens to 
have deficit problems, too.
  Just to increase this entitlement and really kind of turn the formula 
upside down--this goes all the way back to the creation of Medicaid, a 
successful program to help low-income States; a program designed to 
benefit the poorer States, to assist them. Medicaid is a good program, 
but this amendment says, well, we want the Federal Government to make 
up more, and when some States are abusing it, we don't stop that abuse. 
We are just going to have the Federal Government pick up more. We can 
hand out cards. Your State is going to get so many billion dollars. 
We'll just borrow some Federal money.
  The Senator from Texas said it is Social Security money. It is Social 
Security, plus we are going into debt $165 billion.
  We will borrow every penny that we are talking about. We will pay 
interest on that debt and write a check for that interest. It is not 
just an accounting gimmick. It is not just crediting some fictitious 
trust fund. We will write a check for every dime that is spent in this 
program.
  I question the wisdom of doing that. The administration is opposed.
  I will ask unanimous consent to have printed in the Record a letter 
from the Secretary of Health and Human Services, Tommy Thompson, dated 
July 18 that says:

       The Administration is opposed to this amendment. A 
     temporary change in the FMAP rate would be an unprecedented 
     disruption of the longstanding shared fiscal responsibility 
     for the Medicaid program. FMAP rates are not designed to 
     change according to short-term economic developments. Such 
     cyclical movements are contrary to the intent of the Medicaid 
     statute, and in the long term, would serve the interest of 
     neither the States nor the Federal Government.

  I believe that is exactly right.
  I ask unanimous consent that this letter be printed in the 
Record.
  There being no objection, the letter was ordered to be printed in the 
Record, as follows:


                                       The Secretary of Health

                                           and Human Services,

                                    Washington, DC, July 18, 2002.
     Hon. Trent Lott,
     Minority Leader, U.S. Senate,
     Washington, DC.
       Dear Minority Leader Lott: We understand that Senators Jay 
     Rockefeller, Susan Collins, Ben Nelson, and Gordon Smith will 
     offer an amendment to S. 812, the ``Greater Access to 
     Affordable Pharmaceuticals Act.'' The amendment would provide 
     temporary increases in the Federal Medical Assistance

[[Page 14422]]

     Percentage (FMAP) under the Medicaid program under Title XIX 
     of the Social Security Act. It would also provide grants to 
     States through Title XX to be used for a variety of social 
     services programs.
       The Administration is opposed to this amendment. A 
     temporary change in the FMAP rate would be an unprecedented 
     disruption of the longstanding shared fiscal responsibility 
     for the Medicaid program. FMAP rates are not designed to 
     change according to short-term economic developments. 
     Although FMAPs are based on State per capita income levels 
     and other economic indicators, they have not typically risen 
     and fallen with short-term economic trends. If State logic 
     suggests raising FMAPs now, then it would also imply lowering 
     them in times of economic boom. If we had followed such a 
     course, after nine years of economic recovery, current FMAP 
     rates would be much lower than they are today. Such cyclical 
     movements are contrary to the intent of the Medicaid statute, 
     and in the long term, would serve the interest of neither the 
     State nor the Federal government.
       An FMAP increase is unlikely to increase health insurance 
     coverage. Instead of using increased funds to provide more 
     health services, States would likely use the increase in 
     Federal dollars to lower their spending on health care. 
     Increasing the FMAP would not lead to more coverage; it 
     simply shifts additional health care costs onto the Federal 
     government.
       The President has introduced a nunber of initiatives to 
     help alleviate State fiscal pressures and to increase access 
     to health care coverage for millions of uninsured Americans, 
     including:
       $89 billion over 10 years for health credits for the 
     uninsured;
       A Medicaid drug rebate proposal that would save States 
     billions of dollars over the next ten years;
       A proposal to provide Federal funding for prescription drug 
     coverage to low-income seniors prior to implementation of 
     comprehensive improvements in Medicare. Such a proposal has 
     already passed the House and would provide quick fiscal 
     relief to States, which have had to take responsibility for 
     prescription drug coverage in the absence of Senate action;
       Medicaid coverage for families transitioning from welfare 
     to work through FY 2003;
       A proposal to make available State Children's Health 
     Insurance Program (SCHIP) funds that under current law would 
     return to the Treasury at the end of FY 2002 and 2003; and
       The Health Insurance Flexibility and Accountability 
     Demonstration Initiative that gives States more flexibility 
     using Medicaid and SCHIP funds to expand health insurance 
     coverage to low-income Americans.
       All of these proposals would provide both temporary and 
     long-term fiscal relief for States, which is the right policy 
     response given that States' health care obligations are 
     expected to continue to increase rapidly. In addition, these 
     proposals would help provide more secure and affordable 
     health care assistance for low-income Americans right away. 
     These are far more effective approaches than an increase in 
     the FMAP.
       The Administration also opposes the temporary increase in 
     funding for the Social Service Block Grant under Title XX of 
     the Social Security Act. We believe that States already have 
     sufficient access to other Federal block grant funds to 
     supplement the Social Services Block Grant and other social 
     services-related programs.
       We understand that some States continue to have financial 
     difficulties and that Medicaid constitutes a large share of 
     State spending. However, we do not feel that this temporary 
     increase in FMAP is an effective or proper way to address 
     these final difficulties. We will continue to work with the 
     Senate to implement effective approaches of providing relief 
     to states while improving health care coverage and 
     affordability.
       The Office of Management and Budget has advised that there 
     is no objection to the submission of this report from the 
     standpoint of the President's program.
           Sincerely,
                                                Tommy G. Thompson.

