[Congressional Record (Bound Edition), Volume 151 (2005), Part 16]
[Senate]
[Pages 21210-21214]
[From the U.S. Government Publishing Office, www.gpo.gov]




                    EMERGENCY HEALTH CARE RELIEF ACT

  Mr. BAUCUS. Mr. President, I would like to speak a few moments about 
the need for health care assistance to Katrina-related victims. When I 
finish, I am then going to join with Senator Grassley, the chairman of 
the Finance Committee, in a unanimous consent request, and that is 
bring up and pass the bill.
  Tina Eagerton fled Louisiana for Clearwater, FL, to escape Hurricane 
Katrina. As Tampa Bay's 10 News reported, Tina is 7 months pregnant. 
She has a high-risk pregnancy. Plainly she needs a doctor's care, but 
Tina could not find a Florida doctor who would accept her Louisiana 
Medicaid card. She said, ``I've called some doctors, [but they say] `We 
don't know what to do.' I guess nobody has gotten the memo.''
  Congress needs to get the memo. We need to pass S. 1716, the 
Emergency Health Care Relief Act, and we need to do it today.
  The last 4 weeks, we have seen terrible destruction, destruction that 
Katrina wrought as well as Rita has wrought; more than 1,000 people are 
dead, a million people displaced, hundreds of billions of dollars of 
damage. I went down there to the gulf to see it myself, and I must say 
it is worse than the pictures.
  Katrina has exposed deep problems that plague American society: 
chronic poverty, stark inequality, strained race relations. We could 
not solve all of these problems today, but some are so pervasive, so 
severe, that a single bill cannot remedy them. It requires a sustained 
national debate and reexamination of what we as a nation hold dear.
  We cannot fix everything today, but we can fix some things today. One 
thing we can fix is a lack of health coverage for tens of thousands of 
Katrina survivors. We can and must pass the Emergency Health Care 
Relief Act today.
  This broadly supported legislation would provide victims of Hurricane 
Katrina with the health care services they urgently need. As we so 
often do,

[[Page 21211]]

Chairman Grassley and I worked together on this bill. We worked 
together on the Katrina tax package which the President signed Friday 
and which is even now putting cash in the hands of Katrina victims.
  And we worked together on this health bill as well. We spent a lot of 
time together--our staffers--consulting with Senators, especially with 
Senators in related States.
  Our health bill would provide temporary Medicaid coverage for Katrina 
survivors, available through a streamlined application. It is that 
simple. These benefits would be available right away. Those eligible 
would get coverage for up to 5 months, with a possible extension of 5 
months.
  Pregnant women such as Tina Eagerton, as well as children, would be 
eligible for health care at higher income levels.
  To support those who lost their jobs and income, our bill allows 
those individuals to keep their current coverage with assistance from 
the Federal Government. And our bill would set up a fund to help health 
care providers deal with their tremendous uncompensated care losses--
health care, hospitals, specialists. These funds would go to providers 
who experienced a surge in patient load from the evacuation of Katrina 
victims. These funds would go to those facilities that no longer have 
the patient base to make ends meet.
  But this is not just health care providers who are incurring 
uncompensated care expenses. States are as well. Texas has taken in 
200,000 Katrina evacuees. Katrina is adding $30 million a month in 
costs to the Texas Medicaid Program.
  Our legislation provides Texas--and other States caring for Katrina 
evacuees--with the full Federal Medicaid funding for those evacuees.
  The bill would also cover all the costs of Louisiana's and 
Mississippi's Medicaid and child health programs for 2006, with the 
same treatment being provided to a number of particularly ravaged 
counties in Alabama.
  This legislation would give solid help to those who receive TANF and 
unemployment insurance.
  In short, our bill does a great deal to help Katrina victims in 
commonsense ways.
  As a result, our bill has broad support from consumer, health care, 
and business groups. Here is what some of the groups have to say about 
our bill.
  The American Red Cross says:

       As our nation faces the challenging task of ensuring that 
     the victims of Hurricane Katrina receive the care, 
     compassion, and support needed to reconstruct their lives, 
     legislation such as yours helps to ensure their health care 
     needs will be met.

