[Congressional Record (Bound Edition), Volume 150 (2004), Part 7]
[Senate]
[Pages 9571-9573]
[From the U.S. Government Publishing Office, www.gpo.gov]




                             THE UNINSURED

  Mr. AKAKA. Mr. President, I rise today to address a growing problem 
in my home State of Hawaii and the Nation, individuals that do not have 
health insurance. The total number of uninsured people in the United 
States reached 43.6 million in 2002. Since 2000, the total number of 
uninsured has increased by 3.8 million. In the State of Hawaii, it is 
estimated that there are approximately 120,000 people who do not have 
health insurance.
  The uninsured delay seeking medical treatment, which is likely to 
lead to more significant and more costly problems later on than if they 
had sought earlier, preventative treatment or proper disease 
management. Health insurance is essential to making sure that 
individuals can access health care services and properly manage their 
chronic diseases, such as diabetes. A tremendous amount of needless 
pain and suffering can be eliminated by ensuring that health insurance 
is universally available.
  Everyone should have access to affordable health insurance. We must 
expand Medicaid and the State Children's Health Insurance Program, 
SCHIP, to provide essential access to health care for more people. In 
addition, we must take steps to help rein in health care costs in an 
attempt to keep coverage affordable. Providing additional resources for 
disease management programs and primary health care services will lead 
to long-term savings and benefits. Also, meaningful prescription drug 
patent law reforms need to be made to ensure that generic drugs can be 
brought to market in a timely manner.
  We are also obligated to help provide support to health care 
providers that provide uncompensated care for the uninsured. In Hawaii, 
it is estimated that hospitals lost $95 million for uncompensated care 
in 2002. However, while other states benefit from Medicaid 
disproportionate share hospital, DSH, payments designed to provide 
additional support to hospitals that treat large numbers of Medicaid 
and uninsured patients, Hawaii is left out of this important program.
  The Balanced Budget Act of 1997, BBA, created specific DSH allotments 
for each state based on each of their actual DSH expenditures for 
fiscal year 1995. In 1994, the State of Hawaii implemented the QUEST 
demonstration program that was designed to reduce the number of 
uninsured and improve access to health care. The prior Medicaid DSH 
program was incorporated into QUEST. As a result of the demonstration 
program, Hawaii did not have DSH expenditures in 1995 and was not 
provided a DSH allotment.
  The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection 
Act of 2000 made further changes to the

[[Page 9572]]