  Mr. NICKLES. Mr. President, I reserve the remainder of our time.
  The PRESIDING OFFICER. Who yields time?
  Seven minutes remain on both sides.
  Who yields time?
  Mr. NELSON of Nebraska. Mr. President, I ask my colleague from West 
Virginia if I might have 2 minutes.
  The PRESIDING OFFICER. Who yields time?
  Mr. ROCKEFELLER. I yield to the Senator from Nebraska 2 minutes.
  The PRESIDING OFFICER. The Senator from Nebraska is recognized.
  Mr. NELSON of Nebraska. Thank you, Mr. President. I thank Senator 
Rockefeller.
  Back in the early nineties when I tried to balance our budget as 
Governor and had a difficult time doing it, the Federal Government 
reduced its share and increased ours.
  Today, the Federal Government is not having the same difficulty the 
State of Nebraska is having in terms of revenue. For only the second 
time in history, Nebraska's revenues are less this year than they were 
last year.
  If we are trying to talk about who is going to do what during 
difficult times and how this partnership is going to work, I think it 
is a little inconsistent to say the Federal Government doesn't reduce 
its share. It does. If it reduces it, it can increase it; and it does 
in the ordinary course of events.
  What we are saying is, this is an unusual set of events--not a 
temporary downturn, although we think it is but it is an unusual set of 
events where the Federal Government continues to have growing income 
and the States are having a reduction in their income.
  It is a recognition that this partnership, which was created by the 
Federal Government with the States, is one that needs to work as a 
partnership where the two partners can work together to make this 
program work. That is what it is.
  Certainly, I am not suggesting the Federal Government take over the 
entire partnership, take it over as a stand-alone program at the 
Federal Government level. But I think it is interesting to say that 
somehow the Federal Government's share should not increase when, in 
fact, from time to time it has increased, as well as from time to time 
it has decreased.
  I think it is important to recognize that the program is about 
people. It is not about giving money to the States, it is about 
recognizing the importance of the program to the people--the faces of 
people who are elderly, working parents, usually single parents who are 
struggling to get out of the welfare system, who currently have 
transitional benefits in Medicaid, who could in fact lose those 
benefits and lose their capacity to be able to work.
  It seems to me we have to be able to look beyond what is being 
suggested here.
  I thank the Chair.
  The PRESIDING OFFICER. There are 5 minutes remaining for the Senator 
from West Virginia.
  Mr. ROCKEFELLER. How much time is left?
  The PRESIDING OFFICER. The Senator has 5 minutes, and there are 7 
minutes for the other side.
  Mr. ROCKEFELLER. I failed to hear the Chair.
  The PRESIDING OFFICER. There are 5 minutes remaining for the Senator 
from West Virginia and 7 minutes remaining for the Senator from Texas. 
And the Chair understands that the final 5 minutes to close belong to 
the Senator from West Virginia.
  Mr. ROCKEFELLER. I say to the Presiding Officer, I am not going to 
use all my time at the present time. I will just make a couple very 
quick points.
  The Senator from Oklahoma--it is very important my colleagues and 
their staffs, who may be listening to this debate, understand this--
used two arguments, and only two arguments.
  One, he said, we may extend this. In other words, that is a classic 
argument. If you do not want to do something, you say, we may extend 
this. That is why, just like when the tax cut was written into law, it 
will not be extended. We have written into law that will not be 
extended.
  The Senator from Oklahoma is saying we do not want it extended 
because he does not want this to happen. And I understand that. It is a 
good debating technique. But it isn't going to be extended. It is 
temporary. It is a year and a half for a very specific reason.
  Mr. NICKLES. Will the Senator yield for a question?
  Mr. ROCKEFELLER. I will when I am finished.
  Mr. NICKLES. It is a very friendly question.
  The PRESIDING OFFICER. The Senator from West Virginia has the floor.
  Mr. ROCKEFELLER. The other is the upper payment limit, which in fact 
is understood by some of us. And I do not know whether the Senator is 
aware that the Bush administration, which writes a letter against 
this--which maybe is not surprising, I don't know, but it is 
disappointing--has already promulgated a new regulation, which took 
effect in April, which solves most