  The American Hospital Association says of our bill:

       [It] is an important first step toward getting assistance 
     to the thousands of people who have been affected by the 
     storm, as well as those who are providing their care.

  The National Governors Association says:

       The Nation's Governors are very supportive of your relief 
     package. [The] additional investments in Medicaid and TANF 
     that your relief package provide will be critical to help 
     these individuals put their lives back together and regain 
     some sense of stability.

  Congress has taken some steps to respond to the Katrina disaster. We 
have passed more than $60 billion in funding for FEMA. We have passed 
Katrina-targeted tax relief. These bills are helping us in what may be 
the biggest relief operation for a natural disaster in American 
history.
  But we also must do more to help the victims of this natural--and 
national--disaster. We must provide Katrina victims with access to 
health care--not done in part of the legislation--and we must do it 
now.
  Americans have responded generously. Americans have given of their 
time, through the efforts of tens of thousands of volunteers.
  Americans have opened their homes. Web sites report offers for 
shelter totaling nearly 270,000 beds. And Americans have opened their 
wallets in an unprecedented fashion. In the 3 weeks following the 
hurricane, Americans contributed more than $1.2 billion to help 
victims.
  But individual citizens can do only so much. At some point Congress 
needs to help. We need to help people such as Rosalind Breaux. Of 
Rosalind Breaux, the Chicago Tribune reported:

       Diagnosed with colon cancer on May 1, Ms. Breaux was 
     scheduled for her third round of Chemotherapy on August 31, a 
     day after flooding began to wreck New Orleans and Charity 
     Hospital where she had been receiving care. Breaux and her 
     family ended up settling temporarily in Baton Rouge. 
     Nauseated with constant fatigue, profound weakness and 
     frequent pain, Breaux has been trying to survive the stress 
     of her situation as best she could. Meanwhile, her husband, a 
     policeman at Charity Hospital, has lost his job and there are 
     questions about whether his insurance will pay for her care. 
     ``It's been so frustrating not knowing what's going to 
     happen,'' she said. ``I just pray I can make it through 
     this.''

  We need to help. Congress needs to ensure that people such as 
Rosalind Breaux and Tina Eagerton have health care. That is the least 
we can do.
  Let us rise to the level of caring and sympathy of the American 
people who have given so much to the victims of this disaster. Let us 
take action to meet the needs of those whom Katrina has displaced and 
disadvantaged, and let us do our part to help this region and its 
people get back on their feet.
  We can do this today--this evening, now--by passing the Emergency 
Health Care Relief Act, legislation which the chairman of the 
committee, Senator Grassley, and I have worked on so vigorously, so 
assiduously and comprehensively. Talking to Senators, talking to 
groups, we have worked on this, and it is a balanced bill, a needed 
bill. Time is of the essence.
  I urge the Senate to act tonight.
  The PRESIDING OFFICER. The Senator from Iowa.
  Mr. GRASSLEY. Mr. President, I am pleased to join my colleague, 
Senator Baucus, ranking Democrat of the committee that has jurisdiction 
over this issue of Medicaid, to urge passage of the Emergency Health 
Care Relief Act of 2005. He explained very well how we have worked out 
in a bipartisan way the contents of this legislation, not only between 
Senator Baucus and me but by involving the staff of everybody on the 
committee, as well as consulting, particularly, the Senators from 
Arkansas, Texas, Louisiana, Mississippi, and Alabama.
  We are all very deeply moved by the pictures and by the stories of 
those from the States who have been hurt by Katrina--and now, of 
course, Rita--their homes, their jobs and, worst of all, their loved 
ones who have given up everything. My heart, of course, goes out, as 
well, to the others who have suffered as much as a result of this 
terrible disaster.
  I think the need to act is very obvious. About 250,000 people have 
been evacuated as a result of this disaster.
  According to a survey by the Washington Post, fully half of the 
evacuees have no health insurance. Four in ten of the evacuees are 
physically disabled or have chronic illness. According to a survey done 
by the same paper, 6 in 10 evacuees have incomes of less than $20,000.
  It is a function of our Government and our responsibility as 
legislators to provide assistance to these vulnerable families.
  I would like to briefly outline this legislation. The Katrina health 
care relief package is very targeted and, most importantly, temporary. 
It is both a targeted and temporary benefit for the neediest 
individuals and families.
  It provides assistance with private health insurance premiums for 
people in businesses affected by hurricanes so they won't lose their 
coverage; an uncompensated care funding pool to cover evacuation costs 
and emergency health care costs related to the hurricane; most 
importantly, temporary Medicaid coverage limited to 5 months, unless 
the President would extend it for another 5 months, limited to only 
those residents and evacuees from the hardest hit counties of the 
State; and 100 percent Federal funding for the disaster-related 
Medicaid costs until December 31, 2006.
  The compromise package bill limits Medicaid to those most in need: To 
those below the poverty level; pregnant women and children below 200 
percent of poverty, which is current law in Texas already, as one 
example; and