DSH program, which included the establishment of a floor for DSH 
allotments. However, States without allotments were again left out. 
Other States that have obtained waivers similar to Hawaii's have 
retained their DSH allotments. Only two States, Hawaii and Tennessee, 
do not have DSH allotments. I was disappointed that language similar to 
an amendment that I had offered, which was accepted as part of the 
manager's package for the Senate's prescription drug bill was not 
included in the conference report for H.R. 1, the Medicare Prescription 
Drug and Modernization Act of 2003. The language that was finally 
included prevents Hawaii from obtaining its DSH allotment as long as 
the QUEST program remains in place.
  Medicaid DSH funding is needed because our hospitals in Hawaii are 
struggling to meet the elevated demands placed upon them by the 
increasing number of uninsured people. DSH payments will help Hawaii 
hospitals meet the rising health care needs of our communities and 
reinforce our health care safety net. All 50 States need to have access 
to Medicaid DSH support.
  While Hawaii continues to be denied this assistance, many States fail 
to fully utilize their DSH allotments. For fiscal year 1999, more than 
$1.2 billion was returned to the Treasury because States failed to draw 
down their full Medicaid DSH allotments. More than $800 million was 
returned to the Treasury for fiscal year 2000. It is unfair that while 
certain States are declining to use their full allocation, States with 
no or small allotments are being denied the use of these resources. A 
viable option to provide relief for Hawaii and other low-DSH States is 
to redistribute funding that other States have returned to the 
Treasury. It is not fair that States that either lack any DSH funding 
or have low-DSH allotments cannot have an opportunity to apply for 
these excess funds to help bolster their public health safety net.
  I appreciate all of the work done by my colleague from New Mexico, 
Senator Bingaman, to help provide relief to low-DSH States. I look 
forward to continuing to work with my colleagues to help restore 
Medicaid DSH payments to Hawaii. Also, we must continue our efforts to 
improve access to health care so that everyone can obtain affordable, 
comprehensive, and quality health care coverage.
  Mr. President, I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. DASCHLE. Mr. President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mr. DASCHLE. Mr. President, this week our country observes National 
Police Week, a time to honor the men and women who put their lives on 
the line every day to bring peace--and peace of mind--to America's 
cities, towns, and neighborhoods.
  Tomorrw, Police Week culminates in Peace Officers Memorial Day, when 
we pay special honor to those officers who gave their lives in he line 
of duty.
  This memorial has a long history. In 1789, a U.S. Marshal named 
Robert Forsyth was shot and killed in the line of duty.
  Since then, over 14,000 law enforcement officers have given their 
lives to protect the liberties upon which America was founded.
  Police officers have always served as the first line of protection 
for our communities. But 3 years ago, on September 11, our Nation 
gained a new appreciation both for the dangers they face and for the 
courage they routinely exhibit.
  We owe our police officers a debt of gratitude that is immeasurable 
and unending.
  Every year we honor those that lost their lives in the line of duty 
and carve their names into the Police Memorial so that future 
generations will know who they are, and that they lived, and died, as 
heroes.
  This year, one of South Dakota's heroes will be honored and 
remembered.
  Deputy Bill Davis joined the Moody County Sheriff's Office in 1982, 
where he served as deputy sheriff for 21 years.
  Like so many of our officers, Deputy Davis's service to his community 
was bigger than his badge.
  Bill Davis was a veteran of the U.S. Navy and the National Guard.
  He embodied the values of community service and civic duty throughout 
his life. Last November, while investigating a car accident, Deputy 
Davis was struck by a car and killed.
  As we commemorate the heroism of Deputy Bill Davis, and all those who 
lost their lives in the line of duty, we cannot help but acknowledge 
the risks undertaken each and every day by America's police officers.
  Our police officers do not ask for reward or recognition, merely the 
tools they need to do their job. And in return for all they have given 
us, we have an obligation to ensure they have every available resource 
necessary to keep our neighborhoods safe.
  Over the past year, I have spent a lot of time meeting with South 
Dakota's police officers, asking about the specific challenges they 
face, and what we can do here in the Senate to support them.
  The most pressing issue for our Nation's law enforcement is the added 
responsibility and burden of being first responders in the event of 
terrorist attack. The complexity of this new role requires training and 
tools that no small local police department could be expected to have 
on its own.
  That is why I am pleased that South Dakota recently received $15 
million in grants from the Department of Homeland Security to pay for 
new count-
erterrorism training and technologies.
  In addition, dozens of our local police and sheriffs' departments 
received Federal grants last year for first responder training and 
equipment, such as bulletproof vests.
  I was pleased that because of the great work being done in my State, 
we were able to ensure that the South Dakota Police Chiefs and Sheriffs 
Associations received $1.5 million in Federal funding in 2003, and an 
additional $250,000 in 2004.
  Rural communities, such as those in South Dakota, have a number of 
unique law enforcement challenges, as well.
  People in rural areas face the same problems of gangs and drugs as 
their urban counterparts, but with fewer officers and across broader 
geographic areas. Methamphetamine production and use, for example, is a 
growing concern for South Dakota's communities and families. Because 
the ingredients and the equipment used to produce methamphetamines are 
so inexpensive and readily available, the drug can be produced in 
homes.
  Over the past several years, methamphetamine labs have proliferated 
throughout South Dakota, and law enforcement has struggled to keep up 
with its troubling growth.
  To help law enforcement combat the spread of methamphetamine and 
other challenges, I have introduced the Rural Safety Act, which would 
authorize grants to establish methamphetamine prevention and treatment 
pilot programs in rural areas, and provide additional financial support 
to local law enforcement.
  In addition, I have recently joined with Senator Johnson in 
cosponsoring the Federal Emergency Meth Lab Cleanup Funding Act of 
2004, which helps our local law enforcement and communities with the 
contamination left behind by meth labs.
  For all the work we are doing to support our police, this weeks 
reminds us that we are asking them to do more with less.
  Unfortunately, under the administration's Fiscal Year 2004 budget, 
funding for several important programs related to State and local law 
enforcement are drastically reduced. Of particular concern is the 
administration's cut to the COPS program.
  Since 1994, South Dakota has received $43.7 million from the COPS 
program for much-needed training, equipment, and new police officers, 
including officers for the Spearfish, Custer, Huron, and Tripp police 
and sheriff departments.
  In the finest tradition of community policing, these officers are out 
in our

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neighborhoods, working with schools, churches, and businesses to find 
new ways to make our streets safer.
  Over the past 10 years, COPS is responsible for putting more than 
100,000 new police officers on the streets throughout our country and 
was pivotal in the historic reductions in crime we saw during the 
1990s.
  But despite its ongoing success, the COPS budget has been targeted 
for cuts by this administration every year--in fact, last year the 
administration proposed eliminating COPS altogether.
  For FY 2005, the administration has proposed a staggering 86 percent 
cut for the COPS program--from $703 million to only $44 million.
  More than ever, we depend upon our police officers' ability to 
protect our communities from combating terrorism, to protecting our 
citizens from the dangers of drug abuse, to helping young people stay 
clear of trouble.
  State, local, and tribal law enforcement officers are contributing on 
a daily basis to the effort to make our Nation safer and more secure. 
We have a responsibility to provide them the support they need.
  This week, we honor officers, such as Deputy Bill Davis who have made 
the ultimate sacrifice for our communities and for our safety.
  The debt we owe them can never be repaid.
  But this week, and every week, we have an obligation to commit 
ourselves to ensuring that the priorities of America's police men and 
women are at the very top of our agenda.
  I yield the floor.
  I suggest the absence of a quorum.
  The ACTING PRESIDENT pro tempore. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. CORNYN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Chafee). Without objection, it is so 
ordered.
  Mr. CORNYN. Mr. President, I ask unanimous consent to speak for as 
much time as I may consume.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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