[[Page 14423]]

of the problem about which the Senator is talking. The problem he is 
talking about is real, but it has no place in this debate. First, the 
administration has moved to solve it. Secondly, it has no part in this 
debate.
  I yield the floor and reserve the remainder of my time.
  The PRESIDING OFFICER. The Senator has 3 minutes 14 seconds 
remaining.
  Mr. NICKLES. Will the Senator yield for a very brief question?
  The PRESIDING OFFICER. Who yields time?
  Mr. NICKLES. On my time.
  Is the Senator saying that should his amendment become law, there 
will not be a request to extend this next year?
  Mr. ROCKEFELLER. No, I think there probably will not be, No. 1. And, 
No. 2, I would probably oppose that because this is an emergency 
measure. That is what the Senator understood right after September 11. 
That is why it was in the emergency package. It is an emergency 
measure, not a permanent measure. It is a way of helping people.
  It is interesting, the Senator from Texas talked about the budget 
deficit. He never talked about people. This is about 40 million people 
who are suffering.
  Mr. NICKLES. Do I have the commitment of my colleague to oppose an 
extension of this next year?
  Mr. ROCKEFELLER. I have no instinct to extend this program because 
the States----
  Mr. NICKLES. I thank my friend.
  Mr. ROCKEFELLER. All right.
  The PRESIDING OFFICER. Who yields time?
  Mr. ROCKEFELLER. I am going to yield time--3 minutes--to the Senator 
from Massachusetts, if he can arrive at his distinguished point of 
oratory.
  Mr. REID. Will the Senator from West Virginia yield?
  Mr. ROCKEFELLER. Of course.
  Mr. REID. It is my understanding the Senator from West Virginia needs 
a little more time.
  Mr. ROCKEFELLER. That is correct.
  Mr. REID. I ask the Senator, approximately how much time do you need 
on your side?
  Mr. ROCKEFELLER. Four minutes.
  Mr. REID. So 5 minutes on each side. Is that OK with the Senator from 
Oklahoma, an additional 5 minutes on each side?
  I ask unanimous consent, Mr. President, that the Senator from West 
Virginia be given 5 additional minutes and the Senator from Texas 5 
additional minutes.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.
  The Senator from Massachusetts.
  Mr. KENNEDY. Mr. President, first, I thank our friend from West 
Virginia for his excellent presentation and strong support.
  I welcome the opportunity to be a cosponsor of this legislation. I 
know there has been a good deal of debate and discussion about the 
technicalities of this amendment, but what we are really talking about 
are real people being hurt in the most egregious way if we fail to 
respond.
  We know that our States are facing economic challenges, and those 
economic exigencies have required cutbacks in some of the very 
important programs that reach out to the neediest people in these 
States.
  We are talking about real people who are being hurt. Pregnant women 
in Florida will lose their current Medicaid coverage if their income 
just happens to fall between 150 and 185 percent of poverty.
  A North Carolina family of four, with a child suffering from juvenile 
diabetes, could see their drug coverage shrink, potentially limiting 
their access to vital medicines.
  Some 45,000 children could be cut from the Medicaid rolls in New 
Mexico because of the proposed cuts to deal with the $47 million 
shortfall.
  Some 50,000 children, pregnant women, disabled, and elderly could 
lose their Medicaid coverage in Oklahoma because of the $21 million 
shortfall.
  It may be expressed in dollars, but it is really being expressed in 
real people's lives: real suffering, real sacrifice, and real pain.
  We have a chance to do something about that. This can be an 
expression of our values as a society and our concern about our fellow 
human beings. These are the neediest of the needy in our society, and 
this amendment will help them.
  I commend the Senator for bringing this matter to the attention of 
the Senate. I am very hopeful it will be accepted and that the point of 
order will be waived.
  The PRESIDING OFFICER. Who yields time?
  The Senator from West Virginia.
  Mr. ROCKEFELLER. Mr. President, I yield 2 minutes to the 
distinguished Senator from Maine.
  The PRESIDING OFFICER. The Senator from Maine is recognized for 2 
minutes.
  Ms. COLLINS. I thank the Senator from West Virginia.
  Mr. President, I just want to make a couple points.
  First of all, an increase in the Federal match under Medicaid was 
part of the Centrist Coalition's economic recovery package we 
considered. It was part of virtually every version. It had widespread 
support. It was supported by the administration. It did not make it 
into the final package. But this is not a new idea. This is an idea 
with widespread bipartisan support.
  The second point I want to make is in response to an argument made by 
my friend and colleague from Oklahoma. My friend from Oklahoma said 
Medicaid spending does not get cut in economically good times. In fact, 
it is countercyclical. In good times, far fewer people qualify for 
Medicaid. In fact, Federal and State spending on Medicaid declined 
dramatically during the 1990s, when the economic times were good.
  So there is a countercyclical aspect of Medicaid. It does go down 
when times are good and the program is less needed.
  Now times are not good. There are more people in need of assistance 
from the Medicaid Program. We know 40 million Americans rely on this 
program.
  What we are trying to do is preserve this essential, vital health 
care program that provides services and care to the most vulnerable and 
needy in our society. That is the motivation behind our proposal. It is 
not to bail out the States, it is to help the States, our partners, 
provide essential services.
  The PRESIDING OFFICER. Who yields time?
  The Senator from Texas.
  Mr. GRAMM. Mr. President, we are coming to the end of this debate. I 
would like to make note of how deficits occur.
  If anybody wants to understand why the Federal Government, which is 
the summation of all of the taxpayers in the country, owes trillions of 
dollars, this is a classic example of how that comes about. We are 
talking about spending $9 billion. There are 140 million taxpayers. 
That is $64 per taxpayer.
  The problem is, taxpayers are at work. It is 11:30 on a Thursday. 
They don't know this debate is occurring. But all the special interest 
groups that want this $9 million, members of the State legislatures who 
ran for office to make decisions in the States, all the people who want 
this money are looking over their Senator's right shoulder trying to 
tell them that they ought to care about people on Medicaid or about the 
State legislature or about the State's deficit.
  That would be insignificant if the 140 million taxpayers were looking 
over the left shoulder. The problem is, it is 11:31 on a Thursday 
morning and all those 140 million taxpayers are at work. They don't 
even know this debate is occurring. So as a result, what tends to 
happen over and over and over again is that spending interests 
dominate.
  Our colleagues tell us: States have difficulty. I remind my 
colleagues, the Federal Government has difficulty. A year ago we had a 
$283 billion surplus. We were spending madly. Today we have a $165 
billion deficit, and we are still spending like drunken sailors, as 
Ronald Reagan would say. Only drunken sailors are spending their own 
money, and in all fairness, we are spending somebody else's money.