[[Page 21212]]

those eligible under the host State's Medicaid coverage under existing 
law.
  It is very limited. The bottom line is that this is a responsible 
compromise. It is time limited. It is targeted only to those who have 
the most need.
  The legislation includes a simplified enrollment procedure. One 
important part of our bill that I want to highlight would help those 
with private insurance pay premiums on their policy. Many of the folks 
affected by Katrina have private health insurance which they would like 
to keep.
  Many of the evacuees also have chronic conditions. For these folks, 
losing health insurance can mean the loss of important provider 
relationships. This legislation will help these folks avoid that 
situation.
  The legislation also offers help to certain employers who, prior to 
Katrina, offered their employees health insurance.
  We all know that many businesses face a difficult time in maintaining 
coverage. Now these businesses will be able to get back up and 
contribute to a revitalization of the economy in that area.
  Our bill would also waive the Medicaid Part B late enrollment penalty 
for those who miss the initial enrollment period. We don't want people 
to have opportunities to get into Part B enrollment only to have to pay 
a penalty when they wouldn't otherwise do that if we had not had the 
hurricane.
  I am pleased that Senator Baucus and I have been able to take action 
on behalf of those whose lives have been disrupted by the hurricane.
  As Senator Baucus said, the bill is supported by the Governors 
Association, the American Medical Association, the American Hospital 
Association, the Health Care Leadership Council, the American Red 
Cross, the March of Dimes, and many others.
  I hope my colleagues will support this legislation, and I urge swift 
Senate consideration of S. 1716.
  I would also like to point out some things more procedural than just 
the contents of the bill. As a reminder to all of my friends on this 
side of the aisle, the Wednesday after Labor Day we had a news 
conference assuring the people of this country--that news conference 
involved leadership, as well as those who are chairmen of the 
committee--promising appropriate as well as immediate relief for the 
States that are hurt. That hurting is extended beyond the States that 
were hit by the hurricane to States that have taken evacuees.
  I also point out that it is quite obvious from television the hurt 
that people have. Also, we tried to pretty much do a total paralleling 
of what we did for New York City after 9/11. Along that line, I remind 
my colleagues of something that President Bush said as he was speaking 
in a news conference about the hurricane not discriminating. We were 
not going to discriminate.
  It seems to me that doing for the people in this area hurt by this 
Katrina catastrophe ought to be done in the same way that we did to 
help people who were hurt by the New York City 9/11 catastrophe.
  Then, as a practical matter--and I don't say this just because 
Senator Lincoln is in the Chamber--I use her as an example of a lot of 
people who are trying to accomplish the goals that Senator Baucus and I 
want to accomplish, as she did on an appropriations bill by offering an 
amendment.
  That amendment went much further than what we do in this legislation. 
She withdrew that amendment. But I think there are people who are going 
to want to push those issues if we don't move in this comprehensive, 
bipartisan way that Senator Baucus and I have done. I remind colleagues 
that we might end up actually adopting a proposal much more expensive 
than S. 1716, if Senator Lincoln offers her amendment, than we do 
through this approach that we are taking here in the case of Senator 
Baucus and my working out this bipartisan agreement.
  I urge that we move forward with this legislation for the reasons 
that I have given, as well as the substance being a responsible 
approach.
  I would like to ask, if I could, unanimous consent that we move 
forward with this legislation. Then, if somebody wants to speak 
afterwards, speak afterwards on the subject.
  Mr. President, I ask unanimous consent that we move immediately to 
the consideration of S. 1716.
  The PRESIDING OFFICER. Is there objection?
  Mr. ENSIGN. Mr. President, reserving the right to object.
  The PRESIDING OFFICER. The Senator from Nevada.
  Mr. ENSIGN. Mr. President, I appreciate the efforts that the chairman 
of the Finance Committee and the ranking member have made on this 
legislation. They are working hard to help out the people who have been 
affected by Hurricane Katrina on the gulf coast. All of our hearts go 
out to the people in the gulf region. The devastation that region has 
experienced simply cannot be put into words. The issue we are 
considering tonight is not what kind of assistance should be provided 
to evacuees but how that assistance should be provided and whether this 
should be done by unanimous consent.
  The administration has taken administrative steps to provide 
necessary medical care to evacuees. They have provided Medicaid waivers 
to certain states. Secretary Leavitt has pledged additional waivers to 
states that request one if the request is reasonable. For its part, 
Congress has already approved $62 billion for the recovery of victims 
and their care. I am concerned that this bill involves new spending 
rather than reprogramming a part of the $62 billion Congress has 
already appropriated. This bill would add an additional $8.9 billion in 
spending on top of the money FEMA has already been given.
  We should make some changes to this bill. I have serious concerns 
about four provisions included in this bill. First, this bill provides 
for temporary expansion of Medicaid. Second, it requires that the 
federal government provide 100% FMAP for Louisiana, Mississippi and 
affected counties in Alabama. This is a dangerous precedent and removes 
any incentive for these states to keep Medicaid costs down. Third, it 
holds 29 states harmless from a scheduled FMAP reduction in 2006. This 
means the federal government continues to pay more of the costs, even 
in states with few or no Hurricane Katrina evacuees. My final concern 
is that this bill also increases spending by $8.9 billion and probably 
unnecessarily so given the steps that Congress and the Administration 
have already taken.
  Any legislative proposal should be well thought out and fiscally 
responsible. If these services can be provided administratively, which 
HHS says they can, we should allow HHS to do so. Congress does not, and 
should not, alter the Medicaid formula as this bill seeks to.
  We, as a Congress, need to get a better handle on the money being 
spent. We have an obligation to those affected by the hurricane as well 
as to those Americans we are asking to help pay the costs of relief. We 
must ensure this money is spent wisely.
  I object to the unanimous consent.
  The PRESIDING OFFICER. The objection is heard.
  Mr. BAUCUS. I am astounded by the statement made by the Senator who 
just spoke. This has nothing to do with the $62 billion, nothing 
whatever. If there are contract problems with FEMA dollars, we will 
discuss those and deal with them when this Senate deals with additional 
appropriations requests related to Katrina. This has nothing whatever 
to do with that. Those are FEMA dollars, contracts to repair roads and 
bridges.
  Mr. ENSIGN. Will the Senator yield?
  Mr. BAUCUS. Not at this moment, no.
  It has nothing to do with FEMA. We will deal with legitimate points 
that the Senator from Nevada raised at another time and context when we 
deal with additional appropriations for FEMA. This has nothing to do 
with that.
  We are talking about people. FEMA was projects, contracts. This is 
people. This is people's health care. This is Medicaid, that pays for 
people's health care. This is an emergency. It is people's health 
care--for people. That is what this is.