[[Page 14424]]

  We hear that the States in total could run as much as a $40 billion 
deficit this year. I certainly am unhappy about it. My State faces 
tough decisions. But we are running a $165 billion deficit. We are 
running a deficit over four times as big as all the States combined.
  Our colleagues say: This fits an emergency. This is unforeseen, 
unpredicted, unanticipated. Well, it is created by a formula that has 
only existed for 37 years. So for 37 years we have known what the 
formula was. What is unanticipated, what is unpredicted about this?
  Finally, as if the argument to waive this budget point of order and 
bar this $9 billion and take it away from Social Security could be any 
weaker, the argument basically comes down to: There are some States 
that in the last few years have been doing better than other States, 
better than the country as a whole, and unless we give them more money 
now, they may be adversely affected by the formula.
  The way the formula works is, the higher the State's income relative 
to national income, the more of the Medicare share they pay. Should it 
be the other way around? Should poorer States pay a higher share?
  There is not one substantive argument in favor of borrowing this $9 
billion. If the American people knew this debate was occurring at 11:35 
this morning, if all 120 million taxpayers were following this debate, 
this amendment would never have been offered and probably would not 
have gotten 20 votes.
  The problem is, those 120 million taxpayers are at work, and all the 
people who want this money are looking over their Senator's right 
shoulder, sending letters back home, telling people whether he cares 
about State finances or she cares about Medicaid beneficiaries.
  That is the dilemma we are in. I urge my colleagues to look at the 
fact that in 12 short months, we have gone from $283 billion in the 
black to $165 billion in the red. When does it stop? We are broke, and 
we don't act like it. When do we stop spending this money that we do 
not have?
  I urge my colleagues to sustain this budget point of order. I urge 
everybody who has ever lamented the spending of the Social Security 
surplus to put their vote where their mouth is. I urge everyone who has 
ever lamented the deficit, who has ever gone back to their State and 
said, I am for fiscal responsibility, to put your vote where your mouth 
is. I want to urge everybody who has ever said, we can't let working 
people keep more of what they earn because we have a deficit, we need 
the money, we can't afford it; I urge them to vote against this 
spending.
  I don't know how you can have any possibility of being consistent in 
taking the position that we ought to borrow this money. This is totally 
unjustified. I know some people want it. If you spend $9 billion, you 
are going to benefit somebody even if by mistake. I am not in any way 
denigrating that this $9 billion will help people. I am not saying it 
won't. But the point is, we have a budget process. We have seen the 
surplus go from $283 billion in the black to $165 billion in the red. 
Let us stop that process here.
  I urge my colleagues to vote to sustain the budget point of order.
  The PRESIDING OFFICER. Who yields time?
  The Senator from West Virginia.
  Mr. ROCKEFELLER. I yield 30 seconds or such time as he might need to 
the distinguished Senator from Nevada.


                        Appointment of Conferees

  Mr. REID. Mr. President, I am sorry I was not here when the unanimous 
consent agreement was entered assigning conferees to the antiterrorism 
legislation. It is very important legislation. It is going to help all 
over the country.
  I compliment and applaud Senator Lott and others who allowed us to go 
forward. It is an important day. Construction will be able to go 
forward as soon as we complete this conference in Nevada, Delaware, all 
over the country. It is important legislation. I compliment and applaud 
the Republican leader.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mr. ROCKEFELLER. Mr. President, let me make a couple comments.
  No. 1, my friend from Texas speaks with enormous passion about the 
overriding power of the budget, and at the very last moment of his last 
statement, for the first time he used the word ``people.'' I sat in the 