[[Page 21213]]

  It has nothing to do with FEMA, nothing whatever.
  I hope the Senators understand that. I hope the country understands 
and realizes that. I am astounded at the objection I just heard because 
it has nothing to do with the objection at hand.
  Mrs. LINCOLN. Will the Senator yield?
  Mr. BAUCUS. I yield to the Senator from Arkansas.
  Mrs. LINCOLN. If the Senator from Nevada is worried about the dollars 
FEMA received, why did no one object to that? Why did no one object to 
the $60 billion being sent to FEMA, which has been so inefficient in 
the wake of this disaster?
  Now we are going to ask, as the chairman of the Committee on Finance 
points out, the disproportionately low-income, disproportionately 
disabled individuals to pay for this?
  I am here today to speak in support of the Emergency Care Relief Act 
of 2005 and to compliment the chairman of the Committee on Finance and 
the ranking member, Senator Baucus, for making this important issue a 
priority, for working hard and bringing people together to recognize it 
is not only a natural disaster but a national disaster. We as Americans 
have to come together to help our neighbors.
  I find it odd that here we are talking about $8 billion, $7.5 
billion, $8 billion compared to the $60 billion no-bid contracts. Maybe 
my colleagues who want to object to this are willing to jump in and 
help provide the bipartisan-nonpartisan commission we need to review 
the response to the natural disasters that happened on the gulf coast. 
Maybe they want to join in saying we need somebody who can review what 
is going on--not just what happened then but what continues to happen 
in FEMA.
  Our Nation's health care providers and States have been there at a 
time when vulnerable Americans needed them the most. The moment 
Hurricane Katrina hit the gulf coast, they jumped into action without 
being asked. No one asked them to get in their cars and drive to the 
gulf coast to provide medical care, to get in their helicopters and go 
rescue those people off those rooftops. States all across the country 
opened their doors to welcome Katrina survivors. Hospitals sent 
helicopters to the gulf coast to evacuate those who needed immediate 
attention. Doctors, nurses, and other health care providers have come 
together to provide much needed health care to thousands of Katrina 
survivors. And they did it all with no questions asked. They exemplify 
what it means to be a good neighbor and what it means to be a part of 
this American family.
  Our own Arkansas Children's Hospital is one of the many hospitals 
around the country that immediately jumped into action to provide 
health care for Katrina survivors. Even before the worst of the storm 
hit, they were evacuating young patients to safety. One patient, in 
particular, was a 9-year old boy. Let me tell you, that hits home with 
me; I have twin boys who are 9 years old. This young man had a severe 
heart condition that required a complicated heart pump to be flown in 
from Germany. Arkansas Children's Hospital evacuated this child from 
Louisiana, and he received the necessary pump, saving this 9-year-old 
boy's life. Does that mean anything to anybody in this body? It meant 
something to his parents. And for once, we as a Senate should stand up 
and take notice.
  Arkansas Children's Hospital did. And they have already provided $1.7 
million in uncompensated care to Katrina survivors.
  There are health care providers all around the country doing 
similarly inspiring work. In Arkansas, our pharmacists have been 
filling prescriptions as fast as they can, paying special attention to 
those who have chronic conditions or were in the middle of their cancer 
treatment. Senator Baucus mentioned one of those cancer patients.
  Hospitals have deployed medical teams to approximately 60 camps and 
shelters around our great State to address the medical needs of these 
evacuees. I have always been proud of the people of Arkansas. I have 
always recognized them as our greatest asset. And I am enormously proud 
of the countless providers and volunteers in Arkansas and all around 
this great country who have given their time to make sure that the 
health care needs of Katrina survivors are met.
  By passing the Emergency Health Care Relief Act, we in this Senate 
have the same opportunity to give Katrina survivors, health care 
providers and States, the relief they so desperately need.
  We are not talking about walking away and closing the doors. We are 
talking about a temporary relief for people who jumped in there and 
provided care, without being asked, without being mandated, but because 
that is what human beings do when other human beings need that kind of 
care.
  Medicaid is our Nation's health care safety net. That is what we are 
talking about, a safety net for some of the most vulnerable of 
Americans who have been hit by an unbelievable natural disaster. This 
crisis has shown just how important this safety net is to our Nation. 
We need to make sure it does not unravel in the face of this national 
emergency.
  Our home State of Arkansas, per capita, has taken in unbelievably 
disproportionate numbers of evacuees--not because we had to, but we 
believe that is what it means to be a part of the American family.
  This place is paralyzed because too few are willing to recognize how 
important it is to not only reach out to our neighbors but to also 
follow up and back up those who have been there in these emergencies, 
to provide the health care needed.
  I said earlier that it hit home for me. While I was on vacation this 
summer, one of my 9-year-old sons did get sick. I was in a strange 
State, in a strange town, never been there before. I found a clinic, 
and I went. I was so grateful. I felt so blessed to have Federal 
employee health insurance, to be able to access health care for my 
child while on vacation. Think about the mothers, the fathers, the 
families, the elderly who find themselves in a strange place--in a 
church, a makeshift camp out of a church or maybe in a church basement 
or maybe in some evacuated housing that has been made a makeshift place 
for the evacuees to stay. What happens to them when they go to get 
health care? What happens to that provider who has to look them in the 
eye and say, I don't know where you are going to get health care. That 
is not what we are about in this country.
  We talked about billions of dollars we have directed to FEMA. We have 
talked about tax cuts we provided to low-income people who may or may 
not even know if they can access those tax cuts. But here we are 
talking about the elemental part of being a good neighbor, a fellow 
human being, looking to make sure the essentials of providing health 
care to our brothers and sisters in this country, and we are going to 
sit here and twiddle our thumbs over redtape? We are going to talk 
about the possibility of waivers that would cause us to have to 
petition the devastated States to pay back or to look at these waivers 
that do not have the funding so we give them a false sense of security 
so they can provide these services and then find they do not get 
reimbursed after all?
  What is our Federal Government for if it is not to provide a safety 
net at a time such as this, to give peace of mind to the hard-working 
men and women who provide health care day in and day out? I have been 
to these evacuee camps. I have watched the redtape. I have watched the 
Red Cross volunteers argue with the volunteering physicians and health 
care providers on whether they can even give a tetanus shot to somebody 
who had to swim out of New Orleans.
  We have an opportunity to stand up and be counted, to provide 
temporary peace of mind to the medical providers who are reaching out 
to provide the much needed services to the disproportionately low-
income, disproportionately disadvantaged and handicapped.
  I offered an amendment almost 3 weeks ago. As the chairman mentioned, 
it probably did go a little bit further than what is being talked