same Finance Committee with him for a long time when we were debating 
tax cuts--and I am not here to argue whether it was a good or bad 
thing, but there was no question that we went from a $5.6 trillion 
surplus to a $165 billion annual deficit probably for the next 10 
years, if nothing gets worse--and I never heard him make the argument--
for some reason, maybe I missed it, maybe I wasn't there at the 
moment--that we shouldn't do that tax cut which was the largest tax cut 
that this particular Senator from West Virginia, who does not need it, 
has ever received from the Federal Government--I never heard him talk 
about the possibility of budget deficits.
  So it does become a matter of priorities. It is fair, as the Senators 
from Nebraska, Massachusetts, and Maine have mentioned, to talk about 
40 million people. And to say we are doing this to bail out the States, 
good grief, it is quite the opposite. The States are not powerful in 
the same sense that the Federal Government is. The States cannot go 
into deficit financing--with the exception of Vermont--as can the 
Federal Government. They have to balance their budgets.
  I was a Governor; I know that. The Senator from Nebraska was a 
Governor; he knows that. The States are not being bailed out. If the 
States cut their Medicaid eligibility, they cannot receive any of this 
money, unless they restore their portion through legislative action to 
the proper eligibility rate and, only then, on a temporary basis, for 1 
and a half years, written into law, do they get this money.
  I want to close on the concept of people. Sometimes it appears to me 
on this floor that helping people is sort of a bad thing to do because 
if you help people, it implies that it might cost some money. It almost 
always does. It also costs an awful lot more money if you don't, on 
some occasions. This is one of those occasions. If we do not support 
the motion to waive, then health infrastructure all across this country 
is going to be hurt because of its dependency upon Medicaid. Forty 
million people are going to be hurt, including disabled people, 
children, seniors, and others, because of this motion.
  I need to tell you that this is not a bailout. This is temporary. 
This was in the original emergency stimulus package. Nobody argued 
then. Now, all of a sudden, they argue. It is very important for the 
States to be healthy and for the States to be able to balance their 
budgets, and therefore I strongly urge colleagues to support the motion 
to waive the point of order.
  The PRESIDING OFFICER. The time of the Senator has expired.
  Mr. GRAMM. How much time do I have remaining?
  The PRESIDING OFFICER. The Senator has 3 minutes 51 seconds 
remaining.
  Mr. GRAMM. Mr. President, anybody who has not heard me talk about the 
deficit has not been listening in the last days, weeks, and years.
  Secondly, I ask unanimous consent to have printed in the Record the 
accounting of the Office of Management and Budget on where this deficit 
has come from. We have gone from $283 billion in the black to $165 
billion in the red, and only 9 percent of that change had anything to 
do with the tax cut.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                                CHANGE IN SURPLUS
----------------------------------------------------------------------------------------------------------------
                                                               FY2002             FY2003         FY2002-FY2011
                                                        --------------------------------------------------------
                                                         Billions  Percent  Billions  Percent  Billions  Percent
----------------------------------------------------------------------------------------------------------------
Total surplus (OMB February 2001)......................    $283    .......    $334    .......    $5,637  .......
                                                        ========================================================
Economic and technical changes.........................     278        64      194        49      1,669      43
Bush tax cut...........................................      41         9       94        24      1,491      38