[[Page 21214]]

about here. I am not ashamed of that. But I didn't give away the barn. 
It was still temporary just to make sure that these evacuees, these 
fellow Americans, could get the services they need at the most 
vulnerable time of their lives. I was asked in good faith to withdraw 
my amendment because nobody wanted to vote against it. Withdraw your 
amendment and we will work out a good bipartisan deal. Chairman 
Grassley and Senator Baucus did just that.
  I say to my colleagues who want to object to what we are trying to 
do, if you have a better answer or you want to say of that $60 billion 
that every one of us voted for to go to FEMA, maybe you are willing to 
look to FEMA and make sure that happens, $8 billion out of $60 billion 
is a small piece of the overall pie.
  I withdrew that amendment in good faith. I hope my colleagues will 
recognize that we are talking about the American spirit that I hope we 
produce in the Senate.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mr. SUNUNU. Mr. President, what is the regular order?
  The PRESIDING OFFICER. We are in morning business with 10-minute 
grants.
  Mr. SUNUNU. Mr. President, I will respond in part in supporting my 
colleagues who objected. We do not object in any way to providing 
assistance where it is needed. We have already done so, passing $62 
billion in new spending, $9 billion in tax relief. That is a very great 
core relief effort that is providing assistance to those very much in 
need in the Gulf Coast States and around the country.
  The question and the point we object to is whether we consider this 
bill tonight by unanimous consent, an additional $9 billion in 
spending, several new programs, some of which do not really have 
anything to do directly with providing emergency assistance for health 
care or any other services to those people who need it in the Gulf 
States. That is the question, whether it is imperative we consider this 
bill now or whether we can move forward in a more deliberative fashion, 
and whether some of the elements in this bill can be improved.
  As I said, we provided $62 billion in appropriations, $9 billion in 
tax relief. So at the very beginning of this discussion we have to ask, 
with over $40 billion still unexpended and uncommitted, why can't we 
use a portion of that to cover some of these important needs, some of 
the health care needs the Senator from Arkansas just described? I think 
that is one basic reason why I and others object to moving forward 
tonight on this bill. We ought to be able to find a way to utilize some 
of the $62 billion we have already passed through the House and the 
Senate.
  Second, as I indicated, there is a provision in this legislation that 
changes reimbursement rates for Medicaid for 29 States, regardless of 
whether and how many displaced people from the gulf are currently 
housed in that State, currently seeking services in that State, 
currently looking for health care or employment in that State. For 29 
States whose reimbursement rate was going to change in 2006, we wave 
the wand and say: No change to reimbursement rates regardless of how 
you might have been impacted by Hurricane Katrina or Hurricane Rita. 
That has nothing to do directly with providing the assistance, the 
compassion, the care, the health care the previous speakers were 
describing.
  I question whether this is an appropriate vehicle to include such a 
provision. There is $1.5 billion for disaster relief in Medicaid--well 
intended, well directed. But currently CMS, the regulator of Medicaid, 
is allowing States to apply for waivers to deliver the very kinds of 
benefits contemplated in that $1.5 billion program. In fact, Texas and 
Mississippi and Florida and Alabama have already applied for and have 
received waivers to do those very things contemplated in the 
legislation, which begs the question, is this necessary? And if it is 
necessary in some shape or form, do we need to commit $1.5 billion, or 
can we wait and at least better understand how the waiver process is 
proceeding, which has been approved already in those four States? And I 
hope other States that might apply will get a similar fast response.
  There is also $800 million in this legislation to provide assistance, 
financial support to individuals who are covered by private insurance, 
though indirectly that will provide payment to private insurance 
companies whose participants were affected by the hurricanes. I would 
want, first, to answer the question: What are those private insurers 
doing for the employees they had covered? Are they walking away from 
those employees and those businesses because they were affected by this 
tremendous natural catastrophe? I hope that is not the case. I do not 
know that is the case. But we ought to understand what obligations, 
what commitments these private insurers are meeting before we commit an 
additional $800 million that might allow them to walk away from some of 
their economic or moral obligations for those they have covered in the 
past.
  So $1.5 billion in a disaster relief program that is already being 
addressed through the waiver process, $800 million in support for those 
covered by private insurance, and changes to reimbursement rates for 29 
States, regardless of how they were or might have been impacted by 
these hurricanes--I think all of those items call into question both 
the structure and the timing of this legislation. I think we can do 
better.
  I think there are a lot of questions as to how the $62 billion that 
has already been committed is being spent. Other Members have raised 
the question of working harder to find offsets so any additional 
spending will have a minimum impact on the deficit and the national 
debt, which is a challenge and a crisis we are all going to be faced 
with today and in future generations as well. We do not want to create 
a future economic catastrophe in our heartfelt efforts to deal with 
this natural disaster today.
  There is no question that we need to provide assistance, that we 
should provide assistance, and that the House and Senate will continue 
to provide assistance, in all likelihood, in addition to the $62 
billion we have already committed and the $9 billion in tax relief that 
has been added to that. But we need to work very hard to make sure we 
know how that money is being utilized. I think we should do everything 
in our power to allow some of those funds to be used for these critical 
health care costs. And we need to do much more to try to find ways to 
cover this additional spending so we do not increase the deficit and 
leave an unfortunate financial legacy for future generations.
  I think my colleague's objection was warranted. I do not think being 
more deliberative in addressing this legislation and reviewing this 
legislation will hurt its efficacy and effectiveness in the long run. 
But I do think it will serve the public and the country much better in 
the long run to be as fiscally responsible as we possibly can in 
addressing these critical needs in the Gulf States.
  I yield back the remainder of my time.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Chambliss). The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. FRIST. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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