[[Page 14425]]

 
Appropriations.........................................      45        10       40        10        409      10
Farm bill..............................................       2         0       13         3         81       2
Stimulus...............................................      59        14       39        10         42       1
Other..................................................       9         2       15         4        228       6
                                                        --------------------------------------------------------
      Total change in surplus..........................     434       100      395       100      3,920     100
                                                        ========================================================
      Total deficit/surplus (OMB July 2002)............     150    .......     (62)   .......     1,718  .......
----------------------------------------------------------------------------------------------------------------
Source: CBO; provided by Senator Don Nickles, 7/16/02.

  Mr. GRAMM. Mr. President, I will conclude by saying that we have come 
down to a decision about whether or not we are going to borrow $9 
billion, which we don't have. Given the state of the American economy 
and budget, given that our deficit is four times as big as the 
cumulative deficit of the States, I urge my colleagues not to bust the 
budget, not to waive this budget point of order, but instead to be 
fiscally responsible.
  I yield back the remainder of my time.
  The PRESIDING OFFICER. All time has expired.
  The question is on agreeing to the motion. The yeas and nays have 
been ordered.
  The clerk will call the roll.
  The legislative clerk called the roll.
  Mr. NICKLES. I announce that the Senator from North Carolina (Mr. 
Helms) is necessarily absent.
  The PRESIDING OFFICER (Mrs. Clinton). Are there any other Senators in 
the Chamber desiring to vote?
  The yeas and nays resulted--yeas 75, nays 24, as follows:

                      (Rollcall Vote No. 190 Leg.)

                                YEAS--75

     Akaka
     Allard
     Allen
     Baucus
     Bayh
     Bennett
     Biden
     Bingaman
     Boxer
     Breaux
     Bunning
     Burns
     Byrd
     Campbell
     Cantwell
     Chafee
     Cleland
     Clinton
     Cochran
     Collins
     Conrad
     Corzine
     Daschle
     Dayton
     Dodd
     Domenici
     Dorgan
     Durbin
     Edwards
     Enzi
     Feinstein
     Fitzgerald
     Graham
     Hagel
     Harkin
     Hatch
     Hollings
     Hutchinson
     Hutchison
     Inouye
     Jeffords
     Johnson
     Kennedy
     Kerry
     Kohl
     Landrieu
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     McCain
     McConnell
     Mikulski
     Miller
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Reed
     Reid
     Rockefeller
     Sarbanes
     Schumer
     Sessions
     Shelby
     Smith (OR)
     Snowe
     Specter
     Stabenow
     Stevens
     Torricelli
     Warner
     Wellstone
     Wyden

                                NAYS--24

     Bond
     Brownback
     Carnahan
     Carper
     Craig
     Crapo
     DeWine
     Ensign
     Feingold
     Frist
     Gramm
     Grassley
     Gregg
     Inhofe
     Kyl
     Lott
     Nickles
     Roberts
     Santorum
     Smith (NH)
     Thomas
     Thompson
     Thurmond
     Voinovich

                             NOT VOTING--1

       
     Helms
       
  The PRESIDING OFFICER. On this vote the yeas are 75, the nays are 24. 
Three-fifths of the Senators duly chosen and sworn having voted in the 
affirmative, the motion is agreed to.
  Mr. REID. I move to reconsider the vote.
  Mr. ROCKEFELLER. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. REID. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant bill clerk proceeded to call the roll.
  Mr. DASCHLE. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________